Issue Briefs | Apr 12, 2012

Overview of Final Exchange Regulations

Manatt Health Solutions 

On March 12, 2012, the Department of Health and Human Service (HHS) issued final and interim final rules governing the Establishment of Exchanges and Qualified Health Plans; and Exchange Standards for Employers under the Patient Protection and Affordable Care Act (ACA). These final rules represent the most significant guidance to date on the operation of Exchanges, setting forth the minimum standards Exchanges must meet, including: those related to eligibility and enrollment into qualified health plans and insurance affordability programs; the minimum requirements for issuers to offer plans through the Exchange; and, the standards for employers to participate in the Small Business Health Options Program (SHOP).

The purpose of this document, authored by Manatt Health Solutions, is to provide an overview of the final rules. Section I provides a high level overview of important highlights, focusing on key areas where HHS has changed or expanded upon previous guidance. Section II provides a more detailed summary of the regulations.