Common Questions
Application
When will CMS stop accepting ERRP applications?
ANSWER: The ERRP statute grants the Secretary of Health and Human Services the authority to stop taking applications for participation in the ERRP based on the availability of program funding appropriated in the statute. 42 U.S.C. 18002(e) & (f). The ERRP interim final regulation also grants the Secretary such authority (see discussion in the regulation preamble at 75 FR 24456). Based on the amount of the $5 billion in appropriated program funding that remains available and the rate at which it is being disbursed, we will no longer accept applications for the program after May 5, 2011. For more information, please see the related notice in the April 5, Federal Register.
Answer ID: 100-25
Date Posted: 04/08/2011
The ERRP application must be signed by an authorized representative. What are some examples of individuals who typically have such legal authority?
ANSWER: Common examples of individuals who typically have the requisite authority to serve as the Early Retiree Reinsurance Program authorized representative for a sponsor include the sponsor's Chief Executive Officer (CEO), Chief Financial Officer (CFO), President, Human Resources (HR) Director, and General Partner. For plan sponsors that are unions, a member of the union fund's board of trustees typically would have the requisite authority. Please note that this list is not exhaustive. The authorized representative and account manager identified in the application must be different individuals.
Answer ID: 100-3
Date Posted: 08/09/2010
Do a plan's programs and procedures for chronic and high-cost conditions have to be in place at the time the sponsor submits the application?
ANSWER: Yes. The program's regulations state that as part of the application, the applicant must include a summary of the programs and procedures it has in place that have generated, or have a potential to generate, cost-savings with respect to participants with chronic and high-cost conditions. The regulation defines a chronic and high-cost condition as a condition for which $15,000 or more in health benefit claims are likely to be incurred during a plan year by any one plan participant. The sponsor, when responding to this question in the application therefore should identify at least two conditions for which it has such programs and procedures, and should identify the type of programs it has in place (e.g., case management, wellness, awareness programs, disease management, etc.) It would be helpful in the summary for the applicant to explain how it determined which conditions to address (i.e. how was it determined that the chronic and high-cost condition has generated, or is likely to generate, $15,000 in claims in a plan year), how the program and procedures will generate cost savings with respect to plan participants with these conditions, a description of the programs and procedures, and who benefits from the cost savings (i.e. the plan sponsor and/or plan participants). This list is not exhaustive. While the Secretary only expects a summary, the applicant must describe how it would support its assertions in the event of an audit.
Answer ID: 100-7
Date Posted: 08/09/2010 Last Updated: 09/24/2010
Does a sponsor need to make HHS aware of any changes or corrections in information reported on the sponsor's application?
ANSWER: Yes. We understand that information on a sponsor's application may need to be updated or corrected as the program progresses. A sponsor should update information on its application as soon as the sponsor is aware of any change to the information provided in the application. Depending upon the update or correction, the applicant may make the change in the Early Retiree Reinsurance Program Secure Website, once it has access, or a separate process may be established. The details as to how sponsors should update HHS on specific issues will be provided in further guidance.
Answer ID: 100-8
Date Posted: 08/09/2010 Last Updated: 01/21/2011
If an applicant has not been informed whether its application has been approved or denied, what should it do?
ANSWER: No action is required. When the application is processed the Authorized Representative and Account Manager identified in an application will both be notified of the application's status.
Answer ID: 100-9
Date Posted: 08/31/2010
If an applicant submitted multiple ERRP applications for the same plan, what should the applicant do?
ANSWER: If an applicant submitted multiple applications for the same plan, the applicant need not take any action. The ERRP Center will contact the account manager and/or authorized representative listed in the applications to determine which application(s) the applicant wishes to have processed.
Answer ID: 100-10
Date Posted: 08/31/2010
When do different health benefit arrangements constitute different employment-based plans for purposes of the Early Retiree Reinsurance Program?
ANSWER: Plan sponsors should submit a separate Early Retiree Reinsurance Program (ERRP) application for each employment-based plan for which it intends to seek program reimbursement. Internal Revenue Service regulations at 26 C.F.R. 54.4980B-2 address the question of how the number of group health plans that an employer or employee organization maintains is determined, for purposes of COBRA. We believe that some of the principles articulated in that regulation can be applied to ERRP. Therefore, for purposes of ERRP, a sponsor may consider multiple health benefit arrangements as one employment-based plan, unless (1) it is clear from the instruments governing an arrangement or arrangements to provide health benefits that the benefits are being provided under separate plans, and (2) the arrangement or arrangements are operated pursuant to such instruments as separate plans. However, a multiemployer plan and a non-multiemployer plan are always separate plans.
