The RDS Welcome Kit Top 5 Things to Know page contains information you should always keep in mind for success in the RDS Program.
Plan Sponsor, Retiree, and Cost Eligibility
It's important to understand Plan Sponsor, retiree, and cost eligibility to participate in the RDS Program.
Plan Sponsor Eligibility
To participate in the RDS Program, an organization must:
- Have a valid Employer Identification Number (EIN).
- Fall under one of the following categories: Commercial, Government, Nonprofit, Religious, or Union.
- Demonstrate that its Prescription Drug Plan coverage is equal to or greater than the defined standard coverage under the Medicare Part D Prescription Drug Benefit.
A Plan Sponsor must not be on the General Services Administration Debarment List or Office of Inspector General's Exclusion List. Plan Sponsor eligibility is determined when the Plan Sponsor's account is created in the RDS Secure Website.
Plan Sponsors submit monthly retiree updates to CMS' RDS Center to establish Qualifying Covered Retirees (QCRs) for whom eligible costs may be submitted. A QCR must be:
- A retiree of the Plan Sponsor or a retiree's spouse/dependants.
- A person covered under the Plan Sponsor's Qualified Retiree Prescription Drug Plan.
- A person eligible for but not enrolled in a Medicare Part D plan.
Plan Sponsors submit Gross Retiree Costs for which they are seeking subsidy. Gross Retiree Costs are eligible costs aggregated by plan month based on the incurred date. To be eligible, the drug cost(s) must be:
- Covered under Medicare Part D and not reimbursable under Medicare Part B.
- Incurred on or within the Subsidy Period Effective Date and Termination Date for the QCR listed on the Covered Retiree List (CRL).
- Paid by the plan, the QCR through out-of-pocket co-pay or deductible, or a combination of the two.
Additional information regarding Plan Sponsor, retiree, and drug cost eligibility may be found on CMS' Employer & Union Retiree Drug Subsidy page.
- Monitoring the "Featured Content" section of this website for updates to important deadline information.
- Reviewing the Application Status page in the RDS Secure Website for a specific application's key dates. The Reconciliation Deadline is found in the Application Information panel on the right-hand side of the page.
Federal Security Regulations mandate that RDS Secure Website users log into the RDS Secure Website at least once every 180 days to maintain an active user account. Maintaining an active user account is essential to RDS Program participation including submitting applications and completing Reconciliation. CMS' RDS Center will not make payments to a Plan Sponsor if the Account Manager or Authorized Representative has an inactive user account.
Refer to the User Management section of the User Roles Support Tool for tips to help you maintain an active user account.
When planning your RDS Program tasks, monitor the Events page for important dates related to RDS Secure Website availability, CMS' RDS Center closures, and webinar events scheduled to inform you about the program.
RDS Program contact information is available on the Contact Us page. This page provides:
- Contact information for CMS' RDS Center.
- Mailing information for sending specific forms and requests.
- A list of email addresses from which official RDS correspondence may be sent.
Note: Email is CMS' RDS Center's official means of communication to the Plan Sponsor. It is important to take the necessary steps to ensure all emails are received and not marked as "spam" or automatically deleted for any other reason.