Under the Consolidated Appropriations Act (CAA), health insurers offering group or individual health coverage and self-funded group health plans are required to report data annually regarding prescription drugs and healthcare spending to the Departments of Health and Human Services, Labor, and Treasury (Tri-Agencies).
The next required submission date to report 2025 data is June 1, 2026. This information must be submitted through a web portal set up by the Centers for Medicare & Medicaid Services (CMS).
Please refer to the information below that applies to your 2025 health benefit plan arrangement / carrier for further information / reminder on next actions on your part.
Please note that ASG/UMR and Anthem are handling the reporting requirements for KTA and KCIT employer groups. No action is required for KTA or KCIT employer groups at this time.
Fully Insured Employer Groups:
Anthem: Anthem will be submitting the files for all fully insured customers who had active coverage during the 2025 reference year. Anthem previously sent out an email containing a survey link to certain fully insured customers to gather needed information to complete their data for the upcoming filing. Customers MUST submit the requested data to Anthem by the due date of 3/25/2026 so that the filing can be complete. If any questions, or if you have not received your survey link via email, contact your Bim Group Account Executive / Manager.
UnitedHealthcare (UHC): UHC will be submitting the files for all fully insured and level-funded customers who had active coverage during the 2025 reference year. UHC sent a communication to all fully insured and level-funded customers to gather needed information to complete their data for the upcoming filing. Customers are to submit the requested data to UHC via the employer portal by the due date of 3/31/2026 so that your filing can be complete.
Self-Funded Employer Groups:
We have summarized below the TPA approaches for self-funded employer groups. Your Bim Group Account Executive / Account Manager can assist with required additional data to be supplied to your carrier / TPA.
Anthem: Anthem will file on behalf of ASO customers for the benefits they administered and maintained for the 2025 reference year. Anthem ASO customers have the option to request that Anthem also file the Data Sheet (D1) reports on their behalf provided that the request and required additional information is received by 3/25/2026. Anthem has sent an email to certain ASO customers with more information and what is needed for them to complete the filing. Bim Group can assist in providing the needed data to customers to return to Anthem by 3/25/2026.
Point C (formerly Aspirant) Point C can file on behalf of customers for the benefits they administered and maintained (assuming customers utilized their preferred pharmacy vendor) for the 2025 reference year*. Point C has sent customers a worksheet to opt in to this service and to provide needed information to complete their filing. Bim Group will assist in providing the needed data to customers to return to Aspirant by 4/17/2026.
*for customers who only utilize CVS / Caremark through Point C, Point C will share filing obligations with medical TPA
UMR: UMR can file on behalf of customers for the benefits they administered and maintained for the 2025 reference year. UMR has sent a RFI (request for information) to customers to opt in to this service and provide needed information to complete their filing. Bim Group will assist in providing the needed data to customers to return to UMR by 3/31/2026.
We are providing this information as a reminder. You should have previously received information on your specific carrier / administrator’s approach to this reporting.
If you have questions regarding your obligations as an employer in this regard or would like our assistance in providing needed information for your TPA / Carrier, please contact your Bim Group Account Executive / Manager.