RxDC Reporting Form

Submissions due April 18, 2025.

Understanding the RxDC Report

Under Section 204 of the Consolidated Appropriations Act, insurance companies and employer-based health plans must submit information regarding prescription drug benefits and health care spending to the Centers for Medicare & Medicaid Services (CMS) by June 1 of each year for the prior year’s coverage. This report is also known as the RxDC Report.

In 2025, insurance companies and employer groups are required to report data on the average monthly premium paid by them and their employees who were enrolled in benefits in 2024. This information is reported on the D1 Template of the RxDC Report filing.

RxDC Employer Reporting Intake Form

The purpose of this intake form is to gather the required information to enable Sharp Health Plan to complete the D1 Template on your behalf. Please provide the information requested below for the 2024 calendar year and submit it by April 18, 2025.

If we do not receive the completed form by April 18, 2025, then you will be responsible for submitting all required data directly to CMS by June 1, 2025. Failure to do so could result in penalties.

* Required field.

1. Group name:

3. Group Employer Identification Number [EIN]:

5. Group contact title:

2. Group ID:

4. Group contact name:

6. Group contact email:

View these instructions to complete items 7-8.

7. Average monthly premium paid by members in calendar year 2024:

8. Average monthly premium paid by employer in calendar year 2024:

Please make sure all information is correct. If you need to make updates to your submission, contact your dedicated account manager. You will not be able to complete this form again.

I certify this information is true and complete to the best of my knowledge.*

Resources

For more information, please review this information from CMS.

Questions

If you have any questions, please contact your account manager. Please view the FAQ for more information.