CMS Sets Termination Dates For Processes Under ACA’s Early Retiree Reinsurance Program

The Centers for Medicare and Medicaid Services (CMS) has issued a notice that sets forth termination dates for several processes under the Early Retiree Reinsurance Program (ERRP) in preparation for the Jan. 1, 2014, program sunset date. The notice was published in the April 23 Federal Register.

The Patient Protection and Affordable Care Act (ACA) established the ERRP, a temporary reinsurance program to reimburse part of the claims costs for participating employment-based plans that provide health insurance coverage for early retirees ages 55 through 64, and their eligible spouses, surviving spouses, and dependents.

This notice describes how five operational processes will be impacted by the Jan. 1, 2014 sunset date, as follows:

(1) Reporting changes to information in ERRP applications. The CMS expects plan sponsors to update by Dec. 31, 2013, all information that they know to be inaccurate. Contact and banking information should be updated using the ERRP website, while all other application information should be updated by amendment to the paper ERRP application. If the information needs to be updated after Dec. 31, 2013, the plan sponsor should communicate the changes to contact information by phone call or email to the ERRP Contact Center.

(2) Reporting change of ownership. Currently, the ERRP regulations require plan sponsors that are considering or negotiating a change of ownership to notify the CMS at least 60 days before the anticipated effective date of the change. In preparation for the ERRP sunset date, plan sponsors need not notify the CMS of any change of ownership in instances where the anticipated effective date of the change would occur after Dec. 31, 2013.

(3) Submitting reimbursement requests. The last day that a plan sponsor may submit an ERRP reimbursement request is July 31, 2013. This termination date will allow for a phase-down of ERRP operational processes related to the ERRP website, the CMS noted.

(4) Reporting and submitting corrections to data inaccuracies. Currently, plan sponsors must correct data inaccuracies relating to reimbursement requests no later than the end of the next calendar quarter. Plan sponsors will no longer be required to submit corrections to data inaccuracies after July 31, 2013, also the last day that a plan sponsor may submit a reimbursement request. According to the CMS, this means that plan sponsors that know before or on April 30, 2013, of any data inaccuracy contained in a reimbursement request, must submit corrections to the data inaccuracy in a manner consistent with the ERRP regulations and guidance. If the plans sponsor does not know of the inaccuracy until after May 1, 2013, the plan sponsor is required to report and correct the data by July 31, 2013.

(5) Requesting the CMS to reopen and revise an adverse reimbursement determination. In preparation for the ERRP sunset date, the last day upon which a plan sponsor may submit an ERRP reopening request is Dec. 31, 2013.

Despite the termination of these processes, the CMS noted that plan sponsors are required to maintain, and furnish to the HHS upon request, certain ERRP-related records. These records must be maintained for six years after the expiration of the plan year in which the costs were incurred, or longer if otherwise required by law.

For more information, contact David Mlawsky at (410) 786-6851.

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