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Proposed 2018 Individual Mandate Required Contribution Released

Sep 20, 2016

​HR360, Inc.

September 8, 2016

Agencies Also Seek Codification of Certain Special Enrollment Periods 

The U.S. Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS) recently released the proposed Notice of Benefit and Payment Parameters for 2018. Among other things, the proposal seeks to establish the required contribution percentage under the individual mandate and codify certain special enrollment periods for plan years beginning in 2018. 

Proposed 2018 Required Contribution Percentage 

The Affordable Care Act's "​individual mandate" provision requires every individual to have minimum essential health coverage for each month, qualify for an exemption, or make a penalty payment when filing his or her federal income tax return. Under the law, an individual qualifies for an exemption if the amount that he or she would be required to pay for minimum essential coverage (the required contribution) exceeds a particular percentage (the required contribution percentage) of his or her actual household income for a taxable year. 

Under the proposed rule, the required contribution percentage for 2018 would be set at 8.05%, a decrease from the ​final required contributio​n percentage for 2017 (8.16%). 

Special Enrollment Periods 

In addition, the HHS is proposing to codify special enrollment periods for the following consumers who apply for coverage on the Exchange: 

Note: While these special enrollment periods are currently available to consumers, the agency is now seeking codification in order to ensure the rules are clear and to limit abuse. 

Click ​here to read the proposed Notice of Benefit and Payment Parameters for 2018 in its entirety. 

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