U.S. Office of Personnel Management www.opm.gov - Recruiting, Retaining and Honoring a World-Class Workforce to Serve the American People
Federal Employees Health Benefits Program
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FEHB Program Carrier Letter Community-rated Carriers |
U.S. Office of Personnel Management Insurance Services Programs |
Letter No. 2004-05 |
Date: May 5, 2004 |
SUBJECT: Reconciliation Instructions for 2004 Rates. Community-Rated Carriers
Most community rated carriers must complete some of the enclosed documents (Attachments III, IV, V and VI) to reconcile their 2004 Federal rates. These documents comprise the final part of the 2004 Rate Proposal. To decide which attachments apply to you, see the following chart:
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Step |
If… |
Then… |
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1. |
Your 2003 income from the Federal group was less than $500,000.00 |
Stop here. You do not need to complete the enclosed documents. If your 2004 rates were reduced to generate a contingency reserve payment, it will be sent automatically in the summer. |
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2. |
You had more than 1500 contracts at the time of the 2004 rate proposal, or You are a small carrier that filed as large by submitting detailed documentation with your rate proposal, |
You must email Attachments III through VI by April 30, 2004, to Actuary@opm.gov. Send any documents which cannot be emailed to:
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3. |
You are a small carrier with more than $500,000.00 income and did not 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 2004" gives pertinent definitions and an overall view of our 2004 reconciliation policy. All carriers, except those with income less than $500,000.00 in 2003, must complete the Reconciliation Questionnaire (Attachment IIIB) as indicated by the following table:
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If you use… |
Then you must complete… |
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Traditional Community Rating |
Sections IIIB (1),(2),(3) |
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Community Rating by Class |
Sections IIIB (1),(2),(4) |
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Adjusted Community Rating (ACR) |
Sections IIIB (1),(2),(4) |
If you have questions about the reconciliation please call Sherry Simon or Jim Quayle at (202) 606-0722, or send an email to us at actuary@opm.gov. This year's reconciliation is being emailed to you as a Word document. Please e-mail the completed forms as a word document to the above email address. Please send any documents which cannot be emailed by overnight delivery.
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Sincerely, |
Enclosure
Download this Letter as a PDF File
Attachments [Web]
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