On May 7, the Centers for Medicare and Medicaid Services (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 provide payment parameters and instructions to insurers and consumers. In the initial proposed rule in January, CMS proposed eliminating advance premium tax credits (APTCs) for enrollees with $0 plans who choose to auto-renew. This was not adopted or finalized in this rule. The final rule allows for faster effectuation dates for consumers enrolling after the 15th of the month, allowing coverage to begin the first of the following month instead of waiting an additional 30+ days. Some other changes include counting drug manufacturer coupons toward the annual limitation on cost-sharing and promoting the adoption of Value-based Insurance Designs (VBID). Here is the fact sheet with more details on the final rule.