- Coronavirus Disease 2019 (COVID-19)
- Affordable Care Act
- Consumer Support and Information
- Content Requirements for Plan Finder
- Pre-Existing Condition Insurance Plan (PCIP)
- Health Insurance Marketplaces
- Premium Stabilization Programs
- Consumer Operated and Oriented Plan (CO-OP) Program
- Other Insurance Protections
- Health Insurance Market Reforms
Additional FAQs and resources related to the Affordable Care Act may be available on other agencies’ websites, including:
- BusinessUSA.gov - Opens in a new window
- Department of Labor - Opens in a new window
- Department of Treasury - Opens in a new window
- Office of Personnel Management - Opens in a new window
Coronavirus Disease 2019 (COVID-19) Guidance
FAQs
- March 5, 2020
Information Related to COVID–19 Individual and Small Group Market Insurance Coverage (PDF) - March 12, 2020
FAQs on Essential Health Benefits Coverage and the Coronavirus (COVID-19) (PDF) - March 18, 2020
FAQs on Catastrophic Plan Coverage and the Coronavirus Disease 2019 (COVID-19) (PDF) - March 24, 2020
FAQs on Availability and Usage of Telehealth Services through Private Health Insurance Coverage in Response to Coronavirus Disease 2019 (COVID-19) (PDF) - March 24, 2020
Payment and Grace Period Flexibilities Associated with the COVID-19 National Emergency (PDF) - March 24, 2020
FAQs on Prescription Drugs and the Coronavirus Disease 2019 (COVID-19) for Issuers Offering Health Insurance Coverage in the Individual and Small Group Markets (PDF) - April 11, 2020
FAQs about Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act Implementation (Set 42) (PDF)
*This document was updated on April 15, 2020, to correct an error in footnote 10 regarding the current end date of the public health emergency related to COVID-19. - April 13, 2020
Postponement of 2019 Benefit Year HHS-operated Risk Adjustment Data Validation (HHS-RADV) (PDF) - April 18, 2020
COVID-19 and Suspension of Certain Activities Related to the Health Insurance Exchange Quality Rating System, QHP Enrollee Experience Survey (QHP Enrollee Survey) and Quality Improvement Strategy Program (PDF) - April 21, 2020
FAQs on Issuer Flexibilities for Utilization Management and Prior Authorization (PDF) - April 27, 2020
- Risk Adjustment Telehealth and Telephone Services During COVID-19 (PDF)
This guidance document was updated by the below April 11, 2023, Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs. - May 12, 2020
Quality Rating System (QRS), Qualified Health Plan (QHP) Enrollee Experience Survey, and Quality Improvement Strategy (QIS) FAQs in Response to the Coronavirus (COVID-19) Pandemic (PDF) - May 14, 2020
Temporary Period of Relaxed Enforcement of Certain Timeframes Related to Group Market Requirements under the Public Health Service Act in Response to the COVID-19 Outbreak (PDF) - June 5, 2020
Letter to Sponsors of non-Federal Governmental Plans Regarding COVID-19 Guidance (PDF) - June 12, 2020
Temporary Period of Relaxed Enforcement for Submitting the 2019 MLR Annual Reporting Form and Issuing MLR Rebates in Response to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PDF) - June 23, 2020
FAQs about Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act Implementation (set 43) (PDF) - June 29, 2020
Leveraging Existing Health and Disease Management Programs to Provide Mental Health and Substance Use Disorder Resources During the COVID-19 Public Health Emergency (PHE) (PDF) - August 3, 2020
- Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs (PDF)
This guidance document was updated by the below April 11, 2023, Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs. - August 4, 2020
Temporary Policy on 2020 Premium Credits Associated with the COVID-19 Public Health Emergency (PDF) - August 25, 2020
Technical Fact Sheet: CCIIO Premium Reductions: Medicare and Medicaid Programs, Clinical Laboratory Improvement Amendments (CLIA), and Patient Protection and Affordable Care Act; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (PDF) - August 25, 2020
Medicare and Medicaid Programs, Clinical Laboratory Improvement Amendments (CLIA), and Patient Protection and Affordable Care Act; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (PDF) - October 28, 2020
Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency Interim Final Rule (CMS-9912-IFC) (PDF) - October 28, 2020
COVID-19 Vaccines: Information for Providers, Health Insurance Issuers, State Medicaid Programs, and Children’s Health Insurance Programs (CHIP) and Basic Health Programs (BHP) - January 7. 2021 (Updated)
Toolkit on COVID-19 Vaccine: Health Insurance Issuers and Medicare Advantage Plans (PDF) - February 26, 2021
FAQs about Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act Implementation (Set 44) (PDF)
* Some of the guidance in FAQs Set 44 has been superseded by guidance contained in FAQs Set 50.
** The Provider Relief Fund, described in Q14 in FAQs set 44, no longer accepts claims for testing, treatment, or COVID-19 vaccination. - May 6, 2021
- Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs (PDF)
This guidance document was updated by the below April 11, 2023, Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs. - August 16, 2021 (Updated—replaces the July 23. 2021 version)
Toolkit on COVID-19 Vaccine: Health Insurance Issuers and Medicare Advantage Plans (PDF) - November 1, 2021
Temporary Policy on 2021 Premium Credits in the Small Group Market Only Associated with the COVID-19 Public Health Emergency (PDF) - December 17, 2021 (Updated—replaces the August 16. 2021 version)
Toolkit on COVID-19 Vaccine: Health Insurance Issuers and Medicare Advantage Plans (PDF) - December 29, 2021 (Updated—replaces the December 17, 2021 version)
Toolkit on COVID-19 Vaccine: Health Insurance Issuers and Medicare Advantage Plans (PDF) - January 10, 2022
FAQs about Affordable Care Act Implementation, Families First Coronavirus Response Act, and Coronavirus Aid, Relief, and Economic Security Act Implementation (Set 51) (PDF)
This set of FAQs addresses rapid coverage of COVID-19 diagnostic testing and coverage of preventive services, including contraceptive services. - January 10, 2022
How to get your At-Home Over-The-Counter COVID-19 Test for Free - February 4, 2022
Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act Implementation (Set 52) (PDF) - April 6, 2022
Toolkit on COVID-19 Vaccine: Health Insurance Issuers and Medicare Advantage Plans (PDF) - April 29, 2022
Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs (PDF) (PDF)
This guidance document was updated by the below April 11, 2023, Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs. - March 29, 2023
FAQs about Families First Coronavirus Response Act, Coronavirus Aid, Relief, and Economic Security Act and Health Insurance Portability and Accountability Act Implementation (Set 58) (PDF) - April 11, 2023
Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs (PDF)
This guidance document replaces previous Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs listed above. - April 13, 2023
FAQs about Affordable Care Act and Coronavirus Aid, Relief, and Economic Security Act Implementation (Set 59) (PDF) - May 13, 2024
Risk Adjustment Telehealth and Audio-only Services FAQ (PDF)
This guidance document replaces previous Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs listed above.
