On July 11, 2011, the U.S. Department of Health and Human Services (HHS) issued a proposed rule on the establishment of health insurance exchanges and qualified health plans. Published in the July 15, 2011, Federal Register, the proposed rule identifies (1) the requirements states must meet if they establish and operate a health insurance exchange; (2) the requirements health insurance issuers must meet to offer qualified health plans through an exchange; and (3) the standards employers must meet to participate in the Small Business Health Options Program. The proposed rule also discusses the enrollment process for moving qualified individuals into qualified health plans offered on an exchange. HHS invites comments to the proposed rule through September 28, 2011.