aso reinsurance membership reporting training · aso reinsurance membership reporting training ....

September 2015

ASO REINSURANCE MEMBERSHIP

REPORTING TRAINING

Cigna has created reporting

to assist you with the

eligibility data needed for

the Average Covered Lives

calculation required for the

Reinsurance Fee.

The following slides will assist you in

accessing the self-service reports based on

the appropriate portal for your plans/policies.

REINSURANCE REPORTING FOR ASO CLIENTS

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2015 Cigna.

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REINSURANCE FEE OVERVIEW


What it is Annual fee on insured and self-funded health plans from 2014–2016

Purpose Fund reinsurance program to help lessen impact of adverse selection in the individual market

Amount 2014

$12 billion

2015

$8 billion

2016

$5 billion

Who pays Insured: Insurers

Self-funded: Employers

Tax implications Tax deductible

Estimated cost

impact

2014

$63 PMPY

Paid in two installments of $52.50

and $10.50. The first installment is

due no later than January 15,

2015. The second installment will

be due no later than November 15,

2015.

*If the fee is paid as a combined

payment, then it is due no later

than January 15, 2015.

2015

$44 PMPY

If paid in two installments, then the

first installment is $33.00 and the

second installment is $11.00.

2016

$27 PMPY

If paid in two installments,

then the first installment is

$21.60 and the second

installment is $5.40.

Business affected

Insured individual and group major medical plans

Self-funded group major medical plans

Taft-Hartley plans to the extent the plans meet the other criteria for inclusion

Group retiree medical plans covering individuals who are not eligible for Medicare or for whom

Medicare is the secondary payer

Administrative Services Only (ASO) expatriate plans (2014 only)

Short-term Abroad (STA) expatriate plans (2014 only)

Medical plans that are integrated with a Health Reimbursement Account (HRA)

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Reports are available on CignaAccess.com and

the Client Resource Portal (CRP).

> THE SUMMARY REPORT reflects the average covered

lives by each snapshot month

> THE DETAILED REPORT contains membership detail for

the nine months of snapshots for all subscribers and

dependents

REINSURANCE RESOURCES


CignaAccess.com Client Resource Portal (CRP)

Report name ASO Reinsurance Membership Report Reinsurance Membership Report

Available

• The reports are available in October of each year

• For 2015 and 2016, the Cigna reports will only support the snapshot method using

monthly snapshot dates from January 15th thru September 15th

Format

The summary and detailed

reports can be downloaded

• Excel file (.xls)

• Comma Separated Value (.csv)

• Excel file (.xls)

• PDF

Resources:

• Reinsurance Fee Toolkit

• Reinsurance Fee Fact Sheet

• Reinsurance Fee FAQs

• Informed on Reform Fees & Taxes Page

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http://www.cigna.com/health-care-reform/reinsurance-assessment-toolkit

http://www.cigna.com/assets/docs/about-cigna/informed-on-reform/reinsurance-assessment-fact-sheet.pdf?WT.z_nav=health-care-reform/reinsurance-assessment-toolkit;accordion;Additional resources;Reinsurance Fee Fact Sheet

http://www.cigna.com/assets/docs/about-cigna/informed-on-reform/877865-reinsurancefaq-v7.pdf?WT.z_nav=health-care-reform/reinsurance-assessment-toolkit;accordion;Additional resources;Review the FAQs

http://www.cigna.com/health-care-reform/fees-and-taxes

REINSURANCE TOOLKIT

5 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2015 Cigna.

Reinsurance Toolkit (cont’d) REINSURANCE TOOLKIT (CONTINUED)

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2015 Cigna. 6

ASO REINSURANCE MEMBERSHIP REPORT – KEY FACTS

Average Membership Calculation:

> Average Membership* is a simple calculation

of the nine membership “snapshot” dates

divided by nine. Examples of the calculation

are highlighted in BLUE on:

– slide #8 for CignaAccess.com and,

– slide #21 for Client Resource Portal (CRP).

