User Roles Support Tool: Annual Plan Application

User Roles:

AM

AR

AC

D

Program Components:

Annual Plan Application

To participate in the RDS Program, the Plan Sponsor must submit a timely RDS application prior to the expiration of the Application Deadline. The following identifies the actions and user roles associated with the annual plan application, including the nine steps in the Application Submission Process.

Start Application AM AR

The Account Manager or Authorized Representative may start a new annual plan application. Four pieces of information are required to start the RDS application: the Plan Sponsor ID, which was created during the Plan Sponsor registration; the Plan Name, which should be unique and identifiable; the Plan Year Start Date; and the Plan Year End Date.

Step 1: Application ID Assigned of the Application Submission Process is system generated and automatically assigned when a Plan Sponsor starts a new application.

Benefit Option AM AR D

Application Submission Process Step 2: Benefit Option allows the Plan Sponsor to enter the Benefit Options for an application in the RDS Secure Website. A Benefit Option is a particular benefit design, category of benefits, or cost-sharing arrangement offered within a group health plan.

The Account Manager, Authorized Representative, or Designee with Define Benefit Option privilege may complete Step 2 of the Application Submission Process.

Assign Actuary AM AR D

Application Submission Process Step 3: Assign Actuary allows the Plan Sponsor to search for an Actuary in the RDS Secure Website by email address or invite one to register for the RDS Program.

Actuaries are not contracted by the RDS Program. The Plan Sponsor must contact an Actuary outside of the RDS Secure Website who is a qualified Actuary and is an active member in good standing with the American Academy of Actuaries.

One Actuary may be assigned to an application to attest all of the Benefit Options, or multiple Actuaries may be assigned to an application to attest individual Benefit Options. However, a single Benefit Option may not be attested by more than one Actuary.

The Account Manager, Authorized Representative, or Designee with Assign Actuary privilege may complete Step 3 of the Application Submission Process.

Attestation Summary AM AR AC D

To validate that the Plan Sponsor's benefits are equal to or greater than the Medicare Part D Prescription Drug Benefit, CMS' RDS Center requires that a qualified Actuary complete a two-part actuarial equivalence test before an RDS application can be submitted.

Application Submission Process Step 4: Attestation Summary allows the Account Manager, Authorized Representative, or Designee with Assign Actuary privilege to review the progress of the attestation. They do not have access to editing the attestation. A qualified Actuary completes the attestation and signs the Electronic Signature from a different view in the RDS Secure Website.

Electronic Funds Transfer (EFT) Information AM AR D

Application Submission Process Step 5: Electronic Funds Transfer (EFT) Information allows the Plan Sponsor to set up and change banking information so that CMS' RDS Center can transfer RDS payments to the Plan Sponsor's bank account.

The Account Manager, Authorized Representative, or Designee with Complete Electronic Funds Transfer (EFT) Information privilege may complete Step 5 of the Application Submission Process.

Payment Frequency AM AR D

Application Submission Process Step 6: Payment Frequency allows the Plan Sponsors to define how frequently they would like to request RDS payments. The Payment Frequency is the chosen frequency to submit Payment Requests. After the application is submitted, the Payment Frequency cannot be changed. The Plan Sponsor may select a Payment Frequency of Monthly, Quarterly, Interim Annual, or Annual payments.

The Account Manager, Authorized Representative, or Designee with Define Payment Frequency privilege may complete Step 6 of the Application Submission Process.

Retiree Electronic Data Interchange (EDI) Methods and Sources AM AR D

Application Submission Process Step 7: Retiree Electronic Data Interchange (EDI) Methods and Sources allows the Plan Sponsor to specify and change the method used to submit retiree data, the source of the retiree data, and the methods that CMS' RDS Center should deliver the Retiree Response Files and Weekly Notification Files to the Plan Sponsor or Plan Sponsor Partner such as a Vendor or Coordination of Benefits Contractor.

The Account Manager, Authorized Representative, or Designee with Choose Electronic Data Interchange (EDI) Methods and Sources privilege may complete Step 7 of the Application Submission Process.

Plan Sponsor Agreement AR

Application Submission Process Step 8: Plan Sponsor Agreement allows the Plan Sponsor to review and electronically sign the Plan Sponsor Agreement.

Only the Authorized Representative may complete Step 8 of the Application Submission Process. The Account Manager and Designee have “View Only” access for monitoring purposes.

Valid Initial Retiree List AM AR D

Application Submission Process Step 9: Valid Initial Retiree List is the final step of the process. The Valid Initial Retiree List contains the initial list of beneficiaries for whom the Plan Sponsor is seeking subsidy. It is important to keep in mind that the Valid Initial Retiree List must be received by CMS' RDS Center before the Application Deadline.

The Account Manager, Authorized Representative, or Designee with View/Send/Receive Retiree Data privilege may complete Step 9 of the Application Submission Process by submitting the Valid Initial Retiree List through a manual upload on the RDS Secure Website if this is the selected Retiree Electronic Data Interchange (EDI) Method and Source.

The Valid Initial Retiree List may also be submitted by the Plan Sponsor and Vendors with pre-existing Mainframe connections, as well as by VDSA partners submitting non-Medicare Secondary Payer (MSP) records and Mandatory Insurer Reporting (MIR) participants using the expanded implementation model if this is the selected Retiree Electronic Data Interchange (EDI) Method and Source.

Request Application Deadline Extension AM AR D

The Account Manager, Authorized Representative, or Designee with Request Extension privilege may request a 30-day Application Deadline Extension that is adjusted for weekends and holidays. The one-time Application Deadline Extension may be requested before the Application Deadline using the RDS Secure Website.