Medicare Managed Care Manual (Pub. 100-16), Ch. 9 § 20.4.3
Charging Different Premiums to Different Employer/Union Group
Length: 76 wordsOfficial source
20.4.3 - Charging Different Premiums to Different Employer/Union Group
Health Plan Sponsors
(Rev. 111, 05-03-13, Effective: 05-03-13, Implementation: 05-03-13)
In addition to the flexibilities outlined above for employers/unions to subsidize different amounts
of an enrollee’s premium contribution, “800 series” MAOs have the flexibility to negotiate with
and vary the premium charged to particular employer/union group health plan sponsors. This
includes the ability to “experience rate” “800 series” employer/union group health plan sponsors
in determining these premiums.