This Centers for Medicare & Medicaid Services (CMS) grant is for states with a Federally-facilitated Exchange (FFE) to modernize their Essential Health Benefits (EHB) benchmark plans. Currently, many of these states have not updated their EHB, leading to health plans that may not reflect recent medical advancements or clinical guidelines, causing access issues for enrollees. This grant seeks to alleviate the financial and logistical challenges states face in comprehensively reviewing, seeking public feedback on, and submitting applications to change their EHB. The funding will enable states to bring their EHB-benchmark plans up-to-date, ensuring Qualified Health Plans offer current, accessible benefits and comply with 45 CFR 156.111. The program aims to improve the quality and accessibility of healthcare for millions.
Opportunity ID: 356740
General Information
| Document Type: | Grants Notice |
| Funding Opportunity Number: | CMS-2U2-25-001 |
| Funding Opportunity Title: | EHB-Benchmark Plan Modernization Grant for States with a Federally-Facilitated Exchange |
| Opportunity Category: | Discretionary |
| Opportunity Category Explanation: | – |
| Funding Instrument Type: | Grant |
| Category of Funding Activity: | Affordable Care Act |
| Category Explanation: | – |
| Expected Number of Awards: | 28 |
| Assistance Listings: | 93.679 — EHB-Benchmark Plan Modernization Grant for States with a Federally-facilitated Exchange |
| Cost Sharing or Matching Requirement: | No |
| Version: | Synopsis 1 |
| Posted Date: | Nov 13, 2024 |
| Last Updated Date: | Nov 13, 2024 |
| Original Closing Date for Applications: | Jan 15, 2025 |
| Current Closing Date for Applications: | Jan 15, 2025 |
| Archive Date: | Feb 14, 2025 |
| Estimated Total Program Funding: | – |
| Award Ceiling: | $375,000 |
| Award Floor: | $0 |
Eligibility
| Eligible Applicants: | State governments |
| Additional Information on Eligibility: | You are eligible for funding under this funding opportunity if you meet all of the following criteria:•You are a state government’s executive branch agency.•You regulate the non-grandfathered individual and small group health insurance markets in the state, even if any of the following are true:•The state does not have statutory authority to enforce the EHB requirements.•The state is not otherwise enforcing the EHB requirements, or CMS has determined that the state is not substantially enforcing the EHB requirements. •Your state must have an FFE as of January 1, 2026. The states expected to have an FFE as of January 1, 2026 are: AL, AK, AZ, DE, FL, HI, IN, IA, KS, LA, MI, MS, MO, MT, NE, NH, NC, ND, OH, OK, SC, SD, TN, TX, UT, WV, WI, and WY |
Additional Information
| Agency Name: | Centers for Medicare & Medicaid Services |
| Description: |
We know it can be challenging for states to fund the work necessary to improve the Essential Health Benefits (EHB). Improving EHB typically involves: Comprehensively reviewing EHB-benchmark plans.
As a result, the covered benefits in the Qualified Health Plans (QHPs) offered through the Exchanges in these states may not reflect recent changes in medical evidence, scientific advancement, and clinical care guidelines. Additionally, people enrolled in these QHPs may have trouble accessing EHB because of cost, claims denials, utilization management, discriminatory benefit design, or other factors. We want to lessen these challenges through the EHB-Benchmark Plan Modernization Grant for States with a Federally-facilitated Exchange (FFE EHB Mod Grant). This new grant program will fund states with an FFE for a variety of activities related to the review of EHB-benchmark plans. The goal is to help applicants modernize and change their EHB-benchmark plans under 45 CFR 156.111. |
| Link to Additional Information: | – |
| Grantor Contact Information: | If you have difficulty accessing the full announcement electronically, please contact:
PMPolicy@cms.hhs.gov
Email:PMPolicy@cms.hhs.gov |
Version History
| Version | Modification Description | Updated Date |
|---|---|---|
Related Documents
Folder 356740 Full Announcement-EHB-Benchmark Grant -> CMS-2U2-25-001_REV1_Final.pdf
Packages
| Agency Contact Information: | PMPolicy@cms.hhs.gov Email: PMPolicy@cms.hhs.gov |
| Who Can Apply: | Organization Applicants |
| Assistance Listing Number | Competition ID | Competition Title | Opportunity Package ID | Opening Date | Closing Date | Actions |
|---|---|---|---|---|---|---|
| 93.679 | CMS-2U2-25-001-114121 | EHB-Benchmark Plan Modernization Grant for States with a Federally-Facilitated Exchange | PKG00288705 | Nov 13, 2024 | Jan 15, 2025 | View |
Package 1
Mandatory forms
356740 SF424_4_0-4.0.pdf
356740 SF424A-1.0.pdf
356740 Project_AbstractSummary_2_0-2.0.pdf
356740 ProjectNarrativeAttachments_1_2-1.2.pdf
356740 BudgetNarrativeAttachments_1_2-1.2.pdf
356740 SFLLL_2_0-2.0.pdf
356740 PerformanceSite_4_0-4.0.pdf
356740 OtherNarrativeAttachments_1_2-1.2.pdf
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