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Under the Patient Protection and Affordable Care Act, the Early Retiree Reinsurance program provides $5 billion to plan sponsors based on the claims expenses of covered early retirees.
Program details:
- Available to group plans (self-funded and fully insured, including municipalities).
- The application submission period has begun and applications can be submitted immediately. The program ends January 1, 2014 or until the $5 billion is exhausted, whichever comes first.
- Plans are eligible to be reimbursed 80% of claims between $15,000 and $90,000 incurred by the early retiree, his/her spouse, or his/her dependents.
- "Early retiree" is defined as individuals who are age 55 and older but are not eligible for coverage under Medicare, and who are not active employees of the employer.
- Early Retiree Reinsurance Program Fact Sheet
Application process:
You must submit an application to the U.S. Department of Health and Human Services (HHS). To assist you in applying for the program and the federal funds, we are providing the resources linked below.
The application is available on the ERRP web page. HHS has also provided a list of do's and dont's related to the application submission process as well as important FAQs and other information.
Summary of BCBSRI's Fraud, Waste, and Abuse policies.
Summary of BCBSRI's cost-saving programs for members with chronic and high-cost conditions.
Claims estimation worksheet to assist you in projecting your reinsurance payments.
Additional information:
- Once your group has been approved for reimbursement, you must notify BCBSRI. We will then send you a copy of our early retiree reimbursement agreement.
- BCBSRI will charge employers a fee for services related to this program. For details on this fee please contact your account representative.
- HHS continues to announce important program updates through its ERRP web page. Please continue to monitor this site.
This is a general description of data and programs Blue Cross Blue Shield of Rhode Island has in place today. We are providing this information to the extent that you may find it helpful in applying for the new federal Early Retiree Reinsurance Program. Blue Cross Blue Shield of Rhode Island makes no representation as to whether this information or the programs referenced herein satisfies the requirements of HHS with regard to the Early Retiree Reinsurance Program application. You must make that determination independently.
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