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<REGINFO_RIN_DATA xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" RUN_DATE="2026-04-09-04:00" xsi:noNamespaceSchemaLocation="https://www.reginfo.gov/public/xml/REGINFO_XML_Ver10262011.xsd">
    <RIN_INFO>
        <RIN>0938-AR07</RIN>
        <PUBLICATION>
            <PUBLICATION_ID>201110</PUBLICATION_ID>
            <PUBLICATION_TITLE>The Regulatory Plan and the Unified Agenda of Federal Regulatory and Deregulatory Actions</PUBLICATION_TITLE>
        </PUBLICATION>
        <AGENCY>
            <CODE>0938</CODE>
            <NAME>Centers for Medicare &amp; Medicaid Services</NAME>
            <ACRONYM>CMS</ACRONYM>
        </AGENCY>
        <PARENT_AGENCY>
            <CODE>0900</CODE>
            <NAME>Department of Health and Human Services</NAME>
            <ACRONYM>HHS</ACRONYM>
        </PARENT_AGENCY>
        <RULE_TITLE>State Requirements for Exchange--Reinsurance and Risk Adjustments (CMS-9975-F)</RULE_TITLE>
        <ABSTRACT><![CDATA[This rule implements requirements for States related to reinsurance, risk corridors, and a permanent risk adjustment.  The goals of these programs are to minimize negative impacts of adverse selection inside the Exchanges.]]></ABSTRACT>
        <PRIORITY_CATEGORY>Economically Significant</PRIORITY_CATEGORY>
        <RIN_STATUS>First Time Published in The Unified Agenda</RIN_STATUS>
        <RULE_STAGE>Final Rule Stage</RULE_STAGE>
        <MAJOR>Yes</MAJOR>
        <UNFUNDED_MANDATE_LIST>
            <UNFUNDED_MANDATE>No</UNFUNDED_MANDATE>
        </UNFUNDED_MANDATE_LIST>
        <CFR_LIST>
            <CFR>45 CFR 155, 156</CFR>
        </CFR_LIST>
        <LEGAL_AUTHORITY_LIST>
            <LEGAL_AUTHORITY>PL 111-148, secs 1341 and 1342</LEGAL_AUTHORITY>
        </LEGAL_AUTHORITY_LIST>
        <LEGAL_DLINE_LIST>
            <LEGAL_DLINE_INFO>
                <DLINE_TYPE>Statutory</DLINE_TYPE>
                <DLINE_ACTION_STAGE>Final</DLINE_ACTION_STAGE>
                <DLINE_DATE>01/01/2014</DLINE_DATE>
                <DLINE_DESC> </DLINE_DESC>
            </LEGAL_DLINE_INFO>
        </LEGAL_DLINE_LIST>
        <RPLAN_ENTRY>Yes</RPLAN_ENTRY>
        <RPLAN_INFO>
            <STMT_OF_NEED><![CDATA[This rule finalizes guidelines for the transitional risk-sharing programs, reinsurance and risk corridors, as well as for the risk adjustment program that will continue beyond the first 3 years of Exchange operation.  The purpose of these programs is to protect health insurance issuers from the negative effects of adverse selection and to protect consumers from increases in premiums due to uncertainty for issuers.]]></STMT_OF_NEED>
            <LEGAL_BASIS><![CDATA[This rule implements the new Affordable Insurance Exchanges consistent with title I of the Affordable Care Act of 2010.]]></LEGAL_BASIS>
            <ALTERNATIVES><![CDATA[None.  This is a statutory requirement.]]></ALTERNATIVES>
            <COSTS_AND_BENEFITS><![CDATA[Payments through reinsurance, risk adjustment, and risk corridors reduce the increased risk of financial loss that health insurance issuers might otherwise expect to incur in 2014 due to market reforms such as guaranteed issue and the elimination of medical underwriting.  These payments reduce the risk to the issuer and the issuer can pass on a reduced risk premium to enrollees.  Administrative costs will vary across States and health insurance issuers depending on the sophistication of technical infrastructure and prior experience with data collection and risk adjustment.  States and issuers that already have systems in place for data collection and reporting will have reduced administrative costs.]]></COSTS_AND_BENEFITS>
            <RISKS><![CDATA[If this regulation is not published, the Exchanges will not become operational by January 1, 2014, thereby violating the statute.]]></RISKS>
        </RPLAN_INFO>
        <TIMETABLE_LIST>
            <TIMETABLE>
                <TTBL_ACTION>NPRM</TTBL_ACTION>
                <TTBL_DATE>07/15/2011</TTBL_DATE>
                <FR_CITATION>76 FR 41866</FR_CITATION>
            </TIMETABLE>
            <TIMETABLE>
                <TTBL_ACTION>NPRM Comment Period End</TTBL_ACTION>
                <TTBL_DATE>09/28/2011</TTBL_DATE>
            </TIMETABLE>
            <TIMETABLE>
                <TTBL_ACTION>Final Action</TTBL_ACTION>
                <TTBL_DATE>01/00/2012</TTBL_DATE>
            </TIMETABLE>
        </TIMETABLE_LIST>
        <RFA_REQUIRED>Undetermined</RFA_REQUIRED>
        <SMALL_ENTITY_LIST>
            <SMALL_ENTITY>Governmental Jurisdictions</SMALL_ENTITY>
        </SMALL_ENTITY_LIST>
        <GOVT_LEVEL_LIST>
            <GOVT_LEVEL>State</GOVT_LEVEL>
        </GOVT_LEVEL_LIST>
        <FEDERALISM>Yes</FEDERALISM>
        <ENERGY_AFFECTED>Undetermined</ENERGY_AFFECTED>
        <PRINT_PAPER>No</PRINT_PAPER>
        <INTERNATIONAL_INTEREST>No</INTERNATIONAL_INTEREST>
        <AGENCY_CONTACT_LIST>
            <CONTACT>
                <FIRST_NAME>Alissa</FIRST_NAME>
                <LAST_NAME>Deboy</LAST_NAME>
                <TITLE>Health Insurance Specialist, Center for Consumer Information &amp; Insurance Oversight</TITLE>
                <AGENCY>
                    <CODE>0938</CODE>
                    <NAME>Centers for Medicare &amp; Medicaid Services</NAME>
                    <ACRONYM>CMS</ACRONYM>
                </AGENCY>
                <PHONE>301 492-4428</PHONE>
                <EMAIL>alissa.deboy1@cms.hhs.gov</EMAIL>
                <MAILING_ADDRESS>
                    <STREET_ADDRESS>7500 Security Boulevard,</STREET_ADDRESS>
                    <CITY>Baltimore</CITY>
                    <STATE>MD</STATE>
                    <ZIP>21244</ZIP>
                </MAILING_ADDRESS>
            </CONTACT>
        </AGENCY_CONTACT_LIST>
    </RIN_INFO>
</REGINFO_RIN_DATA>
