Understanding HHS Proposed Transitional Reinsurance Program Under the Affordable Care Act
Over the next few years, the US will experience transformative changes to its healthcare system which will have a deep and unprecedented impact on insurance carriers and group health plans. In an effort to stabilize the transition, the Department of Health and Human Services (HHS) introduced the Transitional Reinsurance Program under the Affordable Care Act. The program is aimed at stabilizing premiums in the individual health insurance market from 2014 through 2016, with funding for the program coming from assessments on fully insured and self-funded commercial health plans. To ensure compliance, plan sponsors and third party administrators need to have a complete understanding of the significant topics surrounding the transitional reinsurance program.
A panel of distinguished thought leaders will share their opinions in a two-hour teleconference and webinar. They will discuss the most important components of the program as well their impact on the health insurance business. A live interaction with the audience in a question and answer format is also included in this event.
- Background (Paul R Houchens, FSA, MAAA)
- Reason for the reinsurance program
- The 3 premium stabilization programs
- Comparison of reinsurance, risk corridors and risk adjustment (chart)
- Overview of the reinsurance program (Paul Houchens, FSA, MAAA)
- Statutory authority
- Set up (state v federal)
- General framework
- Contributions to the reinsurance program (Ken Robinson)
- Total contributions (2014, 2015, 2016)
- Contributions at the plan level (per capita)
- What coverage counts
- Per capital counting methods
- The national contributions rate
- Additional state collections
- Payments by the reinsurance program (Douglas Anderson / Jennifer Lunski)
- What coverage is eligible for reinsurance
- The payment formula
- National payment parameters (attachment point, contribution rate, cap)
- An example of how reinsurance is calculated
- Pro rata adjustment if money runs out
- Supplemental state reinsurance
- Data submission
- Who makes payment
- Annual timeline for reinsurance program (chart) (Jennifer Lunski)
Who Should Attend:
- Insurance Carriers
– Plan Sponsors
– Health Insurance Companies
– Health Care Law Attorneys
– Insurance Attorneys
– Senior Corporate Management
– Health Care Advisory Services Consultants
– Health Policy Directors
– Healthcare Finance People
– Third Party Administrators
Paul is a Consulting Actuary in the Milliman Indianapolis Health Practice. He is a member of the American Academy of Actuaries and a fellow of the Society of Actuaries, the highest professional credentials in the actuarial profession. Paul provides consulting services to employers related to modeling the financial impacts of the Affordable Care Act and identifying strategic opportunities under the frame work of the law. He has provided consulting services to multiple states related to the implementation of a state or federal insurance exchange. He has written several publicly available white papers on healthcare reform issues, such as the individual mandate, employer impacts, rating reforms, and market size changes.
Paul is a Consulting Actuary in the Milliman Indianapolis Health Practice. He is a member of the American Academy of …
Ken Robinson is National Tax Director – Health Plans, and U.S. Tax Health Plans Sector Leader for Deloitte’s Health Sciences & Government industry practice. Ken brings over fourteen years of practical and technical experience in tax, treasury, statutory and financial planning to Deloitte’s health plan clients. In addition, he has another 15 years of financial reporting experience as a Controller and CFO of privately held organizations. Ken is known throughout the health insurance industry for his understanding of tax issues arising from the Patient Protection and Affordable Care Act.
Prior to joining Deloitte, Ken served as Vice President of Tax and a member of the senior management team for a diversified national managed health care company. He also served as Assistant Treasurer for all of the company’s subsidiaries and was on the Board of Directors of several additional entities. During his 10-year tenure, Ken was responsible for tax planning, 10-K/10-Q SEC disclosures, compliance function(s) and tax controversy issues. In addition, he was responsible for the tax due diligence for some 20 acquisitions, including a $1.6B merger in 2005, and three successful acquisitions during 2007 with a combined purchase price in excess of $1.1B.
Ken currently serves as the Chair of the Board of Trustees for the LAYC Career Academy Public Charter School, Washington, D.C., and is a member of the Board of Trustees for Latin American Youth Center, Washington, D.C.
Ken Robinson is National Tax Director – Health Plans, and U.S. Tax Health Plans Sector Leader for Deloitte’s Health Sciences …
Doug is a member of Bailey Cavalieri in Columbus, Ohio, practicing in the areas of insurance law and regulatory compliance, health care law, and general business matters. Doug represents national and regional health insurance companies in matters involving legal and regulatory compliance, market conduct examinations, and product development.
Doug joined Bailey Cavalieri in 2011 after serving as Chief Policy Officer for the Ohio Department of Insurance. In that role, Doug also served as Co-Chair of Ohio’s Health Benefit Exchange Planning Task Force and Project Leader to implement Ohio’s High Risk Pool. Doug also oversaw government relations at the Department, drafted legislation and regulatory guidance, and worked with state and federal agencies on matters involving insurance regulation.
Doug received a degree in economics from the University of Michigan and a law degree from The Ohio State University Moritz College of Law.
Doug is a member of Bailey Cavalieri in Columbus, Ohio, practicing in the areas of insurance law and regulatory compliance, …
Jennifer Graff Lunski is a Vice President, Compliance officer in Woodruff-Sawyer’s Employee Benefits Practice. Jennifer consults directly with our Employee Benefits clients on all matters of compliance, and leads related internal and external training initiatives. Jennifer’s overarching role at Woodruff-Sawyer is to track legislative changes and ensure clients are in compliance by researching, managing and communicating (federal, state, carrier) updates and maintaining relationships with senior-level contacts at carriers. She authors a monthly legislative briefing and hosts her own podcast series to update and educate clients on the latest benefits legislation issues. She is a frequent industry speaker and has traveled throughout California to share her knowledge on benefits legislation and health care reform. In 2010, Jennifer was named as a Business Insurance Woman to Watch.
Jennifer is an attorney and worked for eight years as a senior investigator with the United States Department of Labor (DOL), Employee Benefits Security Administration in San Francisco. An expert in PPACA, ERISA, COBRA and HIPAA rules and regulations, Jennifer has investigated a broad spectrum of company employee benefit plans and has extensive experience negotiating with fiduciaries and service providers in the industry.
Jennifer Graff Lunski is a Vice President, Compliance officer in Woodruff-Sawyer’s Employee Benefits Practice. Jennifer consults directly with our Employee …
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Method of Presentation:
On-demand Webcast (CLE)
NASBA Field of Study:
Specialized Knowledge & Applications
NY Category of CLE Credit:
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