Options After a Missed Application Deadline

If a Plan Sponsor misses the Application Deadline, it has a couple of options, which can be pursued at the same time:

Option 1 – Start a New Application: The Plan Sponsor can start a new application that would have a deadline it CAN meet. The deadline for an application is approximately 90 days prior to the Plan Year Start Date specified in the application (adjusted for Federal holidays and weekends). If the Plan Sponsor pursues this option, it should start the application as soon as possible and immediately request the 30-day Application Deadline Extension so that it has plenty of time to complete and submit both the Valid Initial Online Application and Valid Initial Retiree List.

For purposes of the Retiree Drug Subsidy, a plan year is whatever period of time a Plan Sponsor designates in its Valid Initial Online Application, as long as it does not exceed a 12 month period. In other words, an RDS plan year can be shorter than 12 months.

Refer to the RDS User Guide for instructions to Start a New Application and Request an Application Deadline Extension.

Remember: A timely RDS application consists of both a Valid Initial Online Application and a Valid Initial Retiree List.

Option 2 – Submit the Existing Application for the 12-Month Plan Year Whose Deadline Has Passed: If a Plan Sponsor pursues this option, after CMS' RDS Center has reviewed the submitted application and determined that it was not submitted timely, the Plan Sponsor's Authorized Representative, Account Manager, and any Designees with the Appeal privilege will receive an email determination that the application is denied. That email will contain information about the Plan Sponsor's appeal rights and information on how to pursue such appeal.

For information about appeals, refer to Appeal an Initial Determination in the RDS User Guide.