Communicating With Your RDS Vendor

Whether a Vendor is helping you manage your retiree enrollment or your cost reporting information, maintaining good communication with your Vendor throughout the application lifecycle is key to participating in RDS. It's important to understand when you need to be in contact and what information you should share to ensure you meet your deadlines and get the most out of your program participation.

Review this information to learn how your Vendor relationship fits into each component of the RDS Program and get some Tips for Success.

Select a topic to display the information for that topic.

Note: If you are working with a new Vendor representative, a Vendor Quick Start Guide is available to help them get started in their role.

User Management iconUser Management

If a Vendor will submit cost reports or retiree files using the RDS Secure Website, you must invite a Vendor representative as a Designee to access the RDS Secure Website and assign them the appropriate privileges. The Vendor representative will be required to establish an RDS Secure Website user account by completing the registration process. If the Vendor is submitting cost files or retiree files by Mainframe, a Designee user role is not required, but may still be necessary to allow the Vendor to manage retiree information and cost submissions using the RDS Secure Website.

Tip for Success  Understand Vendor access in retiree management and cost reporting

Return to top

Annual Plan Application iconAnnual Plan Application

If your Vendor is helping you manage retiree enrollment on your application, the Vendor needs to submit your Valid Initial Retiree List before the Application Deadline. Make sure your Vendor knows your Application Deadline.

If your application plan year begins in January through March, it's especially important for you and your Vendor to monitor and manage your retirees during the Medicare Part D Open Enrollment Period (OEP) since the Application Deadline occurs during OEP. CMS' RDS Center recommends submitting both the Valid Initial Online Application and the Valid Initial Retiree List before OEP so that Qualifying Covered Retirees can be established early, and you receive subsidy for the most retirees.

Once the Valid Initial Retiree List has been submitted, keep the Vendor informed of the status of the list. If you have set up a Vendor Designee with the View/Send/Receive Retiree Data privilege, the Designee will be notified by email when the Valid Initial Retiree List is received. After the Valid Initial Retiree List is submitted and CMS' RDS Center has sent a Retiree Response File, you and your Vendor should review the Retiree Response File Reason Codes together and resubmit the retiree information as necessary.

If you plan to set your Electronic Data Interchange (EDI) Method and Source as either Vendor Mainframe to RDS Center Mainframe or Vendor Mainframe to RDS Center Mainframe with a copy of all Retiree Response Files sent to the RDS Secure Website, ensure you have the Vendor's ID to help you complete Application Submission Process Step 7: Retiree Electronic Data Interchange (EDI) Methods and Sources.

Tip for Success  Let your Electronic Data Interchange (EDI) notification method help you better manage your retiree information

Return to top

Retiree Management iconRetiree Management

If your Vendor is helping you manage retiree enrollment, it is critical for both you and your Vendor to monitor and manage retiree information throughout the application plan year. Costs may only be submitted for the Qualifying Covered Retirees (QCRs), Benefit Options, and Subsidy Periods listed in the Covered Retiree List (CRL).

Notify your retiree enrollment Vendor of any enrollment changes:

  • Regularly request and download a CRL using the RDS Secure Website and share it with your Vendor.
  • Scrutinize the CRL with the people who manage retiree enrollment, process claims, and report cost data. Many times the enrollment system and the claims processing system are separate. Compare the CRL against both of these systems and internal records. Reconcile any differences to ensure there are no conflicts. It is important to coordinate these updates so that the cost preparation process does not include data for anything outside the QCRs, Benefit Options, and Subsidy Periods listed in the CRL.
  • Note: Matching RDS Current Covered Retiree Counts to your enrollment systems can help identify any major gaps.

Work with your Vendor to submit any necessary retiree changes to CMS' RDS Center in the form of a retiree file. Ensure your Vendor is receiving Retiree Response Files and Weekly Notification Files. If you have set up a Vendor Designee with the View/Send/Receive Retiree Data privilege, the Designee will receive emails when Retiree Response Files and Weekly Notification Files are available.

You and your Vendor should work together to process Retiree Response Files and Weekly Notification Files received from CMS' RDS Center. The processing of these files may include settling discrepancies with those who manage retiree enrollment, process claims, or report cost data. Any changes are submitted to CMS' RDS Center in the form of a retiree file.

