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Quick Access Reports (QAR)

Supplemental Information

Covered Retiree List File Layout and Format

User Roles:

AM

AR

D

V

Program Components:

Retiree Management

This page contains information about the Covered Retiree List file layout and file format.

Covered Retiree List File Layout

The Covered Retiree List (CRL) is in a Comma Separated Value (CSV) format:

  • A CSV file, or plain text file, is also referred to as a "flat file" or "comma delimited file."
  • Computer systems use CSV files to pass information back and forth between databases.
  • Each line in a CSV file includes one entry or record and a comma to separate each data element within a record.
  • A separate record is created for each unique beneficiary, Benefit Option, and Subsidy Period combination.

Covered Retiree List File Format

The following table shows the data elements that are included in each record in the Covered Retiree List (CRL):

Note: Fields with a caret (^) are filled with the most recent beneficiary data sent to CMS' RDS Center.

Covered Retiree List (CRL) File Format

Data Element

Max Size

Notes

Application ID

10

The RDS Application ID under which the Qualifying Covered Retiree (QCR) was approved for subsidy.

^SSN

09

The Social Security Number (SSN) for the Qualifying Covered Retiree (QCR) that was approved for RDS. This field may be blank if a Medicare beneficiary identifier was provided.

^Medicare beneficiary identifier

12

This field may be blank if the SSN was provided.

May contain:

  • Medicare Beneficiary Identifier (MBI) of the Qualifying Covered Retiree (QCR) that was approved for RDS.
  • Medicare Health Insurance Claim Number (HICN) of the Qualifying Covered Retiree (QCR) that was approved for RDS.
  • Railroad Retirement Board (RRB) number of the Qualifying Covered Retiree (QCR) that was approved for RDS.

^First Name

30

Qualifying Covered Retiree's (QCR's) First Name.

Middle Initial

01

Optional field. Qualifying Covered Retiree's (QCR's) Middle Initial.

^Last Name

40

Qualifying Covered Retiree's (QCR's) Last Name.

^Date of Birth

08

Qualifying Covered Retiree's (QCR's) Date of Birth. Format: CCYYMMDD

^Gender

01

Qualifying Covered Retirees (QCR's) Gender:
Value '0' = Gender Unknown
Value '1' = Male
Value '2' = Female

^Effective Date

08

The beginning date of the Qualifying Covered Retiree's (QCR's) (retiree, spouse, or dependent) coverage under this Prescription Drug Benefit Option. Format: CCYYMMDD

^Termination Date

08

The ending date of the Qualifying Covered Retiree's (QCR's) (retiree, spouse, or dependent) coverage under this Prescription Drug Benefit Option. Format: CCYYMMDD

^Unique Benefit Option Identifier (UBOI)

20

The unique identifier assigned to this Prescription Drug Benefit Option under which this Qualifying Covered Retiree (QCR) was approved for subsidy.

^Relationship to Retiree

02

Qualifying Covered Retiree's (QCR's) Relationship to the retiree:
Value '01' = Self
Value '02' = Spouse
Value '03' = Other

^Type of Record

03

'ADD' or 'UPD'. Will be the same as the last record type submitted for this beneficiary in a retiree file.

Determination Indicator

01

Value 'Y' = Yes. All records in the Covered Retiree List are approved for RDS subsidy.

Reason Code

02

The reason code provided is from the last Retiree Response File record or Weekly Notification File records for this Qualifying Covered Retiree (QCR). For more information, refer to RDS Reason Codes.

Subsidy Period Effective Date

08

The effective date of the beneficiary's (retiree, spouse, or dependent) approved Subsidy Period. Format: CCYYMMDD

Subsidy Period Termination Date

08

The termination date of the beneficiary's (retiree, spouse, or dependent) approved Subsidy Period. Format: CCYYMMDD

Submitter Type

01

The last method by which the Qualifying Covered Retiree (QCR) was submitted to CMS' RDS Center:
Value 'P' = Plan Sponsor
Value 'V' = Vendor
Value 'C' = VDSA/COB: VDSA/MIR

Submitter Name

50

Plan Sponsor, Vendor, or COB Contractor: VDSA/MIR name that last submitted this Qualifying Covered Retiree (QCR) to CMS' RDS Center.

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