Affordable Care Act
FAQs
- September 20, 2010
Affordable Care Act Implementation FAQs (Set 1)
This set of FAQs addresses implementation topics including compliance, grandfathered health plans, claims, internal appeals and external review, dependent coverage of children, out-of-network emergency services, and highly compensated employees. - October 8, 2010
Affordable Care Act Implementation FAQs (Set 2)
This set of FAQs addresses grandfathered health plans, dental and vision benefits, rescissions, preventive health services, and ACA effective date for individual health insurance policies. - October 12, 2010
Affordable Care Act Implementation FAQs (Set 3)
This set of FAQs addresses the exemption for group health plans with less than two current employees. - October 29, 2010
Affordable Care Act Implementation FAQs (Set 4)
This set of FAQs addresses grandfathered health plans. - December 22, 2010
Affordable Care Act Implementation FAQs (Set 5)
This set of FAQs addresses a variety of ACA implementation topics, the HIPAA nondiscrimination and wellness program rules, and the Mental Health Parity and Addiction Equity Act of 2008. - April 1, 2011
Affordable Care Act Implementation FAQs (Set 6)
This set of FAQs addresses grandfathered health plans. - November 17, 2011
Affordable Care Act Implementation FAQs (Set 7)
This set of FAQs addresses the Summary of Benefits and Coverage and Uniform Glossary requirements of PHS Act §2715 and the Mental Health Parity and Addiction Equity Act of 2008. - February 9, 2012
Frequently Asked Questions from Employers Regarding Automatic Enrollment, Employer Shared Responsibility, and Waiting Periods (PDF - 93 KB) (PDF)
This Bulletin provides information on questions from employers and other stakeholders regarding the provisions of the Affordable Care Act governing automatic enrollment, employer shared responsibility, and the 90-day limitation on waiting periods. - March 19, 2012
Affordable Care Act Implementation FAQs (Set 8)
This set of FAQs addresses the Summary of Benefits and Coverage requirements of PHS Act §2715.
*Updated February 15, 2022 - May 11, 2012
Affordable Care Act Implementation FAQs (Set 9)
This set of FAQs addresses the Summary of Benefits and Coverage requirements of PHS Act §2715. - August 7, 2012
Affordable Care Act Implementation FAQs (Set 10)
This FAQ addresses the Summary of Benefits and Coverage requirements of PHS Act §2715. - January 24, 2013
Affordable Care Act Implementation FAQs (Set 11)
This set of FAQs addresses the employer's notice of coverage options, health reimbursement arrangements, disclosure of information related to firearms, employer group waiver plans supplementing Medicare Part D, fixed indemnity insurance and payment of PCORI fees. Related information: CMS Bulletin (PDF) on Non-Medicare Supplemental Drug Benefits.
(**Note: See Technical Release 2013-03 for comprehensive guidance addressing health reimbursement arrangements that were issued after the date of these FAQs.). - February 20, 2013
Affordable Care Act Implementation FAQs (Set 12)
This set of FAQs addresses limitations on cost-sharing under the ACA and coverage of preventive services under the ACA. - March 8, 2013
Affordable Care Act Implementation FAQs (Set 13)
This set of FAQs addresses expatriate health plans. - April 23, 2013
Affordable Care Act Implementation FAQs (Set 14)
This set of FAQs addresses the Summary of Benefits and Coverage requirements of PHS Act §2715. - April 29, 2013
Affordable Care Act Implementation FAQs (Set 15)
This set of FAQs addresses annual limit waiver expiration date based on a change to a plan or policy year, provider non-discrimination, coverage for individuals participating in approved clinical trials and transparency reporting. - September 4, 2013
Affordable Care Act Implementation FAQs (Set 16)
This set of FAQs addresses the employer notice of coverage options and the 90-day waiting period limitation. - November 8, 2013
Affordable Care Act Implementation FAQs (Set 17)
This set of FAQs addresses the implementation of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act. - January 9, 2014
Affordable Care Act Implementation FAQs (Set 18)
This set of FAQs addresses coverage of preventive services, limitations on cost-sharing, expatriate health plans, wellness programs, fixed indemnity insurance, and the Mental Health Parity and Addiction Equity Act of 2008. - May 2, 2014
Affordable Care Act Implementation FAQs (Set 19)
This set of FAQs addresses updated DOL model notices, limitations on cost-sharing, coverage of preventive services, health FSA carryover and excepted benefits, and the Summary of Benefits and Coverage requirements of PHS Act §2715. - July 17, 2014
Affordable Care Act Implementation FAQs (Set 20) (PDF)
This set of FAQs addresses coverage of preventive services. - October 10, 2014
Affordable Care Act Implementation FAQs (Set 21) (PDF)
This set of FAQs addresses limitations on cost sharing under the ACA. - November 6, 2014
Affordable Care Act Implementation FAQs (Set 22) (PDF)
This set of FAQs addresses compliance of premium reimbursement arrangements. - February 13, 2015
Affordable Care Act Implementation FAQs (Set 23) (PDF)
This set of FAQs addresses excepted benefits. - March 30, 2015
Affordable Care Act Implementation FAQs (Set 24)
This set of FAQs addresses proposed changes to the SBC regulations, as well as a new SBC template and associated documents. - April 16, 2015
Affordable Care Act Implementation FAQs (Set 25) (PDF)
This set of FAQs addresses the wellness program requirements. - May 11, 2015
Affordable Care Act Implementation FAQs (Set 26) (PDF)
This set of FAQs addresses coverage of preventive services. - May 26, 2015
Affordable Care Act Implementation FAQs (Set 27) (PDF)
This set of FAQs addresses limitations on cost sharing and provider non-discrimination. - August 11, 2015
Affordable Care Act Implementation FAQs (Set 28) (PDF)
This set of FAQs addresses transparency reporting for non-QHP issuers and non-grandfathered group health plans. - October 23, 2015
