HHS Final Benefit and Payment Parameters for 2022
May 5, 2021
Federal regulators have announced publication of final 2022 indexing for several Affordable Care Act (ACA) requirements, summarized in this fact sheet.
Employers will be particularly interested in the premium adjustment percentage being indexed to 1.3760126457 (about 1.6% higher than 2021, much less than the over 6% that had been proposed, due to a change in the formula going forward). This percentage is used to index maximum out-of-pocket cost-sharing for non-grandfathered health plans and to calculate §4980H penalties for applicable large employers (ALEs). Regulators also indicated that in future years they will release this indexing in guidance each January rather than waiting to formally publish it in proposed and final rulemaking annually (which is typically not finalized until spring). The more formal rule-making process would only be used should they determine they need to adjust the formula in the future.
| Annual Out-of-Pocket Maximum for Non-Grandfathered Health Plans always rounded down to nearest $50, and family always twice the per-person limit |
2020 | 2021 | 2022 |
| Per Person | $8,150 | $8,550 | $8,700 |
| Per Family | $16,300 | $17,100 | $17,400 |
| ALE Penalties always rounded down to nearest $10 |
2020 | 2021 | 2022 |
| §4980H(a) Penalty | $2,570/yr ($214.17/mo) |
$2,700/yr ($225.00/mo) |
$2,750/yr ($229.17/mo) |
| §4980H(b) Penalty | $3,860/yr ($321.67/mo) |
$4,060/yr ($338.33/mo) |
$4,120/yr ($343.33/mo) |
Regulators also codified that cessation of employer contributions or government subsidies toward COBRA is a special enrollment right for individual market coverage, both on and off the Exchange.
IMA will continue to monitor regulator guidance and offer meaningful, practical, timely information.
This material should not be considered as a substitute for legal, tax and/or actuarial advice. Contact the appropriate professional counsel for such matters. These materials are not exhaustive and are subject to possible changes in applicable laws, rules, and regulations and their interpretations.
