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New Mandatory Employer Survey from CMS

Our Wonderful Government…

Quick, what health insurance plan did you have in 2011? Seems like a strange question but due to CMS’s recent mailing it’s one you may have to answer. The letter refers to an online questionnaire for employers dubbed the Data Match Project. In it you are asked to recall and enter health insurance plans details from 2011-2013. For small business owners, completing the questionnaire may be a tall task. So we have compiled some helpful tips and resources that will get you through the survey in no time!

What’s the Point?

The questionnaire website will determine whether your company’s health plan or Medicare was the primary payer for employees from 2011-2013.

“CMS understands that the Data Match Project will prove burdensome to some employers, but we strongly believe the money saved and recovered through this project far outweighs the burdens.”

Do All Employers have to do this?

Nope, you only need to be complete the survey if you received the request from CMS.

Important things to understand before you begin

  • If you had less than 20 employees during the time period, plan details will not be required
    • Even if the plan details are not necessary, you’re still required to complete the survey
  • You only need details for plans that provided coverage to employees on the CMS Worker Information List

What Information is required?

According to the Data Match Project official documentation there are five sections included in the online questionnaire:

  1. Employer Information – Number and type of employees
  2. Group Health Plan Information – For plans that provided coverage to the employees on the Worker Information List
  3. Employee Information – Employee-specific questions for employees included in the Worker Information List
  4. Worker Information List – Downloadable Employee Listing, identifying the employees to be included in the questionnaire
  5. Certification – Agreement and acceptance of terms

The following items are needed for each group health plan :

  • Health Plan Name and Address
  • Taxpayer Identification Number for Health Insurance Company
  • Pharmacy Benefit International Identification Number (Rx BIN)
  • Pharmacy Benefit Processor Control Number (PCN)
  • Rx Group (sometimes the same as the medical policy/group number)
  • Policy Identification Number (policy/group number)

what if you don’t complete the QUESTIONNAIRE?

A Civil Monetary Penalty of up to $1,000 per employee, on the Worker Information List, may be assessed against your business.

Helpful Resources to complete the Data Match Project

So you don’t remember the PCN from your 2012 health plan, welcome to the club! Below is a list of resources to help you find the requested health plan details.

  • Your Health Insurance Broker
    • Google won’t know what health insurance plan you had in 2012 but your broker should
      • Modern insurance agencies can provide all of these required plan details, saving you a lot of time!
  • Carrier Name and Address
  • Carrier Taxpayer Identification Number
    • Pennsylvania Health Insurance Rate Filings
      • First find your health insurance carrier. Then click on the View Final Summary PDF link. The insurance company’s Taxpayer Identification Number will be found within the first few pages of the document.
  • RX BIN and PCN Number

An easier way…

Finally, as a small business owner you have better things to do then waste hours researching this information. Therefore the simplest solution is to contact your health insurance broker.  As mentioned earlier, most modern health insurance agencies will be able to gather the required information from their own records and save you all the leg work!

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