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Texas Department of Insurance
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Affordable Care Act Resources for Health Carriers

TDI Resources | Federal Resources | Filing Time Frames

TDI Resources

Federal Resources

CMS Regulatory Role in Texas

CMS is responsible for enforcing the Affordable Care Act (ACA) individual and group market reforms - refer to 42 U.S. Code Chapter 6A, Subchapter XXV, Part A. As of 2023, TDI is responsible for reviewing rates for compliance with state and federal law. Refer to Insurance Code Chapter 1698

In order to enforce the ACA market reforms, CMS requires Texas carriers to submit form filings for federal review; see CCIIO's December 20, 2022, letter to Texas issuers: Form Filing Instructions for System for Electronic Rates and Forms Filing (SERFF) for Plan Year 2024.

Guidance for Qualified Health Plans (QHPs) Participating in the Federally Facilitated Marketplace

Each year CMS publishes updated operational and technical guidance, including in the CMS Letter to Issuers, Notice of Benefit and Payment Parameters, and QHP Data Submission and Certification Timeline Bulletin. Refer to the CMS QHP Certification website for the latest Published Guidance and Regulations.

Carriers may also access technical assistance. Email the Help Desk at CMS_FEPS@cms.hhs.gov, or call 1-855-CMS-1515.

Filing Time Frames

Rates: June 15 of each year. Refer to 28 TAC §3.505(b).

Forms: Concurrent with CMS filings. To meet CMS deadlines, TDI encourages carriers to submit form filings to TDI at the same time they are submitted to CMS. 

For more information, contact: LifeHealth@tdi.texas.gov

Last updated: 2/8/2024