HHS Provides Additional Responses to Frequently Asked Questions About the ERRP

FAQs2.JPGThe U.S. Department of Health and Human Services (HHS) has issued additional guidance on the Early Retiree Reinsurance Program (ERRP). Created by the Affordable Care Act, the ERRP provides $5 billion in temporary financial help for employer health plans that continue to provide health coverage to “early retirees,” defined as individuals age 55 and older who are neither active employees nor eligible for Medicare, and to the early retirees’ spouses, surviving spouses, and dependents. Under the plan, the HHS will reimburse plan sponsors for certain claims between $15,000 and $90,000. The new and updated responses to common questions posed by plan sponsors address the following issues:

  • With respect to the ERRP application process, the HHS has revised its response to common question 100-17 to further explain the actions political subdivisions or entities should take if multiple ERRP applications are submitted. The section also includes new questions 100-23 and 100-24 regarding the application process itself. The HHS responds that ERRP applications are still being processed, and provides examples of who within the employer’s organization has the authority to sign the application.
  • As for costs and reimbursement under the ERRP, new questions H200-31 and H200-32 address topics related to the submission of reimbursement requests, while questions 200-33 through H200-50 touch on a variety of issues related to the program’s cost.
  • A new revised question H300-32 related to early retirees provides additional information on what constitutes a member ID or member group ID, and why this information is important. Responses to new question 300-34 and question 200-10 explain that ERRP reimbursement may be received for claims of early retirees, their spouses, surviving spouses and dependents (but not surviving dependents) regardless of their age and/or eligibility for coverage under Medicare.
  • With respect to the requirement that a plan sponsor must affirm that it has made a reasonable, good faith effort to ensure that the early retiree is a U.S. citizen or is legally present in the U.S., the response to question 300-35 explains that there is no single, specific method of showing that a sponsor has met this requirement.
  • A revised question 600-2 as well as new questions H600-4 and H600-5 provide information regarding price concessions and cost adjustments.
  • The response to question 500-6 notes that over $4 billion from the $5 billion appropriated for ERRP are still available for disbursement.
  • The answer to question 500-7 explains that under certain circumstances, a sponsor with an approved application for an employment-based plan that includes both early retirees and active workers may create a new employment-based plan, transfer all the early retirees from the original plan into the new plan, and submit for ERRP reimbursement claims incurred and paid by the new plan for the affected early retirees.

This entry was written by Ilyse Schuman.

Photo credit: porcorex

Information contained in this publication is intended for informational purposes only and does not constitute legal advice or opinion, nor is it a substitute for the professional judgment of an attorney.