The Department of Health and Human Services has issued extensive guidance for qualified health plans that will participate in state health insurance exchanges, scheduled to start operating in October 2013. HHS also announced approval for exchanges in four more states.

The 57-page guidance focuses on exchanges that the federal government will run, and exchanges done in partnership with states. States that are building their own exchange have more flexibility to apply certification standards and adjust various processes. “We note that the policies articulated in this letter apply to the 2014 coverage year and beyond,” according to the guidance. “In the future, CMS will issue similar letters to provide operational updates to qualified health plan issuers, but we do not intend to issue these letters more than annually.”

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