High-Cost Risk Pool

Acronym: HCRP

Part of the Risk Adjustment Program and implemented in Benefit Year 2018, the High-Cost Risk Pool (HCRP) partially reimburses issuers for an enrollee’s aggregated issuer plan paid claims amounts that are above a certain threshold attachment point (AP), at a certain coinsurance rate. HCRP applies to all issuers who offer ACA health insurance coverage in the small group and/or individual market (including catastrophic and merged), both on and off the Exchange. HCRP payments are funded by a national percent of premium charge on all issuers by market, and all payments and charges are in addition to any risk adjustment transfers.