Operational Impact on Employer PFFS Plans

30.4.2 – Operational Impact on Employer PFFS Plans (Rev. 99, Issued: 05-27-11, Effective: 05-27-11, Implementation: 05-27-11) In order to offer new employer/union sponsored PFFS plans, organizations must first file a notice of intent to apply (NOIA) and then complete the application for a new Medicare Advantage contract. Employer-only PFFS plans must be network based. Employer/union sponsored PFFS plans that operate on a non-calendar year schedule must complete the initial application process on the same timeline as other MA applicants and pursuant to the same requirements as indicated in the initial application and related materials. Organizations are not required to offer the approved network-based PFFS products, however, until the beginning of the organization’s applicable plan year. For example, if an organization’s 2011 plan year begins on July 1, 2011, then the organization must offer the network-based plan as of that date.