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Fact Sheets & Frequently Asked Questions (FAQs)
- Affordable Care Act
- Consumer Support and Information
- Content Requirements for Healthcare.gov
- Pre-Existing Condition Insurance Plan (PCIP)
- Affordable Insurance Exchanges
- State Innovations
- Consumer Operated and Oriented Plan (CO-OP) Program
- Other Insurance Protections
- Health Market Reforms
Affordable Care Act
FAQs:
- September 20, 2010
Affordable Care Act Implementation FAQs (Set 1)
This set of FAQs addresses implementation topics including compliance, grandfathered health plans, claims, internal appeals and external review, dependent coverage of children, out-of-network emergency services, and highly compensated employees. - October 8, 2010
Affordable Care Act Implementation FAQs (Set 2)
This set of FAQs addresses grandfathered health plans, dental and vision benefits, rescissions, preventive health services, and ACA effective date for individual health insurance policies. - October 12, 2010
Affordable Care Act Implementation FAQs (Set 3)
This set of FAQs addresses the exemption for group health plans with less than two current employees. - October 29, 2010
Affordable Care Act Implementation FAQs (Set 4)
This set of FAQs addresses grandfathered health plans. - December 22, 2010
Affordable Care Act Implementation FAQs (Set 5)
This set of FAQs addresses a variety of ACA implementation topics, the HIPAA nondiscrimination and wellness program rules, and the Mental Health Parity and Addiction Equity Act of 2008. - April 1, 2011
Affordable Care Act Implementation FAQs (Set 6)
This set of FAQs addresses grandfathered health plans. - November 17, 2011
Affordable Care Act Implementation FAQs (Set 7)
This set of FAQs addresses the Summary of Benefits and Coverage and Uniform Glossary requirements of PHS Act §2715 and the Mental Health Parity and Addiction Equity Act of 2008. - February 9, 2012
Frequently Asked Questions from Employers Regarding Automatic Enrollment, Employer Shared Responsibility, and Waiting Periods (PDF - 93 KB)
This Bulletin provides information on questions from employers and other stakeholders regarding the provisions of the Affordable Care Act governing automatic enrollment, employer shared responsibility, and the 90-day limitation on waiting periods. - March 19, 2012
Affordable Care Act Implementation FAQs (Set 8)
This set of FAQs addresses the Summary of Benefits and Coverage requirements of PHS Act §2715. - May 11, 2012
Affordable Care Act Implementation FAQs (Set 9)
This set of FAQs addresses the Summary of Benefits and Coverage requirements of PHS Act §2715. - August 7, 2012
Affordable Care Act Implementation FAQs (Set 10)
This FAQ addresses the Summary of Benefits and Coverage requirements of PHS Act §2715.
Consumer Support and Information
Consumer Assistance Program Grants
Fact Sheets:
- July 22, 2010
Protecting Consumers and Putting Patients Back in Charge of Their Care - November 21, 2011
State Consumer Assistance Program Participation in Exchange Core Area 10 - June 22, 2012
New Funding Opportunity for Consumer Assistance Programs - August 24, 2012
Consumer Assistance Program Grants: Helping States Give Consumers Greater Control of their Health Care - August 24, 2012
Consumer Assistance Program Grants: How States Are Using New Resource to Give Consumers Greater Control of their Health Care
FAQs:
- April 20, 2012
CAP Limited Competition Funding Opportunity Announcement - June 7, 2012
New Consumer Assistance Programs Funding Opportunity for all States and Territories
External Appeals
Fact Sheets:
- July 22, 2010
Protecting Consumers and Putting Patients Back in Charge of Their Care - June 22, 2011
Affordable Care Act: Working with States to Protect Consumers - March 9, 2012
2012 County Data for Culturally and Linguistically Appropriate Services
This Fact Sheet provides data so that group health plans and health insurance issuers offering non-grandfathered health coverage can determine the counties in which they are required to provide notices related to a consumer’s right to external review in a culturally and linguistically appropriate manner. - June 19, 2012
HHS-Administered Federal External Review Process - July 10, 2011
External Appeals: Determinations of External Appeals Review Processes
Summary of Benefits and Coverage and Uniform Glossary
Fact Sheets:
- August 17, 2011
Providing Clear and Consistent Information to Consumers about Their Health Insurance Coverage - March 9, 2012
2012 County Data for Culturally and Linguistically Appropriate Services
This Fact Sheet provides data so that group health plans and health insurance issuers offering health coverage can determine the counties in which they are required to provide the summary of benefits and coverage in a culturally and linguistically appropriate manner.
