WASHINGTON—Organizations that haven’t yet applied to participate in a government program that will provide partial reimbursement of claims incurred by enrollees in their early retiree health care plans will have to use a new application form starting next week, the Department of Health and Human Services announced Tuesday.

Organizations whose applications are postmarked after Nov. 9 must use the new form, HHS said. Those that have not started to complete the prior Aug. 9 application form, and whose application is postmarked Nov. 9 or earlier, also must use the Nov. 2 application.

However, organizations that started to complete the Aug. 9 application, which is no longer available online, may submit that version, provided that it is postmarked no later than Nov. 9, HHS said.

About 3,700 organizations, including private employers, public entities and union funds, have had their applications approved to participate in the Early Retiree Reinsurance Program.

Under ERRP, the government will reimburse organizations with early retiree health care plans for a portion of health care claims incurred by retirees who are at least age 55 but not eligible for Medicare, as well as by retirees’ covered dependents, regardless of age.

After a participant in an early retiree plan incurs $15,000 in health care claims in a plan year, the government will reimburse plan sponsors for 80% of claims up to $90,000. The reimbursement applies to claims incurred June 1 or later.

As part of the health care reform law, Congress appropriated $5 billion for the program, which was seen as a way to encourage employers to continue their early retiree health care plans until at least 2014, when subsidized coverage for the uninsured will be available through newly established state insurance exchanges.

However, researchers at the Employee Benefit Research Institute in Washington have projected that the money will run out sometime next year.

The new application form and instructions are available at www.errp.gov/how_to_apply.shtml.