On February 27, 2013, HHS published a final rule to implement ACA provisions related to fair health insurance premiums, guaranteed insurance availability and renewability, statewide insurance risk pools, enrollment in catastrophic plans, and insurance rate reviews. Among other things, the final rule: (1) allows health insurance issuers to vary premiums for health insurance coverage in the individual and small group markets only based on family size, geography, and age and tobacco use within limits; (2) directs health insurance issuers to offer coverage to and accept every employer or individual who applies for coverage in the group and individual market, with certain exceptions; (3) directs health insurance issuers to renew/continue coverage in the group and individual market, with certain exceptions; (4) codifies the requirement that issuers maintain a single risk pool for the individual market and a single risk pool for the small group market (unless a state merges the markets into a single risk pool); (5) outlines standards for enrollment in catastrophic plans for young adults and people who cannot otherwise afford health insurance; and (6) revises the timeline for states to propose state-specific thresholds for rate review and approval by CMS. The provisions of the rule generally apply to health insurance coverage for plan or policy years beginning on or after January 1, 2014, with certain exceptions. An HHS press release is posted here