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Text of CMS Guidance: Premium Adjustment Percentage, Maximum Annual Limitation on Cost Sharing, Reduced Maximum Annual Limitation on Cost Sharing, and Required Contribution Percentage for the 2026 Benefit Year (PDF)
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]
[Official Guidance] Oct. 9, 2024 "[T]he premium adjustment percentage for the 2026 benefit year is 1.6002042901 ($7,833/$4,895), which represents an increase in ESI premiums of approximately 60.0 percent over the period from 2013 to 2025.... [T]he 2026 maximum annual limitation on cost sharing is $10,150 for self-only coverage and $20,300 for other than self-only coverage. This represents an approximately 10.3 percent increase from the 2025 parameters of $9,200 for self-only coverage and $18,400 for other than self- only coverage.... [CMS is] establishing the values of the 2026 reduced maximum annual limitation on cost sharing at $3,350 for enrollees with household income greater than or equal to 100 percent of the federal poverty level (FPL) and less than or equal to 150 percent FPL, $3,350 for enrollees with household income greater than 150 percent FPL and less than or equal to 200 percent FPL, and $8,100 for enrollees with household income greater than 200 and less than or equal to 250 percent FPL." MORE >> |
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