Regulatory Analysis | Mar 23, 2015

A Guide to Meaningful Difference

Sally McCarty, Georgetown Health Policy Institute, Center on Health Insurance Reforms

Federal regulations state that in order to be certified as a Qualified Health Plan in a Federally-facilitated marketplace, plans must be considered “meaningfully different” from all other plans in their subgroup. ┬áThis document, prepared by the Georgetown Health Policy Institute’s Center on Health Insurance Reforms, is intended to help insurance regulators to understand meaningful difference standards and the ways in which they are applied by CMS. ┬áThe document also includes information on the process for plans flagged for additional review and follow-up, as well as exceptions to these standards.