Opportunity Information: Apply for PR IPR 11 001
Apply for PR IPR 11 001
- The CMS Consumer Information Insurance Oversight in the other (see text field entitled explanation of other category of funding activity for clarification) sector is offering a public funding opportunity titled "2010 Grants to States for Health Insurance Premium Review Cycle I (re release)" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.511 Affordable Care Act (ACA) Grants to States for Health Insurance Premium Review.
- This funding opportunity was created on Oct 5, 2010 and posted on Sep 1, 2010.
- Applicants must submit their applications by Nov 1, 2010 No Explanation. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- Each selected applicant is eligible to receive up to $1,000,000.00 in funding.
- The number of recipients for this funding is limited to 10 candidate(s).
- Eligible applicants include: State governments.
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Opportunity Summary:
The 2010 Grants to States for Health Insurance Premium Review, Cycle I (re-release), was a federal discretionary grant opportunity created to help states strengthen how they review health insurance premium increases and how they report and disclose rate information to the public and to the federal government. The program flows from the Affordable Care Act, specifically Section 2794 of the Public Health Service Act (added by PPACA Section 1003) under the consumer protection goal of "Ensuring That Consumers Get Value for Their Dollars." The central idea is to give states resources to build or improve the kind of rate review infrastructure needed to spot and challenge premium increases that appear unreasonable, excessive, or unjustified, and to make the rate-setting process more transparent to consumers.
A core feature of the Affordable Care Act requirement behind this grant is the creation of an annual health insurance premium review process beginning with the 2010 plan year. Under this framework, insurers are expected to report rate increase information to both HHS and the states where they operate. Two major reporting and oversight expectations are emphasized: insurers must identify rate increases that meet an "unreasonable" threshold (a threshold that was still being developed at the time of this Cycle I solicitation), and they must provide justifications for those potentially unreasonable increases before the higher rates take effect. HHS is also responsible for ensuring that this information becomes public, and insurers are expected to post the information prominently on their own websites, reinforcing the program's transparency goals.
Cycle I was intentionally offered before final federal rate review regulations were released, meaning the first round of grants focused on helping states prepare and enhance their systems ahead of more detailed, binding federal guidance. HHS noted that formal regulatory guidance was under development to define the annual rate review process more precisely, including what factors would be used to decide whether a proposed increase is unreasonable and how to judge whether an unreasonable increase is excessive or unjustified. HHS also highlighted that it was gathering state input through a Federal Register Request for Information and working with state insurance commissioners through the National Association of Insurance Commissioners, signaling that state-federal coordination was a key part of shaping the overall oversight approach.
Eligibility for Cycle I was broad: all state governments could apply. To receive funding, a state had to submit a forward-looking plan describing how it would use the grant funds to develop or enhance its premium rate review process during federal fiscal year 2011. That plan also needed to address how the state would disclose premium and rate review information to the public and to the HHS Secretary, aligning state processes with the broader federal transparency requirements. The program did not require cost sharing or matching funds, reducing barriers to participation and allowing states to focus the award on capacity building rather than meeting financial match requirements.
The award structure for Cycle I was straightforward. Successful applicants would receive a fixed award amount of $1,000,000 per state, with an award ceiling listed at $1,000,000 and a floor of $0. The solicitation anticipated around 10 awards. The funding sits under CFDA 93.511 (Affordable Care Act Grants to States for Health Insurance Premium Review). While Congress appropriated $250 million for the broader grant program across federal fiscal years 2010 through 2014, HHS planned to distribute funds through multiple cycles, with Cycle II to be released after the federal regulatory guidance became available. Unlike Cycle I, Cycle II would more directly tie state grant activities to implementing the specific rate review requirements established in that forthcoming guidance.
Administratively, the opportunity was posted September 1, 2010, and the closing date reflected in the listing was November 1, 2010 (as a re-release that extended beyond an earlier October 1, 2010 closing date). The opportunity was issued by CMS Consumer Information and Insurance Oversight. Applicants needing help accessing the announcement were directed to the Grants.gov Contact Center, underscoring that applications were expected to be handled through the standard federal grants portal and support channels.
