Employers & Plan Sponsors

Plan sponsors must report for the 2023 calendar year by June 1st , 2024

RxDC Basics Employers Brokers TPAs PBMs Pricing Q&A Get Started

Employers & Plan Sponsors

For those plan sponsors who have fully explored the new Drug Cost Reporting Requirements, you are likely aware that this effort will require coordination between you (as the plan sponsor), your TPA and PBM. Specifically, PBMs lack the data necessary to complete the plan level files as well as data files 1 & 2. Further, TPAs also lack data necessary to complete their end of the reporting.

This creates a precarious situation for plan sponsors and their brokers as the marketplace is under the impression that ‘PBMs have it covered‘ since after all this is supposed to be Drug Cost reporting.  Unfortunately this is not reality.  Further, depending upon some circumstances at the plan sponsor level (such as having multiple TPAs or PBMs in a reporting calendar year), the execution of this reporting increases in complexity.  

It was for this reason we developed our reporting solution to:

    • Launch our proprietary software and process to assist in the collection of all data necessary for reporting
    • Data is collected from the plan sponsor as well as files provided by TPAs and PBMs
    • Plan sponsor process is designed to ensure final reporting is accurate and timely
    • Our team works directly with plan sponsors to service questions regarding the required reporting
    • All data is merged and coordinated
    • Reporting is submitted on behalf of plan sponsor to the departments
    • Service plan sponsors on an ongoing basis as questions or audits arise
    • We also offer consulting and data services directly to TPAs and PBMs