Insurance Exchanges

This final rule outlines Exchange standards with respect to eligibility appeals, agents and brokers, privacy and security, issuer direct enrollment, and the handling of consumer cases. It also sets forth standards with respect to a State’s operation of the Exchange and Small Business Health Options Program (SHOP).

With October's open enrollment for exchanges drawing near, a key issue that remains is premium rates for health plans sold in the exchanges. This map tracks states that have released rate information filed by carriers interested in selling plans in health insurance exchanges in both the individual and small group markets.

With open enrollment drawing near, exchanges are mobilizing their efforts to provide assistance to individuals who will begin enrolling in coverage options in October. This chart highlights the approaches states have taken to develop education and training for the individuals who will provide enrollment assistance through Navigator and In-Person Assister (IPA) programs. 

On August 15, CMS awarded $67 million in Navigator Cooperative Agreements to 105 entities to serve in the 34 Federally-facilitated and State Partnership Marketplaces. This document lists the recipients of the Navigator grants, grouped by state.

This final rule provides standards for federally-funded navigator programs operating in federally facilitated and state partnership exchanges, federally-funded in-person assisters, and certified application counselors (CAC). All exchanges are required to have navigators and CACs, while the requirement to have assisters varies by exchange model. The rule includes standards related to conflict of interest, training and certification, accessibility, and SHOP-only navigators.