employer readiness on upcoming … readiness on upcoming requirements ... molly tatting director of...
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Employer Readiness on Upcoming Requirements Part 2
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Web meeting call-in number: 800.644.8235 | Passcode: 801258
October 15, 2014
Health Care Reform Web Meeting Series
Today’s Agenda
> Reinsurance fee refresher
> Pay.gov process
> Proactive checklist
for self-funded employers
> Support for self-funded employers
> Communications and opportunities
to learn more
> Wrap-up
> “Ask the Experts” Q&A
© 2014 Cigna
Molly Tatting Director of Health Care Reform, Cigna
Ken Silvay Accounting Senior Director, Cigna
Pam Hostetler Project Management Director, Cigna
FEATURED SPEAKERS
2
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Reinsurance Fee Action Required: Are You Ready? Final countdown to November 15 compliance date: 30 days left!
3
Insurers and employers
must report their
membership counts
for 2014 and schedule
their fee payments.
A single combined
payment ($63), or the
first installment ($52.50)
per covered life is due.
If paying in two
installments, the
second installment
($10.50) per covered
life is due.
JANUARY
15 2015
NOVEMBER
15 2014
NOVEMBER
15 2015
© 2014 Cigna
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4
PURPOSE Temporary three-year fee (2014-2016) designed to
lessen the impact of adverse selection in the individual
market
Reinsurance Fee Refresher
© 2014 Cigna
WHO PAYS Insured: Cigna will make both payments. No action is
required by employers
Self-funded: Employers are responsible
ESTIMATED
COST IMPACT
$63 PMPY in 2014 ($52.50/$10.50)
$44 PMPY in 2015 ($33.00/$11.00)
Estimated $25–$30 PMPY in 2016
PAYMENT
TIMING (Two options)
The first payment is due no later than January 15, 2015
The second payment is due no later than November 15, 2015
Insurers or employers may also opt for a single payment no later
than January 15, 2015
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Cigna
Snapshot Methodology and Reporting
© 2014 Cigna 5
Employers
> Cigna will only use the snapshot method for
our insured business and for the reports we
provide to self-funded employers.
> Reports include total membership counts,
as well as average membership counts by
Tax Identification Number (TIN), and will be
accessed via existing reporting channels.
> Employers may use the snapshot
method or any other approved
methodologies.
> Cigna will not be able to provide
membership reports to support the
calculation if a different method is used.
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“We made a carrier change to Cigna, and our funding type moved
from insured to self-funded on July 1.”
Question: Will I be responsible for paying the entire fee for 2014,
or will my prior carrier?
Common Unique Scenario FAQ
6 © 2014 Cigna
Timing of Change Employer Cigna
July 1 • Responsible for the period of
July – Sept
• The counting method the
employer chooses will
determine the reinsurance fee
• Will provide covered
lives date for the July 1
snapshot date
October 1 • Not responsible for payment
in 2014
• Will not provide
covered lives data
Responsibilities are dependent upon when the change was made!
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“We made a carrier change to Cigna, and our funding type moved
from insured to self-funded on July 1.”