This same calculation is used in both the

CignaAccess.com and Client Resource Portal

(CRP) reports. This should be the number of

covered lives used to calculate the

Reinsurance Assessment Fee.

– This report is using the “snapshot”

methodology and the monthly dates

selected by Cigna (January 15th through

September 15th). If an ASO Client

chooses to use any other method as

allowed by the Regulations, Cigna will not

provide reporting.

*This number only reflects the covered lives in the self-insured

plan administered by Cigna; it does not reflect covered lives

under plans administered by other entities.

Determining Single Legal Entity or Multiple

Legal Entities:

– You can use the Tax Identification

Number(s) to help determine if you’re a

Single Legal Entity or have Multiple Legal

Entities.

– Use the Total "Avg MBRS" on the

Summary ASO Reinsurance Membership

Report for each Tax Identification

Number(s) to upload the Average

Membership counts for your ASO Cigna

Health plan into Pay.gov.


AVERAGE MEMBERSHIP CALCULATION


TAX ID NUMBER ACCOUNT BENEFIT OPTION BRANCH MONTH TOTAL MBRS AVG MBRS

1234567890 1234567 - SAMPLE COMPANY M2C ACTIVES Jan-15 411

Feb-15 412

Mar-15 413

Apr-15 408

May-15 409

Jun-15 409

Jul-15 407

Aug-15 407

Sep-15 406

ACCOUNT Total 3,682 409.11

TAX ID NUMBER Total 3,682 409.11

Grand Total 3,682 409.11

Sample Client ASO Reinsurance Summary Membership Report

SNAPSHOT DATES: January 2015 thru September 2015

NOTES:

• The covered lives data provided was extracted in October 2015 and reflects retroactive changes through September 30, 2015.

• The covered lives reported may include individuals who have other coverage that may be primary and for whom the reinsurance contribution is not owed by your plan. We

do not have insight as to which plan is responsible for the reinsurance contribution for these individuals.

• This report provides covered lives information for purposes of contributing entity reporting to the Department of Health and Human Services with regards to the

Reinsurance Contribution required under section 1341 of the Affordable Care Act. The information provided is intended for use only in connection with the Reinsurance

Contribution reporting. It is not to be used in connection with the reporting required for the Comparative Effectiveness Research Fee. For that fee, please refer to the

Comparative Effectiveness Research Fee (CERF) Member Life Reports.

REPORTING

INSTRUCTIONS FOR

CignaAccess.com


If you have accessed your current reports on CignaAccess.com, the ASO Reinsurance Membership reports will be

available there as well. Sign in with your current ID and password. The reports are accessed in the same location as

your Financial Experience reporting. Enter CignaAccess.com in your internet browser. Sign in with your User ID and

password as shown below. If you have never used the website, you have the option to register for the first time.

CIGNAACCESS.COM – HOME PAGE


Register as a new user

Enter User ID and password

In the entry screen, click on “Reports and Statistics” as indicated below. You will be taken to this page - Select

“Financial Experience Reports”.

CIGNAACCESS.COM – REPORT SELECTION


Clicking on reports and statistics will bring client to this screen

Select Financial Experience Reports

CIGNAACCESS.COM – CLIENT ID ENTRY


Enter client id and click “go”

The ASO Reinsurance Membership will be located under the “Summary By Client & Product”.

CIGNAACCESS.COM - REPORT SELECTION


Select “Summary by Client & Product” (which is the defaulted radio button) and click “Continue”

Once you have entered into the Monthly Experience Reports “Summary by Client & Product” screen, look for the “ASO

Reinsurance Membership Report” and click on the Download Excel to open the report.

CIGNAACCESS.COM - REPORT SELECTION


Find the “ASO Reinsurance Membership Report” on the list of available reports and “Download Excel” to open report

DATA ELEMENTS – SUMMARY REPORT – CIGNAACCESS.COM


Data element - Summary Report Overview

Tax ID Number (TIN) Identifies the 9 digit number used by the Internal Revenue Service (IRS) and Social Security Administration offices to identify individuals, businesses or tax preparers for tax purposes.

