HealthEZ | RxDC Reporting - Employer Confirmation

Submission Deadline: April 1

RxDC Reporting - Employer Confirmation

This submission takes approximately 2 minutes to complete.

1. For calendar year 2025, did you or will you file a form 5500? *

Yes

No

If YES, what number is in Box 1B? (Three-digit plan number (PN) e.g. 501) *

2. For calendar year 2025, did you collect premium or other amounts from your employees to help offset the cost of offering your group health plan? *

Yes

No

If YES, what are the total $$ contributions collected from employees in the reporting year (e.g. $10,649.53). *

CertificationConfirmed *

Submit