Employer Readiness on
Upcoming Requirements
Part 2
Download this presentation on InformedOnReform.com under Reform News
Web meeting call-in number: 800.644.8235 | Passcode: 801258
October 15, 2014
Health Care Reform Web Meeting Series
Dow nload this presentation on InformedO nReform .co m under Reform New s
Today’s Agenda
> Reinsurance fee refresher
FEATURED SPEAKERS
> Pay.gov process
Molly Tatting
Director of Health Care Reform, Cigna
> Proactive checklist
for self-funded employers
> Support for self-funded employers
Ken Silvay
Accounting Senior Director, Cigna
Pam Hostetler
Project Management Director, Cigna
> Communications and opportunities
to learn more
> Wrap-up
> “Ask the Experts” Q&A
© 2014 Cigna
2
Dow nload this presentation on InformedO nReform .co m under Reform New s
Reinsurance Fee Action Required: Are You Ready?
Final countdown to November 15 compliance date: 30 days left!
NOVEMBER
JANUARY
NOVEMBER
15 15 15
2014
Insurers and employers
must report their
membership counts
for 2014 and schedule
their fee payments.
© 2014 Cigna
2015
A single combined
payment ($63), or the
first installment ($52.50)
per covered life is due.
2015
If paying in two
installments, the
second installment
($10.50) per covered
life is due.
3
Dow nload this presentation on InformedO nReform .co m under Reform New s
Reinsurance Fee Refresher
PURPOSE
WHO PAYS
Temporary three-year fee (2014-2016) designed to
lessen the impact of adverse selection in the individual
market
Insured: Cigna will make both payments. No action is
required by employers
Self-funded: Employers are responsible
ESTIMATED
COST IMPACT
PAYMENT
TIMING
(Two options)
© 2014 Cigna
$63 PMPY in 2014 ($52.50/$10.50)
$44 PMPY in 2015 ($33.00/$11.00)
Estimated $25–$30 PMPY in 2016
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
4
Dow nload this presentation on InformedO nReform .co m under Reform New s
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.
> Employers may use the snapshot
method or any other approved
methodologies.
> Reports include total membership counts,
as well as average membership counts by
Tax Identification Number (TIN), and will be
accessed via existing reporting channels.
> Cigna will not be able to provide
membership reports to support the
calculation if a different method is used.
© 2014 Cigna
5
Dow nload this presentation on InformedO nReform .co m under Reform New s
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
•
Not responsible for payment
in 2014
•
Will not provide
covered lives data
October 1
Responsibilities are dependent upon when the change was made!
© 2014 Cigna
6
Dow nload this presentation on InformedO nReform .co m under Reform New s
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
(0 + 0 +100) ÷ 3
Average membership
Multiplied by $63 (2014 fee)
© 2014 Cigna
= Average membership
= 33.33
= $2,100
7
Dow nload this presentation on InformedO nReform .co m under Reform New s
Pay.gov process and proactive
considerations
Dow nload this presentation on InformedO nReform .co m under Reform New s
Pay.gov Overview
“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
© 2014 Cigna
9
Dow nload this presentation on InformedO nReform .co m under Reform New s
Pay.gov Steps
Insurers and self-funded employers register now to get started
1
© 2014 Cigna
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
Dow nload this presentation on InformedO nReform .co m under Reform New s
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
© 2014 Cigna
11
Dow nload this presentation on InformedO nReform .co m under Reform New s
Scheduling the Payment
Complete the steps by November 15, 2014
Select the
payment date
© 2014 Cigna
Enter the
account
holder name
Select
checking
or savings
account type
Enter bank
routing
number
Enter bank
account
number
12
Dow nload this presentation on InformedO nReform .co m under Reform New s
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, 2015
© 2014 Cigna
13
Dow nload this presentation on InformedO nReform .co m under Reform New s
Support for self-funded employers
Dow nload this presentation on InformedO nReform .co m under Reform New s
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
© 2014 Cigna
15
Dow nload this presentation on InformedO nReform .co m under Reform New s
Expanded Resources
Meeting a variety of needs
Pay.gov
process
General
questions
Get in touch:
Membership
Reports
Phone Line
and Email
1-855-275-0555, (8:30 a.m.-7:30 p.m. ET, M-F)
ASO_PPACA_Fees&[email protected]
Unique
scenarios
© 2014 Cigna
16
Dow nl oa d thi s pr e s e nta ti on on I nfor me dOnRe fo r m. c o m unde r Re for m Ne w s
Communications and opportunities
to learn more
Dow nload this presentation on InformedO nReform .co m under Reform New s
Communications Timeline
This week
Z
Email to employers
Z on these expanded
resources
© 2014 Cigna
Email to brokers
about expanded
resources
Next
week
Z
Email reminder
of upcoming
compliance dates
18
Dow nload this presentation on InformedO nReform .co m under Reform New s
Opportunities to Learn More
> 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]
© 2014 Cigna
19
Dow nload this presentation on InformedO nReform .co m under Reform New s
Wrap-up
Dow nload this presentation on InformedO nReform .co m under Reform New s
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, 2016
© 2014 Cigna
21
Dow nload this presentation on InformedO nReform .co m under Reform New s
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.
© 2014 Cigna
22
Dow nl oa d thi s pr e s e nta ti on on I nfor me dOnRe fo r m. c o m unde r Re for m Ne w s
Ask the Experts
Q&A
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.