1 Centers for Medicare & Medicaid Services Center for Consumer Information and Insurance Oversight Rusty Shropshire 7501 Wisconsin Avenue Bethesda, MD Rate and Benefits Information System User Manual Version: 11.0 Last Modified: March 25, 2013
2 1. APPROVALS Submitting Organization s Approving Authority: Signature Printed Name Date Phone Number Position Title RBIS User Manual Version 11.0 / 25 Mar 2013 Page 1
3 2. REVISION HISTORY Version Date Organization/Point of Description of Changes Contact 1.0 8/25/11 CCIIO/Rusty Shropshire Baseline Version 2.0 9/26/11 CCIIO/Rusty Shropshire Updated Data Dictionary Appendix /6/11 CCIIO/Rusty Shropshire Updated Login Pages and Data Dictionary /1/11 CCIIO/Joe Mercer Added Individual Information /5/11 CCIIO/Joe Mercer Fixed Minor Errors and Accessibility 6.0 1/12/12 CCIIO/Joe Mercer Added / Updated Resubmission Process 7.0 1/27/12 CCIIO/Joe Mercer Updated Resubmission Process 8.0 6/17/12 CCIIO/Joe Mercer Updated Data Dictionary /9/12 CCIIO/Joe Mercer Updated Submission Process and Data Dictionary /18/13 CCIIO/Joe Mercer Fixed Minor Errors and Added Data Clarifications /25/2013 CCIIO/Joe Mercer Minor Edits Made and Updated Sections 6.2, 6.3 and RBIS User Manual Version 11.0 / 25 Mar 2013 Page 2
4 3. TABLE OF CONTENTS 1. APPROVALS REVISION HISTORY TABLE OF CONTENTS LIST OF EXHIBITS INTRODUCTION GETTING STARTED MINIMUM REQUIREMENTS Supported Applications Macro Security Level Setting Set-up Considerations EXCHANGE OPERATIONS SUPPORT CENTER USER REGISTRATION ACCESSING THE SYSTEM Log-In First Time User PROCESS OVERVIEW ROLE OVERVIEW SUBMITTER PROCESS VALATOR PROCESS ATTESTOR PROCESS RESUBMISSION PROCESS HEALTHCARE.GOV REFRESH Interim Refresh Final Refresh RBIS HOME PAGE RBIS ANNOUNCEMENTS RBIS RELATED LINKS USER ASSOCIATION TABLE SUBMISSION MATERIALS INSTRUCTIONS AND REFERENCE MATERIALS DOWNLOAD SUBMISSION MATERIALS ENHANCED SUBMISSION PROCESS TEMPLATES SMALL GROUP TEMPLATES Benefits Template Regions Template Product Availability Template INDIVUAL TEMPLATES RBIS User Manual Version 11.0 / 25 Mar 2013 Page 3
5 Validation/Finalization process Benefits Template Regions Template Rates Template Business Rules Template Automatic creation of pre-populated Templates DATA UPLOAD DATA UPLOAD SMALL GROUP AND INDIVUAL MARKET Upload Files VIEW UPLOADED FILES FOR SMALL GROUP MARKET AND INDIVUAL MARKET SUBMISSION COMPLETE Template Validations Cross-Check Validations VALATE DATA VALATE DATA View All Products ATTESTATION ATTESTATION AVAILABLE ATTESTATION UNAVAILABLE ATTESTATION COMPLETE MANUAL ATTESTATION RESUBMISSION RESUBMISSION REQUIREMENTS RESUBMISSION VALATION REQUIREMENTS HEALTHCARE.GOV REFRESH Interim Refresh Final Refresh APPENDICES APPENDIX A TEMPLATE DATA VALATIONS APPENDIX B - ERROR MESSAGES APPENDIX C - FILE TYPE INSTRUCTIONS Pipe Delimited (.csv) ZIP Savings documents in.zip format APPENDIX D - TEMPLATE DATA FIELD DEFINITIONS Small Group Benefits Template Small Group Regions Template Small Group Product Availability Template Individual Benefits Template Individual Regions Template Individual Business Rules Template Individual Rates Template RBIS User Manual Version 11.0 / 25 Mar 2013 Page 4
6 16.5 APPENDIX E - BUSINESS RULES AND RATES TEMPLATE INTEGRATION Business Rules Template Guidelines Age calculation for Eligibility and Quote determination Rates Template Guidelines Sample rate calculations APPENDIX F BENEFITS AND BUSINESS RULES TEMPLATE.CSV CODES Business Rules Codes RBIS User Manual Version 11.0 / 25 Mar 2013 Page 5