Affordable Care Act Implementation FAQs (Set 29) (PDF)
This set of FAQs addresses coverage of preventive services, wellness programs, and the Mental Health Parity and Addiction Equity Act of 2008. - March 11, 2016
Affordable Care Act Implementation FAQs (Set 30) (PDF)
This set of FAQs addresses the summary of benefits and coverage (SBC) - April 20, 2016
Affordable Care Act Implementation FAQs (Set 31) (PDF)
This set of FAQs addresses coverage of preventive services, rescissions, out-of-network emergency services, coverage for individuals participating in approved clinical trials, limitations on cost-sharing under the Affordable Care Act, the Mental Health Parity and Addiction Equity Act and the Women's Health and Cancer Rights Act. - June 21, 2016
Affordable Care Act Implementation FAQs (Set 32) (PDF)
This set of FAQs addresses notice of coverage options – COBRA and the Health Insurance Marketplace. - October 21, 2016
Affordable Care Act Implementation FAQs (Set 33) (PDF)
(PDF) (PDF)This set of FAQs addresses premium reduction arrangements for student health plan coverage - October 27, 2016
Affordable Care Act Implementation FAQs (Set 34) (PDF)
(PDF) (PDF)This set of FAQs addresses coverage of preventive services under the Affordable Care Act and the Mental Health Parity and Addiction Equity Act - December 20, 2016
Affordable Care Act Implementation FAQs (Set 35) (PDF)
This set of FAQs addresses special enrollment for group health plans, coverage of preventive services under the Affordable Care Act and qualified small employer health reimbursement arrangements. - January 9, 2017
Affordable Care Act Implementation FAQs (Set 36) (PDF)
This set of FAQs addresses coverage of preventive services - January 12, 2017
Affordable Care Act Implementation FAQs (Set 37) (PDF)
This set of FAQs addresses health reimbursement arrangements and Code section 162(m)(6). - June 16, 2017
Affordable Care Act Implementation FAQs (Set 38) (PDF)
This set of FAQs addresses the Mental Health Parity and Addiction Equity Act and the 21st Century Cures Act. Related information: Draft MHPAEA Disclosure Template (PDF) - April 23, 2018
Affordable Care Act Implementation FAQs (Proposed Set 39)
This proposed set of FAQs addresses the Mental Health Parity and Addiction Equity Act and the 21st Century Cures Act. Comments are requested by June 22, 2018. - August 23, 2019
Affordable Care Act Implementation FAQs (Set 40) (PDF)
This set of FAQs addresses limitations on cost-sharing under the ACA. - September 5, 2019
Affordable Care Act Implementation FAQs (Final Set 39) (PDF)
This set of FAQs addresses the Mental Health Parity and Addiction Equity Act and the 21st Century Cures Act. Related information: MHPAEA Disclosure Template (DOCX) (PDF) (PDF) - February 3, 2020
Affordable Care Act Implementation FAQs (Set 41) (PDF)
This set of FAQs addresses the Summary of Benefits and Coverage (SBC). - April 11, 2020
Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act Implementation FAQs (Set 42) (PDF)
This set of FAQs addresses the Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act, and other topics related to COVID-19, including notice requirements, excepted benefits, and telehealth and other remote care services. - June 23, 2020
Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act Implementation FAQs (Set 43) (PDF)
This set of FAQs addresses the Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act, and other topics related to COVID-19, including notice requirements, telehealth, and other remote care services, grandfathered health plans, the Mental Health Parity and Addiction Equity Act, wellness programs, and individual coverage health reimbursement arrangements.
*Some of the guidance in FAQs Set 43 has been superseded by guidance contained in FAQs Set 51. - February 26, 2021
Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act Implementation FAQs (Set 44) (PDF)
This set of FAQs addresses the Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act, and other topics related to COVID-19, including notice requirements, excepted benefits, and the provider relief fund.
* Some of the guidance in FAQs Set 44 has been superseded by guidance contained in FAQs Set 50.
** The Provider Relief Fund, described in Q14 in FAQs set 44, no longer accepts claims for testing, treatment, or COVID-19 vaccination. - April 2, 2021
Affordable Care Act Implementation FAQs (Set 45) (PDF)
This set of FAQs addresses the Mental Health Parity and Addiction Equity Act and the Consolidated Appropriations Act, 2021. - June 4, 2021
Affordable Care Act Implementation FAQs (Set 46) (PDF)
This set of FAQs addresses limitations on cost-sharing under the ACA. - July 19, 2021
Affordable Care Act Implementation FAQs (Set 47) (PDF)
This set of FAQs addresses coverage of preventive services. - August 16, 2021
Affordable Care Act Implementation FAQs (Set 48) (PDF)
This set of FAQs addresses coverage of preventive services - August 20, 2021
Affordable Care Act Implementation FAQs (Set 49) (PDF)
This set of FAQs addresses implementation of the machine-readable files required under ACA price transparency provisions, internet-based self-service tool (or “price comparison tool”) under both ACA price transparency provisions and the Consolidated Appropriations Act, 2021 (CAA), and gag clause, provider directory, continuity of care, and pharmacy benefits and drug costs provisions of the CAA.
*Some of the guidance in FAQs Set 49 has been superseded by guidance contained in FAQs Set 61. This FAQ was updated on September 28, 2023, to include a link to FAQs Set 61. - October 4, 2021
Affordable Care Act Implementation FAQs (Set 50) (PDF)
This set of FAQs addresses rapid coverage of preventive services for coronavirus and HIPAA nondiscrimination and wellness programs. - January 10, 2022
FAQs about Affordable Care Act Implementation, Families First Coronavirus Response Act, and Coronavirus Aid, Relief, and Economic Security Act Implementation (Set 51) (PDF)
This set of FAQs addresses rapid coverage of COVID-19 diagnostic testing and coverage of preventive services.
