It is a requirement of the Center of Medicare and Medicaid Retiree Drug Subsidy (RDS) Program that participating Plan Sponsors attest that the actuarial value of prescription drug coverage for qualifying covered retirees, Part D eligible individuals who are not enrolled in a prescription drug plan or an MA-PD plan, is at least equal to the actuarial value of Part D standard prescription drug coverage, per section 1860D-22(a)(2)(A) of the Social Security Act.
In order to meet this requirement, RDS Plan Sponsors and RDS Actuaries will need to review the H.R.5376 Inflation Reduction Act of 2022 and 42 C.F.R. §423.884(d), and attest actuarial equivalence for their retirees. These revisions are applicable for Plan Years starting January 1, 2023 and thereafter.
Cost Thresholds and Cost Limits can be found on the RDS Public Website. For more information for Medicare Part D actuarial equivalence, please review Application Submission: Attest Actuarial Equivalence. If you have any questions please contact the CMS’ RDS Center.