FEHB Program Carrier Letter
Community Rated Carriers

U.S. Office of Personnel Management
Office of Insurance Programs
Letter No. 2001-07 Date: March 22, 2001
     Fee-for-service [ - ]   Experience-rated HMO [ - ]   Community Rated [ 07 ]

SUBJECT: Reconciliation Instructions for 2001 Rates--Community-Rated Carriers

Most community rated carriers must complete some of the enclosed documents (Attachments III, IV, V and VI) to reconcile their 2001 Federal rates. To decide how this letter applies to you, see the following chart:

StepIf Then
1.Your 2000 income from the Federal group was less than $500,000, Stop here. You do not need to complete the enclosed documents. If your 2001 rates were reduced to generate a contingency reserve payment, it will be sent automatically in the summer.
2.Your 2000 income from the Federal group was more than $500,000,You must complete the enclosed documents. Go to step 3.
3.
  • You had more than 1500 contracts at the time of the 2001 rate proposal, or
  • You are a small carrier that filed as large (i.e., a carrier that submitted detailed documentation with your rate proposal),

You must submit Attachments III through VI by May 1, 2001, to:

Ms. Nancy H. Kichak,
Director
Office of Actuaries
Office of Personnel Management
1900 E St, NW., Rm 4307
Washington, DC 20415
4.You are a small carrier (i.e., a carrier with less than 1500 FEHBP contracts at the time of the 2001 rate proposal) that chose not to file as a large carrier,You must complete Attachments III, IIIA, IIIB and V, and keep them on file and available for OPM review.

The enclosed document entitled "OPM Reconciliation Guidelines 2001" gives pertinent definitions and an overall view of our 2001 reconciliation policy.

All carriers must complete sections (1) and (2) of the Reconciliation Questionnaire (Attachment IIIB). Use the following table to determine which sections to complete:

If you useThen you must complete
Traditional Community RatingSections IIIB (1), (2), and (3)
Community Rating by ClassSections IIIB (1), (2), and (4)
Adjusted Community RatingSections IIIB (1), (2), and (5)

Please direct your questions about the reconciliation to Sherry Simon or Jim Quayle at (202) 606-0722, or address e-mail to actuary@opm.gov.

 

Sincerely,
Abby Block signature
Abby L. Block
Assistant Director
   for Insurance Programs
  

Enclosure

Download Letter as PDF File: Adobe Acrobat PDF File
Download Attachment as PDF File: Adobe Acrobat PDF File
Download Attachment as Word Document: Microsoft Word File

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Page created 27 March 2001