Account A unique number assigned to an employer or other entity sponsoring a plan administered by Cigna; can also be used for financial grouping. This number is determined by the Sales Department. Multiple account numbers can be associated with a single TIN.

Benefit Option An alphanumeric code used internally to identify a Client's Benefit Plan offering. Typically it can vary in length from one to five characters, and can be made up of letters, numbers or a combination of both.

Branch A specific 'group' within an account, to which an Individual belongs.

Month Monthly membership “snapshots” from January 15th

through September 15th

(The covered lives* data provided was extracted in October and reflects retroactive changes through September 30th)

Total Membership (Total MBRS) • Total Membership by Account • Total Membership by TIN • Grand Total Membership

Average Membership (AVG MBRS) • Average Membership for each TIN, Account and Benefit Option Combination • Average Membership by TIN • Average Membership by Client (Grand Total)

*Covered lives is defined as employees, spouses and dependents

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DATA ELEMENTS – DETAIL REPORT – CIGNAACCESS.COM


Data element - Detail Report Overview

Tax ID Number (TIN) Identifies the 9 digit number used by the Internal Revenue Service (IRS) and Social Security Administration offices to identify individuals, businesses or tax preparers for tax purposes.

Account NUMBER A unique number assigned to an employer or other entity sponsoring a plan administered by Cigna; can also be used for financial grouping. This number is determined by the Sales Department.. Multiple account numbers can be associated with a single TIN.

Account NAME The name of the employer or customer that is associated with the account number.

Benefit Option An alphanumeric code used internally to identify a Client's Benefit Plan offering. Typically it can vary in length from one to five characters, and can be made up of letters, numbers or a combination of both.

Benefit Option Name Identifies the name of the Benefit Option.

Branch Code The identifier assigned to a grouping that a person belongs to.

Branch Name A specific 'group' within an account, to which an Individual belongs.

Employee ID (EMP ID) A number assigned by the employer to identify the person as an employee.

Social Security Number(SSN) A number that the Social Security Administration issues to U.S. citizens, permanent residents, and temporary (working) residents for tax purposes. It is a nine-digit number that follows the format: XXX-XX-XXXX.

Member Name (First) - (MBR NAME (FIRST)) This is the member’s First Name

Middle Initial (MID INITIAL) This is the member’s Middle Initial, if applicable

Member Name (Last) - (MBR NAME (LAST)) This is the member’s Last Name

Date of Birth (DOB) The recorded (or stated) month, day and year (date) of an individual’s birth. The accepted time period is between 12:01 am through midnight on a given date.

Relationship Code (REL CODE) Describes the legal, familial or patient connection between the Customer under whom Coverage was acquired, and a potentially Covered Individual. Examples: EE - Employee SP - Spouse DP - Domestic partner CH - Child SC - Stepchild GC - Grandchild FS - Former spouse AD - Adult dependent CL - Collateral dependent

Resident State The geopolitical area in which an individual lives or claims homestead status.

Zip Code Abbreviation for the Zone Improvement Program (ZIP), instituted by the United States Postal Service (USPS) to enhance the accuracy of mail delivery. This is the zip code associated with the member’s address.

Month/Year snapshot This is the date of the monthly snapshot. If the field includes a date, the member was included in that snapshot count. If the field includes N/A, the member was not included. Cigna has chosen the 15

th of each month for the first nine months of the year (January – September) as its snapshot dates.

ACCOUNT "xxxxxx "Total by Snapshot Date This is the Total members included in each snapshot count by Account number.

TAX ID NUMBER "xx-xxxxxxx "Total Active Members by Snapshot Date

This is the Total members included in each snapshot count by TAX ID number.

Total Active Members by Snapshot Date This is the Total Active members included in each snapshot count for all Accounts and Tax ID numbers.

Total Membership This is the Total membership for all snapshot dates for all Accounts and Tax ID numbers .

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ASO REINSURANCE SUMMARY MEMBERSHIP REPORT – CIGNAACCESS.COM

Below is a sample Summary Report.

