93.546: Early Retiree Reinsurance Program

93.546

Inactive

Centers for Medicare and Medicaid Services (CMS) [HHS]

July 15, 2020

Sept. 3, 2019

The program provides reimbursement to sponsors of participating employment-based plans for a portion of the cost of health benefits for early retirees and their spouses, surviving spouses, and dependents. The purpose of the reimbursement is to make health benefits more affordable for plan participants and sponsors so that health benefits are accessible to more Americans than they would otherwise be without this program.

C - Direct Payments for Specified Use

In order to have been eligible for the ERRP, a plan sponsor must have completed and submitted an ERRP application to the ERRP Center on or before May 5, 2011. In summary, the plan sponsor must be an organization that provides health benefits to Early Retirees, have programs and procedures in place that generate cost savings with respect to participants with chronic and high-cost conditions, use reimbursements appropriately, ensure that policies and procedures are in place to protect against fraud, waste and abuse under ERRP, and agree to the Plan Sponsor Agreement included in the ERRP application. Applications were reviewed and either approved or not approved for acceptance in to the program

In order to be eligible to receive reimbursements under the ERRP, a plan sponsor must have completed and submitted an ERRP application to the ERRP Center on or before May 5, 2011. If approved, both the sponsor, and early retirees and their spouses, surviving spouses and their dependents are direct or indirect beneficiaries of the program. In summary, the sponsor must be an organization that provides health benefits to Early Retirees, have programs and procedures in place that generate (or have the potential to generate) cost savings with respect to participants with chronic and high-cost conditions, use reimbursements appropriately, ensure that policies and procedures are in place to protect against fraud, waste and abuse under ERRP, and agree to the Plan Sponsor Agreement included in the ERRP application.