Employers & Plan Sponsors
Plan sponsors must report for calendar years 2020 and 2021 no later than December 27th, 2022.
Plan sponsors must also report for the 2022 calendar year by June 1st , 2023
Plan sponsors must report for calendar years 2020 and 2021 no later than December 27th, 2022.
Plan sponsors must also report for the 2022 calendar year by June 1st , 2023
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: