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About this form

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.

Accepted Payment Methods:

  • Bank account (ACH)

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