*Some of the guidance in FAQs Set 51 has been superseded by guidance contained in FAQs Set 52. - February 4, 2022
Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act Implementation FAQs (Set 52) (PDF)
This set of FAQs address coverage of COVID-19 diagnostic testing. - April 19, 2022
Affordable Care Act Implementation FAQs (Set 53) (PDF)
This set of FAQs addresses Transparency in Coverage machine-readable files.
*Some of the guidance in FAQs Set 53 has been superseded by guidance contained in FAQs Set 61. This FAQ was updated on September 28, 2023, to include a link to FAQs Set 61. - July 28, 2022
Affordable Care Act Implementation FAQs (Set 54) (PDF)
The set of FAQs addresses preventive services requirements for contraceptive coverage. - August 19, 2022
FAQs about Affordable Care Act and Consolidated Appropriations Act, 2021 Implementation (Set 55) (PDF)
This set of FAQs addresses implementation of the No Surprises Act and Transparency in Coverage machine-readable files.
*Some of the guidance in FAQs Set 55 is affected by the decision in Texas Medical Association, et al. v. U.S. Department of Health and Human Services, et al., Case No. 6:22-cv-450-JDK (TMA III). See FAQs Set 62 and FAQs Set 67 for guidance on the relevant provisions in light of this court decision. - December 23, 2022
FAQs about Affordable Care Act and Consolidated Appropriations Act, 2021 Implementation (Set 56) (PDF)
This set of FAQs addresses reporting of prescription drug and health care spending. - February 23, 2023
FAQs about Consolidated Appropriations Act, 2021 Gag Clause Implementation (Set 57) (PDF)
This set of FAQs addresses the gag clause prohibition provisions, including the attestation requirement. - March 29, 2023
FAQs about Families First Coronavirus Response Act, Coronavirus Aid, Relief, and Economic Security Act and Health Insurance Portability and Accountability Act Implementation (Set 58) (PDF)
This set of FAQs addresses coverage of COVID-19 diagnostic testing, vaccines, extension of timeframes, and special enrollment periods. - April 13, 2023
FAQs about Affordable Care Act and Coronavirus Aid, Relief, and Economic Security Act Implementation (Set 59) (PDF)
This set of FAQs addresses coverage of preventive services in light of the court decision in Braidwood Management Inc. v. Becerra. - July 7, 2023
FAQs about Affordable Care Act and Consolidated Appropriations Act, 2021 Implementation (Set 60) (PDF)
This set of FAQs addresses the No Surprises Act, limitations on cost sharing under the ACA, and transparency in coverage with regard to facility fees under the ACA and the No Surprises Act. - September 27, 2023
Affordable Care Act Implementation (Set 61) (PDF)
This set of FAQs addresses the Transparency in Coverage rules. - October 6, 2023
FAQs about Consolidated Appropriations Act, 2021 Implementation (Set 62) (PDF)
This set of FAQs addresses implementation of the No Surprises Act in light of the court decision in Texas Medical Association et al. v. U.S. Department of Health and Human Services et al. (TMA III).
*Some of the guidance in FAQs Set 62 has been superseded by guidance contained in FAQs Set 67. - November 28, 2023
FAQs about Affordable Care Act and Consolidated Appropriations Act, 2021 Implementation (Set 63) (PDF)
This set of FAQs addresses the Culturally and Linguistically Appropriate Services (CLAS) County Data and the No Surprises Act. - January 22, 2024
Affordable Care Act Implementation FAQs (Set 64) (PDF)
This set of FAQs addresses the preventive services requirements for contraceptive coverage. - February 2, 2024
Affordable Care Act Implementation (Set 65) (PDF)
This set of FAQs addresses Transparency in Coverage rules. - April 2, 2024
Affordable Care Act Implementation FAQs (Set 66) (PDF)
This set of FAQs addresses the prohibition on lifetime and annual limits and the annual limitation on cost sharing under the ACA. - May 1, 2024
FAQ about Consolidated Appropriations Act, 2021 Implementation (Set 67) (PDF)
This set of FAQs addresses implementation of the No Surprises Act in light of the court decision in Texas Medical Association et al. v. U.S. Department of Health an Human Services et al. (TMA III).
Consumer Support and Information
Consumer Assistance Program Grants
Fact Sheets
- November 21, 2011
State Consumer Assistance Program Participation in Exchange Core Area 10 (PDF) - June 22, 2012
New Funding Opportunity for Consumer Assistance Programs - August 24, 2012
Consumer Assistance Program Grants: Helping States Give Consumers Greater Control of their Health Care - August 24, 2012
Consumer Assistance Program Grants: How States Are Using New Resource to Give Consumers Greater Control of their Health Care
FAQs
- April 20, 2012
CAP Limited Competition Funding Opportunity Announcement - June 7, 2012
New Consumer Assistance Programs Funding Opportunity for all States and Territories - September 26, 2014
CAP Limited Competition Funding Opportunity Announcement (PDF)
External Appeals
Fact Sheets
- June 22, 2011
Affordable Care Act: Working with States to Protect Consumers - June 19, 2012
HHS-Administered Federal External Review Process - July 24, 2013
2013 County Data for Culturally and Linguistically Appropriate Services (PDF)
This Fact Sheet provides data so that group health plans and health insurance issuers offering non-grandfathered health coverage can determine the counties in which they are required to provide notices related to a consumer’s right to external review in a culturally and linguistically appropriate manner. - December 12, 2014
Culturally and Linguistically Appropriate Services (CLAS) County Data (PDF) *Updated January 7, 2015 - January 27, 2016
Culturally and Linguistically Appropriate Services (CLAS) County Data (PDF) - for plan years (in the individual market, policy years) beginning prior to January 1, 2025 - November 28, 2023
Culturally and Linguistically Appropriate Services (CLAS) County Data (PDF) - for plan years (in the individual market, policy years) beginning on or after January 1, 2025
Summary of Benefits and Coverage and Uniform Glossary
Fact Sheets
- August 17, 2011
Providing Clear and Consistent Information to Consumers about Their Health Insurance Coverage - July 24, 2013
2013 County Data for Culturally and Linguistically Appropriate Services (PDF)
This Fact Sheet provides data so that group health plans and health insurance issuers offering health coverage can determine the counties in which they are required to provide the summary of benefits and coverage in a culturally and linguistically appropriate manner. - December 12, 2104
Culturally and Linguistically Appropriate Services (CLAS) County Data (PDF)*
*Updated January 7, 2015 - December 22, 2014
Proposed Summary of Benefits and Coverage and Uniform Glossary Rules (PDF) - June 12, 2015
Summary of Benefits and Coverage and Uniform Glossary Final Rule (PDF) - January 27, 2016
Culturally and Linguistically Appropriate Services (CLAS) County Data (PDF) - for plan years (in the individual market, policy years) beginning prior to January 1, 2025. - November 28, 2023
Culturally and Linguistically Appropriate Services (CLAS) County Data (PDF) - for plan years (in the individual market, policy years) beginning on or after January 1, 2025.
