Other Resources

Other Resources

Affordable Care Act

Innovation in the Marketplace Newsletters

No Surprises Act

Federal Independent Dispute Resolution

Reports

Consumer Support and Information

Consumer Assistance Program Grants

Reports

Navigators

External Appeals

Model Notice

Notice of Privacy Act Rights

Federal Register Notice

Summary of Benefits and Coverage and Uniform Glossary

SBC Materials and Supporting Documents (Authorized for use for plan or policy years that begin on or after January 1, 2021)

Applicability: Plans and issuers will be required to use the 2021 Summary of Benefits and Coverage (SBC), the 2021 SBC Calculator Guide and Narratives, and, should they choose to use the SBC Calculator, the 2021 SBC Calculator beginning on the first day of the first open enrollment period for any plan years (or, in the individual market, policy years) that begin on or after January 1, 2021, with respect to coverage for plan or policy years beginning on or after that date.

NOTE: The documents below were updated on 7/26/2023 to reflect the new expiration date of 5/31/2026 under the Paperwork Reduction Act. There are no changes to the content of any of the documents.

Forms

Instructions/Guidance

SBC Materials and Supporting Documents (Authorized for use prior to January 1, 2021)

Applicability: Health plans and issuers that maintain an annual open enrollment period will be required to use the April, 2017 edition of the SBC template and associated documents beginning on the first day of the first open enrollment period that begins on or after April 1, 2017 with respect to coverage for plan years (or, in the individual market, policy years) beginning on or after that date. For plans and issuers that do not use an annual open enrollment period, this SBC template and associated documents is required beginning on the first day of the first plan year (or, in the individual market, policy year) that begins on or after April 1, 2017 and before January 1, 2021.

Forms

Instructions/Guidance

SBC Materials and Supporting Documents (Authorized for use prior to April 1, 2017)

Forms

Instructions/Guidance

Content Requirements for Plan Finder

Q&A

Instructions/Guidance

Pre-Existing Condition Insurance Plan (PCIP)

Data

Reports

Early Retiree Reinsurance Program (ERRP)

Reports

Health Insurance Marketplaces

Qualified Health Plan (QHP) Directory Pilot (September 17, 2024)

As part of its ongoing work to improve access to care, reduce clinician burden, and support interoperability throughout the health sector, the Centers for Medicare & Medicaid Services (CMS) is partnering with the state of Oklahoma on a first-of-its-kind directory pilot that will help inform the design and feasibility of any future efforts toward a National Directory of Healthcare (NDH). One goal of this pilot is to develop an automated, single, statewide centralized directory for Qualified Health Plans (QHPs) and providers in Oklahoma to improve data accuracy, lessen burden on providers and payers, lower administrative costs, support interoperable data exchange, and ultimately improve patient and provider experiences. CMS believes that this pilot will serve as a proof-of-concept and help inform any future development of an NDH that can serve as a centralized database for provider information.

Presentations

Marketplace Year 3: Issuer Insights and Innovation - June 9, 2016

Forum Agenda (PDF)
CMS Acting Administrator Andy Slavitt Remarks"> CMS Acting Administrator Andy Slavitt Remarks - Opens in a new window  
HHS Secretary Burwell Remarks"> HHS Secretary Burwell Remarks - Opens in a new window  
Marketplace Success Stories Blog by CEO Kevin Counihan"> Marketplace Success Stories Blog by CEO Kevin Counihan - Opens in a new window  

Forum Recording:

Session Slides:

Marketplace Year 3: Issuer Insights and Innovation – October 5, 2016

Forum Agenda (PDF)
CMS Acting Administrator Andy Slavitt Remarks"> CMS Acting Administrator Andy Slavitt Remarks - Opens in a new window 
HHS Secretary Burwell Remarks"> HHS Secretary Burwell Remarks - Opens in a new window

Forum Recordings (Forthcoming)

Session Slides

Forms

Reports

Planning and Establishment Grants

Pre-Application Conference Calls (Upcoming)

  • June 29, 2012
    Dates and Times of Pre-Application Conference Calls for Exchange Establishment FOA:
    • July 19, 2012 – 1:30-3:00pm EST
    • October 4, 2012 - 2:00-3:30pm EST
    • January 10, 2013 - 2:00-3:30pm EST
    • April 10, 2013 - 1 -2:30 PM EST
      Call in: 1 877 267 1577; Meeting ID: 0360

Consumer Operated and Oriented Plan (CO-OP) Program

Presentations

Health Insurance Market Reforms

Annual Limits

Application Information

Coverage for Young Adults

Data

Excepted Benefits

Medical Loss Ratio

Forms

Reports:

Mental Health Parity

Forms

Reports

Patient’s Bill of Rights

Q&A

Data

Methodology

Reports

Prevention

Forms

Review of Insurance Rates

Forms

Reports (XLSM)

 

Self-Funded Non-Federal Governmental Plans

Compliance Checklists

Presentations

HIPAA Opt-Out Materials

Standard Notices

 

Premium Stabilization Programs

White Papers

Risk Adjustment Spring Meeting (May 7-8, 2012)

Instructions

Forms

COBRA

Forms

 

Reports

GAO

State High Risk Pool Grant Program

CCIIO 

 

Page Last Modified:
10/21/2024 03:11 PM