{"data":{"id":"us/45-cfr-155.1020","jurisdiction":"us","citation":"45 CFR 155.1020","heading":"QHP issuer rate and benefit information.","body":"(a) Receipt and posting of rate increase justification. The Exchange must ensure that a QHP issuer submits a justification for a rate increase for a QHP prior to the implementation of such an increase, except for multi-State plans, for which the U.S. Office of Personnel Management will provide a process for the submission of rate increase justifications. The Exchange must ensure that the QHP issuer has prominently posted the justification on its Web site as required under § 156.210. To ensure consumer transparency, the Exchange must also provide access to the justification on its Internet Web site described in § 155.205(b).\n(b) Rate increase consideration. (1) The Exchange must consider rate increases in accordance with section 1311(e)(2) of the Affordable Care Act, which includes consideration of the following:\n(i) A justification for a rate increase prior to the implementation of the increase;\n(ii) Recommendations provided to the Exchange by the State in accordance with section 2794(b)(1)(B) of the PHS Act; and\n(iii) Any excess of rate growth outside the Exchange as compared to the rate of such growth inside the Exchange.\n(2) This paragraph does not apply to multi-State plans for which the U.S. Office of Personnel Management will provide a process for rate increase consideration.\n(c) Benefit and rate information. The Exchange must receive the information described in this paragraph, at least annually, from QHP issuers for each QHP in a form and manner to be specified by HHS. Information about multi-State plans may be provided in a form and manner determined by the U.S. Office of Personnel Management. The information identified in this paragraph is:\n(1) Rates;\n(2) Covered benefits; and\n(3) Cost-sharing requirements.","path":["Title 45—Public Welfare","SUBTITLE A—Department of Health and Human Services","SUBCHAPTER B—REQUIREMENTS RELATING TO HEALTH CARE ACCESS","PART 155—EXCHANGE ESTABLISHMENT STANDARDS AND OTHER RELATED STANDARDS UNDER THE AFFORDABLE CARE ACT","Subpart K—Exchange Functions: Certification of Qualified Health Plans"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-45.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:21Z","sha256":"2ea247afe3b605247626fcce5c1b71727c05f1c9709d56092a48285bb02b428f","source_id":"us-cfr","stale":true,"prev":"us/45-cfr-155.1010","next":"us/45-cfr-155.1030"},"notice":"GroundRules: Original legal text. Not legal advice."}