Plan Year 2026 Individual, On‑Marketplace Rate Filings
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Governance on how issuers must prepare and submit individual, on‑Marketplace rate filings for plan year 2026, including alternative submissions reflecting possible extension of ARPA premium tax credit enhancements and a standardized CSR load application for On‑Marketplace Silver plans; applies to licensed Arkansas issuers and related entities.
No material clinical or coverage changes in this revision.
Plan Year 2026 Filing Requirements
PY2026 filing criteria
Required elements and actuarial approach issuers must follow when preparing PY2026 individual on‑Marketplace rate filings:
ALL of the following
- Compute the membership‑weighted average of the 87% and 94% CSR variant Actuarial Values (AV) multiplied by their corresponding Induced Demand Factors (IDF).
- Use the AVs and IDFs published by HHS in the ACA risk adjustment program for each CSR variant.
- Divide the weighted average (AV*IDF) by the product of the Base Silver AV and its IDF to produce the CSR load factor.
- Base membership weights on the most recent Open Enrollment data unless AID determines anticipated enrollment differs significantly and adjusts weights.
Alternate Submissions, CSR Load, and Coding Notes
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Filing and Compliance Actions
Filing and compliance — required submission and documentation
Submit Plan Year 2026 individual on‑Marketplace rate filings that incorporate AID instructions, using the final CSR load factor published by AID and including detailed documentation of the methodology and any enrollment‑shift or other assumptions used.
- Use the final load factor published by AID in advance of the filing deadline.
- Include detailed documentation of methodology and any enrollment shifts or other assumptions.
- AID will review submissions for compliance, reasonableness, and adherence to this guidance.
Key Terms and Calculations
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