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HHS offers FAQs on early retiree reinsurance program


WASHINGTON—A Department of Health and Human Services office administering a soon-to-begin program that will partially reimburse employers for claims in their early retiree health care plans is now answering frequently asked questions.

The questions and answers are available on a website provided by the Office of Consumer Information and Insurance Oversight, which is running the Early Retiree Reinsurance Program.

Under that program, after a plan sponsor applies and files claims information under the Early Retiree Reinsurance Program, the government will reimburse employers for a portion of health care claims incurred by retirees who are at least age 55 but not eligible for Medicare, as well as 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 a participant’s claims up to $90,000.

In the FAQ, the government office says there is no predetermined number of applications that HHS is planning to accept, contrary to some reports.

While HHS has “the authority to stop reinsurance payments or accepting applications,” that will happen “only if it appears that the $5 billion in federal funding is insufficient,” the office said.

An analysis released Monday by the Employee Benefit Research Institute projected that the program, which will cover reimbursement of claims incurred beginning on June 1, will run out of funds sometime next year, long before the program expires at the end of 2013.

The office also says the official application will mirror a draft application it has posted, with the only change being the addition of an address where the official application can be sent. That official application will be posted later this month.

Responding to another frequent question, the office says HHS will announce “in the near future” instructions on how plan sponsors can file claims for reimbursement after their applications have been approved.

The frequently asked questions and answers are available online at