The Center for Consumer Information & Insurance Oversight
Since January 1, 2014, consumers and small businesses in every state (including the District of Columbia) have had access to obtain health and/or dental insurance coverage through Individual or Small Business Health Options Program (SHOP) Health Insurance Exchanges, operated by States through State-based Exchanges (SBEs), or operated by the Federal government through the Federally-facilitated Exchange (FFE).
States who wish to establish a SBE are required to convey their intent in doing so by submitting a declaration letter to the Department of Health and Human Services (HHS), Center for Medicare and Medicaid Services (CMS). States were also eligible, through November 2014, to apply for Federal grants to support the establishment of their SBE. Since 2014, CMS’s Center for Consumer Information and Insurance Oversight (CCIIO) has been providing conditional approval for states requesting to establish a SBE. Historic declaration letters and other correspondence from States related to Exchange establishment can be found here. Since 2014, a few States who were conditionally approved to operate a SBE have transitioned to a different Exchange model. As of November 1, 2019, there are 13 SBEs, and 6 State-based Exchanges on the Federal platform (SBE-FPs). SBE-FPs are SBEs who rely on HHS services for performing certain Exchange functions, particularly eligibility and enrollment, while still retaining responsibility for performing certain Exchange functions such as Qualified Health Plan (QHP) certification and consumer outreach and assistance functions. Three of the SBE-FPs also utilize the Federal platform for their SHOP eligibility functions. The three SBE-FPs that perform SHOP eligibility functions are noted below by an asterisk next to the SBE-FP's name.
Below is a list of the SBEs and SBE-FPs, and where available, a state’s declaration letter, HHS/CMS’ conditional approval letter, and a State’s Exchange website link. For further information, please contact the State directly.
Note: People using assistive technology may not be able to fully access information in these files. For assistance, please e-mail AltFormatRequest@cms.hhs.gov.
Updated: November 1, 2019
State-based Exchanges for Plan Year 2020:
District of Columbia
State-based Exchanges on the Federal Platform for Plan Year 2020:
- Declaration Letter (PDF)
- Conditional Approval (PDF)
- My Arkansas Health Insurance Marketplace Website
- November 5, 2019 FAQ: Quality Rating Information Bulletin’s (Quality Bulletin’s) Display Guidelines for Direct Enrollment (DE) Entities
- November 1, 2019 Enhanced Direct Enrollment Approved Partners (Updated)
- September 11, 2019 FAQ: Enhanced Direct Enrollment Participation Requirements for Non-Issuer of a Primary EDE Entity Environment
- August 15, 2019 Quality Rating Information Bulletin for Plan Year 2020 Health Insurance Exchanges Quality Rating System (QRS) for Plan Year (PY) 2019: Results at a Glance
- April 18, 2019 CMS-9926-F: Final HHS Notice of Benefit and Payment Parameters for 2020 Final 2020 Letter to Issuers on Federally-facilitated Exchanges Key Dates for Calendar Year 2019: QHP Certification in the FFEs; Rate Review; Risk Adjustment
- April 4, 2019 Guidance on Unified Rate Review Timeline: Timing of Submission of Rate Filing Justifications for the 2019 Filing Year for Single Risk Pool Coverage Effective on or after January 1, 2020
- March 19, 2019 2020 Final Actuarial Value Calculator 2020 Final Actuarial Value Calculator Methodology
- March 6, 2019 CMS-9921-NC: Request for Information Regarding the Sale of Individual Health Insurance Coverage Across State Lines Through Health Care Choice Compacts
- February 28, 2019 Section 1332 Pass-through Funding Tools and Resources