7 4. LIST OF EXHIBITS Exhibit 6-1: RBIS Login Screen Exhibit 6-2: HIOS Main Page Exhibit 6-3: RBIS First Time User Page Exhibit 7-1: RBIS Submitter Role Exhibit 7-2: RBIS Validator Role Exhibit 7-3: RBIS Attester Role Exhibit 8-1: RBIS Home Page Exhibit 9-1: Instructions and Reference Materials (Example for the Small Group Market) Exhibit 9-2: Download Data Submission Materials (Example from the Small Group Market) Exhibit 10-1: Example Template Submitted Using the Enhanced Submission Process Exhibit 11-1: Benefits Template for Small Group Products Exhibit 11-2: Invalid Data Exhibit 11-3: Regions Template for Small Group Products Exhibit 11-4: Invalid Data Exhibit 11-5: Product Availability Template for Small Group Products Exhibit 11-6: Invalid Data Exhibit 11-7: Benefits Template for Individual Plans Exhibit 11-8: Invalid Data Exhibit 11-9: Rates Template for Individual Plans Exhibit 11-10: Invalid Data Exhibit 11-11: Business Rules Template for Individual Plans Exhibit 11-12: Invalid Data Exhibit 12-1: Data Upload Tab Exhibit 12-2: HIOS Product Data Upload Confirmation Small Group Exhibit 12-3: HIOS Product Data Upload Confirmation Individual Exhibit 12-4: Files Selected to Upload (Example is from Small Group) Exhibit 12-5: Upload Files Exhibit 12-6: View Uploaded Files Exhibit 13-1: Select Issuer (s) for Small Group Market Exhibit 13-2: Select Issuer (s) for Individual Market Exhibit 13-3: Issuer Multi-Select Exhibit 13-4: No Data Received for Issuer (s) (Example from Small Group Market) Exhibit 13-5: No Data to Report for Issuer (s) (Example from Small Group Market) Exhibit 13-6: View Benefit Details for All Issuer s (Example from Small Group Market) Exhibit 13-7: View Benefit Details for Individual Products (Example from Small Group Market) Exhibit 13-8: Benefit Details for Individual Products Small Group Market Exhibit 13-9: Validation Status (Example from Small Group Market) Exhibit 13-10: Search Criteria Small Group Market Exhibit 13-11: Search Criteria Individual Market Exhibit 13-12: Zip Code Field Exhibit 13-13: Search by Scenario Results Small Group Exhibit 14-1: Attestation Exhibit 14-2: Attestation Unavailable RBIS User Manual Version 11.0 / 25 Mar 2013 Page 6
8 Exhibit 14-3: Attestation Complete Exhibit 14-4: Opt-out Checkbox Exhibit 16-1: Small Group Benefits Template Error Messages Exhibit 16-2: Small Group Regions Template Error Messages Exhibit 16-3: Small Group Product Availability Template Error Messages Exhibit 16-4: Small Group Cross-check Error Messages Exhibit 16-5: Individual Benefits Template Error Messages Exhibit 16-6: Individual Regions Template Error Messages Exhibit 16-7: Individual Rates Template Error Messages Exhibit 16-8: Individual Business Rules Template Error Messages Exhibit 16-9: Individual Cross-check Error Messages Exhibit 16-10: Benefits Template Data Dictionary Small Group Exhibit 16-11: Regions Template Data Dictionary Small Group Exhibit 16-12: Product Availability Template Data Dictionary Small Group Exhibit 16-13: Benefits Template Data Dictionary Individual Exhibit 16-14: Regions Template Data Dictionary Individual Exhibit 16-15: Business Rules Template Data Dictionary Individual Exhibit 16-16: Rates Template Data Dictionary Individual Exhibit 16-17: Business Rules Template for Individual and Family Plans Exhibit 16-18: Business Rules Template for Individual and Family Plans Exhibit 16-19: Rates Template for Individual and Family Plans Exhibit 16-20: Rates Template for Individual and Family Plans Exhibit 16-21: Subscriber Type Mapping for Individual Rate Calculations Exhibit 16-22: Subscriber Type Mapping for Group Rate Calculations Exhibit 16-23: Example Scenario 1 - Individual Rate Calculation Exhibit 16-24: Example Scenario 1 Individual Rate Calculation Exhibit 16-25: Example Scenario 1 - Group Rate Calculation Exhibit 16-26: Example Scenario 1 Group Rate Calculation Exhibit 16-27: Example Scenario 2 - Individual Rate Calculation Exhibit 16-28: Example Scenario 2 Individual Rate Calculation Exhibit 16-29: Example Scenario 2 - Group Rate Calculation Exhibit 16-30: Example Scenario 2 Group Rate Calculation Exhibit 16-31: Example Scenario 3 - Individual Rate Calculation Exhibit 16-32: Example Scenario 3 Individual Rate Calculation Exhibit 16-33: Example Scenario 3 - Group Rate Calculation Exhibit 16-34: Example Scenario 3 Group Rate Calculation Exhibit 16-35: Benefits Template Codes - Individual Exhibit 16-36: Business Rules Template Codes RBIS User Manual Version 11.0 / 25 Mar 2013 Page 7
