Part 153 — Standards Related to Reinsurance, Risk Corridors, and HHS Risk Adjustment Under the Affordable Care Act
Current through Aug 10, 2026
Authority: 42 U.S.C. 18031, 18041, and 18061 through 18063.
Source: 77 FR 17245, Mar. 23, 2012, unless otherwise noted.
Sections
- § 153.10 Basis and scope.
- § 153.20 Definitions.
- § 153.100 State notice of benefit and payment parameters.
- § 153.110 Standards for the State notice of benefit and payment parameters.
- § 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.
- § 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.
- § 153.400 Reinsurance contribution funds.
- § 153.405 Calculation of reinsurance contributions.
- § 153.410 Requests for reinsurance payment.
- § 153.420 Data collection.
- § 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.
- § 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.
- § 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.