As a requirement of Reconciliation, Plan Sponsors must finalize their application's Covered Retiree List (CRL) and submit final cost data to CMS' RDS Center. Please review the following guidance and resources for successfully finalizing your application’s retiree count during Reconciliation.
In preparation for the final Reconciliation payment request, the Plan Sponsor agrees to the CRL in the Reconciliation: Finalize Covered Retirees step by completing the following tasks:
- First, request the Covered Retiree List - The Authorized Representative, the Account Manager, or Designees with the Request Payment privilege can request the CRL in Reconciliation. During Reconciliation, the CRL must be requested in this Reconciliation step, not outside the Reconciliation process. If a Retiree Response File or Weekly Notification File is received for the application after requesting the CRL, a new CRL must be requested.
- Second, download the Covered Retiree List - The Account Manager, the Authorized Representative, or Designees with the View/Send/Receive Retiree Data privilege can download the CRL from the Covered Retiree List page of the RDS Secure Website; or the Account Manager, the Authorized Representative, or Designees with both the Request Payment privilege and the View/Send/Receive Retiree Data privilege can download the CRL using the Download Covered Retirees link on the Finalize Covered Retirees page.
- Third, verify the Covered Retiree List - The CRL is validated by the individuals responsible for coordinating retiree eligibility for the Benefit Options listed within the application. This activity occurs outside the RDS Secure Website using resources assigned at the discretion of the Plan Sponsor.
- If necessary, correct discrepancies in the Covered Retiree List - If there are discrepancies in the CRL, the Plan Sponsor must submit an ADD/UPD/DEL Retiree File containing records for each beneficiary in question. This action will ensure that subsidy is requested for valid Qualifying Covered Retirees (QCRs) and Subsidy Periods only.
- Lastly, finalize Covered Retirees - The Account Manager or the Authorized Representative completes this task by certifying that the most recent CRL has been downloaded and reviewed. Designees with the Request Payment privilege can view this step but cannot complete it.
- If the Plan Sponsor identifies discrepancies after completion, the Account Manager or the Authorized Representative can reset Reconciliation and recomplete the Reconciliation: Finalize Covered Retirees step. This feature was recently added to the Secure Website; Plan Sponsors can reset without contacting CMS’ RDS Center. Refer to Resetting Reconciliation for guidance and step-by-step instructions.
For more information and step-by-step instructions for each Reconciliation step, refer to Reconciliation in the RDS User Guide.
IMPORTANT: To avoid missed program deadlines and delayed subsidy payments, ensure that your RDS user accounts and Multi-Factor Authentication (MFA) are active and that you are able to access the RDS Secure Website today! Please encourage all users assigned to your RDS applications to log in to the Secure Website as soon as possible, and well in advance of your deadline date(s). Do not wait until the last minute! For additional information, refer to Protect Your Subsidy: Ensure Your RDS User Account and MFA are Active on the RDS Public Website Announcements page.