Risk Adjustment (RA) FAQ
Guidance for FAQ regarding Risk Adjustment Operations and Policy
Program Area: Risk Adjustment (RA)
Question: Are issuers required to use the full time equivalent method to count part-time employees to be included in the small group market for Risk Adjustment in 2014?
Answer: Yes, issuers must use a full-time equivalent (FTE) counting method for both 2014 data and plan years going forward. The 2014 Payment Notice states that the Affordable Care Act (ACA) requires the use of a counting method that accounts for non-full-time employees, and that the full-time equivalent method described in section 4980H(c)(2)(E) of the Code is a reasonable method to apply.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: December 11, 2014
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