Advanced premium tax credits – filing guidance
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Provides filing guidance to health insurers and other ACA marketplace entities in Alabama on how to calculate 2023 Individual Qualified Health Plan (QHP) rates given the temporary ARPA expansion of APTC and how to submit alternative filings if federal law changes.
No material clinical or coverage changes in this revision.
2023 Individual QHP Rate Filing Criteria
2023 Individual QHP rate filing criteria
Rate filing instructions and supporting materials required from carriers:
Initial rate calculation
- Calculate initial 2023 Individual QHP rates under current law, assuming ARPA-expanded Advanced Premium Tax Credits (APTC) expire at the end of the calendar year.
- These initial rates are the ones the carrier intends to implement upon approval if no legislative changes occur.
Alternative rate filing
- If the carrier intends to revise rates contingent on federal legislative extension of ARPA, prepare and be ready to submit an alternative rate filing during the rate review period (if time allows).
- An alternative filing will only be implemented if the legislative changes occur and the revised rates are approved.
Supporting documentation required with any alternative filing
- Provide the change in rates due to the extension of ARPA by plan.
- Provide a crosswalk of all assumption changes due to the extension of ARPA, including supporting documentation for each change.
- Include a description of where the changes are incorporated into the filing (e.g., the URRT and the Actuarial Memorandum).
- Document the impact on premium rates of all assumption changes due to the extension of ARPA.
Coding / Filing Support Details
Actions Carriers Must Take
Prepare and be ready to submit an alternative rate filing
Carriers that plan to revise rates if federal legislation extends the ARPA APTC expansions must be prepared to submit an alternative rate filing during the rate review period; that alternative filing will only be implemented if the legislative changes actually occur and the revised rates are approved.
- Submit the alternative rate filing during the rate review period if time allows.
- Alternative filing is implemented only if federal legislative changes occur and the revised rates are approved.
Key Terms
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