The form that plan sponsors are required to use to calculate their contribution for the Reinsurance Assessment Fee is now available on Pay.gov. Plan sponsors must submit the form no later than Nov. 15, 2014.
How to access the form and pay the fee
1. Register: Plan sponsors must register on Pay.gov.
2. Complete the contribution form: Go to “find a form” and then “click here to view a listing of all forms.” Then, click on “ACA Transitional Reinsurance Program Annual Enrollment Contributions Submission.”
Plan sponsors need to enter the average number of members in its health plan for the first nine months of the calendar year on the contribution form on Pay.gov no later than Nov. 15 in 2014, 2015 and 2016. Starmark will provide such count1 via a letter sent in October.
The form also requires information for a billing contact and billing address, as well as the name and contact information for plan sponsor contacts. The form will automatically calculate the contribution amount(s).
3. Upload: Plan sponsors must upload their supporting documentation. The federal government has posted two documents on the CMS website to assist in the process:
4. Enter payment information: Plan sponsors should schedule a payment date by selecting “Type of Payment” based on plan sponsors’ preference on when to make the contribution. The first installment deadline is Jan. 15, 2015, and the second installment deadline is Nov. 15, 2015. Plan sponsors can also pay the fee in full by the deadline of the first installment.
For more information on the Reinsurance Assessment Fee, view our flyer.
A new flyer is available that provides an at-a-glance look at the Employer Mandate. This flyer covers the requirements, a glossary of terms, and includes a graphic illustration to help larger employers determine if they are in compliance.
For more detailed information about the Employer Mandate, including specifics about when the rules apply, how to determine full-time employees, penalties, and more, view the Guide to the PPACA Employer Mandate. This guide also includes an example using a fictional company to help illustrate the steps an employer must take to determine its obligation under the Employer Mandate.
A mailing went out this week to Starmark employers with self-funded plans about the Reinsurance Assessment Fee. The employer must submit the required form with payment information and schedule a date to remit the fee no later than November 15, 2014.
The letter outlines where the employer needs to file the required “ACA Transitional Reinsurance Program Annual Enrollment and Contributions Submission Form.”
To assist with the filing, Starmark calculated the average number of lives for the first nine months of the calendar year for each group using one of the three approved counting methods – the “Snapshot” method.
To view a sample of the letter, click here. For more information about the Reinsurance Assessment Fee, view the flyer.
The first compliance date for obtaining a Health Plan Identifier (HPID) for health plans (excluding small health plans) is November 5, 2014. In preparation, CMS made additional functionality improvements to the HPOES system. Two documents are now available on the HPID website to provide employers additional assistance.
The HPID User Manual is a lengthy, detailed document that provides a step-by-step guide to the functionality and includes screenshots for additional clarity. The document may be useful if an employer needs assistance with a specific topic listed in the table of contents.
The HPID Quick Start is a shorter reference guide with graphic explanations for accessing and using HPOES and creating an HPID application. A text-only version is also available.
To learn more about the HPID requirements, including a timeline for compliance and how to register, view our educational flyer.
Final regulations addressing the Shared Responsibility requirements for employers, also known as the employer mandate, have been published. Our flyer, The Guide to the PPACA Employer Mandate, is updated with the final regulations and available in the Healthcare Reform toolkit.
Effective December 31, 2014, the Patient Protection and Affordable Care Act no longer requires certificates of credible coverage to be issued. Previously, HIPAA required these certificates to be issued as proof of previous health coverage.
Effective September 1, 2014, in accordance with the Patient Protection and Affordable Care Act (PPACA) mandate, risk reducing medications such as tamoxifen and raloxifene for women with increased risk of breast cancer will be included as part of the preventive care services benefit under Starmark® self-funded plan designs.
PPACA mandates that non-grandfathered health plans provide coverage without cost-sharing for certain in-network preventive care services for adults and children. Starmark self-funded plan designs include 100% benefits when the services are received from a provider in the health plan’s network. Services may vary by plan/state.
For more information, click here.