CMS-10605 Final Report

The Health Insurance Enforcement and Consumer Protections Grant Program
Cycle I Final 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
Cycle
Project Reporting Period
(Example: Final Report
10/1/2016-9/30/2018)

The purpose of the Final Grant Reports is to:



Summarize the initiatives of the Affordable Care Act (ACA) market reform provisions
funded through the grant program over the course of Cycle I
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.

1
PRA Disclosure Statement
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control
number for this information collection is 0938-NEW. The time required to complete this information collection is estimated to average 40 hours per response, including the time to review
instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy o f the time estimate(s) or
suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.
EXP. DATE: XX/XXXX

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

Grant Performance Period-Cycle I: Date of award through October 18, 2018
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 a final progress report to CCIIO’s Health Insurance Enforcement
and Consumer Protections Grant Program. The final progress report summarizes the significant
advancements made 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 course of the
Cycle I Grant Program.
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

The final report is due ninety days following the end of the Cycle I Health Insurance
Enforcement and Consumer Protections Grant Program. For example, for awardees completing
grant activity by September 30, 2018, the final Cycle I report is due by December 31, 2018. All
final reports must be submitted electronically through the Health Insurance Oversight System
(HIOS). In the final grant year, this 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 final progress report must detail how grants funds are being
utilized, describe program progress, and barriers, and provide an update on the measurable
objectives of the grant program.
2
PRA Disclosure Statement
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control
number for this information collection is 0938-NEW. The time required to complete this information collection is estimated to average 40 hours per response, including the time to review
instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or
suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.

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

PART I: FINAL NARRATIVE REPORT FORMAT
Introduction:
The Final Narrative Report represents the culmination of activity and accomplishments
throughout the Cycle I Grant Program. In the Final 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
Program.
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.

EXAMPLE: Objective 1 was to hire additional staff to conduct formulary reviews: “We worked
throughout the past 24 months to hire two clinicians to conduct formulary review. We achieved
this objective in Cycle I, when we were able to successfully hire two clinicians. Objective 1:
Stage 5”.
3
PRA Disclosure Statement
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control
number for this information collection is 0938-NEW. The time required to complete this information collection is estimated to average 40 hours per response, including the time to review
instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy o f the time estimate(s) or
suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.

The Health Insurance Enforcement and Consumer Protections Grant Program
Cycle I Final Report Template
Please use this guide when answering the following questions. In addition, please use charts
and graphs to highlight progress when appropriate.
Final Program Implementation Status: Include a thorough discussion and update on progress
towards the following:
1. Final Accomplishments: Describe achieved implementation milestones and outcomes,
include Progress Metrics towards each stated goal, objective and milestone outlined in
the Health Insurance Enforcement and Consumer Protections Grant Work Plan.
2. Challenges: 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 twenty four months.
Please include Progress Metrics for each activity not completed. Describe future plans to
complete the originally proposed grant activities.
3. 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
measurements where necessary.
Significant Activities: Undertaken and Planned
Highlight the most significant activities and major grant achievements accomplished. Please
include Progress Metrics to illustrate progress. Please also describe activities, if any that you plan
to continue after the completion of the grant program.
Public Access Activities
Summarize activities and/or promising practices undertaken during the previous twenty four
months, 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
Discuss all materials produced and/or developed during Cycle I, 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). Additionally, please include Progress Metrics for each material
produced or developed.
Final Impact of the Cycle I Health Insurance Enforcement and Consumer Protections
4
PRA Disclosure Statement
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control
number for this information collection is 0938-NEW. The time required to complete this information collection is estimated to average 40 hours per response, including the time to review
instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or
suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.

The Health Insurance Enforcement and Consumer Protections Grant Program
Cycle I Final Report Template
Grant Program
Summarize the overall impact Cycle I grant funds had on planning and/or implementing the preselected ACA market reforms in your State. Include data on how the grant program enhanced the
public’s understanding of the pre-selected ACA market reforms. Summarize the overall impact
Cycle I grant funds had on planning and/or implementing the pre-selected ACA market reforms
in the State over the past twenty four 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 were pursuing an active enforcement role, should also
indicate how the grant funds had impacted their progress towards reaching an active enforcement
role for all ACA market reforms. Provide evidence when available. Examples may include dollar
amounts, statistics, personal stories, anecdotal evidence, media articles/mentions, etc.
Final Lessons Learned
Provide additional information on lessons learned and any promising practices. For example,
what approaches in your implementation strategy worked/are working and why? Which practices
will you continue to employ after completion of the grant program?
Final Budget
Provide a detailed account of expenditures to date and describe whether the current allocation of
funds followed 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
final report submission.
Final Health Insurance Enforcement and Consumer Protections Grant Program Work
Plan and Timeline with Progress Metrics
Provide a final Health Insurance Enforcement and Consumer Protections Grant Work Plan and
Timeline with updated Progress Metrics to reflect the events and progress over the course of the
grant. Please continue to use the Progress Metrics guide, and assign a measurement to each
objective outlined in the work plan.
Final Evaluation
Please attach a copy of the final evaluation. If the State requires more time to complete the final
evaluation of the grant program please provide an update on the progress toward a final
evaluation and timeline for submission.
Final Report Summary Statistics:
Please fill in the data below for all grant activity occurring during Cycle I.
Final
Statistics

FFY17
Quarter

FFY17
Quarter

FFY17
Quarter

FFY17
Quarter

FFY18
Quarter

FFY18
Quarter

FFY18
Quarter

FFY18
Quarter

Total

5
PRA Disclosure Statement
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control
number for this information collection is 0938-NEW. The time required to complete this information collection is estimated to average 40 hours per response, including the time to review
instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or
suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.

The Health Insurance Enforcement and Consumer Protections Grant Program
Cycle I Final Report Template
1

2

3

4

1

2

3

4

Funds
Expended
Number of
Staff
Hired with
Grant
Funds
Number of
Contracts
in place
with Grant
Funds
Number of
ACA
Market
Reforms
Provision
Funded by
Grant. List
Provisions

6
PRA Disclosure Statement
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control
number for this information collection is 0938-NEW. The time required to complete this information collection is estimated to average 40 hours per response, including the time to review
instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or
suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.