2024 Pay or Play Affordability Percentage

2022 Notice of Benefit & Payment Parameters Partially Finalized

Previously issued at the end of 2020, the Department of Health and Human Services (HHS) published a proposed rule describing benefit and payment parameters under the Affordable Care Act (ACA) that would apply to the 2022 benefit year.

On January 19, 2021, the HHS published a Notice of Benefit and Payment Parameters (NBPP) for 2022, which finalizes individual standards and sets forth provisions related to user fees for federally facilitated Exchanges and State-based Exchanges on the Federal Platform. Finalized standards contained in the notice include:

  • Updated user fees for the 2022 benefit year for issuers offering plans through a Federally Facilitated Exchange (FFE) or State-based Exchange on the Federal Platform (SBE-FP);
  • Establishment of a new Exchange direct enrollment option through a state Exchange, SBE-FP or FFE;
  • Implementing standards requiring individual market QHP issuers to accept payments made from an individual coverage health reimbursement arrangement (ICHRA) or qualified small employer health reimbursement arrangement (QSEHRA); and
  • Amending Section 1332 waiver application procedures, monitoring and compliance, and periodic evaluation requirements.

The rule implemented several regulatory changes to provide states and issuers with a more stable and predictable framework that facilitates a more efficient and competitive market. The changes facilitate goals of lowering premiums, promoting program integrity, and stabilizing markets within the consumer experience. The remaining provisions are expected to be finalized later in the year and include:

  • Updated annual limitations on cost sharing — proposed to increase to $9,100 for individual coverage and $18,200 for other than individual coverage; and
  • The individual mandate’s affordability exemption — proposed to increase to 8.74%.

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Trust the Creative Benefits, Inc. Team to keep you informed with pertinent updates surrounding the parameters. Questions? Contact us at 866-306-0200 or solutions@creativebenefitsinc.com.