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Code of Federal Regulations (Last Updated: November 8, 2024) |
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Title 45 - Public Welfare |
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Subtitle A—Department of Health and Human Services |
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SubChapter B—Requirements Relating to Health Care Access |
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Part 153 - Standards Related to Reinsurance, Risk Corridors, and HHS Risk Adjustment Under the Affordable Care Act |
Part 153 - Standards Related to Reinsurance, Risk Corridors, and HHS Risk Adjustment Under the Affordable Care Act
| Subpart A - General Provisions |
| § 153.10 - Basis and scope. |
| § 153.20 - Definitions. |
| Subpart B - State Notice of Benefit and Payment Parameters |
| § 153.100 - State notice of benefit and payment parameters. |
| § 153.110 - Standards for the State notice of benefit and payment parameters. |
| Subpart C - State Standards Related to the Reinsurance Program |
| § 153.200 - [Reserved] |
| § 153.210 - State establishment of a reinsurance program. |
| § 153.220 - Collection of reinsurance contribution funds. |
| § 153.230 - Calculation of reinsurance payments made under the national contribution rate. |
| § 153.232 - Calculation of reinsurance payments made under a State additional contribution rate. |
| § 153.234 - Eligibility under health insurance market rules. |
| § 153.235 - Allocation and distribution of reinsurance contributions |
| § 153.240 - Disbursement of reinsurance payments. |
| § 153.250 - Coordination with high-risk pools. |
| § 153.260 - General oversight requirements for State-operated reinsurance programs. |
| § 153.265 - Restrictions on use of reinsurance funds for administrative expenses. |
| § 153.270 - HHS audits of State-operated reinsurance programs. |
| Subpart D - State Standards Related to the Risk Adjustment Program |
| § 153.300 - [Reserved] |
| § 153.310 - Risk adjustment administration. |
| § 153.320 - Federally certified risk adjustment methodology. |
| § 153.330 - State alternate risk adjustment methodology. |
| § 153.340 - Data collection under risk adjustment. |
| § 153.350 - Risk adjustment data validation standards. |
| § 153.360 - Application of risk adjustment to the small group market. |
| § 153.365 - General oversight requirements for State-operated risk adjustment programs. |
| Subpart E - Health Insurance Issuer and Group Health Plan Standards Related to the Reinsurance Program |
| § 153.400 - Reinsurance contribution funds. |
| § 153.405 - Calculation of reinsurance contributions. |
| § 153.410 - Requests for reinsurance payment. |
| § 153.420 - Data collection. |
| Subpart F - Health Insurance Issuer Standards Related to the Risk Corridors Program |
| § 153.500 - Definitions. |
| § 153.510 - Risk corridors establishment and payment methodology. |
| § 153.520 - Attribution and allocation of revenue and expense items. |
| § 153.530 - Risk corridors data requirements. |
| § 153.540 - Compliance with risk corridors standards. |
| Subpart G - Health Insurance Issuer Standards Related to the Risk Adjustment Program |
| § 153.600 - [Reserved] |
| § 153.610 - Risk adjustment issuer requirements. |
| § 153.620 - Compliance with HHS risk adjustment standards. |
| § 153.630 - Data validation requirements when HHS operates risk adjustment. |
| Subpart H - Distributed Data Collection for HHS-Operated Programs |
| § 153.700 - Distributed data environment. |
| § 153.710 - Data requirements. |
| § 153.720 - Establishment and usage of masked enrollee identification numbers. |
| § 153.730 - Deadline for submission of data. |
| § 153.740 - Failure to comply with HHS-operated risk adjustment and reinsurance data requirements. |