Aetna recently emailed employer groups who had Aetna coverage for any period in 2023. Aetna is requesting data needed to comply with the Prescription Drug Data Collection (RxDC) reporting requirement. To comply with the Consolidated Appropriations Act (CAA) passed in December 2021, insurance companies and employer-based plans must submit information regarding prescription and health care spending to the Centers for Medicare and Medicaid Services (CMS) by June 1 of each year.
The majority of the data required is maintained by Aetna, but plan sponsors are required to provide four data elements:
- issuer legal entity name (Select Aetna Life Insurance Company from the dropdown options)
- funding arrangement (options include fully insured, self-funded, split funding)
- total premium by employer (total employer-paid Aetna premiums for 2023)
- total premium paid by members* (total member-paid Aetna premiums for 2023)
*CMS instructions state the following should be included in the member-paid premium calculation
- premium paid by members for medical and pharmacy coverage,
- member payments for COBRA coverage, including the 2% administrative fee, and
- spousal and tobacco surcharges, if applicable.
CMS defines member-paid premium for self-funded groups differently than fully insured groups. Click here for the CMS calculation.
To complete the survey, click the “Start the form now” link in the Aetna email. Additional information can be found in the plan sponsor notice and job aid.
Aetna’s completion deadline is April 12. Failure to meet this deadline may require employers to submit information on their own or be subject to a CMS penalty of $100 per day per affected individual.
If you haven’t received the Aetna email notification, contact your Bukaty benefits consultant at 913.345.0440.
