HHS anticipates using 2015 risk corridors collections for 2014 benefits
The Department of Health and Human Services anticipates using all 2015 risk corridors program collections to pay 2014 benefits, the agency Friday. Collections for the 2016 program also would be used first to pay remaining 2014 benefits and then 2015 and 2016 benefits, respectively, HHS said. “As we have said previously, in the event of a shortfall for the 2016 benefit year, HHS will explore other sources of funding for risk corridors payments, subject to the availability of appropriations,” HHS said. “This includes working with Congress on the necessary funding for outstanding risk corridors payments.” The risk corridors program provides issuers of qualified health plans in the individual and small group markets additional protection against uncertainty in claims costs during the first three years of the Health Insurance Marketplace, launched in 2014. The program collects charges from issuers whose premiums exceed claim costs for enrollees by a certain amount and makes payments to issuers if their premiums fall short by a certain amount, subject to certain adjustments. To date, CMS has paid about 12% of risk corridor claims for 2014.