Skip to main content

CMS' RDS Center will be performing system maintenance on the RDS Secure Website on Friday, April 19, 2024 beginning at 9:00PM ET and concluding Saturday, April 20, 2024 at 10:00AM ET. The Secure Website will be available, but file processing will be impacted. Refer to this Announcement for details.

Connect:Direct Report File Elements

User Roles:

AM

D

V

Program Components:

Interim Payment

Reconciliation

Connect:Direct Cost Report File Elements

All Connect:Direct Cost Report files that are submitted to the RDS Center must include the following five elements in the order they are listed:

File Header (FHDR)

The following data elements are to be included in the File Header:

Record Type The first four bytes must be the Record Type, and should always be 'FHDR'.
Submitter Type The fifth byte is the Submitter Type. The values are 'P' for Plan Sponsor and 'V' for Vendor. For example, in the sample file, the Submitter Type is 'V'.

Plan Sponsor ID or Vendor ID

(Submitter ID)

The next ten bytes are the Submitter ID. If the Submitter Type was 'P', the Submitter ID is the Plan Sponsor ID. If the Submitter Type was 'V', the Submitter ID is the Vendor ID. This field is alphanumeric, left justified, and followed by trailing spaces if the ID is less than ten bytes. For example, in the sample file, the ID is 'A1234'. This is shown in the file as 'A1234 ' (with five trailing spaces).
File Creation Date The File Creation Date follows the Submitter ID. This field is eight bytes in a CCYYMMDD format. For example, in the sample file, the File Creation Date is May 16, 2006 displayed as 20060516.
File Creation Time The File Creation Time follows the File Creation Date. This field is eight bytes in an HH:MM:SS format. For example, in the sample file, the time is 30 seconds past 12:05 PM displayed as 12:05:30.

Note: Multiple Application/UBOI Detail (DETL) records are allowed between the Application Header (AHDR) and Application Trailer (ATRL) elements. Multiple Application Header and Trailer sets are allowed between the File Header (FHDR) and File Trailer (FTRL) elements. The remaining 79 bytes are filler.

Return to top

Application Header (AHDR)

The following data elements are to be included in the Application Header:

Record Type The first four bytes are the Record Type, and should always be 'AHDR'.
Application ID The next ten bytes are the Application ID. This field is alphanumeric, right justified, and preceded by leading zeros if the ID is less than ten bytes. For example, in the sample file, the Application ID is '5678', displayed as '0000005678' (with six leading zeros).
Note: The Application ID must be a valid Application ID found in the RDS database to prevent the entire file from rejecting. To ensure you have the correct Application ID, compare it to the Application ID located in the RDS Secure Website on the Dashboard page or the Application Overview page.

Note: The remaining 96 bytes are filler.

Return to top

Application/UBOI Detail (DETL)

The following data elements are to be included in the Application/UBOI Detail:

Record Type The first four bytes are the Record Type, and should always be 'DETL'.
Unique Benefit Option Identifier The next twenty bytes are the UBOI. This field is alphanumeric, left justified, and followed by trailing spaces if the UBOI is less than twenty bytes. For example, in the sample file, the first UBOI is 'BENEFIT OPTION E', displayed as 'BENEFIT OPTION E    ' (with four trailing spaces).
Note: The UBOI must be a valid UBOI found in the RDS database to prevent the entire file from rejecting. To ensure you have the correct UBOI, compare it to the UBOI located in the RDS Secure Website on the Benefit Options page.
Year and Month RX Cost Incurred The Year and Month RX Cost Incurred date follows the UBOI. This field is six bytes in a CCYYMM format. (This differs from the File Creation Date in the File Header, as the day is not included.) For example, in the sample file, the first detail record is for January 2006, displayed as 200601.

Estimated Premium Costs

Gross Retiree Cost

Threshold Reduction

Limit Reduction

Estimated Cost Adjustment

Although the fields following Year and Month RX Cost Incurred represent distinct values—Estimated Premium Costs, Gross Retiree Costs, Threshold Reduction, Limit Reduction, and Estimated Cost Adjustment—their formatting is identical. They are twelve bytes, with the first byte being a '+' (positive) sign. The positive sign is required even if the value is zero. The remaining eleven bytes are a numeric value: the first nine bytes represent the whole dollar amount preceded by leading zeros as needed, and the last two bytes represent the decimal amount. For example, in the sample file, the first value is $0.00, displayed as '+00000000000' (with eight leading zeros). The second value is $2,059.60, displayed as '+00000205960' (with five leading zeros).

