• Before You Begin
  • Complete Agency Form
  • Enter Payment Info
  • Review & Submit
  • Confirmation

About this form

Please use this form ONLY to submit your 2016 benefit year annual enrollment count and remit the contribution amount owed for the ACA Transitional Reinsurance Program. ACH Company ID - 7505008016 and Company Name - USDEPTHHSCMS. Please email reinsurancecontributions@cms.hhs.gov if you need to submit your Previous Year's ACA Transitional Reinsurance Program Annual Enrollment Contributions form and contributions.

Notice: Pay.gov cannot initiate an immediate ACA payment. ACA payments require a minimum five days lead time from today. Payments remitted after the January 17, 2017 deadline for the initial 2016 payment will not be assessed a penalty. ACA will work with entities unable to schedule a payment prior to the deadline. The ACH Company ID for 2016 is 7505008016 (USDEPTHHSCMS). Please verify that the account being used to make this payment is not debit blocked for this ID.

Accepted Payment Methods:

  • Bank account (ACH)

You must be signed in to submit this form. Sign In . If you don't have an existing account, you will have the option to create an account on the sign-in page.

This is a secure service provided by United States Department of the Treasury. The information you will enter will remain private. Please review our privacy policy for more information.

Transitional Reinsurance Contributions
000-000-0000 Hrs: 8-10(M-St) ET