Crosswalk

#	Form	Change	Current Location	Reason	Burden Impact
1	CMS-10170	Grammatical changes	All pages	Clarity and readability	No
2	CMS-10170	Added Program Requirements and Qualifications	Justification	Clarification of 42 CFR part 423 subpart R	No
3	CMS-10170	Added subsidy evaluation criteria	Section A2: Information Users	Clarification of 42 CFR part 423 subpart R	No
4	CMS-10170	Modified payment frequency verbiage	Section A6: Less Frequent Collection	RDS defaults all applications to a monthly payment frequency option, however Plan Sponsors decide when to request payments based on their business need.	No
5	CMS-10170	Added data collection justification	Section A11: Sensitive Questions	Clarify justification for data collection	No
6	CMS-10170	Updated Mean Hourly Wage, Fringe Benefit, and, Adjusted Hourly Wage amounts	Section 12: Burden Estimates (Hours & Wages); sub-section 'Wages'	Updated data from U.S. Bureau of Labor Statistics’ May 2023 National Occupational Employment and Wage Estimates	Yes
7	CMS-10170	Updated number of entities, wage amounts, and recalculation	Section 12: Burden Estimates (Hours & Wages); sub-section 'Burden Estimates'	Updated data from RDS Plan Sponsor activity and Updated data from U.S. Bureau of Labor Statistics’ May 2023 National Occupational Employment and Wage Estimates	Yes
8	CMS-10170	Updated cost to Federal government and subsequent calculation	Section 14: Cost to Federal Government	Updated data from 2024 OPM information	Yes
9	CMS-10170	Updated total burden	Section 15: Program and Burden Changes	Change in RDS Plan Sponsor enrollment	Yes
10	CMS-10170	Modified the RDS enrollment table for 2016 - 2022	Section 15: Program and Burden Changes	Updated to include current data for plans that have completed Reconciliation	Yes
11	CMS-10170 Application Instructions	Grammatical changes	All pages	Clarity and readability	No
12	CMS-10170 Application Instructions	Updated item numbers	All sections	Updating item numbers to match modified item numbers in CMS-10156 RDS Application	No
13	CMS-10170 Application Instructions	Updated Designee privilege names	Part I - E. Designee Invitation	Privilege labels changed due to application updates	No
14	CMS-10170 Application Instructions	Added Item 4	Part II - B. Benefit Option(s) Provided Under This Plan	Method by which Plan Sponsors submit retiree data is now collected as part of the Benefit Option screen.	No
15	CMS-10170 Application Instructions	Retiree Data Electronic Data Interchange (EDI) Method has been removed.	Part VI	This information is now collected in Part II - B. Benefit Option(s) Provided Under This Plan	No
16	CMS-10170 RDS Application	Renumbering of data elements	All sections	Changes to the RDS application added, removed, and/or reorganized fields	No
17	CMS-10170 RDS Application	Fax Number removed	Part I - A. Plan Sponsor Account Registration	Fax Number is no longer collected	No
18	CMS-10170 RDS Application	Re-enter Email Address removed	Part I - B. Authorized Representative Invitation	User is no longer required to re-enter the Authorized Representative's email address	No
19	CMS-10170 RDS Application	E-mail Address removed	Part I - C. Authorized Representative Information	Email Address is being collected in the previous application step	No
20	CMS-10170 RDS Application	Fax Number removed	Part I - C. Authorized Representative Information	Fax Number is no longer collected	No
21	CMS-10170 RDS Application	Re-enter Email Address added	Part I - D. Account Manager Information	Retyping the user's email address is now required for this step	No
22	CMS-10170 RDS Application	Fax Number removed	Part I - D. Account Manager Information	Fax Number is no longer collected	No
23	CMS-10170 RDS Application	Re-enter Email Address removed	Part I - E. Designee Invitation	User is no longer required to re-enter the Designee's email address	No
24	CMS-10170 RDS Application	Middle Initial removed	Part I - E. Designee Invitation	User is no longer required to enter the Designee's middle initial	No
25	CMS-10170 RDS Application	E-mail Address removed	Part I - F. Designee Information	Email Address is being collected in the previous application step	No
26	CMS-10170 RDS Application	Fax Number removed	Part I - F. Designee Information	Fax Number is no longer collected	No
27	CMS-10170 RDS Application	Retiree List Submission Method added	Part II - B. Benefit Option(s) Provided Under This Plan	Application updates	No
28	CMS-10170 RDS Application	Vendor ID or VDSA Plan Number or MIR Reporter ID added	Part II - B. Benefit Option(s) Provided Under This Plan	Application updates	No
29	CMS-10170 RDS Application	Middle Initial removed	Part II - C. Actuary Invitation	User is no longer required to enter the Actuary's middle initial	No
30	CMS-10170 RDS Application	Re-enter Email Address removed	Part II - C. Actuary Invitation	User is no longer required to re-enter the Actuary's email address	No
31	CMS-10170 RDS Application	Actuary's Company Name removed	Part II - D. Actuary Information	Actuary's Company Name is no longer collected	No
32	CMS-10170 RDS Application	E-mail Address removed	Part II - D. Actuary Information	Email Address is being collected in the previous application step	No
33	CMS-10170 RDS Application	Fax Number removed	Part II - D. Actuary Information	Fax Number is no longer collected	No
34	CMS-10170 RDS Application	All banking information collected has been clarified	Part IV	This information has been historically collected and is being clarified	No
35	CMS-10170 RDS Application	Section removed	Part VI - A. Retiree Data Electronic Data Interchange (EDI) Method	This information is now being collected in Part II - B. Benefit Option(s) Provided Under This Plan #4	No
36	CMS-10170 RDS Application	There is no longer A and B under this section; added additional clarifying field information that is collected with a Retiree List	Part VI - B. Retiree List	Added field names for clarification; this data is and has been collected as part of a Retiree List	No