Q. For the CAA RxDC reporting, what are the requirements for fully insured and self-funded groups? What are the groups required to do? What as brokers can we do to help them?
A. For fully insured plans, the insurance companies are required to submit the RxDC report. You may want to suggest that your fully insured groups get confirmation in writing that the carriers will meet the CAA RxDC requirements.
For self-funded plans, the burden technically falls on the employer, but most employers will contract with their TPA to handle the submission. You should talk to your self-funded clients and recommend that they review their TPA contracts to insure that the TPA will handle the RxDC submission. Some TPAs are requesting certain data elements from employers, but there really is no preparation your groups can do now until the TPAs request this information.