Early Retiree Program Issues New Reminders and Tips

The Center for Consumer Information and Insurance Oversight (CCIIO) has published a series of reminders and tips regarding the Early Retiree Reimbursement Program (ERRP), which includes the following information for resolving the most common early retiree list questions:

Submitting the Early Retiree List

Including Eligible Records. When preparing an early retiree list, plan sponsors should ensure that the list includes only early retirees who meet or exceed the $15,000 cost threshold. In addition, plan sponsors should verify that each member record has a corresponding subscriber record, even if the subscriber is no longer eligible for reimbursement under the ERRP.

Adding Early Retirees. If a plan sponsor submits an early retiree list and then finds that additional early retirees need to be added to the list, it may do so by submitting another complete early retiree list. Each early retiree list submission is a full replacement of the previously submitted list.

Reviewing The Early Retiree List Response File

Using the Correct Response File. Each time a plan sponsor submits an early retiree list, the ERRP Center produces an early retiree list response file. If a plan sponsor submits multiple early retiree lists, it should ensure that the correct early retiree list response file is being used to research the data elements identified as errors in the corresponding early retiree list. Plan sponsors should consider saving each response file with a different name to keep multiple response files in order.

Understanding the Early Retiree List Response File Reason Codes. Reason codes are numerical codes that correspond to a specific message about a record in an early retiree list response file. Reason codes advise when an ERRP effective and/or termination date returned by the ERRP Center varies from the plan coverage dates originally submitted by the plan sponsor. The reason code will explain the ERRP effective and/or termination dates provided by the ERRP Center. ERRP coverage periods could be adjusted to a shortened coverage period, or no coverage period at all depending on the following scenarios:

• No ERRP coverage period; and
• The ERRP Center will return a reason code and no ERRP coverage period (zeroes in ERRP effective and termination dates) if one or more selected fields are invalid (e.g., last name, first name, eate of birth, coverage effective date, coverage termination date, member ID, member group ID, etc.).

Additionally, the ERRP Center will return a reason code and no ERRP coverage period (zeroes in ERRP effective and termination dates) if one or more of the following can not be confirmed in the ERRP SWS system: plan year start date, application number, ERL submission method, corresponding subscriber record, member ID, and member group ID combination.

Finally, the ERRP Center will return a reason code and a shortened ERRP coverage period (modified ERRP effective and termination dates—not zeroes) and a reason code as applicable, in the following scenarios:

• The plan coverage effective and/or termination dates submitted by the plan sponsor are outside the plan year.
• The subscriber is eligible for Medicare during some portion of or all of the plan sponsor submitted coverage period (this also could result in no ERRP coverage period).
• Subscriber is deceased (this also could result in no ERRP coverage period).
• Ineligible member coverage dates (this also could result in no ERRP coverage period).
• Adjusted subscriber coverage dates (this also could result in no ERRP coverage period).
• Adjusted spouse and/or dependent coverage dates (this also could result in no ERRP coverage period).

For a comprehensive analysis of the Patient Protection and Affordable Care Act, and additional information on health reform and other developments in employee benefits, just click here.

Sneak peek at health exchanges

States aren't required to have an American Health Benefit Exchange in place until January 1, 2014, pursuant to the Patient Protection and Affordable Care Act (ACA). But one private company is testing the waters before then.

Aon Hewitt has announced plans to offer a corporate health care exchange to employers nationwide, targeting 1,000 or more full-time employees, beginning as early as 2012. Aon Hewitt has been providing and administering retiree medical exchanges for several years. In anticipation of changes to the insurance market, the organization is extending its exchange model to offer employers a viable option for active employees.

"Health reform creates an opportunity for employers to re-examine the way in which they provide health benefits to employees," said Ken Sperling, global Health & Benefits Practice leader with Aon Hewitt. "Leveraging the efficiencies and market competition in an exchange environment has the potential to provide immediate and long-term savings to employers, while giving employees more choice and control over their benefit plans. The corporate health care exchange concept was an obvious choice for Aon Hewitt, given our experience and expertise in benefits administration. The Aon Hewitt exchange model already exists; it is an extension of our very successful retiree medical exchange, which administers retiree benefits to more than 2.4 million participants. We are the largest benefits administrator in the U.S., providing outsourcing administration services to more than 10 million employees and their dependents. We know what works."


Aon Hewitt currently is conducting health care conferences for their clients in many cities nationwide. At the Chicago and New York events, 243 participants were asked about their plans to provide health care coverage to their employees in 2015 and beyond. There was a nearly even split between employers who thought they would ultimately be delivering health benefits via a corporate exchange (43 percent) versus continuing to offer health care benefits directly with greater financial controls and policies (47 percent). Meanwhile, 9 percent said they would continue their attempts to manage the health care trend annually, based on current business and economic conditions, and just one percent said they do not believe they would be offering health care coverage at all in 2015.


"Client concerns about providing health care coverage center on the balance between removing risk and volatility, and offering coverage as a key attraction and retention tool," said John Zern, Americas Health & Benefits Practice leader with Aon Hewitt. "The Aon Hewitt corporate exchange model addresses both these issues. Volatility is mitigated through a defined employer contribution for employees to purchase coverage through the exchange, and this important benefit is delivered through a partner with a proven track record for success as the nation's leading health care consultant and employee benefits outsourcer."


Perhaps the states can watch (and learn?) from Aon Hewitt's early efforts.

For a comprehensive analysis of the Patient Protection and Affordable Care Act, and additional information on health reform and other developments in employee benefits, just click here.

High Court declines to speed up reform challenge

This week the Supreme Court denied a request to review a State of Virginia challenge to the ACA before the 4th Circuit Court of Appeals has the opportunity to hear and rule on the case (Virginia, Ex. Rel. Cuccinelli v. Sebelius, Sec. of HHS, cert. denied, S. Ct. 10-1014).

In December 2010, a district court in Virginia ruled the ACA was unconstitutional (Commonwealth of Virginia v. Kathleen Sebelius, No. 3:10CV188-HEH). That case was appealed, but subsequently Virginia Attorney General Ken Cuccinelli asked the Supreme Court to hear the case immediately.

The April 25 denial was expected, because the Supreme Court rarely allows a case to skip the appellate courts. This is the second time the High Court has declined to accelerate an ACA challenge.

Arguments are scheduled to be heard in the Fourth Circuit case on May 10, along with oral arguments in another Virginia case in which the ACA was declared constitutional (Liberty University v. U.S., Case No. 6:10-cv-00015-nkm).

Lineup of cases. In addition to the two Virginia cases, three other courts have ruled on the constitutionality of the ACA itself.



The 11th Circuit has agreed to an accelerated briefing schedule in State of Florida v. U.S. Dept. of HHS (11-11021-HH), in which the district court declared the entire ACA unconstitutional. The court has required all briefings to be filed by May 25, and the case is scheduled to be heard on June 8.

In Thomas More Law Center, et al. v. Obama (No. 10-CV-11156), the district court held that the ACA did not violate the Commerce Clause of the Constitution. The case is scheduled to be heard by 6th Circuit Court of Appeals on June 1.

Finally, the individual mandate in the ACA was upheld by a district court in Margaret Peggy Lee Mead, et al. v. Holder, et al. (No. 10-950). An appeal was filed with the D.C. Circuit U.S. Court of Appeals on March 1, 2011.

Go here for more information. For a comprehensive analysis of the Patient Protection and Affordable Care Act, and additional information on health reform and other developments in employee benefits, just click here.