Employer Readiness on Upcoming Requirements

Transcription

1 Employer Readiness on Upcoming Requirements Part 2 Download this presentation on InformedOnReform.com under Reform News Web meeting call-in number: Passcode: October 15, 2014 Health Care Reform Web Meeting Series

2 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 FEATURED SPEAKERS Molly Tatting Director of Health Care Reform, Cigna Ken Silvay Accounting Senior Director, Cigna Pam Hostetler Project Management Director, Cigna > Wrap-up > Ask the Experts Q&A 2

3 Reinsurance Fee Action Required: Are You Ready? Final countdown to November 15 compliance date: 30 days left! NOVEMBER Insurers and employers must report their membership counts for 2014 and schedule their fee payments. JANUARY A single combined payment ($63), or the first installment ($52.50) per covered life is due. NOVEMBER If paying in two installments, the second installment ($10.50) per covered life is due. 3

4 Reinsurance Fee Refresher PURPOSE Temporary three-year fee ( ) designed to lessen the impact of adverse selection in the individual market 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,

5 Snapshot Methodology and Reporting Cigna 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. 5

6 Common Unique Scenario FAQ 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? 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! 6

7 Common Unique Scenario FAQ The snapshot calculation 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 January 1 snapshot April 1 snapshot July 1 snapshot 0 covered lives 0 covered lives 100 covered lives ( ) 3 = Average membership Average membership = Multiplied by $63 (2014 fee) = $2,100 7

8 Pay.gov process and proactive considerations

9 Pay.gov Overview One-stop process via Collect data, calculate annual enrollment count and prepare supporting documentation Complete all steps and schedule payment no later than 11/15/2014 9

10 Pay.gov Steps Insurers and self-funded employers register now to get started 1 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 2 Upload supporting documentation 3 Enter payment information (e.g. payment date, banking information, etc.) 4 Self-funded employers contact bank to create company IDs (ALC+2 value) for automatic debits 10

11 Supporting Documentation > 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 11

12 Scheduling the Payment Complete the steps by November 15, 2014 Select the payment date Enter the account holder name Select checking or savings account type Enter bank routing number Enter bank account number 12

13 Reinsurance Fee Checklist for Self-Funded Employers Actions to ensure compliance by November 15, 2014 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,

14 Support for self-funded employers

15 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

16 Expanded Resources Meeting a variety of needs Pay.gov process General questions Membership Reports Phone Line and Get in touch: , (8:30 a.m.-7:30 p.m. ET, M-F) ASO_PPACA_Fees&Reporting@Cigna.com Unique scenarios 16

17 Dow nload this presentation on InformedOnReform.com under Reform New s Communications and opportunities to learn more

18 Communications Timeline This week Z to brokers about expanded resources Z to employers on these expanded resources Next week Z reminder of upcoming compliance dates 18

19 Opportunities to Learn More > CMS Reinsurance Contribution Submission Process User Group Series scheduled throughout November 2014 to help self-funded employers to prepare > Visit to register > Reinsurance Fee Toolkit > > Reinsurance Fee ASO Membership Reporting Training > ASO PPACA Fees and Reporting Resources > , (8:30 a.m.-7:30 p.m. ET, M-F) > 19

20 Wrap-up Download this presentation on InformedOnReform.com under Reform News

21 Reminder: 2015 Compliance Activities 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,

22 Resources Visit our website > 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 with links to the replay, slides, and other resources. You will also receive a brief survey. 22

23 Dow nload this presentation on InformedOnReform.com under Reform New s Ask the Experts Q&A

24 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. Some content provided under license.