Reinsurance-Contributions (RIC) FAQ
Guidance for FAQ regarding Validation / Audit and Other
Program Area: Reinsurance-Contributions (RIC)
Question: What are the penalties if the reinsurance contribution payment is not made on time?
Answer: Applicable to All Reinsurance Contributions Benefit Years: Pursuant to 45 CFR 156.1215(c), any amount owed to the Federal government by an issuer and its affiliates for reinsurance is a determination of a debt and will be subject to Federal debt collection rules. Similarly, pursuant to 45 CFR 153.400(c), any amount owed to the Federal government by a self-insured group health plan (including a group health plan that is partially self-insured and partially insured, where the health insurance coverage does not constitute major medical coverage) and its affiliates for reinsurance is a determination of a debt. Additionally, reinsurance contributions are considered Federal funds that would be subject to the False Claims Act.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 07, 2014
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