There are three options for electronic submission: Direct Entry via the internet, the Bulletin Board Service (BBS) or the Electronic Media Questionnaire (EMQ) program.  Using the EMQ is the most efficient method for employers with a large number of worker records. 

Direct Entry

Direct Entry is an internet option that allows employers to complete all Internal Revenue Service (IRS)/Social Security Administration (SSA)/Centers for Medicare & Medicaid Services (CMS) Data Match questionnaires directly online via the IRS/SSA/CMS Secure Web site, without the need to upload or download files.  Employers assign an Account Manager, who will have the ability to login to the Secure Web site from any personal computer.  Data entry screens, modeled after the paper Data Match Questionnaire, are completed directly online, and the information provided is validated for accuracy and completeness as it is entered.  This allows for common errors to be identified and corrected at the time of submission. 

Additionally, users have the ability to view and print the completed questionnaire data in summary format for up to 30 days from the date of submission.  Interactive help menus and online documentation take the user through this process effortlessly.  Although this Direct Entry does not have an employer size limitation, this process is most effective for employers with 500 or less records to complete. Employers with more than 500 worker records should consider utilizing the Electronic Media Questionnaire (EMQ) option described below.

This option can be selected via the Secure Web site.

The Bulletin Board Service (BBS)

Employers with less than 500 workers may submit their responses through the Data Match BBS. This easy-to-use personal computer (PC) program allows employers to download a customized application, and complete the questionnaire on a local PC.  The completed questionnaire is submitted to the COB Contractor via the Secure Web site

The BBS is a convenient way to submit the Data Match Questionnaire; the customized program provides an on-line editing feature that checks your responses for completeness and accuracy. This option can be selected through the Secure Web site, or if you need assistance, contact the Coordination of Benefits (COB) Contractor's toll-free telephone number at 1-800-999-1118 or TTY/TDD: 1-800-318-8782 for the hearing and speech impaired. A representative will be available to assist you Monday through Friday, from 8:00 a.m. to 8:00 p.m., Eastern Time, except holidays.

Further information on the BBS system is available in the Instructions for Completing the Group Health Plan Report for the IRS/SSA/CMS Data Match booklet.

Electronic Media Questionnaire (EMQ) Program

The EMQ program is designed to assist those employers with the largest worker population, i.e., 500 or more, of Medicare beneficiaries and covered spouses. This option offers employers the ability to complete requested questionnaires within the 30-day limit via electronic media rather than paper.

Employers that choose to participate in the EMQ must be able to submit data on an acceptable electronic media, e.g., cartridge or compact diskette. The ability to develop simple software applications is required. Despite the additional technical requirements associated with this program, it is the best choice for those employers who have many hundreds of worker records to complete within a limited time frame.

Voluntary Data Sharing Agreement (VDSA)

Using a VDSA is an alternate method to the options above. The VDSA is an agreement between the Centers for Medicare & Medicaid Services (CMS) and an insurer or employer to electronically exchange Medicare and group health plan (GHP) eligibility information; employers using a VDSA are not required to complete Data Match questionnaires.  Use the link below to learn more about the VDSA program.

Downloads
Instructions for completing the Group Health Plan Report for the IRS/SSA/CMS Data Match (PDF, 1.5MB) Sample Data Match Questionnaire, Part I, Page 1 (PDF, 49 KB) Sample Data Match Questionnaire, Part I, Page 2 (PDF, 30 KB) Sample Data Match Questionnaire, Part II, Page 1 (PDF, 251KB) Sample Data Match Questionnaire, Part III (PDF, 328 KB) Sample Data Match Questionnaire, Part IV (PDF,206 KB)
Related Links Inside CMS
There are no Related Links Inside CMS
Related Links Outside CMS
Coordination of Benefits (COB) Contractor IRS/SSA/CMS Data Match Web site

Page Last Modified: 10/30/2008 10:51:33 AM
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