On April 13, 2017, the Centers for
Medicare and Medicaid Services (CMS) released the final Patient
Protection and Affordable Care Act; Market Stabilization Rule. The final rule is aimed at stabilizing the
individual and small group markets by tightening enrollment standards and
providing increased flexibility related to standards for Qualified Health Plans
(QHPs), as outlined in detail below. The final rule also seeks to provide
greater deference to state regulation of health insurance.
issuing the final regulations, CMS also released:
Finalized timelines for QHP certification and the rate review process for 2018 coverage;
Updated Actuarial Value (AV) Calculator for
FAQ on Compliance
Standards and QHP certification
guidance for Issuers in the Federally-facilitated Marketplaces (FFMs)
PCG subject matter experts have created a comprehensivesummary to assist regulators as they seek to understand what the rule changes
and updated timelines mean for the coverage and markets in their states. The
team also hosted a webinar on Thursday, April 20th to review the final rule.
For a copy of the webinar recording or the presentation slides, please email email@example.com.