Carriers

 

Hello, Marketplace Carriers!

Thank you for visiting the Carrier resources page for Virginia’s Insurance Marketplace. Here, you will find materials and resources to help you serve Virginia consumers.

Exchange carriers offer a variety of Qualified Health Plans (QHPs) and Qualified Dental Plans (QDPs) on Virginia’s Insurance Marketplace for eligible consumers.
 

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Access the Carrier Portal

If you are a certified carrier, log in to the Marketplace portal to manage your account.

Log in

Carrier Informational Updates & FAQs

Carrier Informational Updates provide updates on current conditions affecting HBE carriers. Presentation materials from past Informational Updates are available below.

Carrier FAQs provides a cumulative record of questions and answers. The file is updated frequently and includes historical content.

Click here for ACA Rate & Form Filing Information: Virginia SCC - ACA Rate & Form Filing Information

As referenced in HBE Administrative Letter 2025-01, for each unmet network adequacy standard, carriers must provide a copy of the Virginia Network Adequacy Time and Distance Justification Form or the current CMS Network Adequacy Justification form. Contact ExchangeCarriers@scc.virginia.gov with questions.

HBE User Fee

Insurance carriers participating in the Virginia Health Benefit Exchange (HBE) are required to pay a monthly HBE User Fee to the Virginia Health Benefit Exchange. User Fees due for Plan Year 2024 and beyond will be made through your carrier platform account on Virginia’s Insurance Marketplace. 

See HBE-2023-00001 User Fee Assessment Order - issued June 20, 2023, for fees due 2024 and beyond.

Your organization has designated persons as Issuer Finance Staff.  Persons with the Issuer Finance Staff role will have access to a Finance Portal where they will view monthly invoices and make payments and review the status of unpaid and paid invoices.  Each month, carriers will receive a Statement Packet in the portal with invoices for that month.  The Issuer Finance Primary POC will receive an email notifying them that an invoice is available for review and payment.  

Carriers have the option to submit payment by check if needed, however it is Virginia’s Insurance Marketplace’s preference that carriers make payments through the payment portal.

  • Step 1

    Select “Pay Now” on the applicable invoice. 
    This will redirect the issuer to HBE’s payment portal.  Login using established credentials.

  • Step 2

    Navigate to the Monthly Activity tab and select the month to make the payment.

  • Step 3

    Select “Pay Now” to make the payment for the given month.

  • Step 4

    Enter payment information and submit payment for processing.

  • Step 5

    Repeat the above steps for any other unpaid invoices. 
    Invoice will appear under the “Paid Months” tab after the payment is initiated by the payment processor (typically after 24-hours).

    Note: 
    The “State Packet Index” tab maintains a historical record of all statement packets for the plan year.  To access the statement packet PDF, the Issuer Finance Staff selects the hyperlink for the specific month. 

    The packet includes:
    •    Total statement balance for each invoice
    •    Statement breakdown with gross premiums and user fee percentage for each invoice
    •    Detachable voucher for check payments

    Email us at HBEUserFee@scc.virginia.gov or call us at 804-371-1532 with any questions regarding the payment of the HBE User Fee invoices. 

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Partner Resources

Thank you for your continued partnership with Virginia's Insurance Marketplace. 

With your support and outreach, Virginians across the Commonwealth will gain access to high-quality, affordable comprehensive health coverage. Our partner resource materials are designed to raise Marketplace awareness, provide information about enrollment periods, and more. The Virginia’s Insurance Marketplace partner toolkits include flyers, sample newsletter text, and social media graphics you can use in your outreach efforts.