To comply with the Consolidated Appropriations Act (CAA), we will complete all required pharmacy benefit and prescription drug cost reporting on behalf of fully insured groups (small and large) and self-funded groups with medical and pharmacy coverage with Univera Healthcare for the 2022 reference year.
New for 2022 Reporting
Centers for Medicaid & Medicare Systems (CMS) is requiring reporting entities to include average premiums paid by employers vs members in the D2* report. This applies to both fully insured (small and large group) and self-funded health plans.
We have developed a web form where all employer groups (except carve out groups) can submit the following information to be included in 2022 reporting:
- Total dollar amount the employer contributed for group medical and pharmacy insurance (total dollar amount = premium or premium equivalent minus what is deducted from employee payroll)
- Form 5500 numbers (If you did not file IRS Form 5500, leave this section blank)
- For self-funded/minimum premium plans who have both medical and pharmacy with Univera Healthcare:
- Third Party Administrator fees paid to parties other than Univera Healthcare
- Stop Loss Premiums paid to carrier other than Univera Healthcare
The web form can be accessed and completed on the Employers area of UniveraHealthcare.com: Employers > Data Reporting > CAA Pharmacy Drug Reporting Form.
The deadline for you to provide responses through the form for 2022 reporting is April 3, 2023.
Additionally, self-funded groups who wish to request their data to complete their own reporting and opt-out of our standard process should reach out to their Account Manager by April 3, 2023. Additional fees may apply.
Please contact your Account Manager with any questions.
*NOTE: If you received our March Broker Update email, this was incorrectly list as D1.