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  • Covered California for Small Business

Covered California for Small Business Shares Carrier Update on RxDC Collection

Admin
  • February 27, 2025
  • 2 min
Under Section 204 (of Title II, Division BB) of the Consolidated Appropriations Act, 2021 (CAA),  insurance companies and employer-based health plans must submit information about prescription drugs and health care spending. This data submission is called the RxDC report. Covered California for Small Business (CCSB) serves as an administrator of our participating Health Plan Issuers and is not an insurance company nor an employer-based health plan. Therefore, CCSB is not subject to RxDC data collection requirements on behalf of our employer groups. However, we have been actively engaged with our Health Plan Issuers to understand their approach to meeting the RxDC reporting requirements. Below find a summary of approaches taken by our three plans. If you have further questions, we encourage you to reach out to the Health Plan Issuers directly.

Blue Shield of California is collecting D1 Premium Contribution data as part of the Consolidated Appropriations Act, Section 204 (2021). Prescription Drug Cost Reporting regulation, on behalf of our employer groups. Groups or their brokers with access to an Employer Connection account are encouraged to complete the survey by logging in to Employer Connection. Groups or their brokers without access to an Employer Connection account can submit required information via the Prescription Drug & Healthcare Spending Survey using their group ID and following web key: #25yr24 

The deadline to submit information is April 19, 2025.  Groups that miss the deadline will not be included in Blue Shield’s filing and may be subject to noncompliance if they do not report the required data directly to the CMS on their own. 

As a reminder, Blue Shield will submit D2 for all groups and D3-D8 for groups with prescription drug benefits under a Blue Shield health benefit plan. Please note that data submitted is for the 2024 calendar year. 

Here are a few reminders to prepare for submission: 

Only one individual (group administrator, broker, or other such delegate) may submit responses for a single group ID. Please coordinate a single submission. 

Submitters will receive an email confirmation displaying a record of responses submitted and a link to edit responses. 

Only the submitter will have access to edit responses until the deadline. Blue Shield is committed to supporting our groups in complying with health coverage related regulatory requirements.* Please support your groups by reminding them to submit necessary information before the deadline and helping submit information, as needed.

Blue Shield will send a follow up email to groups that have not yet completed the survey, reminding them to complete the survey before the deadline. 

Kaiser Permanente is compiling and submitting the required data on behalf of their employer groups.

Sharp Health Plan will contact their employer groups directly to obtain the required information. In addition, they will send a broker and employer alert informing all brokers and CCSB employers of the RxDC reporting requirement.

For more information, click here.

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  • Covered California for Small Business

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