CMS recently issued the HHS Notice of Benefit and Payment Parameters for 2019, generally for plan years beginning on or after January 1, 2019. The rule is designed to improve affordability for those with high premiums.
The rule includes provisions in the following key areas:
- Essential Health Benefits (EHB)
- Qualified Health Plan (QHP) Certification Standards
- Risk Adjustment
- Advance Premium Tax Credit (APTC) Program Integrity
- Special Enrollment Periods (SEPs)
- Medical Loss Ratio
- Small Business Health Options Program (SHOP)
- Rate Review
In addition, CMS has extended the transitional policy for one additional year, allowing for the transition to fully ACA-compliant coverage in the individual and small group Health Insurance Marketplaces until 2019.
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