Managers of the Affordable Care Act reinsurance program are hoping health insurers and many self-insured group health plans will send the program $27 per covered life by late 2017.
Related: How to pay your ACA reinsurance bill
The temporary program is supposed to use cash payments from health insurers and health plans to protect issuers of individual major medical coverage against catastrophic claims in 2014, 2015 and 2016.
The Center for Consumer Information and Insurance Oversight, the agency that runs the program, recently published a reinsurance program how-to guide on its website.
Health insurers are supposed to use Pay.gov, a government payment website, to tell the government how many lives they cover, and when they expect to make their ACA reinsurance program contributions, by Nov. 15, according to CCIIO.
An insurer can choose between two payment methods. It can pay all $27 per life through Pay.gov by Jan. 17, 2017, or it can break the payment into two chunks. An insurer that chooses the two-payment option must pay $21.60 per covered life by Jan. 17, 2017, and $5.40 per covered life by Nov. 15, 2017.
The same payment rules apply to self-insured group health plans that use third-party administrators.
The government has exempted some types of plans, including traditional Medicare plans, traditional Medicaid plans, Children’s Health Insurance Program plans, state Basic Health Plan programs, health savings account programs, health reimbursement arrangement programs offered alongside group health plans, military health plans, and plans provided by Indian tribes.
Health insurers can choose from a list of three covered-life counting methods. Self-insured group health plans can choose from a list of four methods.
Drafters of the Patient Protection and Affordable Care Act of 2010, one of the two laws that make up the ACA package, created the reinsurance program to help insurers adjust to tough ACA medical underwriting restrictions.