Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: April 19, 2016

Program Area: CSR Reconciliation (CSR)

Question: If a subscriber in a Cost-sharing Reduction (CSR) plan variation has only claims that are 100 percent covered, should the issuer report claims for that subscriber?

Answer: No. Issuers should not file an (03) record for subscribers with no claims or no claims with reduced cost sharing, and the issuer should not include this subscriber in the (02) record of "Total number of Exchange Subscriber IDs in this plan variation for the benefit year."

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