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Under the 25 percent rules at §§ 422.166(i)(2)–(6) and 423.186(i)(2)–(4), contracts with at least 25 percent of enrollees in a FEMA-designated Individual Assistance area in 2024 will receive the higher of their measure-level rating from the current and prior Star Ratings years for purposes of calculating the 2026 Star Ratings (thus, for 2026 Star Ratings, affected contracts will receive the higher of their measure-level ratings from the 2025 rating or 2026 rating for the applicable measures). Table VI-2 lists the emergency areas affected by emergency declarations first issued in 2024, as defined in section 1135 of the Act, and the exercise of the Secretary’s authority under section 1135 of the Act.

Table VI-2. List of Section 1135 Waivers Issued in Relation to the FEMA Major Disaster Declarations Section 1135 Waiver Date Issued Waiver or Modification of Requirements Under Section 1135 of the Social Security Act FEMA Incident Type Affected State Incident Start Date July 12, 2024 Hurricane Beryl Hurricane Beryl Texas July 5, 2024 August 6, 2024 Hurricane Debby Hurricane Debby Florida August 1, 2024 August 7, 2024 Hurricane Debby Tropical Storm Debby Georgia August 4, 2024 September 12, 2024 Hurricane Francine Hurricane Francine Louisiana September 9, 2024 September 26, 2024 Hurricane Helene Hurricane Helene Florida September 23, 2024 September 27, 2024 Hurricane Helene Hurricane Helene Georgia September 24, 2024 September 28, 2024 Hurricane Helene Tropical Storm Helene North Carolina September 25, 2024 September 30, 2024 Hurricane Helene Tropical Storm Helene Tennessee September 26, 2024 September 30, 2024 Hurricane Helene Hurricane Helene South Carolina September 25, 2024 October 8, 2024 Hurricane Milton Hurricane Milton Florida October 5, 2024 Table VI-3 lists the states and territories with Individual Assistance designations from the FEMA major disaster declarations.