Guidance on Health Reinsurance Fee

The HHS has issued proposed regulations on ACA’s health insurance reinsurance fee applicable for three benefit periods beginning in 2014.

Document Excerpt

This proposed rule provides further detail and parameters related to: the risk adjustment, reinsurance, and risk corridors programs; cost-sharing reductions; user fees for a Federallyfacilitated Exchange; advance payments of the premium tax credit; a Federallyfacilitated Small Business Health Option Program; and the medical loss ratio program. The cost-sharing reductions and advanced payments of the premium tax credit, combined with new insurance market reforms, will significantly increase the number of individuals with health insurance coverage, particularly in the individual market. The premium stabilization programs—risk adjustment, reinsurance, and risk corridors—will protect against adverse selection in the newly enrolled population. These programs, in combination with the medical loss ratio program and market reforms extending guaranteed availability (also known as guaranteed issue) protections and prohibiting the use of factors such as ealth status, medical history, gender, and industry of employment to set premium rates, will help to ensure that every American has access to highquality, affordable health insurance.



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