HEALTH INSURER FEE i. Whether the fee is incorporated in the rates The calendar year 2015 rates, calendar year 2017 rates will be amended based on the calculated HIF attributable to ODM premium revenue. To the extent the actual paid HIF is less than the calculated HIF, the rates for the MCP will be amended based on actual paid HIF.
HEALTH INSURER FEE i. Whether the fee is incorporated in the rates Consistent with ODM’s payment of the Health Insurer Fee (HIF) for the CY 2014 and CY 2015 rates, CY 2017 rates will be amended based on the calculated HIF attributable to ODM premium revenue. To the extent the actual paid HIF is less than the calculated HIF, the rates for the MCP will be amended based on actual paid HIF.
HEALTH INSURER FEE. The Patient Protection and Affordable Care Act (ACA) Health Insurer Fee (HIF) and resulting income tax non-deductibility will be accounted for through an administrative allowance included in the capitation payment. The percentage allowance was calculated based on the anticipated liability for the Contract period. Once each MCO’s final liability is known, the State will reconcile that to the amount paid through the capitation payments. If the amount paid is less than the liability amount, an increase will be made to future capitation payments. If the amount paid is greater than the liability amount, a decrease will be made to future capitation amounts.
HEALTH INSURER FEE i. Whether the fee is incorporated in the rates We have not included the health insurer fee into the capitation rates. We will restate the capitation rates at the time that the actual tax amounts are known and submit an amended capitation rate certification.
HEALTH INSURER FEE. The Contractor may be subject to the Health Insurer Fee (HIF) under Section 9010 of the Patient Protection and Affordable Care Act of 2010. The HIF is imposed on qualifying health insurers based on their premiums in the previous year. If the Contractor is subject to the HIF, EOHHS shall make an annual payment to the Contractor for the amount of the HIF, including an actuarially sound adjustment to the Contractor’s capitation rates. EOHHS will pay the Contractor’s HIF retrospectively. The amount due to the eligible Contractor shall be determined based on the Contractor’s final Form 8963 filing, the final notification of the HIF amount owed by the Contractor received from the United States Internal Revenue Service, and any additional supporting documentation as requested by EOHHS. If Congress issues a moratorium for the HIF in any given year, EOHHS will not issue any payment to the Contractors. Payment is contingent on the availability of State funds and CMS approval of the capitation rates including the HIF adjustment.
