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

Issue Date: July 19, 2016

Program Area: Risk Corridors (RC)

Question: For the 2015 Benefit Year Medical Loss Ratio (MLR) and Risk Corridors (RC) Reporting, what reinsurance (RI) amount should be reported?

Answer: Issuers must report the reinsurance payment amount for their Health Insurance Oversight System (HIOS) ID, as listed in the June 30, 2016 Summary Report on Transitional Reinsurance Payments and Permanent Risk Adjustment Transfers for the 2015 Benefit Year, located here: https://www.cms.gov/CCIIO/Programs-and-Initiatives/Premium-Stabilization-Programs/Downloads/June-30-2016-RA-and-RI-Summary-Report-5CR-063016.pdf. The reinsurance payment amount listed in the June 30, 2016 report should match the adjusted RI payment report that was sent directly to the Chief Executive Officer (CEO) Designates and Alternate contacts. If the amounts do not match, please email RARIPaymentOperations@cms.hhs.gov as soon as possible. The Centers for Medicare & Medicaid Services (CMS) would like to note that the reinsurance payment amount on the June 30, 2016 report and adjusted RI payment report will not match the RI issuer report available on the EDGE Management Console (EMC) because that report has not been adjusted for any overlapping claims discrepancies.

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