FINAL RULE, Reinsurance Exemption
Fed Reg 78-210, pg 65051 (30 Oct 2013)
C. Part 153—Standards Related to Reinsurance, Risk Corridors, and Risk Adjustment Under the Affordable Care Act
In the proposed rule, we proposed certain provisions related to program integrity for State-operated risk adjustment and reinsurance programs, including provisions governing reporting requirements and restricting the use of reinsurance funds for administrative expenses. In addition, we proposed record retention standards for States operating risk adjustment, for contributing entities, and for reinsurance-eligible plans when HHS operates reinsurance on behalf of a State. We intend to propose additional standards related to the oversight of the premium stabilization programs in future regulations and guidance.
We also note that, to alleviate the upfront burden of the reinsurance contributions, we intend to propose in future rulemaking to collect reinsurance contributions in two installments—the reinsurance contributions for reinsurance payments and administrative expenses would be collected at the beginning of the calendar year following the applicable benefit year, and the contributions for payments to the U.S. Treasury would be collected at the end of the calendar year following the applicable benefit year. We also intend to propose in future rulemaking to exempt certain selfinsured, self-administered plans from the requirement to make reinsurance contributions for the 2015 and 2016 benefit years.
Fed Reg 78-210, DHHS, PPACA; Amdts to HHS Notice of Benefit and Payment parameters for 2014; FINAL RULE - (Reinsurance Exemption) (61 pp. PDF, scribd)