Note: The remaining 20 bytes are filler.

Return to top

Application Trailer (ATRL)

The following data elements are to be included in the Application Trailer:

Record Type The first four bytes are the Record Type, and should always be 'ATRL'.
Application ID The next ten bytes are the Application ID. The Application ID in the Application Trailer is formatted the same as in the Application Header (alphanumeric, right justified, and preceded by leading zeroes if the ID is less than ten bytes), and it must be the identical valid Application ID.
Application Record Count The next seven bytes are the Application Record Count. This field is the total number of detail lines within this Application ID. It is numeric, right justified, and preceded by leading zeros if the value is less than seven bytes. For example, in the sample file, the count is '12', displayed as '0000012' (with five leading zeros).

Total Estimated Premium Costs per Application

Total Gross Retiree Cost per Application

Total Threshold Reduction per Application

Total Limit Reduction per Application

Total Estimated Cost Adjustment per Application

The five fields after Application Record Count are the sum of each of the following Application/UBOI Detail record fields: Estimated Premium Costs, Gross Retiree Cost, Threshold Reduction, Limit Reduction, and Estimated Cost Adjustment. Although these fields represent distinct values, their formatting is identical. They are all fifteen bytes, with the first byte being a '+' (positive) sign. The positive sign is required even if the value is zero. The remaining fourteen bytes are a numeric value, with the first twelve bytes representing the whole dollar amount preceded by leading zeros as needed, and the last two bytes representing the decimal amount. For example, in the sample file, the first value is $0.00, displayed as '+00000000000000' (with eleven leading zeros). The second value is $965,989.28, displayed as '+00000096598928' (with six leading zeros). The values in the Application Trailer must match the sum of all the corresponding Detail record fields for that Application ID.

Note: The remaining 14 bytes are filler.

Return to top

File Trailer (FTRL)

The following data elements are to be included in the File Trailer:

Record Type The first four bytes are the Record Type, and should always be 'FTRL'.
Submitter ID The next ten bytes are the Submitter ID. The Submitter ID in the File Trailer is formatted the same as in the File Header (alphanumeric, left justified, and followed by trailing spaces if the ID is less than ten bytes), and it must match the Submitter ID in the File Header.
Application Count The next five bytes are the Application Count field, and this is the total number of applications within the entire file. This field is numeric, right justified, and preceded by leading zeros if the value is less than five bytes. For example, in the sample file, the count is '1', displayed as '00001' (with four leading zeros).

Grand Total Estimated Premium Costs per Application

Grand Total Gross Retiree Cost per Application

Grand Total Threshold Reduction per Application

Grand Total Limit Reduction per Application

Grand Total Estimated Cost Adjustment per Application

The five fields after Application Count are the sum of each of the following Application Trailer fields: Total Estimated Premium Costs per Application, Total Gross Retiree Cost per Application, Total Threshold Reduction per Application, Total Limit Reduction per Application, and Total Estimated Cost Adjustment per Application. Although these fields represent distinct values, their formatting is identical. They are all sixteen bytes, with the first byte being a '+' (positive) sign. The positive sign is required even if the value is zero. The remaining fifteen bytes are a numeric value, with the first thirteen bytes representing the whole dollar amount preceded by leading zeros as needed, and the last two bytes representing the decimal amount. For example, in the sample file, the first value is $0.00, displayed as '+000000000000000' (with twelve leading zeros). The second value is $965,989.28, displayed as '+000000096598928' (with seven leading zeros). The values in the file trailer MUST match the sum of all of all the Application Trailer records for the entire file. The sample file only has one Application ID, so the totals for the File Trailer are the same as the Application Trailer.

Note: The remaining 11 bytes are filler.

What does a sample Connect:Direct cost file look like?

View a sample Connect:Direct cost file.

Return to top

Page last updated: