Insurance Exchanges

This most federal guidance clarifies that individuals have until March 31, 2013 to enroll in coverage through the health insurance marketplaces to avoid being subject to the penalty for not maintaining minimal essential coverage.

This final rule outlines financial integrity and oversight standards with respect to Affordable Insurance Exchanges, qualified health plan (QHP) issuers in Federally-facilitated Marketplaces (FFMs), and States with regard to the operation of risk adjustment and reinsurance programs. It also establishes additional standards for special enrollment periods, survey vendors that may conduct enrollee satisfaction surveys on behalf of QHP issuers, and issuer participation in an FFM, and makes certain amendments to definitions and standards related to the market reform rules.

This report summarizes the health plan choices and premiums that will be available in the Health Insurance Marketplace. It contains new information on qualified health plans in the 36 states in which the Department of Health and Human Services (HHS) will support or fully run the Health Insurance Marketplace in 2014. Plan data is in final stages but is still under review as of September 18 and may be revised in HHS systems before being displayed for consumers, so this information is subject to change. This analysis also includes similar information that is publicly available from 11 states and the District of Columbia that are implementing their own Marketplace. 

This set of Frequently Asked Questions (FAQ) provides guidance on how health insurance Marketplaces will verify incomes of applicants that qualify for premium tax credits or cost-sharing reductions. CMS has determined that they will have sufficient resources to request and process additional income documentation such that the sample size is 100 percent. However, state-based Marketplaces are allowed to determine their own sample size percentage for this group, as long as it is statistically significant.