Frequently Asked Questions (FAQs)
What is the "2010 Grants to States for Health Insurance Premium Review, Cycle I (re-release)" opportunity?
It is a federal discretionary grant opportunity created to help states strengthen how they review health insurance premium increases and how they report and disclose health insurance rate information to the public and to the federal government.
What is the main purpose of this grant program?
The purpose is to provide states resources to build or improve premium rate review infrastructure so they can better identify and challenge premium increases that appear unreasonable, excessive, or unjustified, and to make the rate-setting and review process more transparent for consumers.
What federal law and authority does this grant relate to?
This program flows from the Affordable Care Act. The specific authority referenced is Section 2794 of the Public Health Service Act, added by PPACA Section 1003, under the consumer protection goal of "Ensuring That Consumers Get Value for Their Dollars."
What does the Affordable Care Act framework require around premium review?
The framework emphasizes an annual health insurance premium review process beginning with the 2010 plan year. Insurers are expected to report rate increase information to both HHS and the states where they operate, identify rate increases that meet an "unreasonable" threshold (which was still being developed at the time of this Cycle I solicitation), and provide justifications for potentially unreasonable increases before higher rates take effect.
How does transparency to the public factor into this program?
Transparency is a central goal. HHS is responsible for ensuring rate increase information becomes public, and insurers are expected to post the information prominently on their own websites. States also must address public disclosure of premium and rate review information in their plans for using grant funds.
Why was Cycle I offered before final federal rate review regulations were released?
Cycle I was intentionally offered early so states could prepare and enhance their systems ahead of more detailed and binding federal guidance. The first round focused on capacity building and readiness while HHS developed formal regulatory guidance to define the annual rate review process more precisely.
What was still under development at the time of Cycle I?
HHS indicated that formal regulatory guidance was under development to define how the annual rate review process would work, including the factors used to determine whether a proposed rate increase is "unreasonable" and how to judge whether an unreasonable increase is excessive or unjustified.
How did HHS plan to coordinate with states on shaping the oversight approach?
HHS highlighted that it was gathering state input through a Federal Register Request for Information and working with state insurance commissioners through the National Association of Insurance Commissioners, indicating state-federal coordination as a key element of the overall approach.
Who was eligible to apply for Cycle I funding?
Eligibility was broad: all state governments could apply.
What did a state have to submit in order to receive Cycle I funding?
A state had to submit a forward-looking plan describing how it would use grant funds to develop or enhance its premium rate review process during federal fiscal year 2011. The plan also needed to address how the state would disclose premium and rate review information to the public and to the HHS Secretary.
Was cost sharing or a funding match required?
No. The program did not require cost sharing or matching funds.
How much funding could each state receive under Cycle I?
The award amount was fixed at $1,000,000 per state, with an award ceiling of $1,000,000 and a floor of $0.
How many awards were anticipated under Cycle I?
The solicitation anticipated around 10 awards.
What is the CFDA number associated with this opportunity?
The funding is under CFDA 93.511, titled "Affordable Care Act Grants to States for Health Insurance Premium Review."
How does Cycle I fit into the larger funding provided by Congress?
Congress appropriated $250 million for the broader grant program across federal fiscal years 2010 through 2014, with HHS planning to distribute funds through multiple cycles. Cycle I was one of those cycles.
How was Cycle II expected to differ from Cycle I?
Cycle II was expected to be released after federal regulatory guidance became available. Unlike Cycle I, Cycle II would more directly tie state grant activities to implementing the specific rate review requirements established in that forthcoming guidance.
When was this Cycle I (re-release) opportunity posted?
The opportunity was posted on September 1, 2010.
What was the closing date for the Cycle I (re-release) listing?
The closing date reflected in the listing was November 1, 2010, as a re-release extending beyond an earlier October 1, 2010 closing date.
Which federal office issued this opportunity?
The opportunity was issued by CMS Consumer Information and Insurance Oversight.
How were applications expected to be submitted or supported administratively?
Applications were expected to be handled through the standard federal grants portal. Applicants needing help accessing the announcement were directed to the Grants.gov Contact Center.
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