Helpful Resources
Meet our team (PDF)
Appetite Guide (PDF)
ACORD 130 application (PDF)
Supplemental application (PDF)
Workers' comp checklist (PDF)
Success list (PDF)
Brochures:
California | Colorado | Texas
Carrier submission tips:
California | Colorado | Texas
Groups must meet the following deadlines:
| Calendar Years to Report | Deadline |
| 2020 and 2021 | December 27, 2022 |
| 2022 | June 1, 2023 |
| Each subsequent calendar year | June 1 of each year |
Plan Year 2022
| | ||||
|---|---|---|---|---|
| Carrier* | Carrier Requirement | Employer Survey | Who is Reporting | Resources |
| Aetna (CA & CO) | Employers must provide the following information to Aetna, which will be used to submit on behalf of the plan sponsor:
| RxDC Plan Sponsor Data Collection Form(Opens in a new window) (Opens in a new window)Deadline for submission is 4/1/2023 | Fully Insured: Carrier Self-Funded: Carrier | Pharmacy Benefit and Drug Reporting (Opens in a new window) |
| Anthem (CA) | Starting in 2023, Anthem is requiring employers to provide information on the average monthly premium paid by the member and the employer in the Premium and Life Year (D1) reporting. | RXDC Average Monthly Percentage and Premium Reporting(Opens in a new window) Self-funded groups that want Anthem to submit their 2022 D1 reports need to complete this form(Opens in a new window) with all required information no later than March 24, 2023. | Fully Insured: Carrier Self-Funded: Anthem will submit if the employer completes the form by the required deadline. | Broker Announcement(Opens in a new window) Prescription Drug Data Collection Reporting Provision(Opens in a new window) |
| Anthem Blue Cross Blue Shield (CO) | Starting in 2023, Anthem is requiring employers to provide information on the average monthly premium paid by the member and the employer in the Premium and Life Year (D1) reporting. | RXDC Average Monthly Percentage and Premium Reporting(Opens in a new window) Deadline for submission is 3/1/2023 | Fully Insured: Carrier Self-Funded: Pending carrier response | Broker Announcement(Opens in a new window) |
| Blue Shield of California (CA) | In preparation for the reports due June 1, 2023, Blue Shield is collecting and reporting D1 Premium and Life Year data on behalf of our groups and group plan sponsors. | Groups need to fill out this intake form(Opens in a new window) before March 17, 2023. Group plans that miss the 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. | Fully Insured: Carrier Self-Funded: click here(Opens in a new window) for details | Broker Announcement(Opens in a new window) CAA FAQs(Opens in a new window) |
| CaliforniaChoice (CA) | Employers should refer to Carrier for specific reporting requirements. | Employers should refer to Carrier for specific reporting requirements. | Employers should refer to Carrier for specific reporting requirements. | Employers should refer to Carrier for specific reporting requirements. |
| Cigna (CA & CO) | For the June 1, 2023 submission, which will represent the reporting year 2022, Cigna’s standard approach is to submit on our clients’ behalf. | To submit the June 1, 2023 report: Send an email to the address found in the communication sent from Cigna with the client name, account number, and average employee, versus employer percent of premium across the client’s medical, pharmacy, and behavioral coverage corresponding to their population with Cigna coverage by February 24, 2023. Include both Cigna and non-Cigna coverage. | Fully Insured: Carrier Self-Funded: Carrier | Broker Announcement(Opens in a new window) |
| Cigna + Oscar (CA) | Pending carrier response | Pending carrier response | Fully Insured: Carrier Self-Funded: N/A | Pending carrier response |
| Covered California for Small Business (CA) | Employers should refer to Carrier for specific reporting requirements. | Employers should refer to Carrier for specific reporting requirements. | Fully Insured: Carrier Self-Funded: N/A | Employers should refer to Carrier for specific reporting requirements. |
| Gravie (CO Level Funded) | Pending carrier response | Pending carrier response | Pending carrier response | Broker Announcement(Opens in a new window) |
| Health Net (CA) | Health Net will file the RxDC on behalf of its Commercial groups. The group does not need to report any data to Health Net. | N/A | Fully Insured: Carrier Self-Funded: N/A | N/A |
| Humana (CO) | Humana is currently working to develop a process for gathering average monthly premium paid by employers versus members for the 2022 reference year report and beyond. Fully-insured and self-funded groups will be contacted once a process is developed. | Pending carrier response | Fully Insured: Carrier Self-Funded: Carrier - see Broker Announcement for details. | Broker Announcement(Opens in a new window) |
| Kaiser Permanente (CA & CO) | Kaiser Permanente will be reaching out to fully insured employer groups to obtain the following:
| Data collection process will be communicated in the coming weeks. | Fully Insured: Carrier Self-Funded: Carrier | Broker Announcement(Opens in a new window) |
| Sharp Health Plan (CA) | Pending carrier response | Pending carrier response | Fully Insured: Pending carrier response Self-Funded: N/A | Pending carrier response |
| Sutter Health Plus (CA) | Employer groups must submit information to Sutter Health Plus regarding the average monthly premiums paid on behalf of enrollees and the amount paid by enrollees each year. | Survey Link for Employers || (Opens in a new window)Printable PDF(Opens in a new window) Deadline for submission is 3/1/2023 | Fully Insured: Carrier Self-Funded: N/A | Broker Announcement(Opens in a new window) |
| UnitedHealthcare (CA & CO) | UHC Pharmacy Benefits and Cost Survey FAQ(Opens in a new window) | Survey Link for Employers(Opens in a new window) Deadline for submission is 3/3/2023. The deadline is firm. | Fully Insured: Carrier Self-Funded: Self-funded customers wishing to have UnitedHealthcare provide data to them and who will take responsibility for submitting all data to CMS themselves, must contact their UnitedHealthcare representative no later than March 3, 2023. | (Opens in a new window)Prescription Drug Reporting(Opens in a new window) |
*Disclaimer: Please refer to carrier-specific guidelines for complete details and additional information.