Description: 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.

Description: Please use this form ONLY to submit your 2014 benefit year annual enrollment count and remit the contribution amount owed for the ACA Transitional Reinsurance Program.... ACH Company ID - 7505008015 and Company Name - USDEPTHHSCMS. Please use the Current Year ACA Transitional Reinsurance Program Annual Enrollment Contributions form to submit your Current Year contributions.

Description: Please use this form ONLY to submit your 2015 benefit year annual enrollment count and remit the contribution amount owed for the ACA Transitional Reinsurance Program. ACH Company ID - 7505008015 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.