US · guidance
CMS Pub. 100-16, ch. mc86c16a, § 30.4.2
Operational Impact on Employer PFFS Plans
In order to offer new employer/union sponsored PFFS plans, organizations must first file
a notice of intent to apply (NOIA) and then complete the application for a new Medicare
Advantage contract. Employer-only PFFS plans must be network based.
Employer/union sponsored PFFS plans that operate on a non-calendar year schedule must
complete the initial application process on the same timeline as other MA applicants and
pursuant to the same requirements as indicated in the initial application and related
materials. Organizations are not required to offer the approved network-based PFFS
products, however, until the beginning of the organization’s applicable plan year. For
example, if an organization’s 2011 plan year begins on July 1, 2011, then the
organization must offer the network-based plan as of that date.
History
(Rev. 99, Issued: 05-27-11, Effective: 05-27-11, Implementation: 05-27-11)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
da80024b0319275281cabf812642a1bd9c219f3b623304a699e12dd3e8996d76
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