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TAX ID NUMBER ACCOUNT BENEFIT OPTION BRANCH MONTH TOTAL MBRS AVG MBRS

1234567890 1234567 - SAMPLE COMPANY M2C ACTIVES Jan-15 411

Feb-15 412

Mar-15 413

Apr-15 408

May-15 409

Jun-15 409

Jul-15 407

Aug-15 407

Sep-15 406

ACCOUNT Total 3,682 409.11

TAX ID NUMBER Total 3,682 409.11

Grand Total 3,682 409.11

Sample Client ASO Reinsurance Summary Membership Report


NOTES:


• The covered lives reported may include individuals who have other coverage that may be primary and for whom the reinsurance contribution is not owed by your plan . We

do not have insight as to which plan is responsible for the reinsurance contribution for these individuals.

• This report provides covered lives information for purposes of contributing entity reporting to the Department of Health and Human Services with regards to the

Reinsurance Contribution required under section 1341 of the Affordable Care Act. The information provided is intended for use only in connection with the Reinsurance

Contribution reporting. It is not to be used in connection with the reporting required for the Comparative Effectiveness Research Fee. For that fee, please refer to the

Comparative Effectiveness Research Fee (CERF) Member Life Reports.


Below is a sample of the Detailed Report. To view the entire report, double click on the image to open in Excel.

ASO REINSURANCE DETAILED MEMBERSHIP REPORT – CIGNAACCESS.COM


MID INITIAL MBR NAME (LAST) DOB REL CODERESIDENT

STATEZIP CODE

JAN 2015

SNAPSHOT

FEB 2015

SNAPSHOT

MAR 2015

SNAPSHOT

APR 2015

SNAPSHOT

M LAST NAME YYYY-DD-MM EE� NC� ZZZZZ 01/15/15 02/15/15 03/15/15 04/15/15

L LAST NAME YYYY-DD-MM SP� NC� ZZZZZ 01/15/15 02/15/15 03/15/15 04/15/15

A LAST NAME YYYY-DD-MM EE� NC� ZZZZZ 01/15/15 02/15/15 03/15/15 04/15/15

L LAST NAME YYYY-DD-MM SP� NC� ZZZZZ 01/15/15 02/15/15 03/15/15 04/15/15

L LAST NAME YYYY-DD-MM EE� NC� ZZZZZ 01/15/15 02/15/15 03/15/15 04/15/15

D LAST NAME YYYY-DD-MM EE� NC� ZZZZZ 01/15/15 02/15/15 03/15/15 04/15/15

S LAST NAME YYYY-DD-MM SP� NC� ZZZZZ 01/15/15 02/15/15 03/15/15 04/15/15

S LAST NAME YYYY-DD-MM EE� NC� ZZZZZ N/A 02/15/15 03/15/15 04/15/15

P LAST NAME YYYY-DD-MM EE� NC� ZZZZZ 01/15/15 02/15/15 03/15/15 04/15/15

W LAST NAME YYYY-DD-MM EE� NC� ZZZZZ 01/15/15 02/15/15 03/15/15 04/15/15

L LAST NAME YYYY-DD-MM SP� NC� ZZZZZ 01/15/15 N/A N/A N/A

W LAST NAME YYYY-DD-MM EE� NC� ZZZZZ 01/15/15 02/15/15 03/15/15 04/15/15

J LAST NAME YYYY-DD-MM EE� NC� ZZZZZ 01/15/15 02/15/15 03/15/15 04/15/15

M LAST NAME YYYY-DD-MM EE� NC� ZZZZZ 01/15/15 02/15/15 03/15/15 04/15/15

J LAST NAME YYYY-DD-MM EE� NC� ZZZZZ 01/15/15 02/15/15 03/15/15 04/15/15

C LAST NAME YYYY-DD-MM EE� NC� ZZZZZ 01/15/15 02/15/15 03/15/15 04/15/15

D LAST NAME YYYY-DD-MM EE� NC� ZZZZZ 01/15/15 02/15/15 03/15/15 04/15/15

Sample Client ASO Reinsurance Detailed Membership Report


NOTES:


• The covered lives reported may include individuals who have other coverage that may be primary and for whom the reinsur

• In the instance where a clients PHI election is “No,” the report that appears on

CignaAccess.com will only display the Summary Reinsurance report. The Detailed

Reinsurance report (which contains member level detail) will appear as “No Data

Found.”

