Frequently Asked Question (FAQ)


FAQ ID:  8487 Publish Date: 01/22/2019

Program Area:

Risk Adjustment (RA)

Primary Category:

Risk Adjustment Operations

Secondary Category:

Risk Scores

Question:

How are risk scores aggregated to the issuer level?

Answer:

Risk scores are only aggregated to the plan level in a rating area and results in the Plan Liability Risk Score (PLRS). Please refer to the 2019 Final Payment Notice located here https://www.govinfo.gov/content/pkg/FR-2018-04-17/pdf/2018-07355.pdf or the 2014 Final Payment Notice located here https://www.govinfo.gov/content/pkg/FR-2014-12-30/pdf/2014-30243.pdf on the Government Publishing Office (GPO) website.


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