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The Center for Consumer Information & Insurance Oversight

 

Qualified Health Plan Certification

The Qualified Health Plan (QHP) Application is available to issuers applying for certification to participate in the Federally-facilitated Marketplaces (FFMs). Health plans, including dental, must meet a number of standards in order to be certified as QHPs. As defined in the Affordable Care Act (ACA), a QHP is an insurance plan that is certified by the Health Insurance Marketplace, provides essential health benefits (EHBs), follows established limits on cost sharing, and meets other requirements outlined within the application process.

Issuers seeking QHP certification should review and submit the QHP Application and complete the certification process. The QHP Application, including templates, instructions, tools, and FAQs, is now located on the new QHP website - Opens in a new window .

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QHP Certification Timeline

Activity Dates

Initial QHP Application Submission Window

5/10/17 – 6/21/17

CMS Reviews Initial QHP Applications as of 6/21/17

6/22/17 – 7/25/17

CMS Sends First Correction Notice

8/1/17 – 8/2/17

Deadline for Service Area Petition

8/4/17

Final Deadline for Issuer Changes to QHP Application

8/16/2017

CMS Reviews Final QHP Submissions as of 8/16/17

8/17/2017 – 9/11/2017

CMS Sends Final Correction Notice to Issuers with Agreements for Signature and Plan Lists for Confirmation

9/14/2017 – 9/15/17

States Send CMS Final Plan Recommendations

9/27/2017

Issuers Send Signed Agreements, Confirmed Plan Lists and Final Plan Crosswalks to CMS

9/16/2017 – 9/27/2017

CMS Sends Certification Notices with Countersigned Agreements and Final Plan Lists to Issuers

10/11/2017 – 10/12/2017

Limited Data Correction Window: Outreach to Issuers with CMS or State Identified Data Errors; Issuers Submit Corrections; CMS Reviews and Finalizes Data for Open Enrollment

9/15/2017 –10/7/2017

Open Enrollment

Begins 11/1/2017

Contact Us

Frequently Asked Questions (FAQs) related to QHP certification are posted here - Opens in a new window and will be updated throughout the application and certification period. Issuers may also contact the Exchange Operations Support Center (XOSC) Help Desk at CMS_FEPS@cms.hhs.gov or at 855-CMS-1515.