The Consolidated Appropriations Act, 2021 (CAA), requires all insurance carriers and employer-sponsored health plans to report detailed information on healthcare spending and prescription drug utilization. This submission, known as the RxDC report, is used by federal agencies to better understand what is driving healthcare costs.
All group health plans are subject to this requirement, including fully insured, self-funded, and level-funded arrangements. While carriers, third-party administrators, and brokers typically handle much of the reporting, the responsibility ultimately falls on the employer as the plan sponsor.
The reporting includes key financial and utilization data such as premiums, employer and employee contributions, enrollment, and overall medical and pharmacy spending.
The deadline for submission is June 1 each year, covering the prior calendar year. For fully insured plans, carriers will request employer-level data in advance, with deadlines usually falling between late March and early May. Missing these carrier deadlines will create additional work, as employers will then need to complete portions of the filing directly, which can be significantly more complex.
While the requirement sits with the employer, this is something your advisor should be actively managing. If you are unsure where your group stands with RxDC filing, now is a good time to review and confirm everything is on track.