Final rule in notice of benefit, payment parameters issued

March 16, 2013
Final rule in notice of benefit, payment parameters issued
The final rule of the Department of Health and Human Services Notice of Benefit and Payment Parameters for 2014, which expands on existing standards, has been released.

(HealthDay)—The final rule of the Department of Health and Human Services (HHS) Notice of Benefit and Payment Parameters for 2014, which expands on existing standards, has been released.

As part of the Act, risk adjustment, reinsurance, and risk corridors will help to stabilize premiums as new consumer protection begins in the individual and small group market in 2014. Together with existing programs this will facilitate access to affordable health insurance.

As part of the final rule, the risk adjustment program will assist health insurance plans that provide coverage for higher-risk individuals and will reduce incentives for issuers to avoid enrolling only healthy individuals. A three-year transitional reinsurance program is being established to reduce premiums and ensure market stability by assisting with the costs of high-risk enrollees. Temporary risk corridors have been established to limit the extent of issuer gains and losses and thereby protect against uncertainty in rate setting. The HHS has finalized its proposal to make advance payments for cost-sharing reductions, allowing eligible individuals to pay their premiums and ensuring the affordability of coverage through a Marketplace (also known as an Exchange). The HHS is also finalizing provisions to ensure a with health plan options for small businesses.

"These programs will work with the premium tax credits, cost-sharing reductions, medical loss ratio program, and new market reform, including the guaranteed availability (also known as guaranteed issue) protections and prohibition of the use of factors such as , medical history gender, and industry of employment to set premium rates, to help ensure every American has quality, affordable ," the rule states.

Explore further: Few small employers likely to opt out of health reform rules

More information: More Information

Related Stories

Few small employers likely to opt out of health reform rules

February 8, 2012
Rules that allow some small employers to avoid regulation under the federal Affordable Care Act are unlikely to have a major impact on the future cost of health insurance unless those rules are relaxed to allow more businesses ...

Mental health and substance use disorder benefits expanded

February 22, 2013
(HealthDay)—In a final rule, which will make purchasing health coverage easier for consumers, mental health and substance use benefits will be expanded to 62 million Americans, according to a report published Feb. 20 by ...

New report: The ACA'S PCIP serving as a bridge; High-risk pools not a long-term solution

September 13, 2012
The Pre-Existing Condition Insurance Plan, the name for the federal high-risk health insurance pool established by the Affordable Care Act, is serving its purpose as a bridge program, according to a new Commonwealth Fund ...

New report on health reform implementation: How to ensure access to coverage is maintained

May 19, 2011
Modifications to current policies could help ensure that health insurance coverage and subsidies provided under the Affordable Care Act remain stable even through major life changes, according to a new Commonwealth Fund report ...

Premiums for public health insurance affect coverage

February 8, 2013
Requiring individuals to pay a premium for public health insurance coverage can counteract the coverage effects of expanding eligibility for public health insurance programs to higher income families.

Ending individual mandate would not dramatically hike insurance prices, study finds

February 16, 2012
A new RAND Corporation study concludes that eliminating a key part of health care reform that requires all Americans to have health insurance would sharply lower the number of people gaining coverage, but would not dramatically ...

Recommended for you

Could insufficient sleep be adding centimeters to your waistline?

July 27, 2017
Adults in the UK who have poor sleep patterns are more likely to be overweight and obese and have poorer metabolic health, according to a new study.

Sugar not so sweet for mental health

July 27, 2017
Sugar may be bad not only for your teeth and your waistline, but also your mental health, claimed a study Thursday that was met with scepticism by other experts.

Vitamin E-deficient embryos are cognitively impaired even after diet improves

July 27, 2017
Zebrafish deficient in vitamin E produce offspring beset by behavioral impairment and metabolic problems, new research at Oregon State University shows.

The role of dosage in assessing risk of hormone therapy for menopause

July 27, 2017
When it comes to assessing the risk of estrogen therapy for menopause, how the therapy is delivered—taking a pill versus wearing a patch on one's skin—doesn't affect risk or benefit, researchers at UCLA and elsewhere ...

Blowing smoke? E-cigarettes might help smokers quit

July 26, 2017
People who used e-cigarettes were more likely to kick the habit than those who didn't, a new study found.

Brain disease seen in most football players in large report

July 25, 2017
Research on 202 former football players found evidence of a brain disease linked to repeated head blows in nearly all of them, from athletes in the National Football League, college and even high school.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.