HHS issues final regulations on health insurance exchanges

HRS Insight

The Department of Health and Human Services ("HHS") has released final regulations implementing the Health Insurance Exchange provisions of the Patient Protection and Affordable Care Act ("ACA"). The final regulations are generally designed to offer states substantial discretion in the design and operation of an Exchange, and include standards for:

  • The establishment and operation of an Exchange;
  • Qualification and accreditation of health insurance plans that participate in an Exchange;
  • Determinations of an individual’s eligibility to enroll in Exchange health plans and in insurance affordability programs;
  • Enrollment in health plans through Exchanges; and
  • Employer eligibility for and participation in a Small Business Health Options Program ("SHOP".)

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