• If a client is effective after September 30, there will be no headcount; therefore, no

report will be posted to CignaAccess.com for that client.

• If a client does not see the Advice ASO Reinsurance report on CignaAccess.com,

please send an email to the Customer Reporting Specialist mailbox at “MM Cust Rptg”

and we will research this client to find out why the report did not generate through our

batch cycle.

CIGNAACCESS.COM REPORTING FAQ’S


REPORTING

INSTRUCTIONS FOR

Client Resource Portal (CRP)


AVERAGE MEMBERSHIP CALCULATION


Enter CignaClientResources.com in your internet browser. Sign in with your current ID and password. The

Reinsurance Membership reports can be accessed under “Reports,” which can be found on the CRP homepage. If you

have never used the website, there are registration instructions and training sessions listed.

CLIENT RESOURCE PORTAL – HOME PAGE


Enter Username and passd

Once you have accessed your current reports on the Client Resources Portal (CRP), the Reinsurance Membership

Report will be available there as well. The reports are accessed under “Reports,” which you can access from the CRP

Homepage. Then select Billing reports for the Reinsurance Membership Report.

CLIENT RESOURCE PORTAL (CRP)


Reinsurance Membership Report is located under the Billing Reports category.

On this screen, select the Reinsurance Membership Report located under the billing reports.

CRP REPORT SELECTION


Report Selection

Report Selection

CRP REPORT SELECTION


Set report type:

ALL – will display the Summary and Detail reports in one report.

Summary - will display only the Summary report.

Detail – will display only the Detailed report.

Select the Statement Selection for the Calendar Year you’re reporting on.

DATA ELEMENTS – SUMMARY REPORT - FACETS


Data element - Summary Report Overview Tax ID Number (TIN) Identifies the 9 digit number used by the Internal Revenue Service (IRS) and Social Security Administration offices to identify

individuals, businesses or tax preparers for tax purposes.

Group ID A unique number assigned to an employer, to whom Cigna provides benefits and services; can also be used for financial grouping. This number is determined by the Sales Department. There is one TIN associated with each Group ID.

Subgroup

A subset within the overall group which may reflect a distinct operational division or separate Company. All Sub Groups will reflect the same single TIN as the parent group id

Product ID An alphanumeric code used internally to identify a Client's Benefit Plan offering. The length of the Product ID is eight characters, and it is made up of a combination of letters and numbers.

Product Description

The specific benefit name associated with the Product ID.

Class ID A specific subset of employee types within a group. Examples are “active employees,” retired employees”, or COBRA employees. All employees within a group are assigned to a single class.

Class Description

The Class is defined as a specific subset of employee types within a group. Examples are “active employees,” retired employees, or COBRA employees. All employees within a group are assigned to a single class.

Month Monthly membership “snapshots” from January 15th

through September 15th

(The covered lives* data provided was extracted in October and reflects retroactive changes through September 30th)

Total Membership (Total MBRS) • Total Membership by Account • Total Membership by TIN • Grand Total Membership

Average Membership (AVG MBRS) • Average Membership for each TIN, Account and Benefit Option Combination • Average Membership by TIN • Average Membership by Client (Grand Total)

*Covered lives is defined as employees, spouses and dependents.

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DATA ELEMENTS – DETAIL REPORT - FACETS


Data element - Detail Report Overview Tax ID Number (TIN) Identifies the 9 digit number used by the Internal Revenue Service (IRS) and Social Security Administration offices to identify individuals,

businesses or tax preparers for tax purposes. Group ID A unique number assigned to an employer, to whom Cigna provides benefits and services. It can be used for financial group. This number

is determined during initial setup by the Sales department. Subgroup A sub set within the overall group which may reflect a distinct operational division or separate Company. All Subgroups will reflect the

same single TIN as the parent group id Class ID An alphanumeric identity which represents the Class. The Class is defined as a specific subset of employee types

within a group. Examples are “active employees,” “retired employees,” etc. All employees within a group are assigned to a single class.

