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Plans and Benefits

WEBTo reflect these requirements, the Plans & Benefits Add-in file populates state- and market-specific EHB benchmark data in the benefits package worksheet. Key Changes for …

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URL: https://www.qhpcertification.cms.gov/s/Plans%20and%20Benefits

Application Instructions

WEBPY2025 Qualified Health Plan Issuer Application Instructions. Microsoft Excel Trusted Locations. Each year, CMS makes various Excel-based QHP Application materials …

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Submission Systems

WEBHealth Insurance Oversight System (HIOS) HIOS is the system that aggregates QHP Application data. Issuers in Federally-facilitated Exchange (FFE) states submit the …

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Application Materials

WEBApplication Materials. The sections listed below and contained within this portion of the QHP certification website comprise a QHP Application and guide you through the application …

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Qualified Health Plan Issuer Application Instructions

WEBOpen a blank sheet in Excel (no template or file). The Excel ribbon should not have a Plans & Benefits. ribbon. If the Plans & Benefits ribbon appears, go to File > Options > Add-Ins …

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Accreditation FAQs

WEB2025 and onwards. 2026 and onwards. • Issuer must be accredited by a recognized AE to be eligible for QHP certification. • Accreditation is required 90 days prior to Open …

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Marketplace Quality Initiatives FAQs

WEBAs clarified in 45 CFR 156.1110(a)(2)(ii), a QHP issuer-contracted hospital could instead implement an evidence-based initiative to improve health care quality through the …

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About the Marketplace

WEBKey differences in requirements for issuers participating in the Individual Market and the Small Business Health Options Program (SHOP) Market. New to the Exchange. Tips to …

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QHP Agreement and Plan Confirmation

WEBQHP Agreement and Plan Confirmation. As part of the QHP certification process, issuers must complete plan confirmation to submit their final plan offering decisions to CMS. On …

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Qualified Health Plan Issuer Application Instructions, Plan Year …

WEBAs defined in the Patient Protection and Affordable Care Act (PPACA), a qualified health plan (QHP) is an insurance plan that is certified by the Health Insurance …

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PY2022 QHP Certification State Toolkit

WEBThe Qualified Health Plan (QHP) Certification State Toolkit for plan year (PY) 2022 is a series of consolidated resources to which states may refer throughout the QHP …

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Plan Year 2023 QHP Certification State Toolkit

WEBAPPENDIX C: PLAN YEAR 2023 STATE RESPONSIBILITY FOR QHP REVIEWS, BY EXCHANGE MODEL. The following table outlines the reviews that states …

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Health Insurance Exchange Quality Improvement Strategy: …

WEBQualified Health Plans; Exchange Standards for Employers, Final Rule, 77 Fed. Reg. 18310-18475 (March 27, 2012) .. 53 Patient Protection and Affordable Care Act; …

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Qualified Health Plan Issuer Application Instructions

WEBSection 2D: Plans & Benefits. 1. Introduction. In the Plans & Benefits section, you will enter data about your plans, list covered benefits with any quantitative limits or exclusions, …

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Qualified Health Plan Issuer Application Instructions

WEBStep 3. A prompt will appear asking if you would like to save the screenshots. Select Yes if you wish to save screenshots. Using the prompt, select the file name and location to …

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Qualified Health Plan Issuer Application Instructions

WEBPursuant to 45 CFR 156.122(a)(3), for plan years beginning on or after January 1, 2018, a health plan does not provide Essential Health Benefits (EHBs) unless it uses a …

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Health Insurance Casework System Access Guidance

WEBHealth Insurance Casework System Access Guidance July 11, 2019. This document provides information to issuers about how to request access to the Health Insurance …

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