Rules Coming for High-Risk Health Insurance Program

While still holding meetings to solicit input on implementation of the Risk Adjustment Program authorized under the Affordable Care Act, the Department of Health and Human Services has finished work on a pre-rule bulletin which outlines some of the operations authorized under this program.

The risk adjustment program is designed to protect issuers that attract a high risk population, such as those with chronic conditions. Under the program, money is transferred from issuers with lower risk enrollees to issuers with higher risk enrollees. The program will apply to non-grandfathered plans in the individual and small group markets, inside and outside of the proposed state insurance exchanges.

The draft bulletin is now being reviewed by other agencies and will be issued shortly.
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