On Monday, the Centers for Medicare and Medicaid Services (CMS) released the proposed 2018 Notice of Benefit and Payment Parameters. The 294-page proposed regulation provides guidance on both individual and SHOP marketplaces requirements, changes to the risk adjustment programs for 2017 and 2018, participation requirements for bronze, silver and gold plans, network requirements, special enrollment periods, direct enrollment, and numerous other issues. In addition to the marketplace rule, the administration concurrently released a draft actuarial value calculator and methodology for 2018.
Read the full article here which outlines some of the changes for agents and brokers, Medical Loss Ratio (MLR), Special Enrollment Periods (SEPs), Age-Rating, User Fees, Formulas, Limits, Risk Adjustment, Network Adequacy, and more.
