Transitional Reinsurance Fee for Self-Insured Plans – Nov. 15, 2016

Transitional Reinsurance Fee for Self-Insured Plans – Nov. 15, 2016

The Affordable Care Act (ACA) established three risk-spreading programs to provide payments to health insurance issuers that cover higher-risk populations and to more evenly spread the financial risk carried by issuers:

  • A transitional reinsurance program;
  • A temporary risk corridor program; and
  • A permanent risk adjustment program.

The transitional reinsurance program is intended to help stabilize premiums for coverage in the individual market during the first three years of Exchange operation (2014, 2015 and 2016) when individuals with higher-cost medical needs gain coverage. This program imposes a fee on health insurance carriers and self-insured group health plans (including level-funded health plans).

For 2016, the annual contribution rate is $27 per enrollee per year, or $2.25 per month.  The Centers for Medicare & Medicaid Services (CMS) published a helpful guide outlining the proper methods for counting enrollees.

2016 Key Deadlines

CMS published the below table outlining the key Transitional Reinsurance Fee deadlines for 2016:

chart

For more information regarding the Transitional Reinsurance Fee, please visit CMS’ website.  If you have questions regarding the Transitional Reinsurance Fee, please contact your Kistler Tiffany Benefits’ Consultant.

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