Health Reform regulations are beginning to trickle in. The interim final regulations for Early Retiree Reinsurance Program were published in early May. This is a temporary program that begins June 1, 2010 and ends January 1, 2014 unless funding of $5 billion runs out first. It allows plans that cover early retirees (55+ who are not eligible for Medicare) to obtain 80% reimbursement for their and their dependents’ claims that exceed $15,000, but not more than $90,000 in a plan year. There are certain requirements the plans must meet in order to qualify and HHS must certify them before they can participate. The applications should be available at the end of June.

ABPA is gearing up to assist our clients with this process. There is a one-time application and a requirement to submit ongoing claims. Our clients will decide how much ABPA is involved in this process by selecting the option that best suits their needs. Below are the options currently being offered:

1. Complete the application process and submit ongoing health claims that we process and coordinate the claims submission information with pharmacy benefit managers (PBMs) and mental health providers, if any.
2. Complete the application only.
3. Provide a report of claims ABPA processes to the individual or entity chosen by the client to submit this information to HHS.

Contact your Account Executive with any questions and to discuss your options for the Early Retiree Reinsurance program.

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