45 CFR 153.110
§ 153.110 Standards for the State notice of benefit and payment parameters.
United States · 45 CFR — Public Welfare · Status: effective
Cite this
- Citation
- 45 CFR 153.110, § 153.110 Standards for the State notice of benefit and payment parameters, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/217512
- Permanent ID
ys:prov:217512@1- SHA-256
b0f81b351879b0055dcd9b7620d74cef9a6eb7c9820ba74df7d7fcc760d235fd
The hash is SHA-256 of this version's text, with every run of whitespace collapsed to a single space and the ends trimmed. The ID always leads back here, and checking it says whether the text you cited is still the current version.
Full text
(a) Data requirements. If a State that establishes a reinsurance program elects to modify the data requirements for health insurance issuers to receive reinsurance payments from those specified in the annual HHS notice of benefit and payment parameters for the applicable benefit year, the State notice of benefit and payment parameters must specify those modifications.
(b) Additional collections. If a State that establishes a reinsurance program elects to collect additional funds under § 153.220(d)(1) or use additional funds for reinsurance payments under § 153.220(d)(2), the State must publish in the State notice of benefit and payment parameters the following:
(1) A description of the purpose of the additional collection, including whether it will be used to cover reinsurance payments made under § 153.232, administrative costs, or both;
(2) The additional contribution rate at which the funds will be collected; and
(3) If the purpose of the additional collection includes reinsurance payments (or if the State is using additional funds for reinsurance payments under § 153.220(d)(2)), the State supplemental reinsurance payment parameters required under § 153.232.
(c) Multiple reinsurance entities. If a State plans to use more than one applicable reinsurance entity, the State must publish in the State notice of benefit and payment parameters, for each applicable reinsurance entity—
(1) The geographic boundaries for that entity;
(2) An estimate of the number of enrollees in the individual market within those boundaries;
(3) An estimate of the amount of reinsurance payments that will be made to issuers with respect to enrollees within those boundaries.
(d) Risk adjustment content. A State operating a risk adjustment program must provide the information set forth in § 153.330(a) and the data validation standards set forth pursuant to § 153.350 in the State notice of benefit and payment parameters.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.