Class Description The Class is defined as a specific subset of employee types within a group. Examples are “active employees,” retired employees,”, etc. All employees within a group are assigned to a single class.

Product ID An alphanumeric code used internally to identify a Client's Benefit Plan offering. The length of the Product ID is eight characters, and it is made up of a combination of letters and numbers.

Product Description The specific benefit name associated with the Product ID.

Member ID A system generated ID which uniquely defines the subscriber member. This number identifies the member as the employee.

Social Security Number (Member SSN) A number that the Social Security Administration issues to U.S. citizens, permanent residents and temporary (working) residents for tax purposes. It is a nine digit number that follows the format: XXX-XX-XXXX.

Member Name (First) - (MBR NAME (FIRST)) This is the member’s First Name. Middle Initial (MID INITIAL) This is the member’s Middle Initial, if applicable. Member Name (Last) - (MBR NAME (LAST)) This is the member’s Last Name. Date of Birth (DOB) The recorded (or stated) month, day and year (date) of an individual’s birth. The accepted time period is between 12:01 am through

midnight on a given date. Relationship Code (REL CODE) Describes the legal, familial or patient connection between the Customer under whom Coverage was acquired, and a potentially Covered

Individual. Examples: EE – Employee, SP – Spouse, DP – Domestic Partner, CH – Child, SC – Stepchild, GC – Grandchild, FS – Former Spouse, AD – Adult Dependent, CL – Collateral Dependent.

State Code The geopolitical area in which an individual lives or claims homestead status. Zip Code Abbreviation for the Zone Improvement Program (ZIP), instituted by the United States Postal Service (USPS) to enhance the accuracy of

mail delivery. This is the zip code associated with the member’s address. Snap Date 1, et al. This is the date of the monthly snapshot. If the field includes a date, the member was included in that snapshot count. If the field is blank, the member

was not included. Cigna has chosen the 15th

of each month for the first nine months of the year (January – September) as its snapshot dates.

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This is a screenshot of the CRP Summary report. Only product types required to pay the fee are displayed in these

reports. Refer to the Summary report to obtain the Average membership totals. The Detail report will display the

membership that accounts for the Total Members.

ASO REINSURANCE SUMMARY MEMBERSHIP REPORT – CLIENT RESOURCE PORTAL (CRP)


This is a screenshot of the CRP Detail report, which could be pages long depending on the volume of covered lives.

The Detail report will list out covered lives under your Group by Sub Group, Class, and Product. As in the Summary

report, only product types and associated members used to calculate the fee are displayed in these reports.

ASO REINSURANCE DETAILED MEMBERSHIP REPORT – CLIENT RESOURCE PORTAL (CRP)


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CRP REPORT SAMPLE – COMBINED SUMMARY & DETAIL REPORTS

• If a client is effective after September 30, there will be no headcount; therefore, the report

will not be available on Cigna Client Resources (CRP) for that year.

• For assistance creating the report, please call the Client Resources Helpline,

Monday – Friday (7:00 am – 4:30 pm ET), at 1-800-866-5544.

• For questions related to the context of the report, please contact the ASO PPACA Fees

& Reporting Resources line, Monday – Friday (8:30 a.m. – 7:30 p.m. ET), at 1-855-275-

0555.

• The report layout can be generated in “Summary/Detail,” “Summary only” or “Detail only”

format and available to export into Excel or PDF. While the report is available in Detail

form, for reporting purposes to HHS please use the Summary portion of the report.

• The Reinsurance Report is located under the Billing Reports.

o If access is needed, please contact your Cigna Service Representative.

CLIENT RESOURCE PORTAL (CRP) REPORTING FAQ’S


All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and

Life Insurance Company. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc.

877986 09/14 © 2015 Cigna. Some content provided under license.

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