This section provides an overview of the following topics related to processing Weekly Notification Files:
The Plan Sponsor must process Weekly Notification Files and update Subsidy Period information in their internal systems so that the appropriate cost calculations may be performed. The Plan Sponsor may receive multiple notification records for a single Qualifying Covered Retiree (QCR) in the event that there is a gap in Subsidy Coverage Periods or the beneficiary is enrolled in multiple Benefit Options.
The Weekly Notification Files contain all the original data elements that you sent in the most recent retiree file, plus the Determination Indicator, Reason Codes, Subsidy Period Effective Date, and the Subsidy Period Termination Date as described below. The transaction type data element will be left blank.
For more information about how coverage dates are populated with regard to reason codes, refer to RDS Reason Codes.
If you receive a Reason Code 21: New Medicare Information, re-submit this beneficiary in the next Monthly Retiree List. The Determination Indicator is blank and the subsidy dates are zero. The new Medicare information may result in increased subsidy coverage.
If the notification event results in a change to the Subsidy Period, new dates are reported in the file.
If the notification event is regarding the beneficiary's initial application for Medicare Part D or is a change that may result in an increased Subsidy Period, the original Subsidy Period Effective and Termination Dates will be reported in the file.
Plan Sponsors could receive a Weekly Notification File as frequently as once a week, on Fridays. If no Weekly Notification File is received, none of the Qualifying Covered Retirees (QCRs) covered under that application had notification events for that week.
The Account Manager and Designee with View/Send/Receive Retiree Data privilege receives an email indicating that Weekly Notification Files are available for download.
Note: When Reconciliation Step 4: Finalize Covered Retirees is marked "Complete" or the Reconciliation Deadline has passed for that application, CMS' RDS Center no longer creates or sends Weekly Notification Files.
The Authorized Representative, Account Manager, and Designee with View/Send/Receive Retiree Data privilege may access the Download Weekly Notification Files page using the Manage Retirees page.
The following Weekly Notification File Layouts are available for reference:
When CMS' RDS Center receives notifications from the Medicare Beneficiary Database (MBD) about beneficiaries, the system re-evaluates the beneficiary's eligibility for subsidy. While reviewing Weekly Notification Files and making updates to the Plan Sponsor's internal records, consider the following:
Note: Plan Sponsors must process Weekly Notification Files and update Subsidy Period information in their internal systems so that the appropriate cost calculations may be performed.
To review the possible reason codes for Weekly Notification Files, refer to RDS Reason Codes.
This section provides step-by-step instructions to download Weekly Notification Files.
To access the RDS Secure Website, and navigate to the Application List page, review instructions to access the RDS Secure Website.
You may choose one of the following methods for accessing the Manage Retirees page:
From the Application List page:
Select Manage Retirees from the Actions dropdown menu then select Go.
From the Application Status page:
Select the Manage Retirees link.
On the Manage Retirees page:
Select the Download Weekly Notification Files link.
The Electronic Protected Health Agreement opens in a new window.
Select I Accept to proceed to the Download Covered Retiree List page or select Cancel to return to the Manage Retirees page.
On the Download Weekly Notification Files page:
Note: Notification files received for the same application on the same day display a timestamp to denote separate files for processing by a Plan Sponsor.
The File Download window displays. You may have an option to select Open with and choose a software program from the dropdown then select OK or you may select Save File then select OK.
Depending on the browser settings, the file download window may close automatically when the download is complete or you may need to close it manually.
You may now download another file or select Return to Manage Retirees.