Customer Care
866.570.5474
Find My Rep
Sales Directory
Send Us Your RFP
Contact Quoting
The RxDC reporting provision of the Consolidated Appropriations Act (CAA) requires reports on drug utilization and spending trends to be submitted to U.S. Department of Health and Human Services. Reports are due annually by June 1.
View the Amwins Connect Health Cost Transparency Guide for Employers.
CMS Resources:
- Prescription Drug Data Collection Reporting page
- Prescription Drug Data Collection Reporting Instructions
- Prescription Drug Data Collection FAQs
- CMS RxDC HIOS Module User Manual
How Carriers Will Handle Reporting
| CARRIER | REPORTING Fully Insured | REPORTING Self/Level Funded | EMPLOYER SURVEYS | RESOURCES |
|---|---|---|---|---|
| Aetna, Banner|Aetna | Carrier will report. | Carrier will report. | Survey required: due by March 31, 2025 | |
| Allstate Benefits | n/a | Details pending for 2024 | Survey not required. | - |
| Anthem | Carrier will report. | Employer must report:
Carrier will report:
| Survey required: due by March 28, 2025 Anthem sent emails directly to the employers with information and the link to the survey. | |
| Blue Cross Blue Shield of Arizona | Carrier will report. | Carrier will report. | Survey not required. | - |
| Blue Shield of California | Carrier will D2 for all groups and D3-D8 for groups with prescription drug under a Blue Shield health benefit plan. | Varies; refer to the Reporting Grid. | Survey required: due by April 19, 2025 Groups or brokers with access to Employer Connection are encouraged to complete the survey at the above link. All others can submit required information at Prescription Drug & Healthcare Spending Survey using their Group ID and the web key: #25yr24 | |
| CareFirst BCBS | Carrier will report. | Carrier will report. | Survey typically required: not yet announced for 2025 | - |
| Cigna | Carrier will report. | Carrier will report. | Survey not required. | - |
| Cigna + Oscar | Carrier will report. | n/a | Survey not required. | - |
| Cigna Administered by Oscar | Carrier will report. | n/a | Survey not required. | - |
| ConnectiCare | Carrier will report. | Carrier will report. | Survey required: due by May 9, 2025 ConnectiCare will email a survey link to employers in mid-April. | |
| EmblemHealth | Carrier will report. | Carrier will report. | Survey required: due by May 9, 2025 EmblemHealth will email a survey link to employers in mid-April. | |
| Florida Blue | Carrier will report. | Carrier will report. | Survey typically required: not yet announced for 2025 | - |
| FHCP | Carrier will report. | n/a | Survey typically required: not yet announced for 2025 | - |
| Health Net | Carrier will report. | n/a | Survey not required. | |
| Healthfirst | Carrier will report. | Carrier will report. | Survey not required. | - |
| Kaiser Permanente | Carrier will report. | Carrier will report. | Survey required: survey will be available until March 31, 2025 | |
| Sharp Health Plan | Carrier will report. | n/a | Survey required: due by April 18, 2025 | |
| Sutter Health Plus | Carrier will report. | n/a | Survey required: due by March 1, 2025 | |
| UnitedHealthcare, Oxford | Carrier will report for groups using OptumRx as PBM. Groups with other PBMs (including OptumRx Direct) should refer to the CAA UHC Approach to Pharmacy Benefits and Costs Reporting Guide | Carrier will report for groups using OptumRx as PBM. ASO groups and groups with other PBMs (including OptumRx Direct) should refer to the CAA UHC Approach to Pharmacy Benefits and Costs Reporting Guide | Survey required: due by March 31, 2025 Survey is located in eServices. Groups can complete the employer worksheet prior to logging in. | |
| Western Health Advantage | Carrier will report. | n/a | Survey not required. Small employers should review their Group Service Agreement Cover Sheet (renewal doc) to ensure contribution values are correct. This will be used for WHA reporting. Large employers will be contacted by WHA to confirm contribution values. | - |
Other Carriers:
- CaliforniaChoice is providing requested data to all carriers and the carriers will report the RxDC information for the employers and plans. There is no additional action needed by CaliforniaChoice groups.
- The following are administrators and not responsible for reporting: Covered California and HealthPass. Employers should follow the enrolled carrier(s) for how reporting will be handled.
- MediExcel Health Plan is exempt from reporting.
Carrier Articles Related to RxDC
RxDC
04/04/2024
RxDC Resources at Amwins Connect
RxDC Resources at Amwins Connect As we get closer to the deadline, you are probably receiving questions from your clients asking you what the carriers are doing or what are they not doing in order ...
03/18/2024
Blue Shield of CA | Improved Process for D1 Premium Reporting - RxDC Mandate
Groups and/or their brokers without Employer Connection access, including active groups, termed groups, and Covered California Small Business groups, can submit required information via the Prescripti...
03/18/2024
Sharp Health Plan Prescription Drug Data Collection Reporting (RxDC) Requirements
Employers should submit the requested information by April 19, 2024.
03/13/2024
Aetna Prescription Drug Data (RxDC) Collection Requirement
Aetna will reach out to groups via email, starting on Friday, March 15th. Groups must response with the requested information by April 12.
02/24/2024
Webinar Replay: RxDC Reporting Round 3
RxDC Reporting Round 3 January 31, 2024 Another round of Rx reporting is just around the corner. As we have started seeing communications from carriers and TPAs requesting data for the Rx report...
02/22/2024
UPDATE - CA | Kaiser Permanente® Form Completion Required By Employers Under CAA
Kaiser Permanente has submitted all required data for all groups (both fully insured and self-funded) for calendar years 2020, 2021, and 2022. For the 2023 calendar year, Kaiser Permanente plans to...
02/07/2024
UPDATED DATES: 2024 UnitedHealthcare/Oxford Approach to CAA Prescription Drug (RxDC) Reporting
UnitedHealthcare and Oxford fully insured and self-funded/level funded groups must complete the online tool for CAA RxDC reporting between February 16, 2024, and April 10, 2024.
02/05/2024
Blue Shield of CA | Rx Drug Cost Data Collection (RxDC) - Group Response Required
To ensure group data is included in Blue Shield’s aggregate filing, groups will need to fill out the Blue Shield D1 intake form.
02/05/2024
Kaiser Permanente®: 2024 Form Completion Required by Employers for Federal Reporting Under CAA - Act Now
To help ensure compliance with the CAA reporting requirements, employer groups must provide additional information. Take a look at this article to learn what is required.
01/02/2024
Sutter Health Plus 2023 Premium Reporting for Employers - Update
The Consolidated Appropriations Act of 2021 (Section 204) requires insurance companies and employer-based health plans to submit information to the federal government about premiums and cost-sharing. ...
05/19/2023
Update on Employer Responsibilities for the Upcoming RxDC Reporting Due June 1, 2023
Update on Employer Responsibilities for the Upcoming RxDC Reporting due June 1, 2023 May 2023 Many employers received an email from their carrier or TPA (for Self-Insured plans) requesting that ...
05/13/2023
