The 2017 Benefit And Payment Parameters Final Rule: Drilling Down (Part 2)

Implementing Health Reform. This is my third post on the 2017 Benefit and Payment Parameters final rule. The first post summarized the highlights of the rule and the final 2017 Letter to Issuers in the Federally Facilitated Marketplace. The second post offered a deep dive into the first half of the BPP rule; this post analyzes the second half of the rule. A final post on the details of the Letter to Issuers will follow in a day or two. This post will cover notices to employers; financial subsidy eligibility verification; reenrollment and binder payments; open and special enrollments; eligibility appeals; individual responsibility exemptions; the SHOP exchange; selective contracting and standard plans in the FFE; FFE user fee; the drug formulary exceptions process; the premium adjustment percentage; the actuarial value calculator; network adequacy; essential community providers; the premium payment grace period; enforcement and appeals; quality and patient safety; third party payments; and medical loss ratios. Click on a topic to navigate to the portion of the post in which it is covered. Notices To Employers The final rule amends the process through which exchanges notify employers when an employee is determined eligible for federal financial assistance. This notice informs an employer that it may be liable for the employer mandate penalty if its employee receives assistance. The notice may also help reduce an employee’s responsibility to pay back tax credits if the empl...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA Insurance and Coverage Source Type: blogs