A state’s Exchange model determines which online system(s) issuers must use to submit their QHP Application, who performs the certification, and who sends certification notifications.
State Exchange Models
| Exchange Model | Who performs functions? | Where do consumers apply & enroll? | Submission System(s)* |
| Federally-facilitated Exchange (FFE)* | HHS performs all Exchange functions | HealthCare.gov | HIOS MPMS Module & SERFF (for rate filing information)** |
| State Performing Plan Management Functions | States administer in-person consumer assistance functions; HHS performs remaining Exchange functions | HealthCare.gov | SERFF & HIOS MPMS Module |
| State-based Exchange on the Federal Platform (SBE-FP) | States perform all Exchange functions but use the FFE IT platform | HealthCare.gov | SERFF & HIOS MPMS Module |
| State-based Exchange (SBE) | States perform all Exchange functions | Exchange websites established & maintained by the states | State-specific system |
* The following states have notified CMS that they do not have the authority to enforce or are not otherwise enforcing the Affordable Care Act market reform provisions: Missouri, Oklahoma, Tennessee, and Texas, and Wyoming. Issuers in these states must submit form filings to CMS for review. Contact formfiling@cms.hhs.gov for details on requirements for form filing in these states.
** States without an Effective Rate Review Program and states that do not have access to SERFF should submit rate filings into the HIOS Unified Rate Review Module.