HHS Final Rule Sets Benefit and Payment Guidelines
March 1—A final rule reduces incentives for health insurance companies to avoid enrolling people with preexisting conditions, stabilizes premiums for high-risk enrollees, and more.
The U.S. Department of Health and Human Services (HHS) Notice of Benefit and Payment Parameters expands on standards set forth in earlier rules, including the following:
- The permanent risk adjustment program will assist health insurance plans that provide coverage to individuals with higher risk populations.
- The three-year transitional reinsurance program will lower premiums in the individual market by an estimated 10 to 15 percent in 2014. The statute sets a fixed contribution amount for the reinsurance program.
- The temporary risk corridors program will protect against uncertainty in rate setting for qualified health plans by limiting the extent of issuer losses and gains.
- HHS is finalizing provisions to provide qualified health plan options for small businesses through the small business health options program (SHOP).
For more detail on the key policies of the final rule, read the HHS fact sheet.
Publication Date: Friday, March 01, 2013