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ACA Compliance | Final Notice of Benefit and Payment Parameters for 2019

ACA Compliance Overview

On April 9, 2018, the Department of Health and Human Services (HHS) released its final Notice of Benefit and Payment Parameters for 2019. This final rule describes benefit and payment parameters under the Affordable Care Act (ACA) that apply for the 2019 benefit year. Standards included in the final rule relate to:

  • Annual limitations on cost sharing;
  • The individual mandates’s affordability exempltion;
  • Special enrollment periods in the Exchange; and
  • Essential health benefit (EHB) benchmark plan options.

Although the tax reform bill effectively eliminated the individual mandate penalty beginning in 2019, the final rule notes that individuals may still need the affordability exemption to determine eligibility for catastrophic coverage.

The final rule also makes changes to certain standards for enrollment in the Small Business Health Options Program (SHOP) Exchange. Finally, the rule eliminates standardized plan options in the federally facilitated Exchanges (FFEs).

ACA Compliance Bulletin For more information on the final rule standards, check out our ACA Compliance Bulletin!

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ACA Compliance Bulletin | Final Notice of Benefit and Payment Parameters for 2019

*This Compliance Bulletin is not intended to be exhaustive nor should any discussion or opinions be constructed as legal advice. Readers should contact legal counsel for legal advice.