FAQs
- September 8, 2015
SBC Online Posting of Policy and Certificate of Coverage (PDF) - March 11, 2016
FAQs Regarding the Summary of Benefits and Coverage (SBC) Related to Rate Filing and QHP Certification (PDF) - July 8, 2016
FAQs on the Summary of Benefit and Coverage Applicability Date (PDF) - February 3, 2020
FAQs on the Applicability Date of the Updated Summary of Benefits and Coverage Template, Calculator, and Related Materials (PDF)
Outreach and Education Resources
- September 29, 2011
Consumer Fact Sheets
-
- Adding Adult Children to Your Health Plan (PDF – English 178 KB (PDF), Spanish 89 KB (PDF))
- Curbing Insurance Cancellations (PDF – English 170 KB (PDF), Spanish 63 KB (PDF))
- Eliminating Dollar Limits on Your Benefits (PDF – English 184 KB (PDF), Spanish 104 KB (PDF))
- Getting Value for Your Premium Dollar (PDF – English 172 KB (PDF), Spanish 104 KB (PDF))
- Lowering Your Cost for Preventive Services (PDF – English 353 KB (PDF), Spanish 111 KB (PDF))
- Protecting Children With Pre-Existing Health Conditions (PDF – English 252 KB (PDF), Spanish 450 KB (PDF))
- Protecting Your Choice of Health Care Providers (PDF – English 219 KB (PDF), Spanish 94 KB (PDF))
- Are You in a Grandfathered Health Plan (PDF – English 307 KB (PDF), Spanish 57 KB (PDF))
- Putting the Brakes on Unreasonable Health Insurance Rate Increases (PDF - English 77 KB (PDF), Spanish 63 KB (PDF))
- April 7, 2011
Consumer Posters and Brochures
-
- State Consumer Assistance Poster (PDF – English 1 MB (PDF), Spanish 884 KB (PDF))
- State Consumer Assistance Brochure (PDF – 2 MB) (PDF)
Language Access Taglines for Exchanges, Qualified Health Plan (QHP) Issuers, and Web-Brokers
FAQs
- August 10,2016
Language Access Tagline Frequently Asked Questions (PDF)
Content Requirements for Plan Finder
Fact Sheets:
Pre-Existing Condition Insurance Plan (PCIP)
Fact Sheets
- July 29, 2010
About the New Pre-Existing Condition Insurance Plan - February 14, 2014
State by State Enrollment in the Pre-Existing Condition Insurance Plan - April 24, 2014
Special Enrollment Period for Individuals Losing Coverage through the Pre-Existing Condition Insurance Program (PCIP) on April 30, 2014 (PDF)
FAQs
- May 8, 2013
PCIP State Contracts and Extension
Health Insurance Marketplaces
Fact Sheets
- January 13, 2013
State Health Insurance Marketplaces (List of Conditionally Approved Exchanges) - May 31, 2013
Progress Continues in Building Exchanges
Marketplace Timeline (PDF - 240 KB) (PDF)
Narrative Description of Marketplace Timeline (PDF - 204 KB) (PDF) - June 14, 2013
Notice of Proposed Rulemaking on Program Integrity - June 24, 2013
Marketplace Outreach Timeline (PDF) - June 26, 2013
HHS Final Rule and Treasury Notices on Individual Shared Responsibility Provision Exemptions, Minimum Essential Coverage, and Related Topics - July 5, 2013
Eligibility Final Rule: Strengthening Medicaid, The Children’s Health Insurance Program and The New Health Insurance Marketplace - August 28, 2013
Program Integrity Rule: Exchanges, SHOP, Eligibility Appeals: Safeguarding Federal Funds and Furthering Consumer Protection - October 24, 2013
Program Integrity Rule: Exchanges, Premium Stabilization Programs and Market Standards; Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 - May 6, 2016
Special Enrollment Periods and the Consumer Operated and Oriented Plan Program (PDF) - December 12, 2016
Pre-Enrollment Verification for Special Enrollment Periods (PDF) - December 12, 2016
Promoting Transparency and Appropriate Coverage for Dialysis Patients (PDF) - November 7, 2018
Fact Sheet for Exchange Program Integrity Proposed Rule (PDF)
FAQs
- November 29, 2011
State Exchange Implementation Questions and Answers (PDF – 135 KB) (PDF) - December 10, 2012
Exchanges, Market Reforms and Medicaid Frequently Asked Questions (PDF - 356 KB) (PDF) - March 29, 2013
Frequently Asked Questions on Reuse of Exchange for Ancillary Products (PDF - 127 KB) (PDF) - May 14, 2013
Frequently Asked Questions on Health Insurance Marketplaces (PDF – 86 KB) (PDF) - July 10, 2013
Question and Answer on Assessment Fees Collected in a State-based Marketplace (PDF – 124 KB) (PDF) - August 5, 2013
Question and Answer on Health Insurance Marketplaces and Income Verification (PDF – 104 KB) (PDF) - September 30, 2013
Question and Answer on Members of Congress and Staff Accessing Coverage through Health Insurance Exchanges (Marketplaces) (PDF) - October 28, 2013
Question and Answer on Enrollment Period (PDF) - November 4, 2013
Question and Answer on Third Party Payments of Premiums for Qualified Health Plans in the Marketplaces (PDF) - December 13, 2013
Question and Answer on Choice of Methodology for Cost-Sharing Reduction Reconciliation (PDF) - February 7, 2014
Third Party Payments of Premiums for Qualified Health Plans in the Marketplaces (PDF) - February 21, 2014*
Question and Answer on Medicaid Managed Care Contractors Outreach to Former Enrollees (PDF)
*Updated January 15, 2015 - May 9, 2014
Question and Answer on Cost-Sharing Reductions for Contract Health Services (PDF) - June 12, 2014
Frequently Asked Questions on Essential Community Providers (PDF – 106 KB) (PDF) - June 1, 2015
