Employers sponsoring certain self-insured group health plans (“contributing entities”) that are subject to the Affordable Care Act’s transitional reinsurance program must submit their 2015 Annual Enrollment and Contributions Submission Form and schedule payment for the 2015 benefit year no later than November 16, 2015.

Contributing Entities

Health insurance issuers and certain self-insured group health plans offering “major medical coverage” that is part of a commercial book of business are contributing entities. A contributing entity must make reinsurance contributions on behalf of its enrollees in plans that provide “major medical coverage,” unless one of the exceptions provided under the law applies to such coverage.

For 2015 and 2016, self-insured plans that do not use a third-party administrator to perform their claims processing, claims adjudication, and enrollment functions do not have to pay reinsurance contribution fees.

Upcoming Deadline for 2014 Contributions

As a reminder, the second contribution deadline for the 2014 benefit year (of $10.50 per covered life) is due no later than November 15, 2015, for contributing entities that opted not to pay the entire 2014 benefit year contribution in one payment.

More information on the reinsurance contribution process can be found in our section on the Transitional Reinsurance Program within the Client Resource Center HR Library.