The Transitional Reinsurance Program – Reinsurance Contributions (RIC)
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 email@example.com.
Please see below for the access information and the dates and times of the Help Line will be available.
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
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
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/.
- 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
- Transitional Reinsurance Program – Timing of Contributions Refund Requests Due to Annual Enrollment Count Misreporting (PDF)
How to Make a Reinsurance Contribution
To successfully complete the RI Contribution Submission process, Contributing Entities must do the following:
- March 5, 2020 Information Related to COVID–19 Individual and Small Group Market Insurance Coverage
- March 12, 2020 FAQs on Essential Health Benefits Coverage and the Coronavirus (COVID-19)
- March 18, 2020 FAQs on Catastrophic Plan Coverage and the Coronavirus Disease 2019 (COVID-19)
- March 24, 2020 FAQs on Availability and Usage of Telehealth Services through Private Health Insurance Coverage in Response to Coronavirus Disease 2019 (COVID-19)
- March 24, 2020 Payment and Grace Period Flexibilities Associated with the COVID-19 National Emergency
- March 24, 2020 FAQs on Prescription Drugs and the Coronavirus Disease 2019 (COVID-19) for Issuers Offering Health Insurance Coverage in the Individual and Small Group Markets
- April 11, 2020 FAQs about Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act Implementation
*This document was updated on April 15, 2020, to correct an error in footnote 10 regarding the current end date of the public health emergency related to COVID 19.
- April 13, 2020 Postponement of 2019 Benefit Year HHS-operated Risk Adjustment Data Validation (HHS-RADV)