Frequently Asked Questions on State-Based SHOP Direct Enrollment (PDF) - July 28, 2015
Frequently Asked Questions on State-based Marketplace Options for Implementing Exemptions from the Shared Responsibility Payment (PDF) - September 18, 2015
Frequently Asked Questions Regarding Agents and Brokers Operating in the SHOP Marketplace (PDF) - September 18, 2015
Frequently Asked Questions Regarding the Federally-Facilitated Marketplace’s (FFM) 2016 Employer Notice Program (PDF) - October 23, 2015
Frequently Asked Questions On The Applicability Of The Minimum Acceptable Risk Standards for Exchanges (MARS-E) 2.0 To Qualified Health Plan (QHP) Issuers (PDF) - May 3, 2016
Frequently Asked Questions on Incarceration and the Marketplace (PDF) - July 21, 2016
Frequently Asked Questions on Annual Income Threshold Adjustment (PDF) - July 19, 2017
Frequently Asked Questions Regarding Third-party Auditor Operational Readiness Reviews for the Proxy Direct Enrollment Pathway (PDF) - June 20, 2018
FAQs Regarding Spanish Translation and Audit Requirements for Enhanced Direct Enrollment (EDE) Entities Serving Consumers in States with FFEs (PDF) - November 21, 2018
FAQs for Agents, Brokers and Assisters Providing Consumers with Details on Plan Coverage of Certain Abortion Services (PDF) - May 1, 2019
2019 Frequently Asked Questions on the Blueprint for Exchanges (PDF) - May 8, 2019
FAQ: Enhanced Direct Enrollment Calendar Year 2019 Timeline (Updated) (PDF) - August 2, 2019
FAQ: Enhanced Direct Enrollment Calendar Year 2020 Timeline (PDF) - November 5, 2019
FAQ: Quality Rating Information Bulletin’s (Quality Bulletin’s) Display Guidelines for Direct Enrollment (DE) Entities (PDF) - April 21, 2020
FAQs on Issuer Flexibilities for Utilization Management and Prior Authorization (PDF) - December 17, 2020
FAQ: Medicare Periodic Data Matching - December 29, 2020
FAQ: Medicaid/CHIP Periodic Data Matching - August 9, 2022
Blueprint for Approval of State-Based Health Insurance Exchanges (PDF) - January 27, 2023
Temporary Special Enrollment Period (SEP) for Consumers Losing Medicaid or the Children’s Health Insurance Program (CHIP) Coverage Due to Unwinding of the Medicaid Continuous Enrollment Condition– Frequently Asked Questions (FAQ) (PDF) - May 16, 2023
Medicaid Continuous Enrollment Condition Unwinding Marketplace Frequently Asked Questions (FAQ) (PDF) - May 25, 2023
Medicaid Continuous Enrollment Condition Unwinding Marketplace Frequently Asked Questions (FAQ) Companion Resource (PDF) - FAQ: Medicaid/CHIP Periodic Data Matching: Updated Guidance (PDF)
- August 14, 2024
Reporting and Reviewing Enrollment Payment Data Inaccuracy Reports in State-based Exchanges (SBE) Frequently Asked Questions and Answers (FAQs) (PDF)
In-Person Assistance
Fact Sheets
- June 10, 2014
Helping Consumers Apply & Enroll Through the Marketplace (PDF - 213KB) (PDF)
Navigator Funding Opportunity Announcement
FAQs
- April 9, 2013
Frequently Asked Questions: Navigator Funding Opportunity Announcement
Overview of Applying for the Cooperative Agreement to Support Navigators in Federally-facilitated and State Partnership Marketplaces (PDF - 381 KB) (PDF)
Plan Management
Fact Sheets
- February 20, 2013
Essential Health Benefits Standards: Ensuring Quality, Affordable Coverage - November 27, 2017
2019 Draft Annual Letter to Issuers for 2019
FAQs
- February 17, 2012
Frequently Asked Questions on the Essential Health Benefits Bulletin (PDF – 88 KB) (PDF) - February 20, 2013
State Evaluation of Plan Management Activities of Health Plans and Issuers (PDF - 35 KB) (PDF) - August 8, 2016
Auto Re-enrollment for QHPs no longer available in the Marketplace (PDF) - October 14, 2016
Frequently Asked Questions on Health Insurance Marketplace Standards (PDF) - December, 16, 2016
Second Lowest Cost Silver Plan Technical FAQs (PDF) - December 23, 2016
FAQ on Compliance Safe Harbor for Issuers Affected by the Extension of the Enrollment Deadline to December 19, 2016 (PDF) - January 3, 2017
Frequently Asked Questions on Medicaid Managed Care Organizations (PDF) - January 19, 2017
Machine-Readable FAQ for FF-SHOP QHPs (PDF) - April 13, 2017
FAQ on Compliance Standard for Issuers in Federally-facilitated Marketplaces (PDF) - October 23, 2018
FAQ on Defrayal of State Required Additional Benefits (PDF) - December 14, 2018
Reminders to Qualified Health Plan Issuers: CMS QHP Agreement Requirements for PII Breach and Security Incident Reporting (PDF) - March 12, 2020
FAQs on Essential Health Benefits Coverage and the Coronavirus (COVID-19) (PDF)
Exchange Planning and Establishment Grants
Fact Sheets
- July 29, 2010
Health Insurance Exchanges: State Planning and Establishment Grants - Opens in a new window - January 20, 2011
Health Insurance Exchange Establishment Grants Fact Sheet - Opens in a new window - November 21, 2011
State Consumer Assistance Program Participation in Exchange Core Area 10 (PDF) - January 22, 2014
Creating a New Competitive Marketplace: Health Insurance Exchange Establishment Grants Awards List
FAQs
- June 29, 2012
Exchange Establishment Cooperative Agreement Funding FAQs - November 9, 2012
Consolidated Exchange Establishment Cooperative Agreement Funding FAQs
