HHS Releases 2018 Benefit Parameters

HHS Releases 2018 Benefit Parameters

DOL_IRS_HHSThe U.S. Department of Health and Human Services (HHS) has released proposed regulations that include 2018 benefit parameters and payment measures. These are scheduled to be published in the Federal Register on September 6, 2016.

While this grouping of proposed rules is mostly for insurance carriers, and includes risk adjustment and revised actuarial value methodology, employers and plan sponsors should review this proposed guidance and become familiar with it.

Here are some key takeaways:

  • 2018 – Increased Annual Cost-Sharing Limits. HHS proposed to increase 2017’s Out-of-Pocket Maximum (OOPMax) from $7,150/single and $14,300/family to $7,350/single and $14,700/family.
  • 2018 – Bronze-Level High-Deductible Health Plan (HDHP) Coverage. HHS proposed an Exchange standardized plan option that qualifies as an HSA-eligible HDHP.
  • HHS also revised some Small Business Health Options Program (SHOP) Enrollment rules. They are doing this to ensure that a newly qualified employee has a full thirty (30) days to enroll – these would not be new hires or during open enrollment, but for employees that become eligible mid-year.
  • Changes to Insurance Market Rules. Changes here include:
    • Small group market – new age-rating bands are proposed for children (2018) – on age band for 0-14, another for ages 15-20.
    • 2018 – Medical Loss Ratio (MLR) Changes – new policies could take advantage of a delay in reporting their MLR until they have a full twelve (12) months of experience. And, insurers could limit their total MLR rebates payable for a calendar year (in certain situations).

Federal Register Notice
CMS Fact Sheet

For more information contact info@apbenefitadvisors.com. The information contained in this post, and any attachments, is not intended and should not be misconstrued as legal advice. You should contact your employment, benefits or ERISA attorney for legal direction.