Transitional Reinsurance Program Fee

Purpose:

To create a fund from which to reimburse individual health plan insurers for coverage provided to high-risk individuals in the individual market or on the Exchange


Intent:

To stabilize premiums in the individual market and Exchanges, resulting in more affordable coverage to individuals


Related Provision:

PCOR Fee
Marketplaces (Exchanges)


Health Plans Affected by this Provision:


Year Effective: 2014
Medical Plan: Yes
Dental/Vision Plan: No, if stand-alone benefit excepted from HIPAA’s portability provisions
HRA: No, if HRA is integrated (the participant receives the HRA coverage because the she is enrolled in the employer’s group medical plan) with employer’s group medical plan or coverage for those entitled to Medicare (the participant is enrolled in any part of Medicare)
Health Care FSA: Not applicable

Document Downloads:


Document Title Last Updated
Transitional Reinsurance Program Fee Flyer 01/06/2017
Annual Enrollment and Contributions Manual 09/16/2016
Quick Start Guide to the 2016 Transitional Reinsurance Form 09/16/2016
2016 ACA Transitional Reinsurance Program Annual Enrollment Contributions Submission Form
 09/16/2016
CMS Fact Sheet, December, 2013 12/01/2013
Federal Register December 2012 12/01/2014
IRS FAQ, November 2012 11/01/2012