The purpose of the Section 111 GHP reporting process is to enable CMS to correctly pay for the health insurance benefits of Medicare beneficiaries by determining primary versus secondary payer responsibility. Section 111 authorizes CMS and Section 111 GHP Responsible Reporting Entities (RREs) to electronically exchange health insurance benefit entitlement information. The actual data exchange process will take place between the RREs and the CMS Coordination of Benefits Contractor (the COBC). The COBC will be managing the technical aspects of the Section 111 data exchange process for all Section 111 RREs.

On a quarterly basis, a responsible reporting entity must submit group health plan (GHP) entitlement information about employees and dependents to the COBC. In exchange, the COBC will provide the RRE with Medicare entitlement information for those individuals in a GHP that can be identified as Medicare beneficiaries. This mutual data exchange helps to assure that claims will be paid by the appropriate organization at first billing.

The Section 111 GHP reporting process includes an option to exchange prescription drug coverage information to coordinate benefits related to Medicare Part D. CMS is also allowing RREs, that are also participating in the Retiree Drug Subsidy (RDS) program or are reporting to RDS on behalf of a plan sponsor, to use the Section 111 GHP reporting process to submit subsidy enrollment (retiree) files to the RDS Center using the Section 111 GHP reporting process.