Final Costs can be prepared after the Covered Retiree List is finalized and Step 4: Finalize Covered Retirees is "Complete." Final costs must only be submitted for the Qualifying Covered Retirees, Subsidy Periods, and Benefit Options listed on the final Covered Retiree List agreed to by the Plan Sponsor in Step 4. The finalized Covered Retiree List must be distributed to those preparing costs. CMS' RDS Center accepts final cost reports when the status of the application is "Reconciliation Cost Reporting Opened" and the Reconciliation Deadline has not passed.
Step 5: Start Preparation of Reconciliation Payment Request requires the Account Manager or Designee with Request Payment privilege to open final cost reporting. After Step 5 is complete, the Application Status changes to "Reconciliation Cost Reporting Opened" and Cost Reporters assigned in Step 2: Review Payment Setup can begin reporting final costs.
A Cost Reporter may be a Vendor, a Vendor Designee, a Plan Sponsor Designee, or the Account Manager.
The Plan Sponsor established the method for submitting final costs for each Benefit Option in Step 2: Review Payment Setup. The Plan Sponsor establishes the sources (Plan Sponsor or Vendors) submitting costs for each Benefit Option. The Plan Sponsor reviews and updates as necessary the method for Plan Sponsor Cost Reporters. For Vendors, the Plan Sponsor only needs the Vendor ID. The method for communicating costs to CMS RDS Center was determined when the Vendor first set up their ID with CMS' RDS Center.
Final costs are entered and submitted on the RDS Secure Website or submitted through Mainframe transfer.
The Account Manager with the Report Costs privilege for the Benefit Option may enter costs on the RDS Secure Website by using the report costs workflow in Step 6: Manage Submission of Final Cost Reports or by using the Final Cost workflow.
All Designee Cost Reporters must view or report costs through the Final Cost workflow available from the Application List page.
Vendors submitting costs using Mainframe submission work with RDS Electronic Data Interchange (EDI) Representatives to establish a connection. If there is an issue with the file format, an EDI Representative will contact the Vendor.
Note: All final cost reports submitted to CMS' RDS Center must contain aggregated Gross Retiree Costs, Cost Threshold Reduction, Cost Limit Reduction, and Actual Cost Adjustment amounts for all plan months by Benefit Option. During final cost reporting, the system performs editing on all submitted final costs.
The Account Manager or Designee with Request Payment privilege manages the reporting of final costs in Step 6. After final cost reporting is complete, the Plan Sponsor closes final cost reporting by completing Step 6. The Application Status changes to "Reconciliation Cost Reporting Closed." A Plan Sponsor may return to Step 6 and reopen final cost reporting at any time prior to the completion of Step 12: Review And Submit Reconciliation Payment Request, and prior to the Reconciliation Deadline.
In Step 7: Review Final Costs, the Account Manager or Designee with Request Payment privilege reviews the final costs and either accepts or rejects the final cost reports. In Step 7, the RDS system runs edits against all accepted final costs. The amount of the Reconciliation payment request is calculated from the final costs accepted in Step 7. A Plan Sponsor can reopen the review of final costs at any time prior to completion of Step 12: Review And Submit Reconciliation Payment Request, and prior to the Reconciliation Deadline.
Step 8: Enter Revision To Final Costs is the last task in cost reporting. In Step 8, the Plan Sponsor considers any necessary revisions to final costs that were accepted in Step 7: Review Final Costs.
Note: Quick Access Reports (QAR) may be used to assist and accelerate the cost reporting activities of Vendors and Plan Sponsors by delivering consolidated cost reporting information.