The U.S. Department of Health and Human Services (“HHS”) recently released final rules under the Patient Protection and Affordable Care Act (“PPACA”) that guarantee the availability and renewability of health insurance coverage in both the individual and group markets. Beginning in 2014, health insurance issuers must offer to and accept any individual or employer who applies for coverage. In addition, issuers cannot deny coverage to small employers for failing to satisfy minimum participation or contribution requirements, and they must renew any existing health insurance coverage at the option of the plan sponsor or individual, subject to a few exceptions, including fraud and nonpayment of premiums. The final rules also restrict the premiums that issuers may charge in the individual and small group markets by only permitting premium variances based on age, geographic area, tobacco use, and family size. Issuers in the large group market may be similarly restricted if the state permits such issuers to offer coverage through a healthcare exchange. HHS also clarified in the final rules that catastrophic plans may be offered both inside and outside of an exchange, but only in the individual and small group market. Contemporaneously with the release of the final rules, HHS issued related guidance regarding age curves and geographical rating areas. The final rules can be found here. The additional HHS guidance can be found here.