Tips for Success

Return to top

Payment Setup iconPayment Setup

If your Vendor is submitting cost data on your behalf, the Vendor needs to be properly assigned in Payment Setup by either the Account Manager or the Authorized Representative. The Payment Setup Process must be completed before an interim payment or a Reconciliation final payment may be requested. Tell your cost reporting Vendor when you have completed Payment Setup. If you need to reopen Payment Setup to make a change, do not leave it incomplete–cost files are rejected when Payment Setup is incomplete.

Tip for Success  Ensure your cost reporting Vendor is set up correctly in Payment Setup

Return to top

Interim Payment iconInterim Payment

Let your Vendor(s) know when you are ready to request payment. Request and download the Covered Retiree List (CRL) throughout the plan year and communicate it to your cost reporting Vendor. The CRL will need to be matched to the cost reporting system. Communicating with Cost Reporters is essential to resolve any discrepancies with retiree data. Since the CRL includes the Plan Sponsor's full array of Benefit Options, in many cases it will need to be divided and communicated to multiple Cost Reporters. The cost data prepared and submitted by these Cost Reporters must not include data for anything outside the Qualifying Covered Retirees, Benefit Options, and Subsidy Periods listed in the CRL.

After your cost reporting Vendor has submitted costs, monitor the status of cost files and alert the Vendor if any of their files are in "Mainframe: Errors Detected" status.

Tips for Success

Return to top

Reconciliation iconReconciliation

Ensure your Vendor knows your Reconciliation Deadline. Inform your retiree enrollment Vendor when Reconciliation is open and work with them to finalize your Covered Retiree List (CRL). Verify your RDS Current Covered Retiree Counts. Retiree files will not be processed once Step 4: Finalize Covered Retirees is complete. Share the finalized CRL with your cost reporting Vendor and inform them when Reconciliation cost reporting is both open and closed.

Ensure individual retiree cost data is coordinated as needed if multiple Cost Reporters are reporting costs for a single Unique Benefit Option Identifier () within the same application. After your cost reporting Vendor has submitted costs, monitor the status of cost files and alert the Vendor if any of their files are in "Mainframe: Errors Detected" status.

Tips for Success

Return to top

Tips for Success

Let your Electronic Data Interchange (EDI) notification method help you better manage your retiree information.

If your Electronic Data Interchange (EDI) source is Vendor Mainframe, consider setting your notification method as RDS Center Mainframe to Vendor Mainframe with a copy sent to the RDS Secure Website. If your Retiree Response Files and Weekly Notification Files only go to your Vendor, you won't be able to view the information. Initially setting up or changing your EDI Method to send a copy of all files to the RDS Secure Website will allow you to also review files, helping you better work with your Vendor to manage your retiree information throughout the application plan year.

Resource to Help
  • Complete Step 7: Retiree Electronic Data Interchange (EDI) Methods and Sources - RDS User Guide: Refer to this section of the RDS User Guide for instructions to set up or change your EDI Methods and/or Sources. The Retiree Electronic Data Interchange (EDI) Methods and Sources may be changed through Application Submission Process Step 7: Retiree Electronic Data Interchange (EDI) Methods and Sources up until Reconciliation Step 4: Finalize Covered Retirees is complete or the Reconciliation Deadline has passed.

Return to top


Understand Vendor access in retiree management and cost reporting.

If your Vendor is submitting retiree information using the RDS Secure Website, you must assign a Vendor Designee the View/Send/Receive Retiree Data privilege. Note that your Vendor Designee must be authorized to view Protected Health Information (PHI) to complete tasks such as uploading retiree files on the RDS Secure Website and viewing Retiree Response Files and Weekly Notification Files.

Vendor Designees submitting cost reports using the RDS Secure Website must be assigned the Report Costs privilege. A Vendor Designee does not have access to any cost reports submitted by the Account Manager, Plan Sponsor Designee, or another Vendor. Additionally, at Reconciliation, the Vendor can only access the Final Costs action in Step 6: Manage Submission of Final Cost Reports. Vendor Designees do not have access to the Reconciliation Checklist.

If a Vendor reports costs using the Mainframe, you may wish to assign one of the Vendor's employees as a Designee with the Report Costs privilege (for example, an RDS Secure Website user) so that they may also use the RDS Secure Website to view the cost report data they submitted.

