CMS-10320 Appendix E - State Requirements

CMS Form Number: CMS-10320
OMB Control Number: 0938-1086
Expiration Date: XX/20XX

Appendix E - State Requirements
State Requests
To gain information on what issuers were authorized to sell health insurance within a given state, an initial
request was forwarded to the states for lists of registered insurance providers and certain basic
information about the state which was believed to be of interest to consumers. This data was requested
from the states by May 21, 2010 in order to provide a source against which vendor and issuer provided
data may be compared. This request may be reiterated annually to present states with the opportunity to
update their information.
A. Underwriting status: A statement of a state’s legal requirement for community rating, or allowance
for medical underwriting of insurance premiums.
B. Website address - state small group insurance: Those states which maintain a website providing
information and links for those seeking small group insurance, the Secretary will require this
information to provide to consumers. Additionally, States will provide a short description of the
conditions under which they want their site to be the primary point of entry for consumers and
why. This information is sought, both under the requirement for State consultation, but also for the
simple reason that some few states have regulatory conditions setting rates under different
conditions. In those cases, States may be able to provide more specific information than is
available from any other source.
C. Website address – individual insurance: Similar to small group markets, some states have
already created portal sites to direct consumers within their borders. We require that states which
have created such sites identify their location and inform the Secretary under what conditions
they would want to prioritize directing consumers to that site over directing them to issuers.
D. State registered small group Issuers: Obtaining a list of those registered by the state to offer small
insurance within their boundaries including contacts and an estimate of products offered is
essential for validating the claims of these issuers.
E. State registered individual Issuers: Obtaining a list of those registered by the state to offer
individual level insurance within their boundaries including contacts and an estimate of products
offered is essential for validating the claims of these issuers.
F. Contact Information: States will be asked to provide names, phone numbers and email addresses
for primary and secondary contacts for initial data collection and for verification of information.

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 0938-1086. The time required to complete
this information collection is estimated to be XX 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 any 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, Baltimore, Maryland 21244-1850.
DO NOT MAIL APPLICATIONS TO THIS ADDRESS. Mailing your application to this address will significantly delay application
processing.

CMS Form Number: CMS-10320
OMB Control Number: 0938-1086
Expiration Date: XX/20XX