This page contains information from the funding opportunity announcement and frequently asked questions from applicants. - April 23, 2013
Using Section 1311(a) Funding for Marketing Activities in a Plan Management State Partnership Marketplace or Federally-facilitated Marketplace - May 13, 2013
Allowable Uses of Section 1311 Funding for States in a State Consumer Partnership Marketplace - May 13, 2013
Allowable Uses of Section 1311 Funding for States in a State Partnership Marketplace or in States with a Federally-Facilitated Marketplace - December 5, 2013
Frequently Asked Questions on Use of 1311 funding for Change Orders and Congressional Inquiries - December 30, 2013
State-based Marketplaces (SBMs): Frequently Asked Questions on the State-based Marketplace Annual Reporting Tool (SMART) (PDF) - February 27, 2014
CMS Bulletin to Marketplaces on Availability of Retroactive Advance Payments of the PTC and CSRs in 2014 Due to Exceptional Circumstances (DOCX) - March 14, 2014
Use of 1311 Funds and No Cost Extensions (PDF) - September 19, 2014
(PDF) (PDF)The Use of 1311 Funds, Project Periods, and Updating the Cost Allocation Methodology (PDF) - June 8, 2015
(PDF) (PDF)Clarification of the Use of 1311 Funds for Establishment Activities (PDF)
Early Innovator Grants
Fact Sheets
- February 16, 2011
States Leading the Way on Implementation: HHS Awards “Early Innovator” Grants to Seven States
Territory Cooperative Agreements
FAQs
Premium Stabilization Programs
Fact Sheets
- November 30, 2012
Technical Fact Sheet: Draft Notice of Payment and Benefit Parameters (PDF – 117 KB) (PDF) - March 1, 2013
HHS Notice of Benefit and Payment Parameters - March 11, 2013
Technical Fact Sheet: HHS Notice of Benefit and Payment Parameters for 2014 (PDF - 234 KB) (PDF) - November 25, 2013
Proposed 2015 HHS Notice of Benefit and Payment Parameters - November 21, 2014
Proposed 2016 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF) - February 20, 2015
Final 2016 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF) - November 20, 2015
Proposed 2017 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF) - February 29, 2016
Final 2017 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF) - August 29, 2016
Proposed 2018 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF) - December 16, 2016
Final 2018 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF) - October 27, 2017
Proposed 2019 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF) - January 17, 2019
Proposed 2020 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF) - April 18, 2019
Final 2020 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF) - January 31, 2020
Proposed 2021 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF) - May 7, 2020
Final 2021 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF) - August 25, 2020
Technical Fact Sheet: CCIIO Premium Reductions: Medicare and Medicaid Programs, Clinical Laboratory Improvement Amendments (CLIA), and Patient Protection and Affordable Care Act; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (PDF) - August 25, 2020
Medicare and Medicaid Programs, Clinical Laboratory Improvement Amendments (CLIA), and Patient Protection and Affordable Care Act; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (PDF) - November 25, 2020
Proposed 2022 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF) - January 14, 2021
Final 2022 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF)
FAQs
- September 12, 2011
Questions and Answers on Risk Adjustment White Paper - November 8, 2013
Question and Answer on Submission of Reinsurance Enrollment Count (PDF) (PDF – 127 KB) - April 11, 2014
Question and Answer on Budget Neutrality for the Risk Corridors (PDF) - May 22, 2014
Questions and Answers on Reinsurance Contributions Process (PDF) - June 8, 2016
Questions and Answers from the March 31, 2016, HHS-Operated Risk Adjustment Methodology Meeting (PDF) - July 26, 2016
Deadline for Submission of MLR and Risk Corridors Data for the 2015 Benefit Year (PDF) - August 22, 2016
FAQs for Federally-facilitated Marketplace (FFM) User Fee Adjustment Submission Requirements (PDF) - October 27, 2017
FAQs for Federally-facilitated Exchange (FFE) User Fee Adjustment Submission Requirements Benefit Year 2016 (PDF) - May 7, 2018
FAQs for Federally-facilitated Exchange (FFE) User Fee Adjustment Submission Requirements Benefit (PDF) - April 8, 2019
FAQs for 2018 Benefit Year Cost-sharing Reduction (CSR) Data Submission (PDF) - May 8, 2019
FAQs for Federally-facilitated Exchange (FFE) User Fee Adjustment Submission (PDF)
This set of FAQs addresses the federally-facilitated exchange (FFE) User Fee Adjustment submission process and is intended to assist issuers and TPAs (including PBMs) with navigating the submission requirements and understanding the mechanism through which CMS will apply the FFE user fee adjustment to FFE issuers. - April 24, 2020
FAQs for 2019 Benefit Year Cost-sharing Reduction (CSR) Data Submission (PDF) - April 13, 2021
FAQs for 2020 Benefit Year Cost-sharing Reduction (CSR) Data Submission (PDF) - May 13, 2024
Risk Adjustment Telehealth and Audio-only Services FAQ (PDF)
This guidance document replaces previous Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs listed above.