Resource to Help
  • Manage the Designee Role - RDS User Guide: Visit this section of the RDS User Guide for an introduction to the Designee role, special considerations for managing Designees, and step-by-step instructions to assign a Designee, change Designee privileges, and delete a Designee.

Return to top


Ensure your cost reporting Vendor is set up correctly in Payment Setup.

To ensure timely submission and monitoring of cost reports, make sure your Vendor/Vendor Designee is set up correctly in Payment Setup. When assigning a Vendor Designee in Payment Setup, avoid the following mistakes:

  • Assigning a reporting method directly to a Designee
  • Attaching Benefit Options directly to a Designee
  • Forgetting to assign the Designee to a Vendor
  • Forgetting to specify a Vendor

For cost reporting, note that the following actions are not allowed in Payment Setup if a Cost Reporter has already reported cost data:

  • You cannot remove a Vendor after the Vendor reported costs.
  • You cannot remove a Benefit Option from a specific Cost Reporter after that Cost Reporter reported costs.

Remember that at least one Cost Reporter must be assigned to each Benefit Option.

Resources to Help
  • Set Up a Vendor Designee in Payment Setup - Technical Article: Refer to this technical article for tips to properly assign a Vendor and Vendor Designee in Payment Setup.
  • Complete Payment Setup - RDS User Guide: Refer to this section of the RDS User Guide for information such as an overview of the Payment Setup Process steps, guidelines, user roles and responsibilities, and common mistakes to avoid, as well as step-by-step instructions to complete Payment Setup.
  • Change Payment Setup - RDS User Guide: Refer to this section of the RDS User Guide for information such as Payment Setup changes by step, limitations to making changes, user roles and privileges to change Payment Setup, and step-by-step instructions to change Payment Setup.

Return to top


Understand the impact of changing Vendors.

If you are changing Vendors, it's important to understand how a change in source can affect receiving retiree information and reporting costs. For retiree management, changing the source on an application with Qualifying Covered Retirees (QCRs) will have a direct impact on Weekly Notification File processing. For cost reporting, data will need to be coordinated, and you will need to decide how to handle any data already reported by the former Vendor, depending on the time of the change.

Resources to Help
  • Coordination of Individual Retiree Cost Data - RDS User Guide: Plan Sponsors are required to coordinate individual retiree cost data within an application for the purpose of appropriately applying each individual retiree's Cost Threshold and Cost Limit. If you have multiple Cost Reporters reporting costs for a single Unique Benefit Option Identifier () within the same application, refer to this section of the RDS User Guide for examples of how cost data is coordinated for one particular retiree in a where there is a change in Vendor mid-year.
  • Changing Cost Reporter Vendors - Technical Article: If you are ending a relationship with a cost reporting Vendor, review this technical article for actions that should be taken to properly submit interim costs, final costs, or both depending on the timing of the change.
  • EDI Methods and Sources Job Aid: If you have already established QCRs on your application, review this job aid for examples of how changing your source can affect your application.

Return to top


Sign up for Quick Access Reports.

RDS Secure Website Quick Access Reports (QAR) assist and accelerate the cost reporting activities of Vendors and Plan Sponsors by delivering consolidated cost reporting information. QAR can tell you when a cost report was last submitted and by whom, what cost figures were last accepted and rejected for the Benefit Option, and whether cost reporting sources were set correctly. Subscribe to QAR and encourage your Vendor to do the same (note that the Vendor must first specify one individual who has a current and active RDS Secure Website account to be the Vendor Composite Report Recipient).

There are two types of reports: 1) the Cost Reporting Summary Report, which displays cost reporting information for approved applications, and 2) the Cost Reporting Exception Detail Report, which only shows reports rejected by the Mainframe. The data shown in the reports is based on existing privileges and rules. The Cost Reporting Summary Report provides much more than just information about cost reports. It displays information such as Application Status, whether retiree files were accepted or rejected by CMS' RDS Center, and Reconciliation information such as deadline and last completed step.

Resource to Help
  • Quick Access Reports (QAR): Refer to the QAR Guide to help you subscribe to and understand QAR, including the differences in what data is displayed for Plan Sponsors and Vendors.

Return to top

Page last updated: December 13, 2016