CMS to Make $7.7 Billion in 2015 Reinsurance Payments

CMS announced that qualified health plan (QHP) issuers will receive $7.7 billion in reinsurance payments for the 2015 benefit year, as part of one of the three ACA programs (reinsurance, risk adjustments and risk corridors) intended to promote insurer competition and market stability. The reinsurance fund is predominantly funded by required contributions from all health insurers and some self-insured group health plans. Approximately $5.5 billion in contributions have been collected to date; $1 billion will be collected by November 2016; and approximately $1.7 billion was carried over from the 2014 benefit year. Reinsurance-eligible insurers will receive a quarter of the total amount owed to them in March 2016, while the final payments will be announced in June 2016. CMS announced last October that QHP issuers would receive $362 million of the requested $2.9 billion in risk corridors payments for 2014.

Vermont: State Releases Draft 1332 Waiver Seeking to Forego Online SHOP Infrastructure

Vermont posted a draft 1332 waiver seeking to forego the federally-required establishment of an online infrastructure for the State's Small Business Health Options Program (SHOP) Marketplace. The waiver proposes to maintain the State's current system, which allows employees direct enrollment through insurers instead of through the Vermont Health Connect (VHC) website. Employers would maintain the ability to offer their employees any qualified health plan (QHP) and insurers would continue to be responsible for all employer and employee notices, premium processing, and reporting enrollment data. VHC would continue to certify QHPs, determine eligibility for the small business tax credit, and operate an appeals process. Vermont is seeking public comment through March 11.