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CMS Issues Health Insurance Exchange Proposed Rules

John Commins, for HealthLeaders Media, June 17, 2013

State marketplaces
State marketplace oversight mechanisms would assure that consumers are properly given their choices of coverage available, that consumers correctly receive advance payments of the premium tax credit or cost-sharing reductions if they qualify, and that marketplaces meet PPACA standards.

Flexibility for states
HHS is proposing additional state flexibility by permitting state-based Small Business Health Options Programs (SHOP) while HHS would operate an individual market federally-facilitated marketplace in that state.

Consumer protections for enrollment assistance
This rule clarifies the ways that agents and brokers will help consumers and small businesses in federally facilitated marketplaces.

Establishment of standards for HHS-approved enrollee satisfaction survey vendors
PPACA calls for an enrollee satisfaction survey that will allow the public to compare enrollee satisfaction among comparable plans in the marketplace. This rule sets forth a process for approving and overseeing survey vendors to administer the survey on behalf of qualified health plan issuers in the marketplace.


John Commins is a senior editor with HealthLeaders Media.

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