Transitional Reinsurance Fee- due by November 15, 2014

07/02/2014

The Transitional Reinsurance Fee is $63 per plan participant for 2014. The purpose of this fee is to help stabilize premiums for coverage in the individual market during the first three years the health insurance marketplaces are in operation. For fully-insured medical plans this fee will be paid by insurers and built into 2014 premiums. Self-funded medical plans are responsible for submitting this fee to HHS.

How will the fee be collected?

  • By November 15, 2014: Contributing entities (i.e., plans and insurers) must send HHS headcount information, based on the first three quarters of the calendar year.
  • By December 15, 2014: HHS will bill the entities
  • Within 30 days after receiving the bill (by approximately January 15, 2015): Contributing entities must pay $52.50 per participant to HHS.
  • Sometime in December 2015: The balance of $10.50 per participant will be due

Recently, the Centers for Medicare and Medicaid Services (CMS) announced the process by which self-funded plans can submit their enrollment count. A form will be available soon via www.pay.gov. A plan will provide basic employer information and the annual enrollment count no later than November 15th. The form will automatically calculate the reinsurance contribution amount due. To complete the submission, the plan will submit payment information and schedule a payment date for remittance of the contributions. CMS will offer training on this process in late June. If interested, register at https://www.regtap.info.

Any questions, please contact your WGA Client Executive or Client Service Manager