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February 12, 2014 at 08:53 AM
State insurance regulators are coming up with guidelines that could affect how health insurers pay for new Patient Protection and Affordable Care Act (PPACA) programs.
The Emerging Accounting Issues Working Group and the Statutory Accounting Principles Working Group are holding a joint teleconference meeting later today to work on accounting rules for the PPACA “3 R’s” risk-management programs — a temporary reinsurance program, a temporary risk corridor program, and risk-adjustment program that’s supposed to be permanent.
The NAIC’s Executive Committee and its Plenary are holding a teleconference meeting next week to consider adopting rules for payment of the PPACA Section 9010 assessment, or “health insurance tax.”
PPACA Section 9010 requires insurers to generate $8 billion in revenue for the government this year and more in later years by paying a size-based fee.
The 3 R’s rules
Regulators on the NAIC working groups say they based the current draft of “INT 13-04: Accounting for the Risk Sharing Provisions of the Affordable Care Act” on NAIC guidelines for Medicare Part D risk-management programs.
The PPACA risk-management program getting the most attention — the risk corridor program — is supposed to use money from any individual or small-group carrier, inside or outside the PPACA exchange system, that has a good underwriting profit margin in 2014, 2015 or 2016 to help PPACA exchange plans with poor underwriting results.
If too few carriers do well to help exchange carriers get underwriting profits up to the PPACA minimum, the federal government is supposed to make up for the funding shortfall.
One open question is how state regulators will handle treatment of payments coming from the temporary risk corridor program.
