Good Afternoon – Today CMS/CCIIO released the draft 2017 Letter to Issuers (Letter), which provides guidance to issuers that want to offer Qualified Health Plans (QHPs) in the Federally Facilitated Marketplaces (FFMs) for the 2017 plan year. Parts of this Letter apply to issuers in State-based Marketplaces using the Federal Platform (SBM-FPs). The guidance addresses technical policy and operational matters. The Letter, which CMS first issued for the 2014 plan year, communicates key dates in the QHP certification and recertification process; standards that will be used to evaluate QHPs for certification; oversight procedures and consumer support policies and programs; and tribal support matters. The draft 2017 Letter builds on policies proposed in the 2017 Payment Notice proposed rule and other previously-released guidance related to the FFMs and SBM-FPs. The information contained in the draft 2017 Letter will help issuers apply for QHP certification for plan years beginning in 2017 and understand FFM and SBM-FPs consumer support and oversight functions. Throughout the draft 2017 Letter, CMS identifies the areas in which states performing plan management functions in the FFMs and SBM-FPs have flexibility to follow an approach different from that articulated in this guidance. CMS welcomes comments on the Letter by January 17, 2016 to FFEcomments@cms.hhs.gov.
CMS also released a draft bulletin for comment on proposed dates for submission and posting of information about proposed rates for single risk pool coverage consistent with the proposals in the 2017 Payment Notice Proposed Rule to amend the regulations at 45 CFR Part 154. Specifically, this bulletin proposes guidance on the timing for health insurance issuers to submit Rate Filing Justifications for proposed rates in the individual and small group markets. It also proposes guidance on the timing for states with an effective rate review program to provide public access to information regarding proposed rate increases that are subject to review and final rate increases (including those not subject to review). The timelines specified in this bulletin apply to rates filed in 2016 for single risk pool coverage (including rates for both qualified health plans (QHPs) and non-QHPs) that are required to be filed using the Unified Rate Review Template effective on or after January 1, 2017. CMS welcomes comment on the bulletin by January 22, 2016 to RateReview@cms.hhs.gov.
Issuer Guidance on Uniform Rate Review Timeline:https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Timeline-Bulletin-12-23-15-FINAL.pdf
Key Dates in 2016 Issuer Timeline: https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/2016-key-dates-table-12-23-15-FINAL.pdf