45 CFR Part 153
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
- Subtitle A—Department of Health and Human Services › Subchapter B—Requirements Relating to Health Care Access
- 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.
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