Group Health Plan (GHP)

Section 111 Provisions For GHP Arrangements, found at U.S.C. 1395y(b)(7)

Section 111 adds reporting rules; it does not eliminate any existing statutory provisions or regulations.

It includes penalties for non-compliance.
It includes provisions for the Secretary to share information on Part A entitlement and enrollment under Part B.
Who Must Report: "an entity serving as an insurer or third party administrator for a group health plan...and, in the case of a group health plan that is self-insured and self-administered, a plan administrator or fiduciary."
What Must Be Reported: Data elements determined by the Secretary.
A voluntary GHP insurer reporting process is already in place. The mandatory reporting process will build upon the existing voluntary process.
When/How reporting must be done:
- In a form and manner, including frequency, specified by the Secretary.
- GHP reporting will be no more than quarterly.
- Submission will be in an electronic format.
Use of Agents: GHP RREs may use agents to submit data on their behalf. An agent is a data services company, consulting company, or the like that can create and submit Section 111 files to the COBC on behalf of the RRE. Information on the use of agents is required as part of the Section 111 registration process. The RRE remains solely responsible and accountable for adhering to the requirements of the Section 111 program and for the accuracy of data submitted.

The following GHP Teleconferences have been scheduled. The Notice and Agenda with the call in and agenda will be posted prior to the teleconference.

August 10 - Technical/Policy
- Call in line is: (800) 603-1774 - Pass Code is: SECTION 111
September 7 - GHP HRA
October 5 - Technical/Policy