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7 The payment rates for Regional EGWPs are in the file Regional Rates and Benchmarks 2026, which can be accessed on the CMS website through the following link: https://www.cms.gov/files/zip/2026-regional-ppo-egwp-rates.zip.
Part D CY EGWP Prospective Reinsurance Amount In accordance with the payment methodology described in the Final CY 2025 Part D Redesign Program Instructions and applied to CY 2026 through the Final CY 2026 Part D Redesign Program Instructions, the CY 2026 prospective reinsurance payment amount for Part D Calendar Year EGWPs is being released concurrently with this release of the Part D national average monthly bid amount, Part D base beneficiary premium, and related Part D bid information. For a detailed description of the CY 2026 Part D payment policy, please refer to the Final CY 2025 Part D Redesign Program Instructions: https://www.cms.gov/files/document/final-cy-2025-part- d-redesign-program-instructions.pdf.
For CY 2026, CMS is calculating the prospective reinsurance payments to all Part D Calendar Year EGWP sponsors using the weighted average of the per member-per month (PMPM) prospective reinsurance amounts submitted by Part D sponsors for enhanced alternative (EA) plans as part of the Part D bid submissions for the payment year in question. For CY 2026, this amount is $47.92.
/s/ Jennifer Lazio, F.S.A., M.A.A.A. Director, Parts C & D Actuarial Group Office of the Actuary