Consolidated Appropriations Act – Required Rx DC Reporting

As a Health Plan Group Administrator, you may have received an email from your medical insurance company requesting information related to Rx DC Reporting. Providing the information allows the carrier to submit a detailed Prescription Drug utilization data to the government on your behalf.

One key item the group is responsible for providing is the premium contribution percentages for 2025.  This is a breakdown of how much of the total premium was paid by the employees versus the employer for the year. In most cases, this information can be obtained from your accounting software or payroll withholding reports. We recommend a good faith effort to calculate these amounts as accurately as possible. 

How to Calculate Your Premium Contribution Percentages

1. Add up the total medical premium paid for all months in 2025

2. Add up the total amount employees paid toward medical premiums (payroll reports may be helpful for this)

3. Add up the total amount employer paid toward medical premiums for the year

Then calculate:

• Employee percentage = Total employee-paid medical premiums divided by total annual medical premiums

• Employer percentage = Total employer-paid medical premiums divided by total annual medical premiums

These two percentages should equal 100% (rounded slightly if needed).

Below you will find some specifics we have received, by carrier:

Anthem Blue Cross

Anthem Link -  data submission form

The deadline to complete this form is March 25, 2026.

Blue Shield

• Active groups will need to fill out the intake form available on Employer Connection upon logging in.

• Terminated groups will need to fill out this intake form, using their Blue Shield group ID and following web key: #26yr25.

• The deadline to submit this data to Blue Shield for the 2025 calendar year reporting is April 10, 2026

Health Net

Health Net does not require employer filing. Health Net will submit everything on the employer’s behalf.

Kaiser

Kaiser for can be found here. The deadline for this form is March 31, 2026.