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Exchange Establishment Cooperative Agreement Funding FAQ

Technical Assistance

Q. What type of technical assistance will be available to States?

A.  The Program is developing a detailed schedule of technical assistance. Included in this will be:

  • Webinars
  • Conference calls
  • “Office hours” with program staff at industry conferences and meetings
  • Grantee workshops

Q. What can States expect from a grantee workshop?

A.  HHS anticipates offering State workshops in the DC area. These workshops will be a learning opportunity for States. HHS anticipates scheduling more workshops later in the grant cycle. If a workshop is announced after grant award and a State did not originally allocate funds to support travel, grantees have the option to reallocate funds for that purpose (subject to the approval of program and grant officials).

Q. Will there be opportunities for peer-to-peer learning with other States?

A.  Yes.  The Program is developing opportunities throughout the grant cycle for States to work and learn collaboratively and share lessons learned.

Miscellaneous

Q. How can individuals and the general public be involved in the establishment process for the health insurance Exchanges?

A.  States may continue the stakeholder consultation initiatives begun during the planning phase throughout the establishment process. Stakeholder consultation was required as part of activities in connection with Exchange planning grants. Stakeholders include but are not limited to consumer organizations, small business organizations, health plans, safety net associations, as well as faith based organizations.  All States were required to seek stakeholder input and involvement in planning for health insurance Exchanges.  Additionally, all States have to meet a standard of transparency and accountability if they elect to establish a State Exchange.  CCIIO will be monitoring this aspect of the planning grants, as well as providing technical assistance to share best practices in this area.

Q: How long are these cooperative agreements for?

A:  There are two different application categories for this cooperative agreement. The project period for Level One Establishment is up to one year. The project period for Level Two Establishment is through December 31, 2014.

Level One Establishment is for States that have received an Exchange Planning grant. Level Two Establishment is for States that have received an Exchange Planning grant and meet the following eligibility criteria:

  1. Has the necessary legal authority to establish and operate an Exchange that complies with Federal requirements available at the time of the application.
  2. Has established a governance structure for the Exchange.
  3. 1) Submits a complete budget through 2014;

2) Submits an initial plan discussing financial sustainability by 2015; and

3) Submits a plan outlining steps to prevent fraud, waste, and abuse.

  1. Submits a plan describing how capacity for providing assistance to individuals and small businesses in the State will be created, continued, and/or expanded, including provisions for a call center.

States that receive “Early Innovator” funding are also eligible for Level One and Level Two Establishment funding.

Q: Are States required to submit a Letter of Intent? Who should submit the Letter of Intent? Is there a standard format? Is the Letter of Intent binding?

A.  Prior to the application due date, the applicant may choose to submit a Letter of Intent. This is not a requirement. If they choose to do so, a Letter of Intent should be submitted by 2/22/11. The Authorized Organizational Representative should submit this letter. There is not a standard format for the Letter of Intent. The Letter of Intent is not binding.

When the State applies, a letter endorsing the application must be submitted by the Governor. This is a Letter of Support. This is to be included as part of their application packet.

For further clarification, and additional information on other required Letters of Support to be submitted as part of the application, please refer to Section III Eligibility Information of the Funding Opportunity Announcement.

Q: How does the State show that it meets the Level Two eligibility criteria for having the necessary legal authority to establish and operate an Exchange that complies with Federal requirements available at the time of application and having established a governance structure for the Exchange?

A.   Whether a State has the necessary legal authority to establish an Exchange is a question of State law.   To demonstrate the State has legal authority to establish and operate an Exchange that complies with Federal requirements in place at the time of application for a Level Two grant, the State must submit one or more of the following:

  1. A copy of current law and/or current regulation that clearly indicates that the State has the necessary legal authority to establish an Exchange or that clearly establishes the Exchange; OR
  2. Other legislation related to health reform implementation or another general authority (such as an Executive Order) that the State determines provides the necessary legal authority to establish an Exchange AND a written legal opinion (correspondence or a formal legal opinion) from the legal counsel of the office of the applicant or the State’s Attorney General’s Office certifying that the State is authorized to establish an Exchange under State law.           

Please note that proposed or pending legislation will not be sufficient to establish that a State has the necessary authority to establish an Exchange.  To the extent that any law or regulation is not clear on its face that either an Exchange has been established or the State (through an identified agency or official) has the authority to establish an Exchange consistent with the requirements of the Affordable Care Act, the written legal opinion described in (2) above should be provided. To accommodate States that are at different points in the process of establishing an Exchange, the FOA provides for multiple application deadlines for Level Two funding, from March 30, 2011 through June 29, 2012.           

To demonstrate that the governance structure for the Exchange has been established, the State should submit one or more of the following, if not provided in documentation submitted to demonstrate the State’s legal authority to establish an Exchange:

  1. A copy of current legislation or regulation establishing the governance structure of the Exchange; OR
  2. Other legislation related to health reform implementation or another general authority (such as an Executive Order) that establishes the governance structure of the Exchange AND a written legal opinion (either correspondence or a formal opinion) from the legal counsel of the office of the applicant or the State’s Attorney General’s Office certifying that the provided authority establishes the governance structure of the Exchange under State law.

Q: Is HHS willing to accept a State’s definition of “quasi-governmental entity” as this definition may vary from State to State?

A.    For purposes of determining whether an applicant is a quasi-governmental entity, HHS will look to whether the entity has been created or established by the State (through legislation or other law), and has State oversight (i.e. the governing body is established, appointed, and overseen by the State and the entity is subject to specific limitations on its authority to act established by the State).  In addition, the grantee must comply with all grant regulations that apply to State grantees.

Q: Are there defined parameters around what excessive executive compensation is?

Only allowable costs may be paid using grant funds.  Executive compensation must be an allowable cost and should reflect the market rate for a similar position in your area.

See the OMB Circular A-110, item #27, at http://www.whitehouse.gov/omb/circulars_a110#27, for more information relating to allowable costs.

New grantees awarded under this Funding Opportunity Announcement should be aware they are subject to the reporting requirements of the Federal Funding Accountability and Transparency Act of 2006 (Pub. L. 109-282), as amended by section 6202 of P.L. 110-252 and implemented by 2 CFR Part 170.  Grant and cooperative agreement recipients must report information for each first-tier subaward of $25,000 or more in Federal funds and executive total compensation for the recipient’s and subrecipient’s five most highly compensated executives as outlined in Appendix A to 2 CFR Part 170.  For more information, please access the following site: http://www.fsrs.gov.