Risk Corridors (RC) FAQ
Guidance for FAQ regarding Calculations and Allocation of Payments and Charges to QHPs
Program Area: Risk Corridors (RC)
Question: Will Risk Adjustment and Reinsurance transfers need to be allocated to each plan based on premium or do the resulting transfers have to be directly assigned to the QHP from which the transfer resulted?
Answer: The pooled amount of allowable costs in the risk corridors numerator should be reduced by the overall amount of net risk adjustment payments and reinsurance payments that the issuer has received for all of its non-grandfathered, ACA compliant plans in a particular market within a state.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: May 28, 2014
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