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Federal Register / Vol. 86, No. 85 / Wednesday, May 5, 2021 / Rules and Regulations may include submission or completion, in the form and manner specified by HHS, of the following:
i Operational data including licensure information, points of contact, and third-party relationships;
ii Enrollment testing, prior to approval or renewal;
iii Website reviews performed by HHS;
iv Security and privacy assessment documentation, including:
A Penetration testing results;
B Security and privacy assessment reports;
C Vulnerability scan results;
D Plans of action and milestones;
and E System security and privacy plans.
v Agreements between the webbroker and HHS.

27. Section 155.221 is amended a. By revising paragraphs b1, 3, and 4;
b. By redesignating paragraphs c through h as paragraphs d through i, respectively.
c. By adding new paragraph c; and d. By amending newly redesignated paragraphs g introductory text, g6, g7, and h by removing the reference to paragraph e and adding in its place a reference to paragraph f.
The additions and revisions read as follows:
155.221 Standards for direct enrollment entities and for third parties to perform audits of direct enrollment entities.

b
1 Display and market QHPs offered through the Exchange, individual health insurance coverage as defined in 144.103 of this subchapter offered outside the Exchange including QHPs and non-QHPs other than excepted benefits, and any other products, such as excepted benefits, on at least three separate website pages on its nonExchange website, except as permitted under paragraph c of this section;

3 Limit marketing of non-QHPs during the Exchange eligibility application and QHP selection process in a manner that minimizes the likelihood that consumers will be confused as to which products and plans are available through the Exchange and which products and plans are not, except as permitted under paragraph c1 of this section;
4 Demonstrate operational readiness and compliance with applicable requirements prior to the direct enrollment entitys internet website
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being used to complete an Exchange eligibility application or a QHP
selection, which may include submission or completion, in the form and manner specified by HHS, of the following:
i Business audit documentation including:
A Notices of intent to participate including auditor information;
B Documentation packages including privacy questionnaires, privacy policy statements, and terms of service; and C Business audit reports including testing results.
ii Security and privacy audit documentation including:
A Interconnection security agreements;
B Security and privacy controls assessment test plans;
C Security and privacy assessment reports;
D Plans of action and milestones;
E Privacy impact assessments;
F System security and privacy plans;
G Incident response plans; and H Vulnerability scan results.
iii Eligibility application audits performed by HHS;
iv Online training modules offered by HHS; and v Agreements between the direct enrollment entity and HHS.

c Exceptions to direct enrollment entity display and marketing requirement. For the Federallyfacilitated Exchanges, a direct enrollment entity may:
1 Display and market QHPs offered through the Exchange and individual health insurance coverage as defined in 144.103 of this subchapter offered outside the Exchange including QHPs and non-QHPs other than excepted benefits on the same website pages when assisting individuals who have communicated receipt of an offer of an individual coverage health reimbursement arrangement as described in 146.123c of this subchapter, as a standalone benefit, or in addition to an offer of an arrangement under which the individual may pay the portion of the premium for individual health insurance coverage that is not covered by an individual coverage health reimbursement arrangement using a salary reduction arrangement pursuant to a cafeteria plan under section 125 of the Internal Revenue Code, but must clearly distinguish between the QHPs offered through the Exchange and individual health insurance coverage offered outside the Exchange including QHPs and non-

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QHPs other than excepted benefits, and prominently communicate that advance payments of the premium tax credit and cost-sharing reductions are available only for QHPs purchased through the Exchange, that advance payments of the premium tax credit are not available to individuals who accept an offer of an individual coverage health reimbursement arrangement or who opt out of an individual coverage health reimbursement arrangement that is considered affordable, and that a salary reduction arrangement under a cafeteria plan may only be used toward the cost of premiums for plans purchased outside the Exchange; and 2 Display and market Exchangecertified stand-alone dental plans offered outside the Exchange and noncertified stand-alone dental plans on the same website pages.

28. Effective May 5, 2021 amend 155.320 by a. Revising paragraph c3iiiA;
and b. Removing and reserving paragraphs c3iiiD and viC2.
The revision read as follows:
155.320 Verification process related to eligibility for insurance affordability programs.

c
3
iii
A Except as specified in paragraph c3iiiB and C of this section, if an applicants attestation, in accordance with paragraph c3iiB of this section, indicates that a tax filers annual household income has increased or is reasonably expected to increase from the data described in paragraph c3iiA of this section for the benefit year for which the applicants in the tax filers family are requesting coverage and the Exchange has not verified the applicants MAGI-based income through the process specified in paragraph c2ii of this section to be within the applicable Medicaid or CHIP MAGIbased income standard, the Exchange must accept the applicants attestation regarding a tax filers annual household income without further verification.

29. Section 155.420 is amended by a. Revising paragraph a4iiB;
b. Adding paragraph a4iiC;
c. Revising paragraphs a4iii introductory text and b2iv;
d. Adding paragraph b5;
e. Revising paragraph c2;
f. Adding paragraphs c5 and d15; and
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