RDS is a complex and challenging process and if done correctly it is a valuable financial opportunity. However, there are so many reasons why you may not have received maximum RDS subsidy. Missing or inaccurate data, eligibility rejections, inaccurate rebate information — are all issues that reduce the total amount of subsidy you receive.
Now you can find out if you have additional RDS reimbursement subsidy payments due to you... easily and without a big expense... when you partner with InTech and their RDS Reopening audit and dedicated technology — RDS VerifyLink©
If you did not average $550 per eligible retiree in every plan year in which you participated, you may have not captured all your RDS subsidy money. But you cannot find out until you spend a lot of time and effort to demonstrate to CMS that an RDS Reopen is justified
Unless... you get InTech to audit and submit your RDS Reopening for you.
Working together with your staff, or your Benefits Administrator, and PBM, InTech will conduct a comprehensive audit from which the results will demonstrate to CMS that an RDS Reopening is justified. Once CMS approves the request, InTech will manage the Reopening reconciliation process including all of the technical and compliance issues associated to retiree eligibility, data accuracy and matching, rebate verification, cost report calculations and assist you with closure of the Reopening reconciliation steps. InTech will prepare all CMS documentation and perform the file transmissions needed to get the additional payments you are due... for every year involved.
If you believe you may not have received the maximum RDS reimbursement for a previously submitted year due to any of the reasons shown above, CMS will now allow you to reopen a previously reconciled plan year. This process can be done up to four years post reconciliation of a plan year. The overall review and analysis is time consuming, complicated, and not something most plan sponsors are able to do without having the analytical tools and expertise to identify the specific data or processing issues causing the subsidy shortfall.
To reopen a plan year, you must first provide CMS with a written notice identifying what issues or errors may have been involved in the past plan year and what is the expected increase in reimbursement. To determine the "new" subsidy total, an audit is done to reevaluate all past data and the RDS processes used to identify what could have potentially caused the subsidy shortfall. For example, as part of the reopen process, CMS allows past plan year retiree eligibility information to be resent to validate and correct past eligibility rejection issues. Adding additional eligible retirees, or correcting subsidy eligible time frames, will result in an additional subsidy for that plan year.
Once the information and documentation is prepared, CMS will then review your request and reply to with a determination allowing or disallowing a reopening. This review and reply process takes approximately 30 days.
If CMS responds with a favorable determination to reopen the plan year, you will be notified that you have a 90 day deadline to resubmit the appropriate information and request payment. The reopen process follows the same administrative steps as an annual reconciliation and upon completion of all the reconciliation steps CMS will electronically pay the additional subsidy in thirty days or less.
You can go to the RDS website to see the list of Questions and Answers about the RDS appeal process at: