• Analysis or Summary
  • January 6, 2017

Summary of Final 2018 Guidance for Health Plans

CHA has summarized the Final Notice on Benefits and Payment Parameters for 2018 (NBPP) and the 2018 Letter to Issuers in the Federally-facilitated Marketplaces (letter), which were released by CMS on Dec. 16, 2016.

The annual NBPP sets standards for qualified health plans (QHPs) in the federally facilitated Exchanges (FFEs). In some instances, the notice will also impact state-based Exchanges (SBEs), the individual and small group markets outside of the Exchanges, and the large group market. 

The annual letter outlines the specific steps that QHPs must take to be certified for sale through the FFEs in the next plan year. The letter also applies to states that are running their own Exchanges, but are using the federal website (Healthcare.gov) and in some instances, to the SBEs. 

The final guidance includes several provisions that reflect recommendations made by CHA and allied organizations in comment letters to CMS on the draft guidance. 

The new guidance is effective on Jan. 17, 2017.