New information regarding Mandatory Insurer Reporting for Non-Group Health Plans (NGHPs) and NGHP Town Hall Events is posted here as it becomes available.
May 16, 2023 – CMS to Host Section 111 Non-Group Health Plan (NGHP) Unsolicited Response File Webinar
CMS will be hosting a Section 111 NGHP Unsolicited Response File webinar on June 6, 2023. Complete webinar information is available in the Downloads section below.
April 24, 2023 – Updated MMSEA Section 111 Non-Group Health Plan (NGHP) User Guide Now Available
The updated MMSEA Section 111 NGHP User Guide version 7.1 has been posted to the NGHP User Guide page. Refer to Chapter 1 for a summary of updates.
February 16, 2023 – Top 10 Section 111 Non-Group Health Plan Reporting Errors Chart Now Available
A new chart titled Top 10 Section 111 Non-Group Health Plan Reporting Errors, covering the period of July 1 – December 31, 2022, is now available in the Download section below. Descriptions of these and all reporting errors are available for review in the NGHP User Guide.
January 31, 2023 – Updates to MMSEA Section 111 Non-Group Health Plan (NGHP) User Guide Chapter IV & V are Now Available
Chapters IV and V of the MMSEA Section 111 NGHP User Guide version 7.0 have been updated specifically in reference to the upcoming change to inform RREs when another source has updated their submitted records. In Chapter IV, the modifier type codes CEM (Employer/Other Plan Sponsor Name), CIN (Insurer Name), DSA (Name of the Voluntary Data Sharing Agreement (VDSA) entity), and PRV (From a Provider) will not be used in the NGHP Unsolicited Response File and have been removed from the list (Table 7-3). In Chapter V, the fields of Relationship Code, Policy Holder’s First Name, Policy Holder’s Last Name, and Policy Holder’s SSN will not be used in the NGHP Unsolicited Response File layout. They have been replaced with filler in the layout description (Appendix F).
January 9, 2023 – Updated MMSEA Section 111 Non-Group Health Plan (NGHP) User Guide Now Available
The updated MMSEA Section 111 NGHP User Guide version 7.0 has been posted to the NGHP User Guide page. Refer to Chapter 1 for a summary of updates including information regarding an upcoming change to inform RREs when another source has updated their submitted records. Effective July 2023 RREs will be able to opt in via the Section 111 Coordination of Benefits Secure Website (COBSW) application to receive a monthly NGHP Unsolicited Response File. This will provide key information about updates to ORM records originally submitted in the last 12 months and allow RREs to either update their own internal data or contact the BCRC for a correction.
Downloads
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Section 111 Non-Group Health Plan (NGHP) Unsolicited Response File Webinar Announcement (PDF) -
Top 10 Section 111 Non-Group Health Plan Reporting Errors - July 1- December 31, 2022 (PDF) -
December 6, 2022, Section 111 Non-Group Health Plan Reporting Webinar Presentation (PDF) -
Section 111 Non-Group Health Plan (NGHP) Reporting Webinar Announcement (PDF) -
Provide Accurate Information Directly (PAID) Act Testing Webinar Presentation (PDF) -
June 23, 2021 - Provide Accurate Information Directly (PAID) Act Webinar Presentation (PDF) -
Section 111 Non-Group Health Plan (NGHP) Reporting Webinar Questions and Answers (PDF) -
August 13, 2020 Section 111 Non-Group Health Plan Reporting Webinar Presentation (PDF)