Sub-Regulatory Guidance Regarding Age Curves, Geographical Rating Areas

HHS releases guidance concerning two of the factors, age and geography required under the final rule for the Health Insurance Market Rules.

Document Excerpt

 Contemporaneously with the posting of this guidance, the Centers for Medicare and Medicaid Services (CMS) is releasing the final rule on the Health Insurance Market Rules. This final rule implements provisions related to fair health insurance premiums, guaranteed availability, guaranteed renewability, single risk pools, and catastrophic plans, consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Specifically, part of the final rule implements section 2701 of the Public Health Service Act (PHS Act), which restricts premium rating factors to age, tobacco use, geography and family size. This guidance provides important information concerning two of the factors, age and geography, and also details the process of state reporting as required by sections 147.103 and 156.80(c) of the final rule.


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