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Early Retiree Reinsurance Program Benefits Are Limited to Medicare-Eligible Services: Watch Out for Compliance with Additional Government Issuances

by Lynn Shapiro Snyder and Lesley R. Yeung

The Early Retiree Reinsurance Program (“ERRP”) was created by the Patient Protection and Affordable Care Act to provide financial assistance to employers, unions, and state and local governments to help them maintain health insurance coverage for early retirees age 55 and older. A report published by the Department of Health and Human Services on March 2, 2011, states that almost 5,500 plan sponsors have been approved to participate in the ERRP and that $535 million in ERRP reimbursement payments have been made to date. It is important for plan sponsors and third-party administrators to understand that the health benefit claims that qualify for ERRP reimbursement are only those for medical services that would be covered by the Medicare program. Compliance is essential for those participating in the ERRP, especially when Medicare rules are relevant to this federal program.

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