Mar 18, 2024
Understanding the RxDC Report
Under Section 204 of the Consolidated Appropriations Act, insurance companies and employer-based health plans must submit information regarding prescription drug benefits and health care spending to the Centers for Medicare & Medicaid Services (CMS) by June 1 of each year for the prior year’s coverage. This report is also known as the RxDC Report.
In 2024, insurance companies and employer groups are required to report data on the average monthly premium paid by employers and their employees who were enrolled in benefits in 2023. This information is reported on the D1 Template of the RxDC Report filing.
Information requested
- Average monthly premium paid by employees (i.e., payroll contribution)
- Average monthly premium paid by the employer group (i.e., total amount of premium paid, minus the employee contribution amounts paid)
- General employer group information (i.e., employer group name, Employer Identification Number [EIN], etc.)
Deadline to submit information
Sharp Health Plan will reach out to employer groups that were enrolled in 2023 to request this information. They will submit the D1 Template on behalf of their employer groups; however, they need information from employers in order to report on their behalf. If Sharp does not receive the completed form by April 19, 2024, then the employer group will be responsible for submitting all required data directly to CMS by June 1, 2024. Failure to do so could result in the employer being subject to penalties.
Employers should submit the requested information using the RxDC Employer Reporting Intake Form. The form includes instructions on how to calculate data per CMS’ instructions.
If you’re submitting the form on behalf of an employer client
Please make sure all information is correct. If you need to make updates to your submission, please contact your dedicated account manager. You will not be able to complete this form again.
Resources
For more information, please view these resources from CMS.
If you have any questions, please check out Sharp's FAQ or contact your Amwins Connect Regional Sales Manager.
