How should the Health Insurance Providers Fee be considered in risk-sharing arrangements and minimum medical loss ratio calculations?

It is reasonable to consider the Health Insurance Providers Fee in these arrangements as they may exist in the contract between the state and the health plan. While CMS does not have specific requirements as to how the Health Insurance Providers Fee should be considered under these arrangements, CMS does recommend that the Health Insurance Providers Fee is generally treated in the same way as other taxes and fees for these purposes.

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