Consumer Operated and Oriented Plan (CO-OP) Program
FAQs
- October 11, 2011
Frequently Asked Questions regarding the CO-OP Program FOA - January 27, 2016
Frequently Asked Questions regarding the CO-OP Program (PDF)
Fact Sheets
- December 8, 2011
New Federal Loan Program Helps Nonprofits Create Customer-Driven Health Insurers - September 26, 2014
CO-OP Awardees Announced
Other Insurance Protections
COBRA
Fact Sheets
- October 17, 2012
COBRA Continuation Coverage
FAQs
- October 19, 2011
COBRA Continuation Coverage Questions and Answers
Mental Health Parity
Fact Sheets
- October 25, 2011
Mental Health Parity and Addiction Equity Act - October 27, 2016
Final Report of President Obama’s Mental Health and Substance Use Disorder Parity Task Force - October 27, 2016
Factsheet: Mental Health and Substance Use Disorder Parity Task Force Announces New Actions and Recommendations - October 27, 2016
Compliance Assistance Materials Index (PDF)
FAQs
- December 22, 2010
Mental Health Parity Implementation (ACA FAQs Set 5) - November 17, 2011
Mental Health Parity Implementation (ACA FAQs Set 7) - November 8, 2013
Mental Health Parity Implementation (ACA FAQs Set 17) - January 9, 2014
Mental Health Parity Implementation (ACA FAQs Set 18) - October 23, 2015
Mental Health Parity Implementation (ACA FAQs Set 29) (PDF) - April 20, 2016
Mental Health Parity Implementation (ACA FAQs Set 31) (PDF) - October 27, 2016
Mental Health Parity Implementation (ACA FAQs Set 34) (PDF) - June 16, 2017
Mental Health Parity Implementation (ACA FAQs Set 38) (PDF)
Related information: Draft MHPAEA Disclosure Template (PDF) - April 23, 2018
Mental Health Parity Implementation (ACA FAQs Set 39 - Proposed) - September 5, 2019
Mental Health Parity Implementation (ACA FAQs Set 39 - Final) (PDF)
Related information: MHPAEA Disclosure Template (DOCX) (PDF) (PDF) - April 2, 2021
Mental Health Parity Implementation (ACA FAQs Set 45) (PDF)
Newborns' and Mothers Health Protection
Fact Sheets
- January 30, 2012
Newborns' and Mothers' Health Protection Act of 1996 (NMHPA)
Women's Health and Cancer Rights
Fact Sheets
- January 30, 2012
Women's Health and Cancer Rights Act of 1998 (WHCRA)
Health Insurance Market Reforms
Fact Sheets
- November 20, 2012
Technical Fact Sheet: Proposed Rule for Health Insurance Market Reforms (PDF - 128 KB) (PDF) - February 22, 2013
Final Rule for Health Insurance Market Reforms - February 27, 2013
Technical Fact Sheet: Health Insurance Market Reforms (PDF - 75 KB) (PDF) - March 15, 2013
Ensuring Health Insurance Protections for Consumers - March 14, 2014
Exchange and Insurance Market Standards for 2015 and Beyond and Final 2015 Letter to Issuers in the Federally-facilitated Marketplace - May 16, 2014
Exchange and Insurance Market Standards for 2015 and Beyond
FAQs
- April 26, 2013
Questions and Answers Related to the Health Insurance Market Reforms - May 16, 2014
Frequently Asked Questions on Health Insurance Market Reforms and Marketplace Standards (PDF) - June 3, 2014
Frequently Asked Question on Qualified Health Plans and Guaranteed Availability Standards (PDF) - April 16, 2015
Frequently Asked Questions on Health Insurance Market Reforms and Wellness Programs (PDF) - June 15, 2015
Frequently Asked Questions on Uniform Modification and Plan/Product Withdrawal (PDF) - October 19, 2015
Frequently Asked Questions on the Impact of PACE Act on State Small Group Expansion (PDF)
*Updated December 17, 2015 - February 29, 2016
Frequently Asked Questions on the 2017 Moratorium on Health Insurance Provider Fee (PDF) - May 26, 2016
Frequently Asked Question on Health Insurance Market Reforms and Marketplace Standards (PDF) - December 16, 2016
Frequently Asked Questions on Agent/Broker Compensation and Discriminatory Marketing Practices (PDF) - June 7, 2022
Frequently Asked Questions on Agent/Broker Compensation and Guaranteed Availability of Coverage (PDF) - December 14, 2022
Clarifying Guidance on the Frequently Asked Questions on Agent/Broker Compensation and Guaranteed Availability of Coverage (PDF) - May 24, 2023
Benefit Coordination and Medicare Eligibility (PDF) - May 31, 2023
Frequently Asked Question on Qualified Health Plans and Plan Data Submissions (PDF)
Annual Limits
FAQs
- February 10, 2012
Questions and Answers Related to Annual Limit Waivers
Coverage for Young Adults
Fact Sheets
- April 20, 2010
Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Families and Businesses
FAQs
- June 29, 2010
Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Businesses and Families
Grandfathered Plans
Fact Sheets
- November 17, 2010
Amendment to Regulation on “Grandfathered” Health Plans under the Affordable Care Act
Medical Loss Ratio
Fact Sheets
- November 22, 2010
Medical Loss Ratio: Getting Your Money’s Worth on Health Insurance - December 2, 2011
Medical Loss Ratio: Final Rule - February 16, 2012
Potential Estimated Rebates Saved by HHS Determinations on State MLR Adjustment Applications - November 30, 2012
Technical Fact Sheet: Draft Notice of Payment and Benefit Parameters (PDF – 117 KB) (PDF)
Prevention
Fact Sheets
Review of Insurance Rates
Fact Sheets
- December 21, 2010
Shining a Light on Health Insurance Rate Increases - February 24, 2011
Nearly $200 Million Available to Help States Fight Health Insurance Premium Increases - May 19, 2011
Fighting Unreasonable Health Insurance Premium Increases - September 20, 2011
Over $100 Million to Help States Crack Down on Unreasonable Health Insurance Rate Hikes - September 21, 2012
Rate Review Grant Map: State-by-State Summary of Rate Review Grants - November 20, 2012
Technical Fact Sheet: Proposed Effective Rate Review Rule Changes for Health Insurance Market Reforms (PDF - 70 KB) (PDF) - May 3, 2013
States with Effective Rate Review Programs
FAQs
- June 7, 2010
Premium Review Grant Solicitations: FAQs - July 1, 2010
Grant Proposals: FAQs - August 22, 2011
Rate Review Training: Technical FAQs - Set 1 - October 24, 2011
Rate Review Training: Technical FAQs - Set 2 - May 8, 2013
Rate Review Grants: Cycle III funding opportunity FAQs - Set 1 - June 6, 2013
Rate Review Grants: Cycle III funding opportunity FAQs - Set 2
Student Health Plans
Fact Sheet
- February 9, 2011
Improving Health Insurance Protections for Students - March 16, 2012
Student Health Plans Final Rule
FAQs
- March 9, 2011
Status of Student Health Insurance Coverage with Policy Years Starting Prior to January 1, 2012
Self-Funded, Non-Federal Governmental Plans
Fact Sheet
- July 18, 2014
Self-Funded Non-Federal Governmental Plans