On May 7, 2020, CMS released the final annual Notice of Benefit and Payment Parameters and Letter to Issuers for the 2021 benefit year. This final rule and Letter set forth payment parameters and instructions to insurers participating in the Health Insurance Exchanges or “Marketplaces”. Among the changes for 2021 are counting drug manufactures coupon toward the annual limitation on cost sharing and promoting the adoption of Value-based Insurance Designs (VBID). CMS also announced a one-week extension of the Qualified Health Plan (QHP) certification and rate review timelines to help issuers and states to better collect and assess data around the effects of COVID-19 and thereby establish more accurate premium rates. Find more information on the notice here. Generally, more information on rural health insurance issues is available from the RHIhub.