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RDS Program Components

Additional Program Tasks

Quick Access Reports (QAR)

Supplemental Information

Request a Covered Retiree List

User Roles:

AM

AR

D

Program Components:

Retiree Management

Overview

This section provides an overview of the following topics related to Covered Retiree Lists:

Important Information About Covered Retiree Lists

The purpose of requesting and downloading the Covered Retiree List (CRL) is for comparison of the Plan Sponsor's internal records with those of CMS' RDS Center. Plan Sponsors should request, download, and review the CRL on a regular basis for a detailed comparison of the Plan Sponsor's internal records of Qualifying Covered Retirees (QCRs), Benefit Options, and Subsidy Periods with CMS' RDS Center records.

The CRL file includes the same fields contained in Retiree Response Files plus two additional fields that give reporting source information. The CRL includes all QCRs having at least one Benefit Option where at least one Subsidy Period exists. A separate record is created for each unique QCR, Benefit Option, and Subsidy Period combination. There may be more than one record per QCR due to gaps in coverage dates or enrollment in multiple Benefit Options.

Retiree records rejected by CMS' RDS Center will not be reflected in this list.

During Reconciliation, the Plan Sponsor is required to review and agree to the CRL in Step 4: Finalize Covered Retirees.

Plan Sponsors may only submit interim or final costs for the QCRs, Benefit Options, and Subsidy Periods listed in the CRL that has been downloaded from CMS' RDS Center.

For more information on requesting a CRL, refer to Step-by-Step Instructions: Request a Covered Retiree List.

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Timing: Covered Retiree List Availability

The CRL is not available until the application is approved and retirees are approved for subsidy. A CRL may be requested multiple times throughout the plan year and during Reconciliation until Reconciliation Step 4: Finalize Covered Retirees has been completed.

The CRL may be requested once per day. The file should be available within approximately 15 minutes from the time of the request. If there are multiple requests made during non-business days, only one CRL will be processed.

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User Roles to Request a Covered Retiree List

The Authorized Representative, Account Manager, and Designee with View/Send/Receive Retiree Data privilege may request a CRL.

The Authorized Representative and the Account Manager may download the CRL. A Designee with View/Send/Receive Retiree Data privilege may access the Download Covered Retiree List page using the Manage Retirees page.

For more information about who can request a CRL during Reconciliation, refer to Finalizing Retirees for Reconciliation.

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Covered Retiree List and Reconciliation

Federal law requires that the Plan Sponsor submit cost data only for the Qualifying Covered Retirees (QCR), corresponding Subsidy Periods, and the Benefit Option in which the QCR is enrolled. By completing Reconciliation Step 4: Finalize Covered Retirees, the Plan Sponsor is agreeing to the accuracy of the Covered Retiree List. When the Covered Retiree List is finalized, the Centers for Medicare & Medicaid Services' (CMS') Retiree Drug Subsidy (RDS) Center stops all retiree processing for that application.

When Reconciliation Step 4: Finalize Covered Retirees is marked "Complete" or the Reconciliation Deadline has passed for that application:

  • The Plan Sponsor is unable to upload retiree files through the RDS Secure Website
  • Any retiree list submitted through the Mainframe, VDSA, or MIR is not processed by CMS' RDS Center
  • Retiree files are rejected for the application and response files are sent with Reason Code 28: File Rejected - Closed application indicating the rejection
  • CMS' RDS Center no longer creates or sends Weekly Notification Files
  • Medicare Part D Enrollment Rejection Notifications no longer are posted to the RDS Secure Website
  • An email is sent to the Authorized Representative, Account Manager, and Designee with View/Send/Receive Retiree Data privilege informing them that retiree processing has stopped

Note: Retiree files should continue to be sent to CMS' RDS Center until the Covered Retiree List is validated and finalized during Reconciliation.

To learn more about the Covered Retiree List as it applies to Reconciliation, refer to Finalizing Retirees for Reconciliation.

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Covered Retiree List File Layout and Format

The following Covered Retiree List layout and format information is available for reference:

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Step-by-Step Instructions

This section contains step-by-step instructions to Request a Covered Retiree List and Download a Covered Retiree List.

Request a Covered Retiree List

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:

  1. Find the appropriate Application ID.
  2. Select Manage Retirees from the Actions dropdown menu then select Go.

     Select [Manage Retirees]

Or

From the Application Status page:

  1. Go to the Application Maintenance Options section at the bottom of the Application Status page.
  2. Select the Manage Retirees link.

     Select [Manage Retirees]

On the Manage Retirees page:

  1. Select the Request List of Covered Retirees link.

     Select [Request List of Covered Retirees]

On the Request Covered Retirees List page:

  1. Select Request Covered Retiree List to request a CRL or select Return to Manage Retirees to return to Manage Retirees without requesting the CRL.

     Select [Request Covered Retiree List]

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Download a Covered Retiree List

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:

On the Application List page:

  1. Find the appropriate Application ID.
  2. Select Manage Retirees from the Actions dropdown menu then select Go.

     Select [Manage Retirees]

Or

On the Application Status page:

  1. Go to the Application Maintenance Options section at the bottom of the Application Status page.
  2. Select the Manage Retirees link Select [Manage Retirees]

On the Manage Retirees page:

  1. Select the Download Covered Retiree List link.

     Select [Download Covered Retiree List]

The Electronic Protected Health Agreement opens in a new window.

  1. Select I Accept to proceed to the Download Covered Retiree List page or select Cancel to return to the Manage Retirees page.

     Select [I Accept]

On the Download Covered Retiree List Files page:

  1. View the Covered Retiree Lists (CRLs) that are available for download for this application.
  2. Locate and select the file to download. The File Download window displays showing the progress of the download.

    Depending on your browser settings, the file download window may close automatically when the download is complete or you may need to close it manually.

     Emphasis [File download window]

  3. You may download another file or select Return to Manage Retirees.

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