Information Required to Complete an Application

Overview

This section provides an overview of information Plan Sponsors must supply to CMS in order to complete an Annual Plan Application. Refer to the applicable User Guide sections for detailed information on each topic:

• Plan Information
• Benefit Option Information
• Actuary Information
• Banking Information
• Designee Information (Optional)
• Retiree Information

After the application is submitted, certain information may be modified using the RDS Secure Website, while other information cannot be modified. Refer to Make Changes to an Application After Submission for additional information.

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Plan Information

• Plan Sponsor
• Account Manager
• Authorized Representative
• Plan Year Start Date and Plan Year End Date
• Application Name

For more information, refer to Application Submission: Create Application.

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Benefit Option Information

• Benefit Option Name
• Unique Benefit Option Identifier (UBOI): For example, an Rx Group Number
• Benefit Option Type (Self-Funded or Fully-Insured)
• Retiree Submission Method - should be selected based on who submits retiree files in the organization and how the retiree files are sent and received. The same method will be used for Weekly Notification Files. The RDS Secure Website will always be copied as a default regardless of the method selected. The following Retiree List Submission Methods and Retiree List Response Methods are available for selection:
  • RDS Secure Website to RDS Center
  • Vendor Connect:Direct to RDS Center Connect:Direct
  • Coordination of Benefits (COB): Voluntary Data Sharing Agreement (VDSA) or Mandatory Insurer Reporting (MIR)
  • Plan Sponsor Connect:Direct to RDS Center Connect:Direct

For more information, refer to Application Submission: Benefit Options.

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Actuary Information

• First Name (exactly as it is on file with the American Academy of Actuaries)
• Last Name (exactly as it is on file with the American Academy of Actuaries)
• Actuary's American Academy of Actuaries Membership Number
• Email Address

For more information, refer to Application Submission: Actuary and Manage the Actuary Role.

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Banking Information

• Bank Name
• Account Type (Checking or Savings)
• Organization Name associated with Account
• Account Number
• Bank Routing Number
• Bank Address
• Bank Contact
  • Name
  • Phone Number
  • Email Address

For more information, refer to Application Submission: Banking Information.

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Designee Information (Optional)

The Designee is an optional RDS role – the Plan Sponsor does not need to assign Designees to applications nor are Designees required to submit applications. If the Plan Sponsor chooses to assign Designees to their applications, Designees can be assigned and registered to an RDS application before or after Application Submission. If the Plan Sponsor opts to assign Designees to its applications, the following information must be maintained.

• Designee Name
• Designee Email Address
• Desired Designee privileges
• Pass Phrase (A simple case-sensitive phrase for the Designee to use as identification during User Registration on the RDS Secure Website)

For more information, refer to Manage the Designee Role.

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Retiree Information

For more information, refer to Retiree Management and Retiree File Layouts.

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