Welcome to the Qualified Health Plan Website

This is the official Centers for Medicare & Medicaid Services’ website for issuers seeking certification to participate in the Federally-facilitated Exchanges (FFEs). As 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 Marketplace, provides essential health benefits (EHBs), follows established limits on cost sharing, and meets other requirements outlined within the application process. The QHP Application, materials, and other resources are available on this site to facilitate the certification process.

About the Marketplace: Click here to learn more about the FFE and the QHP certification cycle. This section contains details on the certification timeline, Exchange models, and guidance on how to stay updated throughout the certification period.

Application Materials: Click here to begin the QHP Application. This section contains the instructions and templates required to complete the application, as well as guidance on reviewing and submitting the application.

Certification & Forms: Click here for more information about QHP Application notices, Plan Preview, data change windows, as well as details regarding the various forms and agreements associated with certification.

FAQs: Click here for frequently asked questions regarding QHP certification. Questions are organized by topic, and are updated throughout the year.

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News and Updates

The Rates Table Template of the Qualified Health Plan (QHP) Application for plan year (PY) 2021 must be submitted to the Health Insurance Oversight System (HIOS) or transferred from the System for Electronic Rates & Forms Filing (SERFF) to HIOS by no later than 1:00 p.m. ET on July 22, 2020. For issuers submitting in HIOS, their QHP Application must be in the "cross validation complete" status by this date. 

This is also the submission deadline for issuers in a state with an Effective Rate Review Program to submit proposed rate filing justifications for single risk pool coverage into the Unified Rate Review (URR) module of HIOS. Stand-alone dental plan (SADP)-only issuers are not required to submit to the URR Module. 

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