December 10, 2020

ACA Regulatory Developments

On December 4, HHS released for public comment its Notice of Benefit and Payment Parameters for 2022 and Pharmacy Benefit Manager Standards.  The proposed 2022 maximum annual limitation on health plan cost sharing is $9,100 for self-only coverage and $18,200 for other than self-only coverage. This approximately represents a 6.4% increase about the 2021 limits of $8,550 for self only coverage and $17,100 for other than self only coverage. In addition, The proposed notice also includes changes to the medical loss ratio calculation. HHS is accepting public comment through December 30.

The IRS has announced that the Affordable Care Act’s Patient Centered Outcomes Research Institute (“PCORI”) fee for policy years and plan years that end on or after October 1, 2020, and before October 1, 2021, is $2.66 per covered health plan life. The PCORI fee payment is due at the end of July. The adjusted fee is 12 cents higher than the fee paid in July 2020.