Understanding HHS Proposed Transitional Reinsurance Program Under the Affordable Care Act
Overview:
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.
Agenda:
- 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 …
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, …
Jennifer Graff Lunski is a Vice President, Compliance officer in Woodruff-Sawyer’s Employee Benefits Practice. Jennifer consults directly with our Employee …
Course Level:
Intermediate
Advance Preparation:
Print and review course materials
Method of Presentation:
On-demand Webcast (CLE)
Prerequisite:
NONE
Course Code:
134418
NASBA Field of Study:
Specialized Knowledge & Applications
NY Category of CLE Credit:
Total Credits:
2.0 CLE
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SPEAKERS' FIRMS:
Woodruff-Sawyer & Co.
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Bailey Cavalieri LLC was formed in 2003 with a lineage that can be traced back over 100 years. Built on the foundation of a large, national firm, Bailey Cavalieri provides the experience and resources necessary to handle the most complex and sophisticated matters with the agility, efficiency, and responsiveness of a mid-size law firm. Bailey Cavalieri’s client base ranges from individuals and emerging businesses to Fortune 500 companies and global insurance companies. The Firm’s primary practice groups include Bankruptcy, Communications/Energy/Public Utilities, Corporate and Business including Insurance, Director and Officer Liability, Employee Benefits, Estates, Trusts and Probate, Green Energy, Health Care, Labor and Employment, Litigation, Real Estate, and Tax. The Firm’s goal is to provide clients with the expertise and personal attention necessary to fairly represent their best interests in a cost-effective and efficient manner.
About Woodruff-Sawyer & Co.
Woodruff-Sawyer is one of the largest independent insurance brokerage firms in the nation, and is an active partner of Assurex Global and International Benefits Network. For over 90 years, Woodruff-Sawyer has been partnering with clients to implement and manage cost-effective and innovative insurance, employee benefits and risk management solutions, both nationally and abroad. Headquartered in San Francisco, Woodruff-Sawyer has offices throughout California and in Portland, Oregon.