Form CMS-10605 Annual Report Template

The Health Insurance Enforcement and Consumer Protections Grant Program (CMS-10605)

CMS-10605 - The Enforcement and Consumer Protections Cycle I Annual Report Template ...

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The Health Insurance Enforcement and Consumer Protections Grant Program
Cycle I Annual Report Template

Report Date

Organization Information
State
Project Title
Grant Project Director
(Name and Title)
Phone/Email
Grant Authorizing
Representative
Phone/Email

Grant Information
Date Grant Awarded
Amount Granted
Project Year (ex. 2017)
Cycle
Project Reporting Period
(Example: Annual Report
10/1/2016-9/30/2017)
The purpose of the Annual Grant Reports is to:




Describe the planning and/or implementation for several of the market reforms under Part A
of Title XXVII of the Public Health Service (PHS) Act over the prior year
Summarize the initiatives funded through the grant program over the prior year
Provide States participating in the Health Insurance Enforcement and Consumer Protections
Grant Program with the opportunity to share information, highlight successes and reflect
upon the progress of their programs

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Exp. Date: xx/xx

The Health Insurance Enforcement and Consumer Protections Grant Program
Cycle I Annual Report Template
Grant Performance Period-Cycle I: Date of award through October 18, 2017
The provisions in Part A of title XXVII of the Public Health Service (PHS) Act include marketwide reforms in the group and individual private health insurance markets intended to protect
consumers, increase transparency, and regulate health insurance industry practices.
One of the goals of the Cycle I Health Insurance Enforcement and Consumer Protections Grant
is to provide States with the opportunity to ensure their laws, regulations, and procedures are in
line with Federal law and that they are able to effectively enforce the pre-selected market reform
provisions under Part A of title XXVII of the PHS Act.
States are required to submit annual progress reports to CCIIO’s Health Insurance Enforcement
and Consumer Protections Grant Program. The annual progress report describes significant
advancements towards the State’s goal of planning and/or implementing the pre-selected market
reforms provisions under Part A of Title XXVII of the PHS Act, over the prior twelve month
period.
Funding under the Health Insurance Enforcement and Consumer Protections Grant Program,
Cycle I was made available to States for activities related to planning and/or implementing the
following pre-selected provisions of Part A of title XXVII of the PHS Act:
I.
II.
III.
IV.
V.

Section 2707 - Non-discrimination under Comprehensive Health Insurance Coverage
(Essential Health Benefits Package)
Section 2713 - Coverage of Preventive Health Services
Section 2718 - Bringing down the Cost of Health Care Coverage (MLR)
Section 2719 - Appeals Process
Section 2726 - Parity in Mental Health and Substance Use Disorder Benefits

Each annual report is due ninety days following the end of the Federal fiscal year. For example,
the first Cycle I annual report are due by December 30, 2017. All annual reports must be
submitted electronically through the Health Insurance Oversight System (HIOS). For the final
grant year, the Cycle I Final Report will replace the Cycle I Annual Report.
The following reporting guidelines are intended as a framework and can be modified when
agreed upon by the CCIIO Health Insurance Enforcement and Consumer Protections Grant
Program and the State. A complete annual progress report must detail how grant funds are being
utilized, describe program progress, barriers and provide an update on the measurable objectives
of the grant program.

The Health Insurance Enforcement and Consumer Protections Grant Program
Cycle I Annual Report Template
PART I: NARRATIVE REPORT FORMAT
Introduction:
The Annual Narrative Report represents the culmination of activity and accomplishments
throughout the past twelve months of the Cycle I Grant Program. In the Annual Narrative Report
please support your explanations of grant progress with quantitative data when available and
other evidence to support the success of your Health Insurance Enforcement and Consumer
Protections Grant.
In answering the questions below, please articulate the annual progress made under the grant,
towards the goals, measurable objectives, and milestones for each proposed enhancement of the
market reforms under Part A of Title XXVII of the Public Health Service (PHS) Act, and
provide updates to the original grant proposal where necessary.
In order to provide metrics for CMS to monitor the progress of each activity, grantees are
required to report quantitative measurements using the following Progress Metrics Guide:
Level of Stages

Description of Stages

Stage 0

No work has begun on stated goal.

Stage 1

Project Plan has been created and staff has
been assigned to task. The work on achieving
the goal has initially begun.

Stage 2

Goal of the Project Plan is underway, and any
refinements or adjustments to original Project
Plan were made.

Stage 3

Goal of the Project Plan is half way complete
and continuously being worked on.

Stage 4

Deliverables are beginning to finalize and
proposed goals are nearly completed.

Stage 5

100% of stated goal has been completely
achieved.

