The Patient Protection and Affordable Care Act - PPACA
SERFF 5.8.3 introduces support for the Patient Protection and Affordable Care Act (PPACA). This release includes the ability to mark a Sub-TOI as PPACA eligible, which triggers the display of a required PPACA field on filings associated with that Sub-TOI. This field has also been added to PDF Pipeline and Post-Submission Updates. Expansion of PPACA support, such as adding the fields to Search and the Export Tool, is planned for upcoming releases.
PPACA Eligibility
A Sub-TOI's eligibility for PPACA is set in Filing Rules and is based on the decisions of the NAIC's Speed to Market Task Force. Once a Sub-TOI is marked as PPACA eligibile, any filing associated with that Sub-TOI will display the PPACA field. If the filing was submitted before the Sub-TOI was made PPACA eligible, the field will have a PPACA value of "Pre-PPACA Submission", which may be changed through a Post-Submission Update.
Additionally, in order indicate that a TOI/SubTOI combination is reportable to HHS, a 'Report to HHS' flag has been added to Filing Rules - Types of Insurance. If the flag is not selected, state users will no longer have the option to select 'Report Rate Filing to HHS' via the Rate/Rule Schedule tab. Instead, the filing will indicated as not eligible for reporting to HHS.
Setting PPACA
For eligible Sub-TOIs the PPACA field can be found on the General Information tab. New filings made on a PPACA eligible Sub-TOI must have at least one PPACA value selected prior to submission. If they are not related to PPACA, the "Not PPACA-Related" option should be selected. Some PPACA values cannot be selected in conjunction with any other value, while others may be selected in combinations.
Click here to see an overview of PPACA changes.
Rate Review Detail
Click here to review descriptions of the multiple fields found on the Rate Review Detail window within the Rate/Rule Schedule and the Disposition.
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Contact the SERFF Help Desk by calling 816-783-8500 or emailing serffhelp@naic.org.