As previously communicated under the Consolidated Appropriations Act (CAA), health insurers offering group or individual health coverage and self-funded (ASO) group health plans are required to report data annually regarding prescription drugs and health care spending to the Departments of Health and Human Services, Labor, and Treasury (Tri-Agencies). This information must be submitted to CMS by June 1, 2023, for 2022 data, through a web portal set up by the Centers for Medicare & Medicaid Services (CMS).
The easiest way for groups to be compliant with this new legislation is if they submit certain premium data to their carrier by a specific deadline prior to the CMS deadline. The carrier will then submit the data to CMS on their behalf.
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Carrier |
Data Collection Summary |
Carrier Links |
| Aetna | Group or Broker must complete an online data collection form by 4/1/23 including total premium paid by employees and total premium paid by employer for 2022. See instructions for all required group information. | |
| Cigna | Group or Broker must send an email to CAA204@Cigna.com by 2/24/23 with the following information: Client Name, Client Account Number, Client ID (if known/ typically 4-6 digits), Average employee % of premium and Average employer % of premium for 2022. |
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| Empire | Group or Broker must complete online form by 3/1/23 including average employee % of premium and average employer % of premium for 2022. See instructions for all required group information. | |
| Horizon | Horizon will be completing the process for all fully insured groups without any data needed from the group or broker. |
N/A No action required from the group or broker. |
| UHC/Oxford | Group or Broker must complete online form by 3/1/23 (by funding arrangement) including average employee % of premium and average employer % of premium for 2022. See instructions for all required group information. |
Fully Insured/Level Funded Communication
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Below is a summary by carrier (that we have received to date) with deadlines, premium data format, instructions, survey links and links to supporting documentation.