[Eternal] RxDC D1 Reporting Services Signup

RxDC D1 Reporting Services
Lumelight’s RxDC D1 Reporting Service files the D1 and P2 data files on behalf of group health plan sponsors. The D1 data file includes information about the number of covered lives under each health plan and the premiums (or premium equivalents for self-funded plans) paid towards such coverage. The P2 includes certain identifying information about the plan.

The registration deadline for our reporting services is ten business days prior to June 1 of the year following the calendar year on which we will be reporting. For registrations received after this date, Lumelight will still help get your data filed but we do not guarantee timely filing with CMS.

If you choose to sign up with Lumelight, you will receive a simple online data collection form requesting basic information needed for us to complete your filing. To ensure timely filing, you must submit the requested data at least five business days prior to the CMS submission deadline of June 1 of the year following the calendar year you selected on your service request. After Lumelight receives your data, we will provide you the opportunity to review your filing before it is submitted. Finally, you will receive a receipt of filing once CMS has accepted our submission on your behalf.

Our compliance specialists will be available to answer questions throughout the RxDC data collection process via e-mail at RxDC@lumelight.com.

To sign up for Lumelight’s RxDC D1 Reporting Service, please complete the form on the next page. Click here for answers to commonly asked questions about the sign-up process. The service is priced based on the funding status of your plan* as follows:

Fully Insured: $800

Level Funded: $1,200

Self-Funded: $1,600

* Please note that for purposes of this filing requirement a “plan” is considered the legal entity sponsored by an employer (or in certain cases an association, trust, committee, etc.), not a plan option. In most cases, each employer sponsors a single plan for their employees. Where this is not the case, the employer or plan sponsor is generally aware that they sponsor more than one legal plan. If you have questions about how many plans you sponsor, please contact us at RxDC@lumelight.com.
What reporting year are you signing up for? If you wish to sign up for multiple years, please complete this form separately for each year.*

January 1, 2022 - December 31, 2022January 1, 2023 - December 31, 2023January 1, 2024 - December 31, 2024January 1, 2025 - December 31, 2025

Legal Name of Plan Sponsor: *
This can be found on the Plan Sponsor’s W-9 form. If you’re not sure who the Plan Sponsor is, you can take a look at your organization’s Summary Plan Description (SPD) document to find out.
EIN of Plan Sponsor: *
This can be found on the Plan Sponsor’s W-9 form
Legal Plan Name: *
Not sure? Check our FAQs which are linked below!
State in which Plan is Headquartered: *
Not sure? Check our FAQs which are linked below!
Click here for our FAQs.
The Plan is: *

Fully InsuredSelf InsuredLevel FundedOther
Who should we contact for data?
Data Contact Name*

First NameLast Name
Data Contact Email*
example@example.com
Data Contact Phone Number*
Please enter a valid phone number.
Invoicing Information

Your invoice will be sent via email to the contact listed below.
Company Name*
Company Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is the invoicing contact the same as the data contact above?
Invoicing Contact Name*

First NameLast Name
Invoicing Contact Email*
example@example.com
Invoicing Contact Phone Number*
Please enter a valid phone number.
Name of the person that completed this form: *

First NameLast Name
Email address of the person that completed this form:*
example@example.com
Phone number of the person that completed this form:*
Please enter a valid phone number.
Subtotal
Discount
Total
If you have a referral code, please enter it here:
I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law.
Signature*

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Lumelight RxDC Payment

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RxDC D1 Reporting Services

Who should we contact for data?

Invoicing Information