Regulations and Guidance

Regulations and Guidance

Affordable Care Act

Guidance

No Surprises Act

Regulations

Good Faith Estimates for Uninsured (or Self-pay) Individuals

Guidance

Patient-Provider Dispute Resolution

Guidance

Federal Independent Dispute Resolution

Guidance

Advanced Explanation of Benefits (AEOB)

Regulations

Consumer Support and Information

Transparency in Coverage

Regulations

Guidance 

  • December 27, 2019
    Announcement of in Intention to Extend the Transparency in Coverage Comment Period (PDF)

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

Guidance

 

Eligibility Appeals

Guidance

Agents & Brokers

Minimum Acceptable Risk Standards

Guidance:

Premium Stabilization Programs

Regulations

Guidance

                       *Document now links to revised version published on May 12, 2020
                         (see posting below)

Risk Adjustment State Flexibility Requests

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

Self-Funded Non-Federal Governmental Plans

Guidance

Health Insurance Portability and Accountability Act of 1996 (HIPAA)

Guidance

Page Last Modified:
12/05/2024 04:35 PM