Opportunity Information: Apply for RFA FD 10 999
Apply for RFA FD 10 999
- The CMS Consumer Information Insurance Oversight in the education health income security and social services other (see text field entitled explanation of other category of funding activity for clarification) sector is offering a public funding opportunity titled "Grants to States for Health Insurance Premium Review Cycle I Office of Consumer Information and Insurance Oversight (OCIIO)" 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 Jul 1, 2010 and posted on Jun 7, 2010.
- Applicants must submit their applications by Jul 7, 2010. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- The funding agency has allocated a total of $51,000,000.00 to eligible and selected applicants.
- 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 51 candidate(s).
- Eligible applicants include: State governments.
- ALL 51 STATES INCLUDING THE DISTRICT OF COLUMBIA
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Opportunity Summary:
This grant opportunity, titled "Grants to States for Health Insurance Premium Review Cycle I," was launched by the Office of Consumer Information and Insurance Oversight (OCIIO) within HHS/CMS in the early implementation period of the Affordable Care Act. It stems from Section 2794 of the Public Health Service Act (added by PPACA Section 1003), a provision aimed at "ensuring that consumers get value for their dollars" by strengthening oversight of health insurance premium increases. The underlying policy goal is to make private health insurance more accessible and affordable while increasing transparency, particularly by deterring or exposing premium hikes that are considered unreasonable, excessive, unjustified, or poorly supported.
At the center of the program is a new requirement, effective beginning with the 2010 plan year, for an annual review process for health insurance premium rate increases carried out jointly by HHS and the states. Under this framework, insurers are expected to report key rate information both to the Secretary of HHS and to the states where they operate. The reporting focuses especially on rate increases that meet an "unreasonable" threshold (which, at the time of Cycle I, was still being developed through federal regulatory guidance). Insurers must also provide justifications for those potentially unreasonable increases before the increases are implemented. A major transparency feature is public disclosure: HHS will ensure that the information is made public, and insurers must prominently post the rate increase information and justifications on their own websites so consumers, employers, and regulators can see and evaluate the rationale behind premium changes.
Cycle I funding is designed to help states build or upgrade their capacity to do this work. Congress appropriated a total of $250 million for this overall grant program across federal fiscal years 2010 through 2014, and HHS planned to distribute funds through multiple award cycles. Cycle I is specifically notable because it was offered before the federal government finalized the detailed regulatory guidance that would define how "unreasonable" rate increases are evaluated and what criteria are used to determine whether increases are excessive or unjustified. Even so, states were invited to apply immediately so they could begin developing or enhancing their rate review and reporting systems for FY 2010 and FY 2011, rather than waiting for the full rulemaking process to conclude. HHS also indicated it was actively gathering state input through a Federal Register Request for Information and coordinating with state insurance commissioners through the National Association of Insurance Commissioners, signaling that the federal approach was meant to be built with state operational realities in mind.
Eligibility for Cycle I is broad: all 51 jurisdictions (the 50 states plus the District of Columbia) are eligible to apply, and the eligible applicant type is state governments. There is no cost-sharing or matching requirement, which lowers the barrier to participation and encourages universal uptake. The funding structure is straightforward and uniform in Cycle I: each successful applicant receives a $1,000,000 grant, with both the award floor and ceiling set at $1,000,000. The opportunity anticipated 51 awards and listed an estimated total funding amount of $51,000,000, consistent with the one-million-per-jurisdiction design. To receive funding, a state needed to submit a prospective plan describing how it would use the grant to develop or strengthen its health insurance rate review process and how it would handle disclosure of rates and related information to both the public and the Secretary of HHS.
The grant sits within a broader staged rollout. HHS indicated that Cycle II would be released after federal regulatory guidance was published (expected in the fourth quarter of calendar year 2010), with the intention of making those Cycle II awards before January 1, 2011. Unlike Cycle I, later grant awards were expected to be more tightly tied to the specific requirements in the finalized regulations, and grantees would be required to implement the rate review requirements detailed in that guidance. In other words, Cycle I served as a capacity-building bridge: it provided immediate resources so states could prepare systems, staffing, analytic tools, data collection methods, and public disclosure mechanisms ahead of a more standardized national framework.
Key administrative details from the announcement include: Funding Opportunity Number RFA-FD-10-999; CFDA 93.511 (Affordable Care Act Grants to States for Health Insurance Premium Review); category listed as discretionary grants with activity areas spanning health, education, income security, and social services as related to Affordable Care Act implementation. The posting date was June 7, 2010, and the application deadline was July 7, 2010. The administering office is identified as CMS Consumer Information and Insurance Oversight. The listed point of contact for access issues with the full announcement was Milton Pitts, Grant Specialist, at 301-827-7162 and Milton.Pitts@fda.hhs.gov.
Frequently Asked Questions (FAQs): Grants to States for Health Insurance Premium Review Cycle I
What is the name of this grant opportunity?
The opportunity is titled "Grants to States for Health Insurance Premium Review Cycle I."
Which federal office is running this grant?
The program was launched by the Office of Consumer Information and Insurance Oversight (OCIIO) within HHS/CMS, identified in the announcement as CMS Consumer Information and Insurance Oversight.
