by Jinghong Chen

Risk adjustment transfers reached $10.8 billion in the Affordable Care Act program for the 2019 benefit year, with the individual market accounting for about $7.98 billion, according to CMS. Among the 561 issuers that participated in the program, a handful were slated to receive significant payments. Blue Shield of California was due to collect more than $1 billion, with $873.8 million related to its individual market plans. Florida Blue followed with an expected $773.9 million payout. Meanwhile, Kaiser Foundation Health Plan, Inc. in California will have to pay nearly $796.6 million into the risk adjustment program.

SOURCE: “Summary Report on Permanent Risk Adjustment Transfers for the 2019 Benefit Year,” CMS, July 17, 2020. Visit