CMS issues guidance on cost-sharing limits for 2016 qualified health plans

The Centers for Medicare & Medicaid Services Friday issued guidance on annual cost sharing limitations for 2016 qualified health plans applying for certification to participate in Federally Facilitated Marketplaces. Under the 2016 Notice of Benefit and Payment Parameters, finalized this March, the self-only annual limitation applies to individuals whether they are enrolled in self-only, family or other coverage, the guidance states. The guidance also clarifies for health plans how to administer the individual annual limitation on cost sharing in High Deductible Health Plans when the family deductible is higher than the annual cost sharing for an individual. Finally, the guidance explains how plans can be in compliance with the minimum family deductible for an HDHP of $2,600 in 2016. “Because the $6,850 self-only maximum annual limitation of cost sharing will exceed the 2016 minimum annual deductible amount for family HDHP coverage, it will not cause the plan to fail to satisfy requirements for a family HDHP,” says CMS.