Gary Cohen, CMS deputy administrator and director of the Center for Consumer Information and Insurance Oversight (CCIIO), has described the federally-facilitated exchange, which HHS has contracted with CGI to develop and operate. The federally-facilitated exchange aims “to assure that residents of every state will have access to affordable health insurance in 2014,” he said in a Dec. 10 briefing.

The exchange includes an initial application, plan evaluation tools and consumer support, such as a website with chat capability and 24-hour call center through which to compare plans, check eligibility for affordability programs and to enroll in a qualified health plan, Cohen said.

In April, qualified health plans will begin submitting applications to the federal exchange.

“HHS will work with states to preserve traditional responsibilities of state insurance departments when establishing the federally-facilitate exchange,” Zemel said. Additionally, HHS will work to harmonize exchange policy with existing state programs and work with state Medicaid programs, either making eligibility determination using state rules or allowing the state agency to make the final determination.

The administration has also proposed a monthly user fee of 3.5 percent of premiums to fund the federally-facilitated exchange. 

 “With the partnership model, states can take on some functions and leave others to the federal government,” she said. A state can perform plan management, which includes tailoring plan choices, selection and plan rates and benefit information, plan monitoring and oversight, and data collection and analysis for quality. Or a state would oversee the consumer assistance function, including managing the navigator program and conducting outreach and education.

HHS would manage the call center and website and written correspondence to support the eligibility and enrollment function, Zemel said.