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Feds delay PPACA health plan report deadline

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The Center for Consumer Information & Insurance Oversight (CCIIO) is giving insurers and employers three more weeks to send it their health plan enrollee counts.

CCIIO is pushing the due date for annual enrollment count reports for the Patient Protection and Affordable Care Act (PPACA) reinsurance program to 11:59 p.m. Dec. 5. The previous deadline was Nov. 15.

PPACA now requires sellers of individual medical insurance to take applicants even if the applicants have health problems. The only personal health information an insurer can use when setting premiums is age and tobacco use. Drafters of PPACA created the reinsurance program in an effort to protect issuers of individual major medical insurance against a flood of seriously ill enrollees.

For three years, the reinsurance program is supposed to pay some of the bills for holders of individual health insurance who run up catastrophic claims. Regulators in Connecticut and in some other states are requiring health insurers to assume the reinsurance program will work as expected when they develop their 2015 rate filings.

For 2014, reinsurance program managers will pay for the program by collecting a $63 “reinsurance contribution” for every covered life with major medical coverage or in a self-insured employer plan with an outside administrator.

Originally, insurers and benefit plan administrators were supposed to file the employee counts they were going to use in the reinsurance payment calculations by Nov. 15, and then pay at least $52.50 per covered life by Jan. 15, 2015. Affected “payers” could choose between paying $52.50 this January, and $10.50 per covered life by Nov. 15, 2015, or simply paying $63 per covered life this January.

Officials at CCIIO — an arm of the Centers for Medicare & Medicaid Services (CMS) — said they postponed the deadline because they received requests for an extension. “The Jan. 15, 2015, and Nov. 15, 2015, payment deadlines remain the same,” officials said.

See also: Regulators back away from PPACA 3 R’s accounting draft


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