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Smart Benefits: Transitional Reinsurance Enrollment Count Deadline Extended to Dec. 5

Monday, December 01, 2014

 

The deadline for health insurance issuers and certain self-insured group health plans offering major medical coverage to submit their 2014 enrollment counts for the transitional reinsurance (TRF) program contributions has been extended to December 5, 2014. The January 15, 2015, and November 15, 2015, payment deadlines remain the same.

The transition reinsurance program was established under the Affordable Care Act to stabilize premiums in the individual market inside and outside of the exchanges. The program collects contributions from contributing entities in 2014, 2015, and 2016 to fund reinsurance payments to issuers of non-grandfathered reinsurance-eligible individual market plans, the administrative costs of operating the reinsurance program, and the General Fund of the U.S. Treasury

The annual fee is $63.00 per covered life for 2014 and $44.00 per covered life for 2015. The methods to count lives are similar to those used to count lives for the Patient Centered Outcomes Research Institute (PCORI) fee. However, the transitional reinsurance fee program fee is calculated on a calendar year basis, and lives are only counted for the first nine months of the year.

To enter their enrollment count, contributing entities visit Pay.gov and access the “ACA Transitional Reinsurance Program Annual Enrollment and Contributions Submission Form.” The form will calculate the annual contribution amount to be remitted based on the annual enrollment count.

Contributing entities can either pay: (1) the entire 2014 benefit year contribution in one payment no later than January 15, 2015 reflecting $63.00 per covered life; or (2) in two separate payments for the 2014 benefit year, with the first remittance due by January 15, 2015, reflecting $52.50 per covered life, and the second remittance due by November 15, 2015, reflecting $10.50 per covered life.  

Upcoming TRF Deadlines:

 

 

 

 

 

 

 

 

 

 

Amy Gallagher has over 21 years of healthcare industry experience guiding employers and employees. As Vice President at Cornerstone Group, she advises large employers on all aspects of healthcare reform, benefit solutions, cost-containment strategies and results-driven wellness programs. Amy speaks regularly on a variety of healthcare-related topics, and is often quoted by national publications on the subject matter. Locally, Amy is a member of SHRM-RI, the Rhode Island Business Group on Health, and the Rhode Island Business Healthcare Advisory Council.

 

Related Slideshow: New England’s Healthiest States

The United Health Foundation recently released its 2013 annual reoprt: America's Health Rankings, which provides a comparative state by state analysis of several health measures to provide a comprehensive perspective of our nation's health issues. See how the New England states rank in the slides below.

 

Definitions

All Outcomes Rank: Outcomes represent what has already occurred, either through death, disease or missed days due to illness. In America's Health Rankings, outcomes include prevalence of diabetes, number of poor mental or physical health days in last 30 days, health disparity, infant mortality rate, cardiovascular death rate, cancer death rate and premature death. Outcomes account for 25% of the final ranking.

Determinants Rank: Determinants represent those actions that can affect the future health of the population. For clarity, determinants are divided into four groups: Behaviors, Community and Environment, Public and Health Policies, and Clinical Care. These four groups of measures influence the health outcomes of the population in a state, and improving these inputs will improve outcomes over time. Most measures are actually a combination of activities in all four groups. 

Diabetes Rank: Based on percent of adults who responded yes to the question "Have you ever been told by a doctor that you have diabetes?" Does not include pre-diabetes or diabetes during pregnancy.

Smoking Rank: Based on percentage of adults who are current smokers (self-report smoking at least 100 cigarettes in their lifetime and currently smoke).

Obesity Rank: Based on percentage of adults who are obese, with a body mass index (BMI) of 30.0 or higher.

Source: http://www.americashealthrankings.org/

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6. Rhode Island

Overall Rank: 19

Outcomes Rank: 30

Determinants Rank: 13

Diabetes Rank: 26

Smoking Rank: 14

Obesity Rank: 13

 

Strengths:

1. Low prevalence of obesity

2. High immunization coverage among adolescents

3. Ready availability of primary care physicians  

Challenges:

1.High rate of drug deaths

2. High rate of preventable hospitalizations

3. Large disparity in heath status by educational attainment

Source: http://www.americashealthrankings.org/RI

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5. Maine

Overall Rank: 16

Outcomes Rank: 25

Determinants Rank: 12

Diabetes Rank: 23

Smoking Rank: 29

Obesity Rank: 28

 

Strengths:

1. Low violent crime rate

2. Low percentage of uninsured population

3. Low prevalence of low birthweight  

Challenges:

1. High prevalence of binge drinking

2.High rate of cancer deaths

3. Limited availability of dentists

Source: http://www.americashealthrankings.org/ME

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4. Connecticut

Overall Rank: 7

Outcomes Rank: 15

Determinants Rank: 4

Diabetes Rank: 16

Smoking Rank: 4

Obesity Rank: 12

 

Strengths:

1. Low prevalence of smoking

2. Low incidence of infectious diseases

3. High immunization coverage among children & adolescents  

Challenges:

1. Moderate prevalence of binge drinking

2. Low high school graduation rate

3. Large disparity in health status by educational attainment

Source: http://www.americashealthrankings.org/CT

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3. New Hampshire

Overall Rank: 5

Outcomes Rank: 7

Determinants Rank: 5

Diabetes Rank: 16

Smoking Rank: 11

Obesity Rank: 22

 

Strengths:

1. Low percentage of children in poverty

2. High immunization coverage among children

3. Low infant mortality rate  

Challenges:

1. High prevalence of binge drinking

2.High incidence of pertussis infections

3. Low per capita public health funding

Source: http://www.americashealthrankings.org/NH

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2. Massachusetts

Overall Rank: 4

Outcomes Rank: 14

Determinants Rank: 3

Diabetes Rank: 10

Smoking Rank: 7

Obesity Rank: 2

 

Strengths:

1. Low prevalence of obesity

2. Low percentage of uninsured population

3. Ready availability of primary care physicians & dentists  

Challenges:

1. High prevalence of binge drinking

2. High rate of preventable hospitalizations

3. Large disparity in health status by educational attainment

Source: http://www.americashealthrankings.org/MA

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1. Vermont

Overall Rank: 2

Outcomes Rank: 12

Determinants Rank: 1

Diabetes Rank: 4

Smoking Rank: 9

Obesity Rank: 5

 

Strengths:

1. High rate of high school graduation

2. Low violent crime rate

3. Low percentage of uninsured population  

Challenges:

1. High prevalence of binge drinking

2. Low immunization coverage among children

3. High incidence of pertussis infections

Source: http://www.americashealthrankings.org/VT

 
 

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