Contribution Enrollees

Reference Documents

Applicable CHA-RI Statutes RI Gen Law 42-12-29 effective until January 2016 – Children's Health Account RI Gen Law 42-12-29 effective January 2016 – Children’s Health Account RI Gen Law 42-7.4-3 – Imposition of Healthcare Services Funding Contribution CHA-RI Contribution Enrollees FAQ C1. What are “contribution enrollees”? C1. What are “contribution enrollees”? Contribution enrollee" means an individual residing in Rhode Island, with respect to whom an insurer administers, provides, pays for, insures, or covers health care services, unless excepted by this section. C2. Who is not a “contribution enrollee”? C2. Who is not a “contribution enrollee”? Contribution enrollee shall not include an individual whose healthcare services are paid or reimbursed by Part A or Part B of the Medicare program, a Medicare supplemental policy as defined in section 1882(g)(1) of the Social Security Act, 42 U.S.C. 1395ss(g) (1), or Medicare managed care policy, the federal employees' health benefit program, Tricare, CHAMPUS, the Veterans' healthcare program, the Indian health service program, or any local governmental corporation, district, or agency providing health benefits coverage on a self-insured basis. C3. Must an entity file reports even if it does not provide medical benefits and therefore has zero contribution enrollees? C3. Must an entity file reports even if it does not provide medical benefits and therefore has zero contribution enrollees? Yes, but the entity may be eligible to file an Annual or Permanent Zero Contribution Enrollees Report instead of the typical quarterly reports. Please note that if an entity has zero contribution enrollees for one quarter only, then it should file a normal quarterly report with “0” values. If, however, an entity does not administer medical benefits or is otherwise exempt by Rhode Island statute so that it has zero contribution enrollees, it should file one of two types of Zero Contribution Enrollees Reports. For example, this type of report would be appropriate for entities such as those administering eye care or dental benefit only plans. If the entity has zero contribution enrollees and will continue to have zero contribution enrollees for the balance of the year, then it should file an Annual Zero Contribution Enrollees Report during the first quarter of the calendar year. No other report will be due until the first quarter of the following calendar year. If the entity has zero contribution enrollees and expects to never have contribution enrollees, it should file a Permanent Zero Contribution Enrollees Report to eliminate the need for further compliance follow up. A guide to Zero Contribution Enrollees Reports is available in the “Filing Guides” section under the “REFERENCE” tab. C4. If an entity files a Permanent Zero Contribution Enrollees Report, but it later has contribution enrollees, what should it do? C4. If an entity files a Permanent Zero Contribution Enrollees Report, but it later has contribution enrollees, what should it do? Contact Help@CHA-Ri.org so that its status can be changed and the entity can start reporting regularly, beginning with the first quarter in which it has contribution enrollees. C5. If my company has filed an Annual Zero Contribution Enrollees Report, when should we file our next report? C5. If my company has filed an Annual Zero Contribution Enrollees Report, when should we file our next report? An Annual Zero Contribution Enrollees Report covers one 12-month period. You should plan to file your report again by June 30 of each calendar year. If, however, your company gains some contribution enrollees during the course of the year, it should start filing for each quarter in which it has contribution enrollees. C6. If my company filed a Permanent Zero Contribution Enrollees Report for RIVAP, should we file the same report for CHA-RI? C6. If my company filed a Permanent Zero Contribution Enrollees Report for RIVAP, should we file the same report for CHA-RI? No, so long as you continue to have permanent zero covered lives and the Rhode Island law remains unchanged, you will not be required to make any filings or payments with respect to the CHA-RI assessment. Your work to confirm your status as a non-payer for RIVAP also confirms that status for CHA-RI with no further administrative requirement for your firm. This remains the case as it relates to the current RIVAP & CHA-RI programs under current laws & regulations and administrative guidance KidsVax® has received to date. It does not have any applicability to any other state program administered by KidsVax® and may or may not be affected by any future change in law, regulation, or administrative ruling applicable to CHA-RI.