A new form is now available for employers sponsoring certain self-insured plans (“contributing entities”) to make contributions required under the Affordable Care Act’s Transitional Reinsurance Program to support payments to individual market issuers that cover high-cost individuals.
Health insurance issuers and certain self-insured group health plans offering “major medical coverage” that is part of a commercial book of business are contributing entities. A contributing entity must make reinsurance contributions on behalf of its enrollees in plans that provide “major medical coverage” unless one of the exceptions provided under the law applies to such coverage.
Although a contributing entity is responsible for the reinsurance contributions, it may elect to use a third party administrator or administrative services-only contractor for submission of enrollment data and the transfer of the reinsurance contributions.
Reinsurance Contribution Process
To successfully complete the reinsurance contribution process, contributing entities (or third-party administrators or administrative services-only contractors on their behalf) must register on www.pay.gov and submit their annual enrollment count of the number of covered lives of reinsurance contribution enrollees for the applicable benefit year. For the 2014 benefit year, the annual enrollment count submission deadline is November 15, 2014.
After contributing entities complete the ACA Transitional Reinsurance Program Annual Enrollment and Contributions Submission Form, their annual contribution amounts to be remitted will be auto-calculated. Contributing entities will then enter their payment information and will be given a chance to review and submit the calculated reinsurance contributions.
For More Information
Additional resources for completing the reinsurance contribution process, including user manuals, are available from the U.S. Centers for Medicare & Medicaid Services.