Find Your Funding Opportunity
EHB-Benchmark Plan Modernization Grant for States with a Federally-Facilitated Exchange
Service
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Source |
Final Application Due Date |
Funding Available
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Match Required
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|---|---|---|---|---|
| Health Care |
Federal
HHS |
01-15-2025 | N/A | No Match Required |
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Service
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Source
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Final Application Due Date
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Funding Available
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Match Required
Status
- Expected Number of Awards 28
- Opportunity Type Discretionary
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CFDA
93.679 -- EHB-Benchmark Plan Modernization Grant for States with a Federally-facilitated Exchange
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.
- Seeking public feedback on the coverage of EHB in the state.
- Submitting an application to CMS to change the EHB in the state.
- We understand that, due in part to these challenges, that there are many states that have not considered updating their EHB-benchmark plans. These states include 24 of the 28 states expected to have a Federally-facilitated Exchange (FFE) as of January 1, 2026.
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.
Eligibility
- IHE
- Local Government
- Non-Profit
- Other
- State Government
- Tribal Government
Additional Eligibility Information
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
Key Date(s)
- November 13, 2024: Last Updated Date
- November 13, 2024: Posted Date
- January 15, 2025: Current Closing Date for Applications
- January 15, 2025: Application Due Date
- February 14, 2025: Application Archive Date
Contact Information
PMPolicy@cms.hhs.gov