Calculation example with a July 1 change
Common Unique Scenario FAQ The snapshot calculation
7 © 2014 Cigna
January 1 snapshot April 1 snapshot July 1 snapshot
0 covered lives 0 covered lives 100 covered lives
(0 + 0 +100) ÷ 3 = Average membership
Average membership = 33.33
Multiplied by $63 (2014 fee) = $2,100
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Pay.gov process and proactive
considerations
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Pay.gov Overview
© 2014 Cigna 9
“One-stop” process via www.pay.gov
Collect data, calculate annual enrollment
count and prepare supporting documentation
Complete all steps and schedule payment
no later than 11/15/2014
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Pay.gov Steps Insurers and self-funded employers register now to get started
© 2014 Cigna 10
Complete the "ACA Transitional Reinsurance Program Annual Enrollment
and Contribution Submission Form" (aka “The Form”)
* Not yet available on Pay.gov; Cigna will keep you posted 1
Upload supporting documentation 2
Enter payment information (e.g. payment date, banking information, etc.) 3
Self-funded employers – contact bank to create company IDs
(ALC+2 value) for automatic debits 4
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Supporting Documentation
11 © 2014 Cigna
> Legal information, such as reporting entity
legal business name, federal tax identification
number, billing address
> Specific information, such as benefit year
and number of covered lives of reinsurance
contribution enrollees
> This information will be used by CMS to verify
gross enrollment counts entered on The Form
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Enter bank
account
number
Enter bank
routing
number
Select
checking
or savings
account type
Enter the
account
holder name
Scheduling the Payment Complete the steps by November 15, 2014
12 © 2014 Cigna
Select the
payment date
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Reinsurance Fee Checklist for Self-Funded Employers Actions to ensure compliance by November 15, 2014
© 2014 Cigna 13
Register on REGTAP: review site materials and resources
Questions along the way: submit to REGTAP as “Reinsurance Contributions”
Register for and attend “Reinsurance Contribution Submission Process”
CMS training throughout November 2014
Register on Pay.gov
Collect information needed to complete “The Form” and upload
supporting documentation
Estimate 2014 fee amount based on average covered lives
(the approximate fee to be paid)
Schedule the payment: combined payment or first installment no later than
January 15, 2015
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Support for self-funded employers
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Expanded Resources Introducing Cigna’s ASO PPACA Fees & Reporting Resources
Eligibility and Billing/Banking areas will:
> Provide resources, information and service
representatives to answer questions
> Assist employers with membership information
needed to report and calculate fee using
snapshot method
Available to help employers and broker partners:
> Understand the requirements and the process for
making Reinsurance Fee payments via Pay.gov
> Access and use Cigna membership reports to help
calculate Reinsurance Fee
15 © 2014 Cigna
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Expanded Resources Meeting a variety of needs
Get in touch:
1-855-275-0555, (8:30 a.m.-7:30 p.m. ET, M-F)
ASO_PPACA_Fees&[email protected] Phone Line
and Email
Unique
scenarios
Membership
Reports
General
questions
Pay.gov
process
© 2014 Cigna 16
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Communications and opportunities
to learn more
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Communications Timeline
18 © 2014 Cigna
This week
Next
week
Z
Email to brokers
about expanded
resources
Z
Email to employers
on these expanded
resources Z
Email reminder
of upcoming
compliance dates
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Opportunities to Learn More
© 2014 Cigna
19
> CMS “Reinsurance Contribution Submission Process
User Group Series” scheduled throughout
November 2014 to help self-funded employers to
prepare
> Visit www.REGTAP.info to register
> Reinsurance Fee Toolkit
> www.cigna.com/reinsurancefee-toolkit
> Reinsurance Fee ASO Membership Reporting Training
> ASO PPACA Fees and Reporting Resources
> 1-855-275-0555, (8:30 a.m.-7:30 p.m. ET, M-F)
> ASO_PPACA_Fees&[email protected]
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Wrap-up
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Reminder: 2015 Compliance Activities
© 2014 Cigna 21
Reinsurance Fee: 11/15/14
> Payments:
– No later than 1/15/15 (combined or first installment) – No later than 11/15/15 for second installment
Health Plan Identifier: 11/5/14 > For health plans with annual receipts of $5 million or more Minimum Essential Coverage (MEC) reporting requirements
> Missing SSN outreach by 12/31/14
> MEC reporting on 2015 coverage due January, 2016 Employer Mandate: 1/1/15 > For 100+ FTE in 2015 > Large Employer reporting on 2015 health benefits January, 2016
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© 2014 Cigna
Resources
Visit our website
www.InformedonReform.com
> Now optimized for desktop,
tablet or mobile devices
> News alerts, fact sheets,
timeline and FAQs
> A replay will be available
within a few days under
“Web Meetings”
Look for our follow-up email with
links to the replay, slides, and
other resources.
You will also receive a brief survey.
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Ask the Experts
Q&A
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Ted: Any suggestions on how to maintain this
template, but weave these two URLs in?
www.cigna.com/reinsurancefee-toolkit
Offered by: Connecticut General Life Insurance Company or Cigna Health and Life Insurance Company.
“”Cigna” and the “Tree of Life“ logo are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All
products and services are provided by or through such operating subsidiaries, including Connecticut General Life Insurance Company and Cigna Health and Life Insurance
Company, and not by Cigna Corporation. All models are used for illustrative purposes only.
10/14 © 2014 Cigna. Some content provided under license.