Health Care Reform Update - Responding to CMS Inquiry Regarding 2014 Transitional Reinsurance Fee

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Willis Human Capital Practice, National Legal & Research Group
Earlier this month, Willis NLRG encouraged you to be on the lookout for inquiries from the
Department of Health and Human Services (HHS) that were inadvertently sent to employers –
communications that should only have been sent to insurance companies that offer insurance policies
in the Health Insurance Marketplace (i.e., the public marketplace/exchange) (See Willis Wire Blog,
May 1, 2015, “Federal Agencies and Compliance Issues are Confusing for Many Employers. (Luckily,
It Does Not Apply to Them).”) We confirmed that these messages do not apply to clients that are not
insurance issuers participating in the public exchange, that no action need be taken and that employers
did not need to respond.
Recently, there has been another round of communications from HHS, specifically from the Centers
for Medicare & Medicaid Services. These communications concern Transitional Reinsurance Fee
(TRF) payments for calendar year 2014. The communication may be in the form of an e-mail, with a
.gov or .com address, and it may look something like this;
WEEK OF MAY 25, 2015:
Health Care Reform Update - Responding to CMS Inquiry
Regarding 2014 Transitional Reinsurance Fee

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Health Care Reform Update | Willis Human Capital Practice, National Legal & Research Group
When these communications were initially distributed a month or so ago, they went to various
employers that had not submitted a TRF payment – including insured employers where the 2014 TRF
payment was made by the insurance company as the “Contributing Entity.” This created concern
among insured employers because the form did not provide for a simple response that the payment had
already been made.
The agencies have recently provided additional guidance/assistance which explains the form and how
employers with insured plans are to respond. The link to CMS guidance is
here. https://www.regtap.info/faq_viewe.php?i=10524. Note, prior to responding to CMS, an insured
employer will need to contact the insurance company with a request for the Pay.gov tracking ID(s)
used in the TRF filing, and the pertinent information associated with the filing:
• Pay.gov Tracking ID
• Third Party Administrator's Legal Business Name
• Your Organization's Legal Business Name in the Listed Applicable Filing
• Your Organization's Federal Tax Identification Number in the Listed Applicable Filing

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Health Care Reform Update | Willis Human Capital Practice, National Legal & Research Group
• Your Organization's Annual Enrollment Count in the Listed Applicable Filing
• Payment Date
• Your portion of the total Gross Annual Enrollment Count submitted in the original filing
AQ ID: 10524 Publish Date: 05/12/2015
Question: Why did some group health plans receive an email requesting information
regarding their reinsurance contribution submission even if the employer,
issuer, Third-Party Administrator (TPA) or Administrative-Services Only
(ASO) contractor already submitted a reinsurance contribution for their
respective covered lives?
Answer: The Centers for Medicare & Medicaid Services (CMS) is contacting group
health plans for whom CMS has been unable to locate a “ACA Transitional
Reinsurance Program Annual Enrollment and Contributions Submission
Form” (Form) for the 2014 Benefit Year, and requesting that plans provide
information to confirm the status of their Form filing for the 2014 Benefit
Year, so that CMS can reconcile records. CMS realizes that some group
health plans may have already filed a Form directly, or had a TPA or ASO
contractor file on their behalf. In addition, if the group health plan is
insured, CMS recognizes that the health insurance issuer may have
submitted the Form and remitted the 2014 Benefit Year reinsurance
contribution for the plan's covered lives.
CMS requests that these group health plans complete the information on
the webpage https://reinsurancecontributions.secure.force.com/ by
answering a series of questions.* If the group health plan believes a health
insurance issuer, TPA or ASO contractor has successfully filed on its
behalf or that they are exempt from filing, the plan should select “No” for
the question “Have you completed a form filing?” By making this selection,
they will be directed to a series of screens that will allow for verification of
this information. If an issuer, TPA or ASO contractor filed on the group
health plan's behalf, the plan will need to provide the Pay.gov tracking
ID(s) for the Form filing. If the group health plan is exempt from submitting
reinsurance contributions under 45 CFR 153.400, the employer will need
to select a reason for the exemption. Before beginning, the Contributing
Entity can access the series of questions by clicking on the webpage link
and then clicking on the link on the upper right-hand of the webpage.
Please send any further inquiries to
reinsurancecontributions@cms.hhs.gov.
*CMS would like to clarify that this is not phishing, although this is “.com”
rather than “.gov”.
This information is not intended to represent legal or tax advice and has been prepared solely for informational
purposes. You may wish to consult your attorney or tax adviser regarding issues raised in this publication.