Reinsurance-Contributions (RIC) FAQ
Guidance for FAQ regarding Contributing Entity and Other
Program Area: Reinsurance-Contributions (RIC)
Question: If a plan provides minimum value but not a "broad range of services and treatments provided in various settings," is that plan exempt from the requirement to make reinsurance contributions?
Answer: Applicable to All Reinsurance Contributions Benefit Years: No. Under 45 CFR 156.20 "major medical coverage" is defined, for purposes of the Reinsurance program, to include a plan that provides minimum value, as defined under 45 CFR 156.145. Reinsurance contributions are generally required for major medical coverage that is considered to be part of a commercial book of business, but are not required to be paid more than once with respect to the same covered life.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 07, 2014
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