Just got this from BCBSTX:
Government Releases Proposed Rule on 2016 Affordable Care Act (ACA) Changes
The U.S. Department of Health and Human Services (HHS) recently released a proposed rule on the Notice of Benefits and Payment Parameters for 2016, which would make ACA changes.
Among the highlights, the proposed rule would:
Set payment parameters for the ACA premium stabilization programs (the reinsurance, risk corridor and risk adjustment programs, or 3Rs).
Require states to select new essential health benefits (EHB) benchmark plans for 2017, based on plans available in 2014.
In order to meet minimum value (part of the Employer Shared Responsibility provisions), the proposed rule would require plans to provide a benefit package that is historically provided under “major medical” employer coverage, in addition to the average 60 percent of allowed costs currently considered minimum value.
Set a new standard definition for habilitative care services under EHB requirements.
Set annual limits on cost sharing for in-network EHBs at $6,850 (individual coverage) and $13,700 (family coverage) in 2016. (Applies to non-grandfathered plans.)
Set annual open enrollment period from Oct. 1 to Dec. 15 going forward for non-grandfathered individual plans on and off the Marketplace.
Retain the user fee at 3.5 percent of monthly premium for qualified health plans on the federally facilitated Marketplace.
We are currently reviewing the proposed and final rules and will provide more information as it becomes available.
