OMB control number
Essential Health Benefits Benchmark Plans (CMS-10448)
OMB 0938-1174 · HHS/CMS.
OMB 0938-1174
The Affordable Care Act requires that all qualified health plans (QHPs) offered in the Exchanges provide the essential health benefits (EHB) and be accredited by an accrediting entity that is recognized by the Secretary of Health and Human Services. In order to establish EHB benchmark plans in each State, CMS will collect data from potential default benchmark plan issuers in each State and from States that select their own benchmark. CMS also intends to ask all States for a voluntary submission of their State mandated benefits. This data collection will include: administrative data necessary to identify the plan, all health benefits offered by the plans and associated limits, drug coverage, network type, and plan level enrollment. Finally, we plan to collect submissions from dental plan issuers on whether they intend to apply for certification to participate in the Exchanges as stand-alone plans.
The latest form for Essential Health Benefits Benchmark Plans (CMS-10448) expires 2027-11-30 and is listed under ICR 202408-0938-009.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form CMS-10448 EHB Benchmark Plan Formulary Drug | Form and Instruction |
| Form CMS-10448 State's EHB-benchmark Plan's Benefits and Limits | Form and Instruction |
| Form CMS-10488 EHB Reporting - EHB Actuarial Certificate Template | Form and Instruction |
| Form CMS-10448 Confirmations on the State EHB-benchmark Plan | Form and Instruction |
 CMS-10448 EHB Substantive Supporting Statement.docx | Supporting Statement A |
 EHB Benchmark Plan Formulary Drug |
Form and Instruction |
| State's EHB-benchmark Plan's Benefits and Limits |
Form and Instruction |
| EHB Reporting - EHB Actuarial Certificate Template |
Form and Instruction |
| Confirmations on the State EHB-benchmark Plan |
Form and Instruction |
All Historical Document Collections
OMB Details
Confirmations on the State EHB-benchmark Plan
Federal Enterprise Architecture: Health - Health Care Services
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form CMS-10448 | EHB State Confirmations | Fillable Fileable | Form and instruction |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.