['Employee Benefits']
['Health Plans']
12/05/2023
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(a) An eligible State may receive a grant to fund up to 50 percent of the losses incurred in the operation of its qualified high risk pool during the period for which it is applying.
(b) Funds will be allocated to each eligible State in accordance with the following formula:
(b)(1) The number of uninsured individuals is calculated for each eligible State by taking a 3-year average of the number of uninsured individuals in that State in the Current Population Survey (CPS) of the Census Bureau. For grants based upon State fiscal years 2002 and 2003, a 3-year average was calculated using numbers available as of September 30, 2003. For grants based upon State fiscal year 2004, a 3-year average will be calculated using numbers available as of September 30, 2004.
(b)(2) Based upon the CPS numbers, the State’s percentage of the total uninsured population of eligible States is calculated and then multiplied by $40 million to determine the State’s maximum allotment for the fiscal year in question. The following example illustrates the formula in paragraph (b):
(b)(2)(i) The most current 3-year average of uninsured individuals in State A is one million, and the 3-year average of uninsured individuals for all eligible States is 10 million. State A has 10 percent of the uninsured population of the eligible States.
(b)(2)(ii) Under this example, State A’s allotment would be 10 percent of $40 million, or $4 million, for the fiscal year in question.
(c) The amount awarded to each eligible State will be the lesser of the 50 percent of losses incurred by its qualified risk pool for the fiscal year in question or its allotment under the formula.
[68 FR 23414, May 2, 2003, as amended at 69 FR 15700, Mar. 26, 2004]
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