Program Components:
Overview
This section provides an overview of the following topics:
- Introduction: Initiate Reconciliation
- Timing & Dependencies
- User Roles
- Preparing to Initiate Reconciliation
- What Happens After This Step Is Complete?
Introduction: Initiate Reconciliation
Plan Sponsors are required to complete Reconciliation for each application within 15 months after the application’s plan year end date. The purpose of the Initiate Reconciliation step is for Plan Sponsors to indicate to CMS' RDS Center that they are ready to submit their application for payment settlement. By choosing to complete this Reconciliation step the Plan Sponsor indicates that they are ready to finalize their Qualifying Covered Retiree List and submit final costs associated with the retiree list for a particular application.
Plan Sponsors that did not receive any interim payments and wish to receive a single subsidy payment must use the Reconciliation process to submit a final payment request for an application.
Timing & Dependencies
Reconciliation can only be initiated after the plan year ends. After Reconciliation is initiated, it cannot be reversed. Ensure you are initiating Reconciliation for the correct plan year before confirming this step.
Plan Sponsors should make sure that sufficient time is allocated to complete all Reconciliation steps by the application's Reconciliation Deadline. Refer to the Reconciliation Toolkit and the Timeline of Events Job Aid for helpful information. For more information on the Reconciliation Deadline, refer to Important Reconciliation Deadline Information.
Reconciliation steps must be completed in order - each step must be marked "Complete" to proceed to the next step.
For more information about the constraints and implications of completing the Reconciliation steps and making changes to completed Reconciliation steps, refer to Conditions and Results for Completing Reconciliation Steps.
User Roles
Only the Authorized Representative or Account Manager can initiate Reconciliation. Designees with the Request Payment privilege can view this step but not complete it.
Preparing to Initiate Reconciliation
A Plan Sponsor can begin Reconciliation for an application when all of the following conditions are met:
- The application is approved.
- The application plan year has ended.
- The Reconciliation Deadline has not passed.
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All desired interim payment requests have either been processed or canceled.
Note: A Plan Sponsor cannot have a negative interim payment request when they start Reconciliation. If there is a negative interim payment, and it will not be fully offset by a positive payment request on another application, the Plan Sponsor will need to contact CMS’ RDS Center to initiate the cancellation process.
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At least 16 calendar days have passed from the date of the last interim payment determination.
Note: It is recommended that Plan Sponsors stop interim payments at least 60 days prior to an application’s Reconciliation Deadline to focus on Reconciliation activities.
What Happens After This Step Is Complete?
After this Reconciliation step is completed, the status of the application will be updated to "Reconciliation Initiated."
After Reconciliation is initiated, RDS Secure Website users cannot report interim costs or request interim payments. Previously reported interim cost data will display in the audit trail accessible through Reconciliation: Manage Final Costs.
After Reconciliation is initiated the status of a Data Entry cost report changes to "Data Entry: Update/Entry Required" in preparation for final cost reporting.
Step-by-Step Instructions
This section provides step-by-step instructions to initiate Reconciliation.
To access the RDS Secure Website and navigate to the Dashboard page, review instructions to access the RDS Secure Website.
On the Dashboard page:
- Select In Progress to view a list of all Applications in progress.
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Select the Application ID for which you want to view Reconciliation.
On the Application Overview page:
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Select Reconciliation.
On the Reconciliation page:
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Read the warnings and click the checkbox to indicate that you agree to the warnings and instructions.
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Select Initiate Reconciliation.
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The RDS Secure Website will refresh to display the Finalize Covered Retirees page. Reconciliation will be marked with an orange triangle exclamation point in the Left Navigation menu of the application. The status of the application will change to "Reconciliation Initiated."
Review any Warning Messages displayed on the Finalize Covered Retirees page and proceed with the remaining Reconciliation steps.
Return to Reconciliation Overview | Continue to Reconciliation: Finalize Covered Retirees
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