The Transitional Reinsurance Program – Reinsurance Contributions (RIC)
Announcements
The 2016 ACA Transitional Reinsurance Program Annual Enrollment Contributions Form is NOW available on pay.gov. As noted below, you must complete the Form no later than Tuesday, November 15, 2016.
The Centers for Medicare & Medicaid Services (CMS) will conduct a Help Line to assist Contributing and Reporting Entities with the reinsurance contributions submission process for the 2016 Benefit Year. Health Insurance Issuers, Self-insured Group Health Plans, and third parties on their behalf can participate in the Help Line to ask specific questions to subject matter experts related to the 2016 Benefit Year reinsurance contribution submission process. Please note, the Help Line is an open line and all participants dialed into the call will hear all questions and responses. If you wish to ask a question privately, please email the reinsurance contributions mailbox at reinsurancecontributions@cms.hhs.gov.
Please see below for the access information and the dates and times of the Help Line will be available.
Access Information:
Phone: 1-866-519-4632
Web: https://regtap.webex.com/regtap/onstage/g.php?d=641140011&t=a
Help Line Dates |
Help Line Times |
Wednesday, November 9, 2016 |
1:00 p.m. – 5:00 p.m. ET |
Thursday, November 10, 2016 |
1:00 p.m. – 5:00 p.m. ET |
Friday, November 11, 2016 |
1:00 p.m. – 5:00 p.m. ET |
Monday, November 14, 2016 |
3:00 p.m. – 6:00 p.m. ET |
Tuesday, November 15, 2016 |
10:00 a.m. – 5:00 p.m. ET |
Payment Options:
The 2016 Reinsurance Contribution Rate is $27.00 per covered life.
Contributions can be made:
- In one lump sum of $27 per covered life
- In a two-part payment of $21.60 per covered
life (first payment) and $5.40 per covered life
(second payment)
Who Makes Contributions in 2016?
Contributing entities are required to make contributions to fund the reinsurance program.
Contributing entities include:
- Health insurance issuers
- Self-insured group health plans
- Group health plans with a self-insured coverage option and an insured coverage option
- Multiple group health plans, including an insured plan, that are maintained by the same plan sponsor, that collectively provide major medical coverage for the same covered lives simultaneously
- Multiple group health plans, not including an insured plan, that are maintained by the same plan sponsor, that collectively provide major medical coverage for the same covered lives simultaneously
Although a contributing entity is responsible for the reinsurance contribution, it may use a TPA or ASO contractor to support the reinsurance contribution process.
2016 Key Deadlines
The 2016 ACA Transitional Reinsurance Program Annual Enrollment and Contributions Submission Form’ (2016 Form) is now available via https://www.pay.gov/.
Educational Resources
- Module 1: 2016 Reinsurance Contributions Overview (PDF)
- 2016 Reinsurance Contributions Glossary of Terms (PDF)
- Module 2: 2016 Reinsurance Contributions Counting Methods Overview (PDF)
- 2016 Reinsurance Contributions Examples of Counting Methods for Contributing Entities (PDF)
- Module 3: 2016 Reinsurance Contributions Form Completion (PDF)
- 2016 Transitional Reinsurance Quick Start Guide (PDF)
- 2016 Reinsurance Contributions Annual Enrollment and Contributions Submission Form Manual (PDF)
- Special Topic: 2016 Reinsurance Contributions Supporting Documentation (.CSV file) (PDF)
- 2016 Supporting Documentation Job Aid (ZIP)
- 2016 Supporting Documentation Job Aid Manual (PDF)
- 2016 File Layout (PDF)
- 2016 Reinsurance Contributions Information Guide Specifically for Reporting Entities (Third Party Administrator, ASO Contractors and other third parties completing the Form on behalf of a contributing entity) (PDF)
- 2016 Reinsurance Contributions Form Completion, Submission, and Payment Web-based Training
- Module 4: 2016 Reinsurance Contributions Updating Contributions Filings (PDF)
- 2016 Reinsurance Contributions: Updating Contributions Filings Manual (PDF)
- 2016 Reinsurance Contributions Review & Discussion (PDF)
2016 Operational Guidance Documents
How to Make a Reinsurance Contribution
To successfully complete the RI Contribution Submission process, Contributing Entities must do the following: