January 12, 2016

On Dec. 14, 2015, the Texas Department of Insurance updated its previously released FAQ in response to the passage of the federal PACE Act (HR 1624). The FAQ clarifies that issuers must use the definition of 50 employees as the upper threshold, rather than 100 employees, for purposes of MLR rebates. However, subsequent guidance issued by CMS on Dec. 17, 2015 (see article in this edition of Compliance Corner) allowed states to delay implementation of the lower threshold until the 2017 reporting year. It is unclear at this time if Texas will be updating this FAQ to reflect the newest CMS guidance.