The Centers for Medicare & Medicaid solutions (CMS) focus for buyers Know-how and cover Oversight (CCIIO) happens to be dedicated to boosting clearness through the Health Insurance change. While health arrange data including amazing benefits, copayments, rates, and geographical insurance coverage happens to be widely on heath care treatment.gov, CMS in addition posts online community make use of records (PUFs) to make certain that experts also stakeholders can quicker access trade reports.
Medical cover swap open public incorporate data files (trade PUFs) are available for program age 2014 to 2021 to compliment regular advantage and speed evaluation. It is critical to be aware that the 2021 swap PUFs might be updated regularly to mirror the routine document that buyers will see when buying an Exchange Qualified Health organize (QHP). Facts for your 2021 Exchange PUFs happened to be imported to websiste creation tool programs by April 28, 2021.
The change PUFs include prepare and institution degree info for licensed good fitness Designs (QHPs) and stand-alone oral campaigns (SADPs) wanted to folk and smaller businesses with the medical insurance swap. The trade PUFs integrate facts from says taking part in the Federally Facilitated swaps (FFE), condition relationship substitution (SPEs) and shows whose State-based exchange programs depend on government employees I . t system for QHP eligibility and enrollment performance (SBE-FP). The PUFs likewise incorporate info on Multi-State Designs (MSPs) and accredited off-exchange SADPs. The trade PUFs exclude information from SBEs which don’t depend on government employees system for QHP eligibility and registration features.
The swap PUFs contain eleven separate documents as expressed below.
- Perks and value writing PUF (BenCS-PUF) – prepare variant-level records on necessary physical health benafits, protection limitations, and cost posting.
- Speed PUF (Rate-PUF) – Plan-level info on individual charges centered on an eligible subscriber’s era, cigarette need, and geographic area, and family-tier rate.
- Approach options PUF (Plan-PUF) – Plan-level data on optimum up front transfers, deductibles, HSA eligibility, formulary ID, or program qualities.
- Organization policies PUF (BR-PUF) – Plan-level information on rating organization policies, for instance allowed relationships (e.g., partner, dependents) and tobacco smoking need.
- Provider locations PUF (SA-PUF) – Issuer-level info on geographical solution markets like status, region, and postcode.
- Network (Ntwrk-PUF) – Issuer-level records pinpointing carrier community URLs.
- Program identification Crosswalk PUF (CW-PUF) – Plan-level reports mapping projects available in the last structure annum to blueprints available in the present day program yr.
- Machine-readable URL PUF (MR-PUF)—Issuer-level URL spots for machine-readable approach system provider and formulary records.
- Transparency in insurance coverage PUF (TC-PUF) – Issuer-level claim, speaks, and effective Address facts. The PY2021 PUF have data from PY2019 for providers playing the swap in PY2019.
- High quality PUF (Qual-PUF) – Good quality ranks records for projects in pilot shows. The PY2017 PUF is available below. The PY2018 PUF through PY2021 PUFs tend to be found in this article.
- Nationwide high quality score technique PUF (NatQRS-PUF) – good quality listings records for plans country wide, most notably say built trades (SBE). The PY2020 through PY2021 PUFs are only in this article.
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