2024 Pay or Play Affordability Percentage

Proposed Notice of Benefit & Payment Parameters for 2022

The Department of Health and Human Services (HHS) has published its proposed Notice of Benefit and Payment Parameters for 2022. The proposed rule describes benefit and payment parameters under the Affordable Care Act (ACA) that would be applied to the 2022 benefit year.

The rule also implements a limited number of regulatory changes to provide states and issuers with a more stable and predictable regulatory framework that facilitates a more efficient and competitive market.  

Included in the proposed standards are:

  • Updated annual limitations on costsharing — The 2022 maximum annual limit on cost-sharing is proposed to increase to $9,100 for individual coverage and $18,200 for other than individual coverage. This represents an approximate 6.4% increase above the 2021 parameters. 
  • The individual mandate’s affordability exemption — The 2022 required contribution percentage is proposed to increase to 8.74%.
  • Special enrollment periods (SEPs) in the Exchanges — Existing rules related to SEPs would be revised.

These changes would further the Administration’s goals of lowering premiums, promoting program integrity, and stabilizing markets within the consumer experience.

Keep in mind that the proposed standards of the rule are subject to change, therefore, employers will want to keep a close eye on updates surrounding the rule. The HHS has also published a fact sheet and press release on the proposed rule, which is expected to be finalized early this year.  

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Questions? Contact the Creative Benefits Team at 866-306-0200 or solutions@creativebenefitsinc.com.