The Health Insurance Enforcement and Consumer Protections Grant Program
Cycle I Annual Report Template
EXAMPLE: Objective 1 was to hire additional staff to begin reviewing additional processes as
part of the MLR oversight: “We worked throughout quarter 1 and quarter 2 to hire staff. We
hired one new staff member, and are continuing to look for a second hire. Objective 1: Stage 3.”
Please use this guide when answering the following questions. In addition, please use charts
and graphs to highlight progress when appropriate.
Annual Program Implementation Status: Include an update on progress towards the
following:
1. Accomplishments to Date: Describe achieved implementation milestones and outcomes,
include the above Progress Metrics towards each stated goal, objective and milestone
outlined in the Health Insurance Enforcement and Consumer Protections Grant Work
Plan.
2. Progress as, or towards, becoming or maintaining an active enforcement role of the ACA
Market Reforms: For States that are currently enforcing the ACA market reforms, the
States must discuss how the grant is helping them maintain their active enforcement role
for the ACA market reforms. States that are not currently enforcing the ACA market
reforms under Part A of Title XXXVII of the PHS Act must transition to an active
enforcement role for all ACA market reforms by the end of the first year and a half of the
grant program and must describe the barriers and challenges faced. Please discuss in
detail, progress over the last year towards transitioning to an active enforcement role for
all ACA market reforms. Per the instructions given in question #1 above, please include
detailed progress toward each stated goal, objective and milestone outlined in the original
grant application and the proposed Health Insurance Enforcement and Consumer
Protections Grant Work Plan. In your explanation, please include Progress Metrics
(where necessary) to indicate progress. HHS may restrict future grant funds for certain
grant activities if proposed milestones are not met.
3. Challenges faced this year: Provide a detailed description of any encountered challenges
in implementing your program, the response and the outcome. Please include a list of any
proposed grant activities that were not completed during the prior twelve months. Please
include Progress Metrics for each activity not completed. Describe future plans to
complete the originally proposed grant activities.
4. Variations of Work Plan and Timeline: List any required variations from the original
Health Insurance Enforcement and Consumer Protections Grant Work Plan and
companion timeline. Provide explanation for variations and provide Progress Metrics

The Health Insurance Enforcement and Consumer Protections Grant Program
Cycle I Annual Report Template
where necessary.
Significant Activities: Undertaken and Planned
Please list the most significant activities that occurred during the past year, or are anticipated to
occur in the near future, that affect the progression of implementing the ACA market reforms in
your State. Please include Progress Metrics to illustrate progress.
Operational/Policy Developments/Issues
Identify all significant program developments/issues/problems that have occurred in the past
twelve months and proposed ways to rectify the barriers.
Public Access Activities
Summarize activities and/or promising practices undertaken during the previous year working
towards increased public access and awareness from the pre-selected ACA market reforms
activities for your State. To illustrate progress, please include Progress Metrics for each activity
or practice.
Materials Produced
Please list any materials produced or developed over the past year, including website upgrades,
consumer materials, reports/studies, and any other relevant documents. Please provide detail
where available. For example, if a new website related to the pre-selected ACA market reforms
was developed, please provide the link, date the website went live, number of visitors to the
website (total or monthly). Please include Progress Metrics for each material produced, or that is
in the process of being produced or developed.
Annual Impact
Summarize the overall impact Cycle I grant funds had on planning and/or implementing the preselected ACA market reforms in the State over the past twelve months. State’s that are actively
enforcing the ACA market reforms should include how the grant funds improved their
compliance and enforcement of the pre-selected market reforms. State’s that are pursuing an
active enforcement role, should indicate how the grant funds have impacted their progress
towards reaching an active enforcement role for the ACA market reforms. Provide evidence
when available. Examples may include dollar amounts, statistics, personal stories, anecdotal
evidence, media articles/mentions, etc.
Annual Lessons Learned
Provide additional information on lessons learned and any promising practices. For example,
what approaches in your planning and/or implementation strategy worked/are working and why?

The Health Insurance Enforcement and Consumer Protections Grant Program
Cycle I Annual Report Template
Annual Updated Budget
Provide a detailed account of expenditures to date and describe whether the current allocation of
funds follows the progression of the detailed budget provided in your original application. Also,
provide any unforeseen expense and a brief description of the event that led to its occurrence.
Attach an updated detailed budget, including an updated SF-424A as necessary, with the State’s
annual report submission.
Updated Annual Work Plan and Timeline with Progress Metrics
Provide an updated Health Insurance Enforcement and Consumer Protections Grant Work Plan
and Timeline with Progress Metrics to reflect the events of the previous year. Highlight any
additional time frames or items that were not included on the State’s original submission as well
as completion of milestones. Please continue to use the Progress Metrics guide, and assign a
measurement to each objective outlined in the work plan.
Updated Evaluation Plan
Please provide an update to the Evaluation Plan originally described in the Cycle I Health
Insurance Enforcement and Consumer Protections Grant application, including updates to the
established measurable objectives, key indicators, and methods and/or resources to monitor
progress. If contracting for an evaluation, discuss progress with the contract.
Annual Report Summary Statistics:
Please fill in the data below for grant activity occurring over the past year:
Annual
Statistics
Funds
Expended
Number of
Staff
Hired with
Grant
Funds
Number of
Contracts
in place
with Grant
Funds
Number of
ACA

FFY17
Quarter 1

FFY17
Quarter 2

FFY17
Quarter 3

FFY17
Quarter 4

Total

The Health Insurance Enforcement and Consumer Protections Grant Program
Cycle I Annual Report Template
Market
Reforms
Provision
Funded by
Grant. List
Provisions

File Type	application/pdf
File Title	Health Insurance Rate Review Grant Program Cycle I Quarterly Report Template
Author	CMS
File Modified	2016-12-19
File Created	2016-06-08