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Text of CMS FAQ on Impact of PACE Act on State Small Group Expansion (PDF)
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]
[Official Guidance] Oct. 20, 2015
"What constitutes a State election to extend the definition of small employer? ... [M]ay States allow carriers to modify their rate filings for small group coverage for 2016? ... Does the enactment of the PACE Act affect the counting methodologies to be used by the SHOPs... and for purposes of the medical loss ratio (MLR), risk adjustment, and risk corridors programs? ... How does the PACE Act impact employer size for MLR, risk corridors, and risk adjustment reporting purposes? ... If a State with a SHOP that uses HealthCare.gov elects to extend the definition of small employer to 1-100 employees, when will CMS make the applicable changes to the employer eligibility screens on HealthCare.gov?"
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