Minimum Essential Coverage (CMS-10465)

The NPRM titled "Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions; Miscellaneous Minimum Essential Coverage Provisions" proposes to designate certain types of health coverage as minimum essential coverage. Other types of coverage, not statutorily designated and not designated as minimum essential coverage in this regulation, may be recognized as minimum essential coverage if certain substantive and procedural requirements are met. The proposed rule would require coverage recognized to be minimum essential coverage to offer substantially the same consumer protections as those enumerated in the Title I of Affordable Care Act relating to non-grandfathered, individual coverage to ensure consumers are receiving adequate coverage. The proposed rule would require sponsors of individual coverage that seek to have such coverage designated as minimum essential coverage to adhere to certain procedures. Sponsoring organizations would have to submit to HHS information about their coverage and an attestation that the plan substantially complies with the provisions of Title I of the Affordable Care Act as applicable to non-grandfathered individual health insurance coverage. Sponsors would also have to a notice to enrollees informing them that the plan has been designated minimum essential coverage for the purposes of the individual coverage requirement.

The latest form for Minimum Essential Coverage (CMS-10465) expires 2022-09-30 and can be found here.