Reinsurance-Contributions (RIC) FAQ
Guidance for FAQ regarding Contributing Entity and Other
Program Area: Reinsurance-Contributions (RIC)
Question: A fully insured plan offering medical coverage has a December 31 plan year, and a self-insured group health plan providing only prescription drug coverage has a January 31 plan year. All full-time employees are enrolled in the medical and prescription plans at the same time. Retirees, however, can elect to enroll in either or both plans. Does the prescription drug plan need to make reinsurance contributions?
Answer: Applicable to All Reinsurance Contributions Benefit Years: No. Pursuant to 45 CFR 153.400(a)(2)(xiii), a Contributing Entity is not required to make contributions on behalf of a self-insured group health plan or health insurance coverage that consists solely of benefits for prescription drugs.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: December 06, 2013
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