Outreach and Education Resources
September 29, 2011
Consumer Fact Sheets
- Adding Adult Children to Your Health Plan (PDF – English 178 KB, Spanish 89 KB)
- Curbing Insurance Cancellations (PDF – English 170 KB, Spanish 63 KB)
- Eliminating Dollar Limits on Your Benefits (PDF – English 184 KB, Spanish 104 KB)
- Getting Value for Your Premium Dollar (PDF – English 172 KB, Spanish 104 KB)
- Lowering Your Cost for Preventive Services (PDF – English 353 KB, Spanish 111 KB)
- Protecting Children With Pre-Existing Health Conditions (PDF – English 252 KB, Spanish 450 KB)
- Protecting Your Choice of Health Care Providers (PDF – English 219 KB, Spanish 94 KB)
- Are You in a Grandfathered Health Plan (PDF – English 307 KB, Spanish 57 KB)
- Putting the Brakes on Unreasonable Health Insurance Rate Increases (PDF - English 77 KB, Spanish 63 KB)
April 7, 2011
Consumer Posters and Brochures
- State Consumer Assistance Poster (PDF – English 1 MB, Spanish 884 KB)
- State Consumer Assistance Brochure (PDF – 2 MB)
Content Requirements for Healthcare.gov
Fact Sheets:
- May 1, 2011
Establishing the Web Portal Called For in the Affordable Care Act (PDF – 115 KB)
Pre-Existing Condition Insurance Plan (PCIP)
Fact Sheets:
- July 29, 2010
About the New Pre-Existing Condition Insurance Plan - October 12, 2012
State by State Enrollment in the Pre-Existing Condition Insurance Plan as of August 31, 2012, and Links to Previous Monthly Reports
Affordable Insurance Exchanges
Fact Sheets:
- July 11, 2011
Exchange Regulation Overview Fact Sheet - July 11, 2011
Affordable Insurance Exchange Basics - July 11, 2011
Small Business Fact Sheet - July 11, 2011
States Fact Sheet - July 11, 2011
Health Plans Fact Sheet - August 12, 2011
Affordable Insurance Exchange Overview Fact Sheet - August 12, 2011
Exchange Eligibility and Employer Standards - August 12, 2011
Medicaid, CHIP and the Affordable Care Act - August 12, 2011
Health Insurance Premium Tax Credits and the Affordable Care Act (PDF – 145 KB) - September 19, 2011
Affordable Insurance Exchanges: State Partnership Model - December 16, 2011
Essential Health Benefits Bulletin Fact Sheet - March 12, 2012
Affordable Insurance Exchanges Final Rule: Choices, Competition and Clout for States
FAQs:
- July 11, 2011
Affordable Insurance Exchanges: Questions and Answers - November 29, 2011
State Exchange Implementation Questions and Answers (PDF – 135 KB) - February 17, 2012
Frequently Asked Questions on the Essential Health Benefits Bulletin (PDF – 88 KB) - May 16, 2012
Frequently Asked Questions on the Draft Blueprint for Exchanges
Exchange Planning and Establishment Grants
Fact Sheets:
- July 29, 2010
Health Insurance Exchanges: State Planning and Establishment Grants - January 20, 2011
Health Insurance Exchange Establishment Grants Fact Sheet - November 21, 2011
State Consumer Assistance Program Participation in Exchange Core Area 10 - September 27, 2012
Creating a New Competitive Marketplace: Health Insurance Exchange Establishment Grants Awards List
FAQs:
- July 29, 2010
Process FAQs for Exchange State Planning and Establishment Grants - July 29, 2010
Exchange State Planning & Establishment Grant FAQs - September 30, 2010
Health Insurance Exchanges: State Planning and Establishment Grants - March 9, 2011
Exchange Establishment Cooperative Agreement Funding FAQ - June 2, 2011
Exchange Establishment Cooperative Agreement Funding FAQs - June 29, 2012
Exchange Establishment Cooperative Agreement Funding FAQs
Early Innovator Grants
Fact Sheets:
- February 16, 2011
States Leading the Way on Implementation: HHS Awards “Early Innovator” Grants to Seven Statest
Territory Cooperative Agreements
FAQs:
Information Technology Systems
FAQs:
Payment Policy and Financial Management
Fact Sheet:
- July 11, 2011
Reinsurance, Risk Corridors and Risk Adjustment Fact Sheet - March 16, 2012
Reinsurance, Risk Corridors and Risk Adjustment Final Rule Fact Sheet
FAQs
September 12, 2011
Questions and Answers on Risk Adjustment White Paper
State Innovations
Fact Sheets:
- March 10, 2011
Preparing for Innovation: Proposed Process for States to Adopt Innovative Strategies to Meet the Goals of the Affordable Care Act - February 22, 2012
