Overview
As a registered user of the RDS Secure Website, it's important for you to understand the various components of the RDS Program. The graphic in this section explains the RDS Program components:
User Management
Annual Plan Application
Retiree Management
Payment Setup
Interim Payment
Reconciliation
These components sometimes overlap with each other. For example, you may be completing the Reconciliation process for one application, but submitting an interim payment request for another application. Additionally, components such as User Management and Retiree Management are ongoing processes.
User Management AM AR AC D
Plan Sponsors continuously manage current RDS Secure Website user roles to prevent delays in tasks being completed. User management includes not only maintaining roles and user information, but also remaining in compliance with Federal Security Regulations by logging into the RDS Secure Website at least once every 180 days.
Keep This in Mind: Maintaining an active user account is essential to RDS Program participation including submitting applications and completing Reconciliation. CMS' RDS Center will not make payments to a Plan Sponsor if the Account Manager or Authorized Representative has an inactive user account.
Annual Plan Application AM AR AC D
To participate in the RDS Program, Plan Sponsors must submit a timely application prior to the expiration of the Application Deadline, which is approximately 90 days before the selected Plan Year Start Date (adjusted for Federal holidays and weekends). For example, if a Plan Sponsor's Plan Year Start Date is January 1, 2015, the Application Deadline is October 2, 2014. If the Application Deadline is not met, the application will be denied.
Keep This in Mind: If the Plan Sponsor finds it will be unable to meet the original Application Deadline, the Account Manager, Authorized Representative, or a Designee assigned the Request Extension privilege may request one 30-day extension using the RDS Secure Website.
Retiree Management AM AR D
Plan Sponsors may only submit costs for the Qualifying Covered Retirees, Benefit Options, and Subsidy Periods listed in the Covered Retiree List. Therefore, it is necessary to manage retiree information throughout the phases of an RDS application.
Payment Setup AM AR
After an application is approved, the Account Manager or the Authorized Representative must identify the individuals who will report costs and request payment(s) by completing Payment Setup. If there are changes to the individuals who will report costs and request payment(s), changes can be made to Payment Setup.
Keep This in Mind: Payment Setup must be complete in order to report costs or request payment. Additionally, a single individual may not have both the Report Costs privilege and the Request Payment privilege on a given application.
Interim Payment AM AR D
Plan Sponsors can request interim payment on a Monthly, Quarterly, or Interim Annual schedule. NOTE: Beginning May 8, 2020, all current and future RDS applications’ Payment Frequency will be set to a maximum frequency of monthly interim payments, consistent with the general payment rules regarding timing set forth in 42 C.F.R. 423.888(b)(1). Although 12 interim payment requests are permitted, a Plan Sponsor may choose to submit fewer than 12 interim payment requests, or forego interim payments and instead choose to submit one final payment request during Reconciliation as described in 42 C.F.R. 423.888(b)(2)(ii). Please refer to Important Enhancement to RDS Payment Frequency for important details.
Keep This in Mind: If interim payment is received, the Reconciliation process must be completed 15 months after the end of the application plan year. If the Plan Sponsor does not complete Reconciliation by the Reconciliation Deadline, the sum of all payments received will become an overpayment, and CMS will initiate immediate action to recover those funds.
Reconciliation AM AR D
Within 15 months after the application Plan Year End Date, Plan Sponsors complete Reconciliation to finalize their application’s Covered Retiree List and submit final cost data to CMS' RDS Center. If the Plan Sponsor did not select an Interim Payment Frequency, it must use the Reconciliation process to request its annual payment. NOTE: Beginning May 8, 2020, all current and future RDS applications’ Payment Frequency will be set to a maximum frequency of monthly interim payments, consistent with the general payment rules regarding timing set forth in 42 C.F.R. 423.888(b)(1). Although 12 interim payment requests are permitted, a Plan Sponsor may choose to submit fewer than 12 interim payment requests, or forego interim payments and instead choose to submit one final payment request during Reconciliation as described in 42 C.F.R. 423.888(b)(2)(ii). Please refer to Important Enhancement to RDS Payment Frequency for important details. The 12 steps of Reconciliation can typically average 90 days to complete.
Keep This in Mind: If interim payments were received and the Plan Sponsor does not complete Reconciliation by the Reconciliation Deadline, the sum of all payments received will become an overpayment, and CMS will initiate immediate action to recover those funds. Plan Sponsors that fail to meet the Reconciliation Deadline for a given application and have not received interim payments for that application will not be eligible for any subsidy payments for that application.