['Employee Benefits']
['Patient Protection and Affordable Care Act']
12/05/2023
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(a) Collections. If a State establishes a reinsurance program, HHS will collect all reinsurance contributions from all contributing entities for that State under the national contribution rate.
(b) Contribution funding. Reinsurance contributions collected must fund the following:
(1) Reinsurance payments that will total, on a national basis, $10 billion in 2014, $6 billion in 2015, and $4 billion in 2016;
(2) U.S. Treasury contributions that will total, on a national basis, $2 billion in 2014, $2 billion in 2015, and $1 billion in 2016; and
(3) Administrative expenses of the applicable reinsurance entity or HHS when performing reinsurance functions under this subpart.
(c) National contribution rate. HHS will set in the annual HHS notice of benefit and payment parameters for the applicable benefit year the national contribution rate and the proportion of contributions collected under the national contribution rate to be allocated to:
(1) Reinsurance payments;
(2) Payments to the U.S. Treasury as described in paragraph (b)(2) of this section; and
(3) Administrative expenses of the applicable reinsurance entity or HHS when performing reinsurance functions under this subpart.
(d) Additional State collections. If a State establishes a reinsurance program:
(1) The State may elect to collect more than the amounts that would be collected based on the national contribution rate set forth in the annual HHS notice of benefit and payment parameters for the applicable benefit year to provide:
(i) Funding for administrative expenses of the applicable reinsurance entity; or
(ii) Additional funds for reinsurance payments.
(2) A State may use additional funds which were not collected as additional reinsurance contributions under this part for reinsurance payments under the State supplemental payment parameters under §153.232.
[77 FR 17248, March 23, 2012; 78 FR 15526, March 11, 2013; 78 FR 66655, Nov. 6, 2013]
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