pa-56-25-880: 1332 Waiver Reinsurance Program—Plan Year 2027 parameter update
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On July 24, 2020, the Centers for Medicare & Medicaid Services, a division of the United States Department of Health and Human Services, and the United States Department of the Treasury, approved the Insurance Department's 1332 Waiver Application. The approval is effective for a waiver period from January 1, 2021, through December 31, 2030. The reinsurance program is a claims-based, attachment point reinsurance program that will reimburse health insurers for claims costs of qualifying Affordable Care Act-compliant individual enrollees, where a percentage of the claims costs exceeding a specified threshold (attachment point) and up to a specified ceiling (reinsurance cap) will be reimbursed. Beginning January 1, 2027, the program-adopted parameters will be adjusted to an attachment point of $60,000, a cap of $100,000 and a coinsurance rate of 34%. Questions regarding this notice may be addressed to the Bureau of Life, Accident and Health, Insurance Department, 1311 Strawberry Square, Harrisburg, PA 17120, RA-IN-PA1332WAIVER@pa.gov. MICHAEL HUMPHREYS, Insurance Commissioner
The agency’s own summary, as published.
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