Regulations and Guidance

Affordable Care Act

Guidance

Consumer Support and Information

External Appeals

Regulations

Guidance

Summary of Benefits and Coverage and Uniform Glossary

Regulations

 Guidance

February 2016 Proposed Supporting Materials for Public Comment

Language Access Guide for Exchanges, Qualified Health Plan (QHP) Issuers, and Web-Brokers

Updated with minor corrections to the information posted January 13, 2017. Entities that relied on the information in previous appendices will not be penalized.

Content Requirements for Plan Finder

Regulations

Guidance

Pre-Existing Condition Insurance Plan (PCIP)

Regulations

Guidance

Early Retiree Reinsurance Program (ERRP)

Regulations

Guidance

Health Insurance Marketplaces

Regulations

Guidance

Plan Management

Regulations

Additional Information on State EHB Benchmark Plans

2014 Actuarial Value Calculator (XLSM – 1.4 MB) 

2014 Actuarial Value Calculator Methodology (PDF - 214 KB)

*See below under Premium Stabilization/Regulations for 2015 Actuarial Value Calculator and Methodology and 2016, 2017 and 2018 Actuarial Value Calculator and Methodologies are under the Guidance portion of this section.

Minimum Value Calculator (XLSM – 598 KB)

Minimum Value Calculator Methodology (PDF - 154 KB)

Guidance

Eligibility Appeals

Guidance

Minimum Acceptable Risk Standards

Guidance:

Premium Stabilization Programs

Regulations

 

Guidance

State Innovations

Regulations

Consumer Operated and Oriented Plan (CO-OP) Program

Regulations

Guidance

Other Insurance Protections

Mental Health Parity

Regulations

Guidance

Health Insurance Market Reforms

Regulations

Guidance

      Annual Limits

      Regulations

      Guidance

      Association Coverage

      Guidance

      Coverage for Young Adults

      Regulations

      Guidance

      Employer Responsibility

      Guidance

      Grandfathered Plans

      Regulations

      Medical Loss Ratio

      Regulations

      Guidance

      Patient's Bill of Rights

      Regulations

      Guidance

      Prevention

      Regulations

      Guidance

      Review of Insurance Rates

      Regulations

      Guidance

      Student Health Plans

      Regulations

      Guidance

      Health Insurance Portability and Accountability Act of 1996 (HIPAA)

      Guidance