New York State Health Care Reform Act (HCRA)

February 18, 1997

Re: 1997 Public Goods Pool Reporting Forms For Payors

Dear Payor:

Enclosed are monthly reporting forms and instructions for electing payors to use in calculating and remitting payments to the 1997 Public Goods Pools. Note that the reporting forms are required to be filed monthly by each electing entity even if there is no activity to report for the reporting month.

ALL PAYMENT CHECKS SHOULD BE MADE PAYABLE TO THE "1997 PUBLIC GOODS POOL"
AND MAILED WITH THE APPLICABLE REPORTING FORMS VIA:

Regular Mail:

Mr. Jerome Alaimo, Pool Administrator
Office of Pool Administration
Excellus BlueCross BlueShield,
Central New York Region
P.O. Box 4757
Syracuse, New York 13221-4757

-OR-

Express or Overnight Mail:

Mr. Jerome Alaimo, Pool Administrator
Office of Pool Administration
Excellus BlueCross BlueShield,
Central New York Region
344 South Warren Street
Syracuse, New York 13202-2008

A schedule of report and payment due dates for the months January through December 1997 is provided on the first page of the instructions. Note also that the first report, covering the month of January, 1997, must be submitted (postmarked) by March 3, 1997.

A payor may be denied the opportunity to remit the HCRA surcharges directly based on repeated late payments, failure to remit correct amounts, or failure to provide adequate certification of the accuracy of surcharge payments. Additionally, failure to file reports and payments will result in interest and penalties being applied in accordance with the provisions of Section 2807-j(8) of the Public Health Law.

Should you have any questions concerning the foregoing or the enclosed forms, please contact Mr. Richard Pellegrini, Director of the Bureau of Financial Management and Information Support at (518) 473-4653.

Sincerely,

Mark H. Van Guysling
Assistant Director
Division of Health Care Financing

Enclosures