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Sav-Rx Support & Implementation Services
If you select to continue offering prescription benefits to your retirees and apply for the retiree drug subsidy, Sav-Rx can assist you in the RDS application process as well as support the on-going RDS data file requirements.
RDS Application Support
Sav-Rx will be happy to coordinate the RDS application on your behalf, for no additional fee. We will assign an Account Manager to your application who will:
- Establish your account.
- Manage the account and application process.
- Complete all portions of the application except for those that must be completed by the assigned actuary and authorized representative, such as actuarial attestation and sign-off.
- Coordinate to ensure timely sign-off by actuary and authorized representative.
For Sav-Rx to perform this service you will need to provide us with information about:
- The Authorized Representative who will be responsible for final sign-off.
The Authorized Representative is the Business Owner, Officer, or Trustee of the plan who will ultimately be responsible for the accuracy of the application information. Once Sav-Rx’s assigned Account Manager completes the application and the actuary completes the attestation, then the Authorized Representative will sign-off on the application.
- The Actuary who will attest to your plan’s actuarial equivalency.
The actuary who performed your attestation of actuarial equivalence will also be set up as a designee in the application, so that they can attest to your plan’s actuarial equivalent status. No supporting documentation will need to be submitted by the actuary, though they will need to maintain their work papers in case of an audit.
Sav-Rx will also prepare the initial enrollment file of your eligible retirees that must accompany the RDS application. This initial enrollment file will be prepared free of charge.
RDS On-Going Support
Sav-Rx Prescription Services will, on your behalf, prepare and forward the following CMS required data files, at the frequency indicated below:
- Monthly enrollment file update in CMS specified format
- Quarterly summary of cost data for interim payment *
- Annual reconciliation file that includes claim totals by retiree
Optional Services that we can provide include:
- Designing your Customized Creditable Coverage Notification, Sav-Rx will assist you in designing your notification free of charge.
- Creditable Coverage Notification Mailings to Retirees, Sav-Rx recommends that creditable coverage notifications be included with other plan materials that you regularly send out to retirees. Creditable coverage notifications must be sent prior to November 15, 2005. If you wish to have the creditable coverage notification sent to retirees under separate cover and you would like Sav-Rx’s assistance in managing this process and sending notifications, please contact your Sav-Rx Account Manager for a quote.
- Creditable Coverage Notification Mailings to Active Members, Sav-Rx recommends that creditable coverage notifications be included with other plan material that you regularly send out to members. . If you wish to have the creditable coverage notification sent to retirees under separate cover and you would like Sav-Rx’s assistance in managing this process and sending notifications, please contact your Sav-Rx Account Manager for a quote.
- Sav-Rx RDS Customized Member Level Comparison – It is our experience that each group we serve offers unique benefit packages for individuals with unique prescription needs. Based on your specific benefit offering and the utilization patterns of your individual retirees there may be cases where a Medicare Part D benefit would be more valuable than the group’s benefit. We have designed a process to perform custom evaluations of Medicare Part D PDP (Prescription Drug Program) options based on member’s previous utilization. These reports are provided to individual members to assist them in navigating the complex nature of the Medicare Part D benefit. Members can quickly see if their current benefit provides them with more value, or if a specific Medicare Part D PDP offers a benefit which would provide them with a lower out of pocket total expense. We believe that by providing this information, in an unbiased manner we can assist retirees in understanding their options and making educated decisions about their pharmacy benefit. The Customized Member Level Comparison also includes a dedicated toll free customer service line which will be provided to members that receive comparison letters. This line will allow your retirees to call and arrange an appointment with a Sav-Rx Medicare Specialist. This specialist will review the member’s options and assist them by providing specific information about their current benefit as well as options available in their region.
| Service |
Sav-Rx Applicable Fees |
Notes |
| RDS Application Process |
| RDS Application Coordination (Account Manager Support) |
$0.00 |
Sav-Rx will assign a designated individual to prepare your RDS application. This individual will be the "Account Manager" as defined in the CMS application process. |
| RDS Enrollment Initial File |
$0.00 |
Provide the initial enrollment file, in the CMS specified format, to accompany the RDS application. |
| Other Services |
| On-going Data Files to CMS including Monthly Eligibly files, Quarterly Interim Data Files, and Annual Reconciliation Files |
$0.00 |
The $0.00 fee applies only if Sav-Rx has all prescription data for the group’s retirees. It is very important that all prescriptions for eligible retirees are included in the submission files to CMS, in order to ensure that you receive the full subsidy that you are eligible for. If eligible retiree prescriptions are adjudicated through other mechanisms, for example directly by the group or Fund, then there will be a fee associated with coordinating the data files. This coordination is critical to ensure that all claims are included in the data feeds to CMS. If coordination is required, then there will be an initial set-up fee charged on a “Time and Materials” basis (dependent on the level of effort) and an on-going monthly fee of $250.00/month. |
| Creditable Coverage - Letter Design and Development |
$0.00 |
Assistance is provided in designing a customized Creditable coverage notification for your group. |
| Creditable Coverage - Letter Mailing to Retirees |
Quote Available Upon Request |
Sav-Rx recommends that Creditable Coverage notification be included with other plan material that you send to retirees. If you want Creditable Coverage notification to be sent separately and you would like Sav-Rx’s assistance, please contact your account manager for a quote. |
| Creditable Coverage - Letter Mailing to Active Members |
Quote Available Upon Request |
Creditable coverage notification must be provided to all members who may be Medicare eligible. If you are not sure if dependents and spouses may be covered under Medicare, for example, if they are disabled, you may wish to ensure that all active members receive the creditable coverage notification. Sav-Rx is recommending that creditable coverage notification be included with other plan information, or associated with a newsletter or other mass mailing to covered individuals. If you want Creditable Coverage notification to be sent separately and you would like Sav-Rx’s assistance, please contact your account manager for a quote. |
| Sav-Rx RDS Customized Member Level Comparison Service |
$0.00 |
This service offers particular value to members in cases where there are some individual retirees who may have a lower patient out-of-pocket cost under a Medicare Part D benefit. We can assist you to determine if some of your individual members may receive more value from alternatives and we will work to coordinate customized communication to them. Following an initial evaluation, if it is clear that your benefit will always offer lower patient out-of-pocket expense under your plan we will work with you to determine the best mechanism to communicate to retirees the high value of your benefit. In these cases comparison letters may not be required.
The $0.00 fee applies only if Sav-Rx has all prescription data for the group’s retirees. It is very important that all prescriptions for eligible retirees are included in the analysis so that correct and complete information is provided to retirees. If eligible retiree prescriptions are adjudicated through other mechanisms, for example directly by the group or Fund, then there will be a fee associated with coordinating claims data so that all information is available for comparative purposes. If coordination is required, then there will be an initial set-up fee charged on a “Time and Materials” basis (dependent on the level of effort) and a fee of $2.50/Member for the customized comparison.
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Please note: Interim data files must be submitted based on the frequency that you wish to receive payment. Sav-Rx’s standard service includes quarterly interim data files, which will support quarterly payment of the RDS. If you wish to receive payment at any other frequency (for example, monthly), then please contact your Sav-Rx Account Manager for a quote. (back to reference )
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