Feb 05, 2024
Blue Shield of California is collecting D1 Premium Contribution data as part of the Consolidated Appropriations Act, Section 204 (2021)– Prescription Drug Cost Reporting regulation, on behalf of Blue Shield's employer groups.
To ensure group data is included in Blue Shield’s aggregate filing, groups will need to fill out the Blue Shield D1 intake form.
Update: Instructions included for On-Exchange plans purchased through Covered California also known as CCSB or "shop" groups.
Covered CA Small Business groups, whether active or inactive with Blue Shield, will need to fill out this intake form, using the group ID and following web key: #24yr23
All other groups (Off-Exchange/non-Covered California plans) will need to follow the process below
- Active groups will need to fill out the intake form available on Employer Connection upon logging in. If an active group does not have an Employer Connection account, Blue Shield asks that you please support the group in creating an Employer Connection account and in completing the intake form on their behalf.
- Inactive groups (terminated on or before December 31, 2023) will need to fill out this intake form, using their Blue Shield group ID and the following web key: #24yr23.
The deadline to provide information is Friday, April 5, 2024 at 6:00PM (PST).
Groups that miss this deadline will not be included in Blue Shield’s filing and may be subject to non-compliance if they do not report the required data directly to the CMS on their own.
As a reminder, Blue Shield will submit D2 for all groups and D3-D8 for groups with prescription drug benefits under a Blue Shield health benefit plan. If a group does not have prescription drug benefits with Blue Shield, they should coordinate submission of D3-D8 with their pharmacy/prescription drug benefits carrier. Please see sections 6 and 7 of the CMS Instructions Manual for information on each of the reporting elements.
Please note that data submitted is for the 2023 calendar year. For group plan sponsors whose benefit structure includes multiple groups (subgroups), the intake form must only be completed for the group, and not subgroup, under the main group ID.
Here are a few reminders to prepare for submission:
- Brokers or other delegates of the group may fill out the intake form on behalf of the group. If you do not have access to the intake form for active groups via Employer Connection, please reach out to your group for delegate access.
- Only one individual may submit responses for a single group ID. Multiple individuals will not be able to submit information for a single group. Please coordinate submission with your group and any other delegates.
- A single broker or delegate may, however, submit a response for multiple groups.
- You may preview the intake form questions before submitting responses. Please submit the form only when all requested information is available.
- Once responses are submitted, only the submitter will have access to edit responses.
- Multiple submissions can be made until the deadline of April 5, 2024.
- Submitters will receive an email confirmation displaying their submitted responses and a link to edit responses. If you are completing the intake form on behalf of a group, please forward the confirmation email to the group.
We are requesting the following data from groups:
- Basic group information such as submitter email
- Healthcare premium percentage paid by employer for Small Business Groups and Large Groups that have pharmacy/prescription drug benefits with Blue Shield or,
- Total healthcare premium paid by employer and employee, for Large Groups that have pharmacy/prescription drug benefits with another carrier besides Blue Shield
- Total Premium Equivalent Amount (for self-funded ASO only, when applicable) - Total cost of providing and maintaining coverage, including claims costs, administrative costs, self-funded ASO and other TPA fees, and stop-loss premiums.
Blue Shield is committed to supporting their groups in complying with health coverage related regulatory requirements.* Please support your groups by reminding them to submit necessary information before the deadline and helping submit information in the intake form, as needed.
Please view the D1 Intake FAQs for more information. If you have any additional questions, contact Blue Shield or your Amwins team. We are here to help.
*Blue Shield does not provide legal advice. Please consult your legal advisor to confirm your group’s compliance with CAA Section 204 (2021).
