Filing Guideline for Plan Year 2027 ACA Forms and Rates

Tennessee is a Federally Facilitated Marketplace (FFM) without an Effective Rate Review Program; carriers must follow the timeline set out by CMS:

PY2027 QHP Data Submission and Certification Timeline

Activity Dates
QHP Application data validation window opens 4/15/26
QHP Application submission window opens 5/20/26
CMS reviews QHP Application data as they are submitted and releases results for issuers and

5/20/26 – 6/5/26

HHS-approved QHP Enrollee Survey vendor securely submits the QHP Enrollee Survey response data to CMS on behalf of the QHP issuer 3 5/8/26 – 5/15/26

TDCI Form Filing and Binder Submission Deadline

6/10/26

Initial Application Deadline: Initial deadline for issuers to submit QHP Applications to CMS, including Plan ID Crosswalk data

6/10/26

CMS reviews initial QHP Applications and releases results for issuers and states to review 6/11/26 – 7/10/26
QHP issuer submits the validated Quality Rating System (QRS) clinical measure data, with attestation, to CMS via the National Committee for Quality Assurance’s (NCQA) Interactive Data Submission System (IDSS) 4

6/15/26

Secondary Application Deadline: Deadline for issuers to submit their QHP Application Rates Table Templates to CMS; optional deadline for issuers to submit corrected QHP Application data to CMS

7/15/26

CMS reviews Rates Table Template data and resubmitted QHP Application data, and releases results for issuers and states to review

7/16/26 – 8/7/26

Issuers, State and Federally-facilitated Exchange administrators, and CMS preview the 2026 QHP quality rating information Aug./Sept. 2026
Issuer Plan Confirmation/Crosswalk Deadline: Issuers complete final plan confirmation and submit final Plan ID Crosswalk Templates

8/5/26 – 8/19/26

Final Application Deadline: Deadline for issuers to submit changes to their QHP Applications 8/12/26
CMS reviews QHP Applications and releases results for issuers and states to review 8/13/26 – 9/8/26
CMS sends QHP Certification Agreements to issuers 9/8/26
QHP Agreement Signing Deadline: Issuers return signed QHP Certification Agreements to CMS 9/8/26 – 9/16/26
State Plan Confirmation Deadline: States complete final plan confirmation 9/8/26 – 9/16/26
Limited data correction window 9/10/26 – 9/11/26
Machine-Readable/URL Deadline: Deadline for issuers’ machine-readable data to be posted and marketing URLs to be live and active

9/16/26

CMS releases certification notices to issuers and states 9/29/26 –9/30/26
Anticipated public display of QHP quality rating information 11/1/26
Open Enrollment begins 11/1/26

CMS has finalized the Notice of Benefit and Payment Parameters for PY2027, located here.

Templates

CMS has posted the relevant and required PY27 templates, including:

  • Business Rules Template
  • Network Adequacy Template
  • Network ID Template
  • Plan ID Crosswalk Template
  • Plans & Benefits Add-In
  • Plans & Benefits Template
  • Prescription Drug Template
  • Rates Table Template
  • Service Area Template
  • Transparency in Coverage Template
  • Unified Rate Review Template

Filing Instructions:

  • All filings to the State should be made via SERFF.
  • Individual and small group filings may not be combined.
  • Silver loading for CSRs must be included and limited to Marketplace QHPs
  • Each plan variation, such as copay versus coinsurance, deductible only, or open or closed networks, must have a separate schedule page, rates, actuarial memorandum, and actuarial value calculation.
  • Each variation does not require a separate filing but may be combined with the appropriate policy or certificate of coverage.
    • There may be no language variations in the schedules, but the deductibles, copays, coinsurance, etc., may be bracketed with the range of number variables.
  • Each filing must include the following information:
    • Identification of where the plan will be sold (i.e., on/off exchange, both)
    • Identification of the rating area(s) where the plan will be sold. A carrier participating in a designated rating area must make coverage available throughout the entire rating area.
    • Identify metal level for each benefit design for a health plan (i.e., bronze, silver, gold, platinum).
    • A separate schedule with the language for each plan design that is to be offered, numerical amounts may be bracketed.
    • The Actuarial Value of each plan design must be submitted, including a screenshot of the Actuarial Value Calculator.