A second document outlines how the federally facilitated exchanges or partnerships will operate and how HHS and states will partner in an exchange. In a partnership exchange states can elect to handle plan management and in-person consumer assistance or leave those activities to HHS.
Plan management includes ensuring that health insurance companies are certified, have an adequate provider network, and offer the required essential benefits package. Consumer assistance includes enrollment activities.
Exchange applications should be submitted by mid-November 2012. HHS will review and approve or conditionally approve the applications by Jan. 1, 2013.