Updated research request forms and data security approval requirement effective 4/24/23
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 would pay no premium for this plan.
| Code | Code value |
|---|---|
| D | Below De minimus Amount |
| B | Below Regional Benchmark |
| N | No |
| 9 | Not Applicable |
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 (2011 forward, only). The CCW constructs the Plan Characteristics File from information submitted by Part D 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/PrescriptionDrugCo...).