Rx Data Collection & Reporting
A BRIEF OVERVIEW OF
Who is required to submit the RxDC Report?
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Health insurance issuers offering group coverage
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Health insurance issuers offering individual market coverage, including:
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Student health plans
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Plans sold through the Exchanges
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Plans sold outside of the Exchanges
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Individual coverage issued through an association
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Fully-insured and self-funded group health plans, including:
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Non-federal governmental plans, such as plans sponsored by state and local government
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Church plans that are subject to the Internal Revenue Code
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Federal Employees Health Benefits (FEHB) Plans
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Who is NOT required to submit?
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Account-based plans, such as health reimbursement arrangements
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Excepted benefits including but not limited to:
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Short-term limited-duration insurance
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Hospital or other fixed indemnity insurance
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Disease-specific insurance
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Medicaid Plans
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State children's health insurance program plans
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Basic Health Program plans
These requirements apply regardless of whether a plan is considered a grandfathered or grandmothered health plan.
How will this information be used?
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The data submitted by BABD Data Services will help to:
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Identify major drivers of increases in prescription drug and health care spending
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Understand how prescription drug rebates impact premiums and out-of-pocket costs
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Promote transparency in prescription drug pricing