The Affordable Care Act: Supporting State Innovation
Consumer Operated and Oriented Plan (CO-OP) Program
FAQs:
- October 11, 2011
Frequently Asked Questions regarding the CO-OP Program FOA
Fact Sheets:
- December 8, 2011
New Federal Loan Program Helps Nonprofits Create Customer-Driven Health Insurers - October 12, 2012
CO-OP Awardees Announced
Other Insurance Protections
COBRA
Fact Sheets:
- October 19, 2011
COBRA Continuation Coverage
FAQs:
- October 19, 2011
COBRA Continuation Coverage Questions and Answers
Mental Health Parity
Fact Sheets:
- October 25, 2011
Mental Health Parity and Addiction Equity Act
Newborns' and Mothers Health Protection
Fact Sheets:
- January 30, 2012
Newborns' and Mothers' Health Protection Act of 1996 (NMHPA)
Women’s Health and Cancer Rights
Fact Sheets:
- January 30, 2012
Women's Health and Cancer Rights Act of 1998 (WHCRA)
Health Market Reforms
Annual Limits
Fact Sheets:
- Updated August 19, 2011
The Affordable Care Act: Increasing Transparency and Protecting Consumers
FAQs:
- February 10, 2012
Questions and Answers Related to Annual Limit Waivers
Coverage for Young Adults
Fact Sheets:
- April 20, 2010
Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Families and Businesses
FAQs:
- June 29, 2010
Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Businesses and Families
Grandfathered Plans
Fact Sheets:
- June 14, 2010
Keeping the Health Plan You Have: The Affordable Care Act and “Grandfathered” Health Plans - November 17, 2010
Amendment to Regulation on “Grandfathered” Health Plans under the Affordable Care Act
Medical Loss Ratio
Fact Sheets:
- November 22, 2010
Medical Loss Ratio: Getting Your Money’s Worth on Health Insurance - December 2, 2011
Medical Loss Ratio: Final Rule - February 16, 2012
Potential Estimated Rebates Saved by HHS Determinations on State MLR Adjustment Applications
Patient’s Bill of Rights
Fact Sheets:
- June 22, 2010
The Affordable Care Act’s New Patient’s Bill of Rights - July 1, 2010
Patient’s Bill of Rights: How These New Rules Will Help You
Prevention
Fact Sheets:
- July 14, 2010
Benefits for Asian Americans and Pacific Islanders of New Affordable Care Act Rules on Expanding Prevention Coverage - July 14, 2010
Benefits for African Americans of New Affordable Care Act Rules on Expanding Prevention Coverage - July 14, 2010
Benefits for Latinos of New Affordable Care Act Rules on Expanding Prevention Coverage - July 14, 2010
Benefits for Seniors of New Affordable Care Act Rules on Expanding Prevention Coverage - July 14, 2010
Benefits for Women and Children of New Affordable Care Act Rules on Expanding Prevention Coverage
Review of Insurance Rates
Fact Sheets:
- August 16, 2010
Health Insurance Premium Grants: Detailed State by State Summary of Proposed Activities - December 21, 2010
Shining a Light on Health Insurance Rate Increases - February 24, 2011
Nearly $200 Million Available to Help States Fight Health Insurance Premium Increases - May 19, 2011
Fighting Unreasonable Health Insurance Premium Increases - July 6, 2011
States with Effective Rate Review Programs - September 1, 2011
Review of Health Insurance Rate Increases - September 20, 2011
Over $100 Million to Help States Crack Down on Unreasonable Health Insurance Rate Hikes - September 21, 2012
Rate Review Grant Map: State-by-State Summary of Rate Review Grants - October 1, 2012
New Resources to Help States Crack Down on Unreasonable Health Insurance Premium Hikes
FAQs:
- June 7, 2010
Premium Review Grant Solicitations: FAQs - July 1, 2010
Grant Proposals: FAQs - August 22, 2011
Rate Review Training: Technical FAQs - Set 1 - October 24, 2011
Rate Review Training: Technical FAQs - Set 2
Student Health Plans
Fact Sheet:
- February 9, 2011
Improving Health Insurance Protections for Students - March 16, 2012
Student Health Plans Final Rule
FAQs:
- March 9, 2011
Status of Student Health Insurance Coverage with Policy Years Starting Prior to January 1, 2012
Self-Funded Non-Federal Governmental Plans
Fact Sheet
- April 7, 2011
Self-Funded Non-Federal Governmental Plans