Answer ID: 100-11
Date Posted: 08/09/2010
If a sponsor submitted its application via a carrier other than the United States Postal Service, will the application be accepted for processing?
ANSWER: Yes, provided the application is otherwise acceptable for processing. However, for operational reasons, HHS prefers sponsors to use the United States Postal Service. If you submitted your application via a carrier other than the United States Postal Service, and it was accepted at the address listed on the official application, do not re-submit the application. You may want to verify with your courier that your application package was accepted at the address listed on the official application.
Answer ID: 100-12
Date Posted: 09/24/2010
Can the individual identified on the Early Retiree Reinsurance Program application as the Account Manager, be the same individual who is identified as the Authorized Representative?
ANSWER: No.
Answer ID: 100-15
Date Posted: 09/24/2010
If a sponsor combines plans during or at the end of a plan year but after it has submitted its application to participate in the program, does the sponsor have to submit a new application?
ANSWER: If the plans are being consolidated into a new plan, the sponsor will need to submit a new application.
If plans are being combined into an existing plan that has been certified for ERRP purposes, the sponsor should not submit a new application. The sponsor will need to make HHS aware of the change in plan structure through a process that will be developed and announced by HHS.
For plans that are combined during a plan year, the question of how claims will accrue for each early retiree, early retiree’s spouse, surviving spouse and dependent across plans arises. Claims do not accrue across plans so if a new plan is created, the claims accrual (including costs which accrue toward the $15,000 ERRP subsidy threshold) begins on the date when the new plan begins. If plans are combined into an existing plan, the claims from the consolidated plans will not be affected by the consolidation. In such cases, HHS intends to roll the consolidated claims into the plan that ultimately exists and the claim accrual will not start over during a plan year.
Answer ID: 100-16
Date Posted: 09/24/2010
Political subdivisions of a state, and/or their agencies or instrumentalities, (such as townships, counties, school districts, etc.) frequently pool their resources in an effort to provide and/or purchase health coverage for their early retirees (as well as other plan participants). These arrangements can take various forms, and in many cases, the health benefit arrangement is overseen and/or administered by a committee, board, or other body. In such arrangements, is each political subdivision an appropriate entity that could apply for the Early Retiree Reinsurance Program? Or, does one employment-based plan exist at the committee or board level, with the committee or board being the entity that would apply for the program?
ANSWER: It is the obligation of the entity that is considering applying to the Early Retiree Reinsurance Program to determine whether it is an appropriate entity to submit an application and participate in the program. We refer entities to 42 U.S.C. 18002, the program regulations at 45 C.F.R. Part 149, and program guidance. Either a political subdivision that participates in a pooled arrangement to provide and/or purchase health coverage, or the committee, board, or other body that oversees and/or administers the pooled arrangement, could conceivably be appropriate entities to submit an application and participate in the program depending on the arrangement between these entities. The regulations require that a sponsor submit one application per plan. Therefore, it is critical that sponsors make sure they are not each submitting applications for the same "employment-based plan."
If multiple applications were submitted for the same employment-based plan, the entities are responsible for determining which application(s) should be withdrawn. If multiple entities submitted applications and/or reimbursement requests for the same employment-based plan, the entities are expected to notify the ERRP Center of the duplicate applications and/or reimbursement requests, including among other applicable information, the identifying information available to the reporting-entity, for all entities involved. In order for the Department to process this information, the notification must be sent to help@errp.gov as soon as an entity is aware of any such duplicate applications and/or reimbursement requests. The entities, working closely with HHS' ERRP Center, are responsible for determining which application(s) will be withdrawn and/or which reimbursement determination(s) should be cancelled, or reopened and revised, to ensure the proper disposition of any ERRP reimbursement received.
Answer ID: 100-17
Date Posted: 09/24/2010 Last Updated: 12/30/2010
Can retiree-only plans participate in the ERRP?
ANSWER: Yes. The Affordable Care Act does not prohibit retiree-only plans from participating in the ERRP, provided the employment-based plan and its sponsor satisfy all applicable requirements.
Answer ID: 100-18
Date Posted: 09/24/2010