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The RDS User Guide provides comprehensive, detailed information about participating in the RDS Program. Get overview information and step-by-step instructions for key program areas and more.
This section provides information to assist in preparing cost data for submission to CMS' RDS Center:
This section of the RDS User Guide provides overview information and step-by-step instructions for Annual Plan Application tasks such as starting and completing an application, changing an application, and requesting an Application Deadline Extension.
This page contains information about completing Step 9: Valid Initial Retiree List of the annual plan application.
This section explains what application information must be maintained after an application has been submitted and approved, how information should be maintained, and what application information cannot be changed.
Within 15 months after the application Plan Year End Date, Plan Sponsors complete Reconciliation to finalize their application’s Covered Retiree List and submit final cost data to CMS' RDS Center.
This section provides an overview of Reconciliation.
This section provides information about when and how final costs may be submitted, as well as the user roles for submitting final costs.
This section provides an overview and step-by-step instructions related to Submitting Final Costs.
This section provides information about when Plan Sponsors are required to coordinate individual retiree cost data, as well as examples for coordinating data.
An overpayment occurs when the sum of all interim payments received for an application exceeds the sum of the Reconciliation payment request.
Doubling costs occurs when a Plan Sponsor is reporting for the same months after the first payment request has been completed.
The most common reason for the overstating Gross Retiree Costs error is including costs that are not covered by Medicare Part D, therefore making them ineligible for RDS subsidy during interim payments.
The reduction in retirees error results from a Plan Sponsor failing to process and send in retiree updates during the plan year.
Underestimating Cost Adjustments during interim payments occurs when a Plan Sponsor does not make changes to their Cost Adjustment methodology from one plan year to the next when the Cost Adjustment percentage has increased.
Underreporting Threshold Reduction and Limit Reduction occurs for a couple of reasons: 1) Plan Sponsors do not understand the definition of Threshold Reduction, and 2) Plan Sponsors are not reporting the correct Threshold Reduction and Limit Reduction during interim payments.
Learn about Plan Sponsor and Vendor responsibilities when coordinating final costs for Reconciliation.
Understand when a Plan Sponsor is required to coordinate individual retiree cost data and what is needed to report cost data.
This technical article provides tips and reminders to help Plan Sponsors prepare for the Reconciliation process and navigate through some of the most common issues reported to CMS' RDS Center.
Covers information such as how to complete the Application Submission Process and how to change application information.