1332 Waiver Reinsurance Program—Parameter Updates; Notice 2024-12

NOTICES

INSURANCE DEPARTMENT

1332 Waiver Reinsurance Program—Parameter Updates; Notice 2024-12

[54 Pa.B. 4407] [Saturday, July 27, 2024]

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.

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.

The program parameters for Plan Year 2025 will be adjusted from the parameters announced in Notice 2024-07 published at 54 Pa.B. 2907 (May 25, 2024). Beginning January 1, 2025, the program-adopted parameters will be adjusted to an attachment point of $60,000, a cap of $100,000 and a coinsurance rate of 60%.

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].

MICHAEL HUMPHREYS,

Insurance Commissioner

[Pa.B. Doc. No. 24-1062. Filed for public inspection July 26, 2024, 9:00 a.m.]