On May 5, 2021, the Department of Health and Human Services (HHS) published a second Notice of Benefit and Payment Parameters (NBPP) for 2022 that finalized the remainder of the standards included in the proposed notice issued at the end of 2020.
The first final 2022 NBPP was published Jan. 19, 2021.
This second NBPP describes additional benefit and payment parameters under the Affordable Care Act (ACA) that apply for the 2022 benefit year, including the following:
- The annual out-of-pocket maximum limitation will increase to $8,700 (self-only coverage) and $17,400 (family coverage) for 2022. This amount is $400 lower than was initially proposed.
- The required contribution percentage for catastrophic coverage eligibility will decrease from 8.27% for 2021 to 8.09% for 2022.
- An additional special enrollment period (SEP) for Exchange coverage to allow Exchange enrollees who lose premium tax credit eligibility to change to a new plan, and allow individuals who were unaware that an SEP triggering event occurred to select a new qualified health plan within 60 days.
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The first 2022 NBPP finalized provisions including 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.
Highlights
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.
Affordability Percentage
The required contribution percentage for catastrophic coverage eligibility will decrease to 8.09% for 2022.
This Legal Update is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice. ©2021 Zywave, Inc. All rights reserved.