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Federal Exchange Guidance

Blueprint for Exchange Approval

On January 3, 2013, the U.S. Department of Health and Human Services announced the conditional approval for California to establish a health care marketplace.

DHHS - Conditional Approval Letter to Gov. Brown

Covered California - Blueprint Declaration Letter 

Covered California - Blueprint Response


Federal Proposed Rules:

The federal government has issued—and will continue to issue—proposed regulations for various implementation aspects of the ACA—including  the Exchange.  The federal government refers to a proposed regulation as a “Notice of Proposed Rule Making or “NPRM’”. Generally, an NPRM has two major portions:  1) the preamble in which the promulgator explains what the NPRM is intended to do and sets forth areas where comments are particularly welcome and 2) the actual language of the proposed regulation. The federal government (usually the Department of Health and Human Services, but sometimes other departments) seeks comments on its NPRM which it then considers as it drafts the final rule. The due date for comment is usually 75 days after an NPRM is published in the federal register. Covered California’s responses to NPRMs are posted below. 


Comments on Notice of Proposed Rulemakings:

Covered California Comments - Eligibility for Exemptions Applications

Covered California Comments - Navigators and Non-Navigator Assistance Personnel

Covered California Comments on Exchange Functions: Eligibility for Exemptions; Miscellaneous Minimum Essential Coverage Provisions

California Joint Comment on Medicaid, Children’s Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing

California Joint Comments to Notice of Proposed Rulemaking on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans

California Joint Comments on Establishment of the Multi-State Plan Program (MSPP)

California Joint Comments on Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation

California Joint Comments on Health Insurance Market Rules and Rate Review

California Joint Comments on HHS Notice of Benefit and Payment Parameters for 2014

Covered California Comments on CMS Proposed Rules on Navigators and Non-Navigator Assistance Personnel


Comments on Request for Information:

California Comments on Request for Information about Exchange Quality

California Joint Comments on Request for Information about the Basic Health Program



2011 Federal Exchange Guidance