By Danielle Capilla
Chief Com­pli­ance Offi­cer at Unit­ed Ben­e­fit Advisors

2017FeeThe 2017 Ben­e­fit and Pay­ment Para­me­ters (BPP) rule, an annu­al rule that sets poli­cies relat­ing to the Patient Pro­tec­tion and Afford­able Care Act (ACA), has been released by the Cen­ters for Medicare and Med­ic­aid Ser­vices (CMS). The 2017 rule con­tains numer­ous updates, includ­ing the annu­al open enroll­ment peri­ods for the indi­vid­ual mar­ket, rat­ing areas for small group health plans, guar­an­teed avail­abil­i­ty and renewa­bil­i­ty, bro­ker and agent reg­is­tra­tion to assist con­sumers with apply­ing for Exchange cov­er­age, the employ­er notice sys­tem when its employ­ees are deter­mined to be eli­gi­ble for a tax cred­it, and exemp­tions to the indi­vid­ual man­date. The rule also set cost shar­ing lim­its for 2017.

In con­junc­tion with the rule, the Depart­ment of Health and Human Ser­vices (HHS) released an FAQ on the imple­men­ta­tion of the 2017 mora­to­ri­um on the Health Insur­ance Provider (HIP) fee. The FAQ states that insur­ers will not be charged the HIP fee for the 2017 fee year, based on 2016 infor­ma­tion. Insur­ers should adjust pre­mi­ums down­ward as a result.

Final­ly, HHS also released a bul­letin that extends tran­si­tion­al plans from expir­ing on Octo­ber 1, 2017, to the end of 2017 to allow indi­vid­u­als to enroll in an ACA-com­pli­ant plan begin­ning in cal­en­dar year 2018, rather than hav­ing to account for Octo­ber through Decem­ber 2017 pri­or to the new cal­en­dar year.

Cost Shar­ing Limits

The rule set the 2017 max­i­mum annu­al lim­i­ta­tion on cost shar­ing at $7,150 for self-only cov­er­age and $14,300 for oth­er than self-only coverage.

Open Enroll­ment – Exchange

Open enroll­ment for 2017 and 2018 will be from Novem­ber 1 until Jan­u­ary 31. No new spe­cial enroll­ment peri­ods are being added, and no cur­rent spe­cial enroll­ment peri­ods are being eliminated.

Employ­er Notice

Employ­ers will be noti­fied when an employ­ee actu­al­ly enrolls in a qual­i­fied health plan through the Exchange. Cur­rent­ly employ­ers are noti­fied when an employ­ee is deter­mined to be eli­gi­ble for fed­er­al finan­cial assis­tance. The Exchange can either noti­fy employ­ers on an employ­ee-by-employ­ee basis or for groups of employ­ees who enroll with finan­cial assis­tance. The notice employ­ers receive will indi­cate that the law pro­hibits retal­i­a­tion against employ­ees who receive finan­cial assis­tance on the Exchange.
For more infor­ma­tion on stan­dard­ized plans, small employ­er def­i­n­i­tion, rein­sur­ance fees, rat­ing areas, guar­an­teed avail­abil­i­ty, and exemp­tions, down­load UBA’s ACA Advi­sor, “Ben­e­fit and Pay­ment Para­me­ters Rule and HIP FAQ”.

Read more here …