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This variable is contained in the following files: Plan Characteristics File
SAS Name
BELOW_BENCHMARK

Indicates whether the plan benefit package is a stand-alone Prescription Drug Plan (PDP) that offers a basic benefit with a premium below the regional benchmark or de minimis amount. A beneficiary with a full (100%) low-income premium subsidy (LIPS) would pay no premium for this plan.

Comments

The Part D premium benchmarks vary by region.The de minimis amount is $2.00.

See the DEMINIMIS_PD_FLAG variable in the data dictionary for the Plan Base File.

The CCW constructs the Plan Characteristics File from information submitted by plan sponsors to CMS’s Health Plan Management System (HPMS). Employer and National Program of All-inclusive Care for the Elderly (PACE) plans are waived from reporting Plan Benefit Package information.

For those plans that did not report, the value of this variable will be blank.

Provisions in the Patient Protection and Affordable Care Act of 2010 (ACA) changed the way benchmarks are calculated to improve continuity of Part D plan enrollment for LIS beneficiaries. Refer to the CMS Medicare Prescription Drug Benefit Manual for additional details (see, for example: http://www.cms.gov/Medicare/Prescription-DrugCoverage/PrescriptionDrugCovContra/PartDManuals.html).

Source: CMS (HPMS Files)

CodeCode value
D
Below De minimis Amount (note - starting in 2011, this value is retired and is combined with "B")
B
Below Regional Benchmark (2011 forward this may also mean below de minimis amount)
N
No
9
Not Applicable