Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: June 18, 2015

Program Area: Risk Corridors (RC)

Question: What experience should issuers report in the risk corridors columns of the Medical Loss Ratio (MLR) Form? Should the risk corridors columns of the MLR Form only contain information that applies to the issuers Qualified Health Plans (QHPs)?

Answer: The risk corridors columns of the MLR form should only be completed by issuers that offered at least (1) certified QHP through an Exchange in 2014. These issuers should report experience of all of their non-grandfathered, ACA-compliant plans, including QHPs and non-QHPs, in the risk corridors columns of the MLR Form. Experience pertaining to grandfathered and non-ACA compliant business should not be reported in the risk corridors columns.

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