HHS Issues Appeals Process Guidelines under the Early Retiree Reinsurance Program

On October 3, the Department of Health and Human Services issued operational guidance regarding how plan sponsors participating in the Early Retiree Reinsurance Program (ERRP) under health care reform could submit a request for appeal of an adverse reimbursement determination. The ERRP reimburses plan sponsors for a portion of the costs of health benefits for early retirees and their spouses or surviving spouses until the earlier of January 1, 2014 or the depletion of available funds. The guidance includes information regarding determinations that are appealable, the deadlines for submitting appeals, the information required in appeals, and the appeals process in general. Plan sponsors must appeal an adverse reimbursement determination within 15 calendar days after receiving such determination. A decision by the HHS Departmental Appeals Board is generally final and binding. A copy of the guidance can be found here.