2017 Benefit and Payment Parameters Rule and HIP FAQ | Health Insurance IL

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”.

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