Regulators wrestle with PPACA 3R's data lag

The proposed table would also provide information better aligned with the kind of information actuaries use to review health rates, according to Steve Ostlund, an Alabama regulator.

Joe Zolecki, of the Blue Cross and Blue Shield Association, and Max McGee, of America’s Health Insurance Plans (AHIP), said regulators should either stick with the HHS data or use the preliminary national data given in the RBC section of the blank.

Otherwise, Zolecki said, an insurer will have to send preliminary three R’s data to every state in which it does business, even though the actual HHS data will be available a few months later. Insurers wouldn’t actually submit the information in the table until April 2016, and the first rate filings regulators could apply the results to would be the 2017 rate filings, Zolecki said.

Zolecki and William Weller of AHIP have also sent regulators a letter suggesting that the NAIC help states pull three R’s data from the 2014 HHS MLR report.

See also: 3 weird ways PPACA lifeboat programs may affect insurers

The Health Actuarial Task Force, the parent of the Health Care Reform Actuarial Working Group, has approved a working group report that includes a three R’s SHCE addition.

The solvency working group decided against forwarding its three R’s table proposal to the NAIC’s Blanks Working Group.

The three R’s programs include a reinsurance program that will use a broad-based insurance market fee to help issuers of fully PPACA-compliant individual coverage pay the bills of patients with catastrophic claims in the 2014, 2015 and 2016 benefit years; a risk corridors program that’s supposed to shift PPACA exchange plan issuers with good results in 2014, 2015 and 2015 to issuers with poor results for those years; and a risk-adjustment program that’s supposed to shift cash from issuers in a market with relatively low-risk enrollees to market competitors with relatively high-risk enrollees.

The Centers for Medicare & Medicaid Services (CMS) has given insurers preliminary information how the reinsurance program will work, and rough estimates of risk-adjustment program cash transfers, but no information about risk corridors program transfers. CMS has acknowledged in a memo posted last week that, in some cases, it may be unable to collect the full amount from an insurer that owes a payable to get the cash to the insurer’s competitors by the normal transfer date.