United States Department of Health and Human Services Trains Regulators for June 1, 2010 Early Retiree Reinsurance Program Implementation

 

The United States Department of Health and Human Services (“HHS”) held a May 6 national training session for insurance regulators on the June 1, 2010 implementation of the Early Retiree Reinsurance Program (“Program”), which was established by section 1102 of the Patient Protection and Affordable Care Act.

Training materials and related documents are posted at: 

http://www.hhs.gov/ociio/gatheringinfo/

Additional information on regulations and Program guidance can be accessed by clicking here.

The Program, which ends on January 1, 2014, or when the allocated $5 billion in funding is depleted, provides reimbursement to participating employment-based plans for a portion of the cost of health benefits for early retirees and their spouses, surviving spouses and dependents.  Plan reimbursement will be provided for certain claims between $15,000 and $90,000 (with those amounts being indexed for plan years starting on, or after October 1, 2011).  

During the May 6 training, several insurance commissioners and regulators raised concerns that providing claims reimbursements to employers who cover early retirees through fully insured plans is an inequitable approach because those claims have already been spread across the entire pool and thus, the reimbursements could result in a windfall for these employers. 

HHS Officials indicated that they understood the problem, but did not believe that the statute gave them the flexibility to address it.

During the training session, HHS Officials also gave a brief update on high-risk pools, during which they informed regulators that applications for the Program will be issued imminently.   

Comments on the Program’s interim final Rules can still be submitted.  For complete Rule information and instructions on how to transmit comments, go to:  http://www.regulations.gov/search/Regs/home.html#documentDetail?R=0900006480ae7204  

Another Program training session has been scheduled for Thursday, May 13 at 3:30 p.m. (ET)

 

Additional Comments on Medical Loss Ratios  and Premium Review Process Due May 14

HHS also has requested comments on the following proposed Rules:

Medical Loss Ratios: Request for Comments Regarding Section 2718 of the Public Health Service Act http://edocket.access.gpo.gov/2010/2010-8599.htm.  Please submit written or electronic comments by May 14, 2010, 11:59 p.m. (ET)

Premium Review Process:  Request for Comments Regarding Section 2794 of the Public Health Service Act http://edocket.access.gpo.gov/2010/2010-8600.htm.  Please submit written or electronic comments by May 14, 2010, 11:59 p.m. (ET)

Note:  Responses to the above requests for comment were adopted by the National Association of Insurance Commissioners’ Health Insurance and Managed Care Committee and the Financial Condition Committee during a May 11, 2010 joint conference call.  The comments, which include tracked changes, are attached for review.

 

 

Should you have any questions or comments, please contact Colodny Fass.

 

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