What law or authority created this program?
This grant stems from Section 2794 of the Public Health Service Act, added by the Patient Protection and Affordable Care Act (PPACA) Section 1003.
What is the main purpose of the grant program?
The purpose is to strengthen oversight of health insurance premium increases to help ensure consumers "get value for their dollars," improve transparency, and deter or expose premium increases that are unreasonable, excessive, unjustified, or poorly supported.
What policy goal is this funding meant to support?
The underlying policy goal is to make private health insurance more accessible and affordable while increasing transparency around premium rate increases.
What is the premium rate review requirement mentioned in the announcement?
Beginning with the 2010 plan year, there is an annual review process for health insurance premium rate increases carried out jointly by HHS and the states. Insurers are expected to report key rate information to the Secretary of HHS and to the states where they operate.
What information are insurers expected to report under the framework described?
Insurers are expected to report key rate information, with particular focus on premium rate increases that meet an "unreasonable" threshold. Insurers must also provide justifications for potentially unreasonable increases before those increases are implemented.
What does "unreasonable" mean for a rate increase in Cycle I?
At the time of Cycle I, the "unreasonable" threshold and the detailed criteria for evaluating whether an increase is unreasonable were still being developed through federal regulatory guidance.
Does this program include public disclosure requirements?
Yes. A major transparency feature is public disclosure. HHS will ensure that the reported information is made public, and insurers must prominently post the rate increase information and the justifications on their own websites so consumers, employers, and regulators can review them.
What is Cycle I funding designed to help states do?
Cycle I funding is designed to help states build or upgrade their capacity to carry out health insurance rate review and related reporting and disclosure activities.
Why did HHS offer Cycle I before final federal regulations were completed?
Cycle I was offered before detailed federal regulatory guidance was finalized so states could begin developing or enhancing rate review and reporting systems for FY 2010 and FY 2011 rather than waiting for the full rulemaking process to conclude.
How did HHS plan to develop the federal approach for rate review?
HHS indicated it was gathering state input through a Federal Register Request for Information and coordinating with state insurance commissioners through the National Association of Insurance Commissioners (NAIC).
Who is eligible to apply for Cycle I?
All 51 jurisdictions (the 50 states plus the District of Columbia) are eligible to apply. The eligible applicant type is state governments.
Are entities other than state governments eligible applicants?
No. Based on the information provided, the eligible applicant type is state governments (the 50 states and the District of Columbia).
Is there a cost-sharing or matching requirement?
No. The announcement specifies there is no cost-sharing or matching requirement.
How much funding does each Cycle I award provide?
Each successful applicant receives a $1,000,000 grant.
What are the minimum and maximum award amounts for Cycle I?
Both the award floor and the award ceiling are $1,000,000.
How many awards were anticipated under Cycle I?
The opportunity anticipated 51 awards, consistent with one award for each eligible jurisdiction.
What is the estimated total funding amount for Cycle I?
The estimated total funding amount listed for Cycle I is $51,000,000.
How much total funding did Congress appropriate for the broader grant program?
Congress appropriated a total of $250 million for the overall grant program across federal fiscal years 2010 through 2014, with HHS planning to distribute funds through multiple award cycles.
What did a state need to submit to receive Cycle I funding?
A state needed to submit a prospective plan describing how it would use the grant to develop or strengthen its health insurance rate review process and how it would handle disclosure of rates and related information to both the public and the Secretary of HHS.
What is notable about Cycle I compared with later cycles?
Cycle I is notable because it was offered before detailed federal regulatory guidance was finalized for how "unreasonable" rate increases would be evaluated. It served as a capacity-building bridge so states could prepare systems and processes ahead of a more standardized national framework.
When was Cycle II expected to be released, and how would it differ?
HHS indicated Cycle II would be released after federal regulatory guidance was published (expected in the fourth quarter of calendar year 2010), with the intention of making Cycle II awards before January 1, 2011. Unlike Cycle I, later awards were expected to be more tightly tied to the specific requirements in finalized regulations, and grantees would be required to implement the rate review requirements detailed in that guidance.
What kinds of capacity-building activities does Cycle I support (as described in the announcement)?
Cycle I is described as helping states prepare and enhance the tools and infrastructure needed for rate review, including systems, staffing, analytic tools, data collection methods, and public disclosure mechanisms.
What is the Funding Opportunity Number for this announcement?
The Funding Opportunity Number is RFA-FD-10-999.
What is the CFDA number associated with this opportunity?
The CFDA is 93.511, described as "Affordable Care Act Grants to States for Health Insurance Premium Review."
What type of grant is this categorized as?
The announcement lists this as a discretionary grant.
What activity areas are associated with this opportunity?
The activity areas are listed as spanning health, education, income security, and social services as related to Affordable Care Act implementation.
When was the opportunity posted?
The posting date was June 7, 2010.
What was the application deadline for Cycle I?
The application deadline was July 7, 2010.
Who is the listed point of contact for access issues with the full announcement?
The listed point of contact for access issues was Milton Pitts, Grant Specialist, reachable at 301-827-7162 and Milton.Pitts@fda.hhs.gov.
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