Part 153 - STANDARDS RELATED TO REINSURANCE, RISK CORRIDORS, AND 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 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.

Authority

Secs. 1321, 1341–1343, Pub. L. 111–148, 24 Stat. 119.

Source

77 FR 17245, Mar. 23, 2012, unless otherwise noted.