CMS-R-262 Cost Share Groups

CMS Plan Benefit Package (PBP) and Formulary CY 2026 (CMS-R-262) - IRA

Appendix_C_PBP2026 Cost Share Groups

CY2026 Plan Benefit Package (PBP) Software and Formulary Submission

OMB: 0938-0763

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CY 2026 PBP Data Entry System Screens
Point of Service (POS) Groups Setup

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 1 of 18

CY 2026 PBP Data Entry System Screens
Point of Service Groups – Add New POS Group – Page 1

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 2 of 18

CY 2026 PBP Data Entry System Screens
Point of Service Groups – Add New POS Group – Page 2

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 3 of 18

CY 2026 PBP Data Entry System Screens
Combined Supplemental Benefits Group Setup

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 4 of 18

CY 2026 PBP Data Entry System Screens
Combined Supplemental Benefits – Add New Group – Page 1

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 5 of 18

CY 2026 PBP Data Entry System Screens
Combined Supplemental Benefits – Add New Group – Page 2

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 6 of 18

CY 2026 PBP Data Entry System Screens
Reduction in Cost Sharing (RICS) Groups Setup

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 7 of 18

CY 2026 PBP Data Entry System Screens
Reduction in Cost Sharing – Add New RICS Group – Page 1

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 8 of 18

CY 2026 PBP Data Entry System Screens
Reduction in Cost Sharing – Add New RICS Group – Page 2

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 9 of 18

CY 2026 PBP Data Entry System Screens
Reduction in Cost Sharing – Add New RICS Group – Page 3

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 10 of 18

CY 2026 PBP Data Entry System Screens
Optional Supplemental Packages Setup

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 11 of 18

CY 2026 PBP Data Entry System Screens
Optional Supplemental Packages – Add New Package – Page 1

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 12 of 18

CY 2026 PBP Data Entry System Screens
Optional Supplemental Packages – Add New Package – Page 2

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 13 of 18

CY 2026 PBP Data Entry System Screens
Optional Supplemental Packages – Add Package with Service 4c (sample) - Page 1

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 14 of 18

CY 2026 PBP Data Entry System Screens
Optional Supplemental Packages – Add Package with Service 4c (sample) – Page 2

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 15 of 18

CY 2026 PBP Data Entry System Screens
Optional Supplemental Packages – Add Package with Service 4c2 (sample) - Page 1

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 16 of 18

CY 2026 PBP Data Entry System Screens
Optional Supplemental Packages – Add Package with Service 4c2 (sample) - Page 2

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 17 of 18

CY 2026 PBP Data Entry System Screens
Optional Supplemental Packages – Add Package with Service 4c2 (sample) - Page 3

Softrams

CY2026 PBP – Cost Share Groups
01/08/2025
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING

Page 18 of 18


File Typeapplication/pdf
File TitleCY 2026 PBP Data Entry System Screens
AuthorCMS
File Modified2024-12-19
File Created2024-12-19

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