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Insurers writing coverage in California will receive more than $1.1 billion in federal payments under a reinsurance program created by the health care reform law, according to an analysis released Monday by Covered California, the state’s health insurance exchange.
Under the first year of the three-year Transitional Reinsurance Program — intended to encourage insurers to provide coverage in the individual market — health insurers writing coverage in the individual market are reimbursed by the government for 2014 claims between a $45,000 attachment point and a $250,000 ceiling.
The biggest payments to California-based insurers will go to Anthem Blue Cross of California, $401.1 million; Blue Shield of California, $363 million; and Kaiser Permanente, $240 million, according to Covered California, which drew its analysis from a report issued earlier by the U.S. Centers for Medicare and Medicaid Services.
The $1.172 billion that California insurers will collect under the reinsurance program compares with the nearly $8 billion health insurers will receive nationwide.
First-year revenue for the three-year program comes from a $63-per-participant fee paid by self-insured employers and other health plan sponsors. The 2015 fee is scheduled to decrease to $44 per participant, while the 2016 fee is scheduled to decline to $27 per participant.
Covered California is the largest state insurance exchange program, with 1.365 million enrollees who have paid premiums as of March 31, according to an earlier CMS report.
The Workers’ Compensation Insurance Rating Bureau of California proposes a new experience rating formula and other changes in its 2016 regulatory filing to the state’s insurance department.