Dear Chief Executive Officer: GME Regional Covered Lives Assessment Rates

December 2, 2022

Dear Chief Executive Officer:

The enclosed schedule provides additional information regarding the $40 million increase in Regional Covered Lives Assessment (CLA) rates to support Early Intervention (EI) programs and costs.

Prior correspondence dated October 28, 2022, provided updated rates effective April 1, 2022, as well as notified recipients that further direction would be provided regarding the retroactive piece of this adjustment. This letter provides additional detail on the implementation of the rate change for the April - September 2022 Reports submitted prior to November 1, 2022.

• The Office of Pools Administration has calculated the additional amount owed for previously submitted months related to this increase. This Additional Covered Lives Assessment (ACLA) has been calculated based on your previously submitted reports; if you have already submitted reports for April - September 2022 there is no need to resubmit these reports.
• ACLA Bills reflect the incremental increase in total CLA owed. Payors are only responsible for the difference between previously paid amounts and amounts owed under the updated rates.
• The official rollout date of these adjustments will be December 5, 2022. From this rollout date, remitters will have 90 days to submit the total retroactive amount due (until March 5, 2023).
• Full detail of how to access the ACLA bills is as follows:
  1. Login in to the Pool Administrator’s electronic web reporting portal (www.hcrapools.org) using your Payor/TPA/FTP login credentials.
  2. Select the “Submit an ACLA 2022 Report” option to pay or view the retroactive Covered Lives Bills for April - September 2022 reports filed prior to November 1, 2022.
  3. Click on the bills to verify them on the ACLA 2022 Bills screen. There is a bill for each confirmation number that you previously submitted for the period identified above.
  4. You can select all the bills or only some of the bills to be processed per payment submission, though all bills will ultimately need to be paid.
  5. Once the bills are selected, you will be presented with payment options. If one of the bills is credit, the direct debit option is disabled – you will need to pay by wire transfer or by check.
  6. Once the payment option is selected, a confirmation page is presented showing both the old and new confirmations for the bills selected.
  7. Please click on "Complete Report" to submit the selected bill.
  8. Payment is due by March 5, 2023.

This notice has been sent to you because your organization is an electing payor under the New York State’s Health Care Reform Act (HCRA) Pools, paying and reporting directly to the HCRA Public Goods Pool. If you use a third-party administrator (TPA), the Department suggests that you contact your TPA directly concerning any questions you may have regarding this notice. Others having questions regarding these rates should contact a HCRA representative at webpools@hcrapools.org.

Sincerely,

Michael Spitz
Acting Deputy Division Director
Division of Finance and Rate Setting
Office of Health Insurance Programs