CMS Issues Proposed Rule on HHS Notice of Benefit and Payment Parameters for 2025; Comments Requested
Published November 16, 2023
The Centers for Medicare & Medicaid Services (CMS) has released the proposed annual Notice of Benefit and Payment Parameters for the 2025 benefit year. The notice applies to issuers and Marketplaces, as well as requirements for agents, brokers, web-brokers, and assisters that help consumers with enrollment through Marketplaces and affects individual market qualified health plans, stand-alone dental plans, and all Small Business Health Option Program (SHOP) plans.
CMS has released a notice titled, "Premium Adjustment Percentage, Maximum Annual Limitation on Cost Sharing, Reduced Maximum Annual Limitation on Cost Sharing, and Required Contribution Percentage for the 2025 Benefit Year."
- The 2025 maximum annual limitation on cost sharing is
- $9,200 for self-only coverage and
- $18,400 for other than self-only coverage.
- This represents an approximately 2.6% decrease from the 2024 parameters of $9,450 for self-only coverage and $18,900 for other than self-only coverage.