On Aug. 29, 2016, the Department of Health and Human Services (HHS) released its proposed Notice of Benefit and Payment Parameters for 2018. This proposed rule describes benefit and payment parameters under the Affordable Care Act (ACA), applicable for the 2018 benefit year, including updated standards relating to:

• Annual limitations on cost-sharing;
• The individual mandate’s affordability exemption; and
• Special enrollment periods in the Exchange.

The rule would also enhance standards for state-based Exchanges on the federal platform (SBE-FPs) and create three new sets of six standardized benefit plan options in the federally facilitated Exchange (FFE).

HHS may make changes to the proposed rule before finalizing it. However, the proposed rule is a good indicator of benefit and payment parameters that HHS may adopt for 2018.

Some highlights to the proposed changes include:

• For 2018, the ACA’s out-of-pocket maximum would increase to $7,350 for self-only coverage and $14,700 for family coverage.
• The proposed rule would decrease the required contribution percentage for the affordability exemption from the individual mandate in 2018.
• The proposed rule would establish three new sets of standardized plan options in the individual market federal Exchanges.

When finalized, the changes included in the proposed rule would generally be effective for the 2018 benefit year.

Please see the attached ACA compliance bulletin for detailed information, and contact your NEEBCo representative with any questions you may have.

Proposed Notice of Benefit & Payment Parameters for 2018