Federal officials are still developing the process health insurers and benefit plan administrators will use to “make contributions” to a new Patient Protection and Affordable Care Act reinsurance program.
The Center for Consumer Information & Insurance Oversight talks about the PPACA reinsurance program payment process in a new fact sheet.
CCIIO – the arm of the U.S. Department of Health and Human Services in charge of carrying out PPACA provisions that affect commercial health insurance – said in the fact sheet that it will post a PPACA reinsurance program payment form at Pay.gov, a federal government payment website.
CCIIO should be ready to train plans to use the system in late June, and payment information will be due Nov. 15, CCIIO said.
PPACA now requires health insurers to sell individual coverage on a guaranteed-issue basis. The only personal health information insurers can use when setting individual rates is age.
The PPACA reinsurance program is supposed to help protect individual health insurers against a flood of high-risk enrollees by paying part of the bill for patients with claims over $45,000. CCIIO says the program will cover 80 percent of the costs from the $45,000 attachment point up to a cap of $250,000.
For 2014, the reinsurance program fee is $63 per enrollee. Harvard Pilgrim, for example, has estimated in Connecticut filings that the PPACA reinsurance program fee could amount to about 1 percent of base plan premium revenue.
Plans will be able to enter the number of enrollees in the Pay.gov form and have the form calculate the required payment, CCIIO officials said.