Reinsurance-Contributions (RIC) FAQ
Guidance for FAQ regarding Calculation / Methodology and Other
Program Area: Reinsurance-Contributions (RIC)
Question: Are the counting methods for calculating the Annual Enrollment Count for reinsurance contribution purposes the same as the counting methods used for the Patient-Centered Outcome Research Trust Fund fee (PCORI Fee)?
Answer: Applicable to All Reinsurance Contributions Benefit Years: No. The counting methods for the Reinsurance program are similar to, but vary in certain instances from, the counting methods permissible for the PCORI fee, largely due to the differences in the timing of the payments from the two (2) programs. For the Reinsurance program, a Contributing Entity must use one (1) of the permitted counting methods in 45 CFR 153.405(d) through 45 CFR 153.405(g). These counting methods generally calculate covered lives based on enrollment in the first nine (9) months of a calendar year. You may also refer to the Supporting Document, titled: 'The Transitional Reinsurance Program Operational Guidance: Examples of Counting Methods for Contributing Entities' available in the Registration for Technical Assistance Program (REGTAP) Library under "Reinsurance-Contributions" and the applicable benefit year or Module 2: Counting Methods Overview for the applicable benefit year.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: July 03, 2014
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