AUGUST 31ST, 2016

CMS Proposes New Benefit Limits for 2018

August 31, 2016 - Larry Grudzien, Attorney at Law


On August 29, 2016, CMS proposed new annual cost-sharing limits for nongrandfathered group health plans for 2018.  It would increase to $7,350 for individuals and $14,700 for families in 2018. This would be a 2.8% increase from the 2017 limits, which cap out-of-pocket costs for in-network covered essential health benefits under nongrandfathered group health plans at $7,150 for self-only coverage and $14,300 for broader coverage.


Please remember that IRS uses the same premium adjustment percentage to determine the annual increase in employer shared-responsibility assessments. Using the proposed adjustment percentage, the play-or-pay assessment for not offering coverage would increase to $2,320, while the assessment for offering coverage that is unaffordable or lacks minimum value would increase to $3,480 for 2018. These assessments, currently set at $2,160 and $3,240 for 2016, are expected to increase to $2,260 and $3.390 for 2017.


For a copy of proposed rule, please clink on the link below:


For a copy for the fact sheet explaining the proposed rule, please click on the link:


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