AR| Arkansas Bulletin No. 6-2026, establishes standardized guidance for all healthcare insurers, HMOs, fraternal benefit societies, and hospital medical service corporations on how to apply Cost Sharing Reduction (CSR) loads to individual, on-marketplace Silver plans for plan year 2027. The Arkansas Insurance Department (AID) is now requiring all issuers to use a uniform CSR load factor of 1.40 (calculated from 2026 enrollment data) instead of allowing insurers to independently determine their own CSR loads, as had been the practice since 2018 when federal CSR subsidy funding was discontinued. The bulletin outlines the methodology for calculating the CSR load using membership-weighted averages of actuarial values and induced demand factors from HHS, specifies how issuers must apply this factor to pricing actuarial values, and addresses single risk pool requirements with specific instructions for ARHOME plans versus other plans.
Main Points:
- Compliance Requirements: Issuers must incorporate the prescribed 1.40 CSR load into their plan year 2027 rate filings with detailed documentation of methodology and enrollment assumptions, with special provisions for ARHOME plans requiring rate changes to apply exclusively to those plans, while non-ARHOME issuers must apply changes proportionally to all non-Silver plans
- Standardized CSR Load Factor: AID mandates a uniform CSR load of 1.40 for plan year 2027, replacing the previous practice where insurers independently determined their own CSR loads, ensuring consistency across all issuers in the individual market
- Calculation Methodology: The CSR load is calculated using a membership-weighted average of each Silver plan variant’s actuarial value (ranging from 0.70 for Base Silver to 0.94 for 94% CSR) multiplied by its induced demand factor, based on current enrollment distribution where 58.6% of enrollees are in the 94% CSR tier