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Remainder of 2022 Notice of Benefit and Payment Parameters Finalized

On May 5, 2021, the Department of Health and Human Services (HHS) published a second Notice of Benefit and Payment Parameters (NBPP) for 2022. The first final 2022 NBPP was published January 19, 2021 and included provisions regarding updated user fees for issuers offering plans through the Exchange, establishment of a new Exchange direct enrollment option, Exchange payment standards related to individual coverage HRAs (ICHRAs) or qualified small employer HRAs (QSEHRAs) and amended Section 1332 waiver procedures.

The updated NBPP describes additional benefit and payment standards under the Affordable Care Act (ACA) for the 2022 benefit year, including the following:

  • Out-of-Pocket Maximum: The ACA’s out-of-pocket maximum limit will increase to $8,700 (self only coverage) and $17,400 (family coverage) for 2022. Up from the 2021 amounts of $8,550 for an individual and $17,100 for family.
  • Affordability Percentage: The required contribution percentage for catastrophic coverage eligibility will decrease to 8.09% for 2022. In 2021 affordability percentage is 8.27%.

In addition, the revised NBPP allows for a special enrollment period (SEP) related to Exchange-based coverage when one loses premium tax credit eligibility and the ability to change to a new plan.

Read the Legal Update.

Contact your Cowden representative for more information on this or other compliance issues.