Prescription Drug Data Collection (RxDC) Reporting Carrier Guidelines
The Consolidated Appropriations Act, 2021 (CAA) requires health plan sponsors to submit detailed information on prescription drug expenses and coverage reports to CMS annually by June 1st.
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Published: 01.28.2026
What is Prescription Drug Data Collection (RxDC) Reporting?
Under Section 204 (of Title II, Division BB) of the Consolidated Appropriations Act, 2021 (CAA), insurance companies and employer-based health plans must submit information about prescription drugs and health care spending. This data submission is called the Prescription Drug Data Collection Reporting, also referred to as RxDC Reporting.
In addition to collecting information about prescription drugs, it also reports on information about health care services spending and premium paid by employers and members.
CAA Prescription Drug Reporting is required to be submitted annually no later than June 1st to the Centers for Medicare and Medicaid Services (CMS).
Who is responsible for Prescription Drug Data Collection (RxDC) Reporting?
Fully-Insured Groups
For fully-insured groups, carriers are largely taking on the responsibility of reporting, but employers must still ensure that the carrier is filing on their behalf. It is important for plan sponsors to keep any written communication from the carrier that states how they are complying with the reporting requirement on behalf of fully-insured plans.
Self-Insured Groups / Level-Funded Plans
Self-insured groups, including level-funded plans, have more responsibility in ensuring the reporting is completed. We recommend that self-insured (and level-funded) plan sponsors contact their carrier, TPA and/or PBMs to ensure how these vendors can assist with the reporting requirement.
Self-insured plans may enter into a written agreement with their vendors to fulfill the reporting function on behalf of the plan; however, the plan sponsor remains liable for any failures.
Prescription Drug Data Collection Reporting (RxDC) Requirements by Carrier
Reference Year 2025 Reporting is Due June 1, 2026
Each carrier may have different guidelines and details for how they are handling RxDC reporting. For your reference, we have prepared the carrier RxDC reporting chart below which outlines carrier-specific guidelines and resources.
If a carrier survey remains open after the deadline, there is no guarantee that the information will be received by the carrier.
CARRIER
REPORTING
FULLY-INSURED
REPORTING
SELF/LEVEL-FUNDED
EMPLOYER SURVEYS
RESOURCES
Aetna
Aetna is committed to complying with all legal and regulatory requirements affecting their business operations and customer's health benefits. The following is how Aetna is helping their Small Group plan sponsors submit these reports. The submission process
Starting February 2nd, Aetna will send an email to all Small Group plan sponsors with instructions on how to submit the required data.
Clients should fill out the RxDC Plan Sponsor Data Collection Form with the required data by 3/31/2026. Required data:
Average monthly premium paid by members
Average monthly premium paid by employer
Broker Submission Option: you may use this form to provide the information to Aetna on behalf of your client
We can then use the data to submit on behalf of your client.
Process for submissions that are missing or incomplete by 3/31/2026
We will submit the report without the required plan sponsor data. Failure to respond will impact our ability to accurately report on the plan sponsor’s behalf, and Aetna will not be responsible for any liability associated with the inaccurate report. What you can do: Help your clients gather and report the data so they won’t have anything else to worry about.
Aetna is committed to complying with all legal and regulatory requirements affecting their business operations and customer's health benefits. The following is how Aetna is helping their Small Group plan sponsors submit these reports. The submission process
Starting February 2nd, Aetna will send an email to all Small Group plan sponsors with instructions on how to submit the required data.
Clients should fill out the RxDC Plan Sponsor Data Collection Form with the required data by 3/31/2026. Required data:
Average monthly premium paid by members
Average monthly premium paid by employer
Broker Submission Option: you may use this form to provide the information to Aetna on behalf of your client
We can then use the data to submit on behalf of your client.
Process for submissions that are missing or incomplete by 3/31/2026
We will submit the report without the required plan sponsor data. Failure to respond will impact our ability to accurately report on the plan sponsor’s behalf, and Aetna will not be responsible for any liability associated with the inaccurate report. What you can do: Help your clients gather and report the data so they won’t have anything else to worry about.
UnitedHealthcare/Oxford requests your support in completing a few necessary questions in the Prescription Drug Data Collection (RxDC) RFI now available on the employer/broker portals until March 31, 2026.
What’s Required:
All commercial Fully-Insured, Level-Funded, and Self-Funded employer groups with UnitedHealthcare (and Surest) medical coverage must complete the RxDC Request for Information (RFI) by March 31, 2026.
If a self-funded client plans to submit their own data, they must notify UHC by March 31, 2026.
UMR customers follow a separate process and should use the link provided by their Strategic Account Executive (SAE).
Completing the RFI allows UnitedHealthcare to submit accurate RxDC data to CMS by June 1, 2026. Missing information could result in incomplete reporting and compliance risks for your clients.
Note: UMR customers received a customer-specific link to an RFI in an email from their UMR Strategic Account Executive (SAE). UMR customers must also complete the RFI by the March 31 deadline.
To facilitate this process for UHC customers, we recommend using the RxDC RFI worksheet to gather the required data in advance.
UnitedHealthcare/Oxford requests your support in completing a few necessary questions in the Prescription Drug Data Collection (RxDC) RFI now available on the employer/broker portals until March 31, 2026.
What’s Required:
All commercial Fully-Insured, Level-Funded, and Self-Funded employer groups with UnitedHealthcare (and Surest) medical coverage must complete the RxDC Request for Information (RFI) by March 31, 2026.
If a self-funded client plans to submit their own data, they must notify UHC by March 31, 2026.
UMR customers follow a separate process and should use the link provided by their Strategic Account Executive (SAE).
Completing the RFI allows UnitedHealthcare to submit accurate RxDC data to CMS by June 1, 2026. Missing information could result in incomplete reporting and compliance risks for your clients.
Note: UMR customers received a customer-specific link to an RFI in an email from their UMR Strategic Account Executive (SAE). UMR customers must also complete the RFI by the March 31 deadline.
To facilitate this process for UHC customers, we recommend using the RxDC RFI worksheet to gather the required data in advance.
To facilitate this process for UHC customers, we recommend using the RxDC RFI worksheet to gather the required data in advance.
To facilitate this process please refer to the following helpful resources: RxDC Brainshark Information video, RxDC Guide, and external RxDC FAQs about the CMS RxDC requirements and the process for you to submit data to UHC. You can watch the video at your convenience, review any information you need, and easily print out any resources for future reference.
For further details, visit the CMS CAA Prescription Drug Reporting (RxDC) resources below.