- Out-of-Pocket Maximum: The ACA’s out-of-pocket maximum limit will increase to $8,700 (self-only coverage) and $17,400 (family coverage) for 2022.
- Affordability Percentage: The required contribution percentage for catastrophic coverage eligibility will decrease to 8.09% for 2022.
The Department of Health and Human Services (HHS) published a second Notice of Benefit and Payment Parameters (NBPP) for 2022 on May 5, 2021 – this finalized the remainder of the standards included in the proposed notice issued at the end of 2020. The first final 2022 NBPP was published on January 19, 2021.
This second NBPP describes additional benefit and payment parameters under the Affordable Care Act (ACA) that apply for the 2022 benefit year, including the following:
- The annual out-of-pocket maximum limitation will increase to $8,700 (self-only coverage) and $17,400 (family coverage) for 2022. This amount is $400 lower than was initially proposed.
- The required contribution percentage for catastrophic coverage eligibility will decrease from 8.27% for 2021 to 8.09% for 2022.
- An additional special enrollment period (SEP) for Exchange coverage to allow Exchange enrollees who lose premium tax credit eligibility to change to a new plan, and allow individuals who were unaware that an SEP triggering event occurred to select a new qualified health plan within 60 days.
The first 2022 NBPP finalized provisions including updated user fees for issuers offering plans through the Exchange, establishing a new Exchange direct enrollment option, Exchange payment standards related to individual coverage HRAs (ICHRAs) or qualified small employer HRAs (QSEHRAs), and amended Section 1332 waiver procedures.
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