SECTION 3. PROCEDURES FOR

SHCE FILERS

To claim the benefit of the special rule for expatriate health plans for fee years 2014 and 2015 under the EHCCA, a covered entity that satisfies the requirements in § 3.01 of this notice must report its direct premiums written for expatriate health plans as reported on its SHCEs on a statement attached to its 2015 Form 8963 that includes the certifications described in § 3.02 of this notice. For this limited purpose, an expatriate health plan means an expatriate policy under the MLR final rule definition described in § 2 of this notice.

.01 Filing Prerequisites.

A covered entity must satisfy the following requirements:

(1) The covered entity (including controlled group members, if any) filed SHCEs for 2014, 2015, or both with the NAIC in which it reported direct premiums written for expatriate health plans (defined by reference to the MLR final rule definition of expatriate policies, which is used for purposes of the SHCE); and

(2) The covered entity included some or all of those direct premiums written for expatriate health plans in column (f), Di- rect premiums written, on its Form 8963 for 2014 or 2015 (or both), as applicable.

.02 Certification.

A covered entity described in § 3.01 must attach a statement to its 2015 Form 8963 certifying the following: (1) The covered entity (or designated entity, in the case of a controlled group) filed the SHCE for 2014, 2015, or both, as the case may be;

(2) The covered entity is filing the statement pursuant to Notice 2015–29;

(3) (a) The aggregate dollar amount of direct premiums written for expatriate health plans reported on its SHCE(s) for 2014 for that covered entity (including the amounts for all members of the controlled group, if applicable) and (b) the amount of direct premiums written for expatriate health plans the covered entity excluded in determining the amount of direct premiums written reported in column (f), Di- rect premiums written, on its 2014 Form 8963 (see § 3.01 of Notice 2014–24, which permitted an entity to exclude 50% of this aggregate amount); and

(4) The aggregate dollar amount of direct premiums written for expatriate health plans that is reported on the SHCE(s) for 2015 for the covered entity (including the amounts for all members of the controlled group, if applicable) and included in direct premiums written reported in column (f), Direct premiums written, on the covered entity’s 2015 Form 8963.

.03 Example.

The following example illustrates the application of this section 3:

Company X, the designated entity of a controlled group, and X’s controlled group members (collectively, X Group)

April 13, 2015 874 Bulletin No. 2015–15

SHCEs for either 2014 or 2015 with the NAIC.

(2) The covered entity (including controlled group members, if any) included direct premiums written for expatriate health plans as defined by the MLR final rule definition described in § 2 of this notice in column (f), Direct premiums written, on its Form 8963 for 2014 or 2015 (or both).

.02 Certification.

A covered entity described in § 4.01 must attach a statement to its 2015 Form 8963 certifying the following: (1) The covered entity is filing the statement pursuant to Notice 2015–29;

(2) The aggregate dollar amount of direct premiums written for expatriate health plans that it included in column (f), Direct premiums written, on its 2014 Form 8963 (including the amounts for all members of the controlled group, if applicable);

(3) The aggregate dollar amount of direct premiums written for expatriate health plans that it included in column (f), Direct premiums written, on its 2015 Form 8963 (including the amounts for all members of the controlled group, if applicable); and

(4) The source of information that the covered entity has available on request for determining direct premiums written for expatriate health plans for 2014 and 2015, such as the Accident and Health Policy Experience filed with the NAIC, the MLR Annual Reporting Form filed with the Center for Consumer Information and Insurance Oversight of the Department of Health and Human Services, or any similar statements filed with the NAIC, with any state government, or with the federal government pursuant to applicable state or federal requirements.

.03 Example.

The following example illustrates the application of this section 4:

Company Y, the designated entity of a controlled group, and Y’s controlled group members (collectively, Y Group) reported $20,000 in direct premiums writ

ten for expatriate health plans, in the aggregate, on its 2014 Form 8963. Y Group reported $15,000 in direct premiums written for expatriate health plans, in the aggregate, on its 2015 Form 8963. Company Y must attach the following statement to its 2015 Form 8963.

Company Y hereby certifies that: (1) Company Y is filing this statement pursuant to Notice 2015–29; (2) Y Group reported an aggregate of $20,000 in direct premiums written for expatriate health plans that met the MLR final rule definition on its 2014 Form 8963; (3) Y Group is reporting an aggregate of $15,000 in direct premiums written for expatriate health plans that met the MLR final rule definition on its 2015 Form 8963; and (4) Y Group reported for 2014 and expects to report for 2015 direct premiums written for expatriate plans on Y Group’s MLR Annual Reporting Form filed with the Center for Consumer Information and Insurance Oversight in the amounts described in (2) and (3) above, which Y Group will supply upon request.