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Bulletin51 Pa.B. 4175

1332 Waiver Reinsurance Program—Program Parameters; Notice 2021-09

Pennsylvania · PAID · effective July 31, 2021
First seen July 21, 2026 · last checked August 22, 2026
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v1fetched Jul 21, 2026·effective Jul 31, 20217db4b15e7275
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NOTICES
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INSURANCE DEPARTMENT
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1332 Waiver Reinsurance Program—Program Parameters; Notice 2021-09
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[51 Pa.B. 4175] [Saturday, July 31, 2021]
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On July 24, 2020, the Centers for Medicare & Medicaid Services, a division of the United States Department of Health and Human Services, and the United States Department of the Treasury, approved the Insurance Department's 1332 Waiver Application. The approval is effective for a waiver period from January 1, 2021, through December 31, 2025, with a provision for a possible extension at the end of the initial term.
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The reinsurance program is a claims-based, attachment point reinsurance program that will reimburse health insurers for claims costs of qualifying Affordable Care Act-compliant individual enrollees, where a percentage of the claims costs exceeding a specified threshold (attachment point) and up to a specified ceiling (reinsurance cap) will be reimbursed. Beginning January 1, 2022, and slightly adjusted from the preliminary parameters in Notice 2021-16 published at 51 Pa.B. 3073 (May 29, 2021), the program-adopted parameters are an attachment point of $60,000, a cap of $100,000 and a coinsurance rate of 45%.
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Questions regarding this notice may be addressed to the Bureau of Life, Accident and Health, Insurance Department, 1311 Strawberry Square, Harrisburg, PA 17120, [email protected].
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JESSICA K. ALTMAN,
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Insurance Commissioner
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[Pa.B. Doc. No. 21-1207. Filed for public inspection July 30, 2021, 9:00 a.m.]