Under the Affordable Care Act, employers that provide a self-funded group health plan (as well as health insurance issuers for fully-insured plans) must fund a traditional reinsurance program.
The fees will be used to help stabilize premiums for coverage in the individual market for the first three years of the Exchange operation (2014 – 2016).
If you currently provide a self-funded group health plan, here are a few key items to note regarding this program:
- Deadline: Entities that must pay these fees are generally required to submit their annual enrollment count to HHS by November 15th. Since that date falls on a Sunday this year, the the deadline for submitting the reinsurance fee contribution form is Nov. 16, 2015.
- How to Submit the Count: Annual enrollment counts are submitted via www.pay.gov using the Annual Enrollment and Contributions Submission Form
- Fee Amount: For 2015, the annual contribution rate is $44 per enrollee per year, or about $3.67 per month.
- When To Pay: These fees may be paid in two installments, or they may be in full at one time. For entities making two payments, the first contribution amount of $33 per covered life is payable by January 15, 2016 and the second is payable by November 15, 2016. For companies making one payment, the full contribution amount of $44 per covered life is payable by Jan. 15, 2016.
I hope that you find this reminder helpful. For existing clients of CBG Benefits that offer self-funded plans, your Account Management team is available to help you throughout this process. If you have any questions about this program, please contact us at 781-759-1222.