Published Guidance & Regulations

CMS Letter to Issuers

The CMS Letter to Issuers in the Federally-facilitated Exchanges provides guidance for issuers seeking to offer QHPs, including stand-alone dental plans (SADPs) in the Federally-facilitated Exchanges (FFEs) or Federally-facilitated Small Business Health Options Programs (FF-SHOPs). On May 7, 2020, CMS released the Final 2021 Letter to Issuers in the Federally-facilitated Exchanges. This document has key dates for the 2021 QHP certification timeline.

Notice of Benefit and Payment Parameters 

The Notice of Benefit and Payment Parameters sets payment parameters for each benefit year and proposes standards to improve the Exchange experience for consumers. CMS released the HHS Notice of Benefit and Payment Parameters for 2021 on May 7, 2020.
Final Rule for Exchange and Insurance Market Standards
The Final Rule for Exchange and Insurance Market Standards finalizes the policies and standards regarding consumer notices, the quality report and enrollee satisfaction survey, the SHOP, navigators and other consumer assisters, and the premium stabilization programs.

Health Insurance Market Reforms

Health Insurance Market Reforms provides general CMS guidance. 

Health Insurance Marketplace

Health Insurance Marketplace provides general CMS guidance.  

SADP Voluntary Reporting Guidance

CMS is releasing the SADP Intent-to-Offer Survey for issuers to voluntarily report their intent to offer Exchange-certified stand-alone dental plans (SADPs) for plan year 2022 through the Exchange in states with Federally-facilitated Exchanges (FFEs), including states performing plan management functions. The documents below reflect the survey instrument and a letter that provides information to SADPs on the purpose of this data collection and how to submit the survey that is due on February 15, 2021, as well as frequently asked questions.

HICS Access Guidance

QHP issuers operating in FFEs or in states that delegate certain authorities to the FFE resolve consumer cases through the Health Insurance Casework System (HICS). The document below provides information to issuers about how to request access to HICS.