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.
Access The CAA Pharmacy Drug Reporting Form
*NOTE: If you received our March Broker Update email, this was incorrectly list as D1.