9 5. INTRODUCTION The Center for Consumer Information and Insurance Oversight (CCIIO), a division of the Department of Health and Human Services (HHS), is charged with helping implement many provisions of the Affordable Care Act. CCIIO oversees the implementation of the provisions related to private health insurance including providing oversight for the Issuer based data exchanges that populate The Health Insurance Oversight System (HIOS) allows the government to collect data from individual and small group market Issuers in order to facilitate this charge. The collected data is aggregated with other data sources and made public on a consumer-facing website. The Rate and Benefits Information System (RBIS) web site gathers detailed product benefit and eligibility data. This user manual explains the features and other aspects related to the use of the RBIS web site. 6. GETTING STARTED 6.1 MINIMUM REQUIREMENTS Supported Applications RBIS supports all Templates to be downloaded and completed in the following versions of Microsoft Excel: 2003, 2007 and If using Excel 2003 and 2007, please use the.xls version of the Template. If using Excel 2010, please use the.xlsm version of the Templates. Some capability issues may occur when using the.xls version of the Template in Excel The RBIS web site supports Firefox versions 3.5 and 4.0 and Internet Explorer versions 7 and Macro Security Level Setting The RBIS Templates use macros to perform the built-in functions including the Validation and finalization processes. It is imperative that Excel s macro security level settings are set to allow macros. The following are the Excel macro security level settings: Excel Macro security level should be Medium. Instructions for setting the level once the spreadsheet is open will be covered in section 6.1.3, Set-up Considerations. This will allow the user to pick and choose which macros to work with versus which to not enable. Excel 2007 or Later - Macros should be set to Disable all macros with notification. Instructions will be provided in section 6.1.3, Set-up Considerations. RBIS User Manual Version 11.0 / 25 Mar 2013 Page 8
10 6.1.3 Set-up Considerations Configuration on the computer must be set to satisfy the following requirements for the Issuer Data Entry Form to work properly: Have Microsoft Excel 2003, 2007 or Enable the Excel standard toolbar. Set Excel macro security settings to Medium (recommended) for Excel Select Tools from the menu bar. 2. Select Macro on the dropdown menu. 3. Select Security. 4. Select Medium (recommended). 5. Click on OK. 6. When the workbook is opened, it is fully functional. Set Excel macro security settings to Disable all macros with notifications for Excel 2007 or Select the Office Button in the upper left corner of the window. 2. Select the Excel Options button at the bottom of the menu. 3. Select Trust Center on the left navigation pane. 4. Select Trust Center Settings. 5. Select Macro Settings on the left navigation pane. 6. Select the Radio Button in front of Disable all macros with notification. 7. Select OK from the Trust Center window. 8. Select OK from the Excel Option window. 9. Select the Options Button when the workbook is opened. 10. Select Enable this content. 11. Select OK. 6.2 EXCHANGE OPERATIONS SUPPORT CENTER If you need assistance with registering as a user, submitting data, reviewing and validating data, or other technical website functions, please contact the Exchange Operations Support Center (XOSC). Phone Number: Address: The XOSC hours of operation are 9:00AM to 6:00PM ET, Monday through Friday. 6.3 USER REGISTRATION Issuers must first be a registered user in HIOS in order to gain access into RBIS. A user can be registered in HIOS by being added as a contact for an Issuer. If you have questions, please refer to the HIOS User Guide or call the XOSC. Any access requests outside of the normal HIOS RBIS User Manual Version 11.0 / 25 Mar 2013 Page 9
11 process must be submitted for CCIIO approval via the XOSC at or via at 6.4 ACCESSING THE SYSTEM Log-In Users who are registering with HIOS for the first time will receive a user name (their listed contact address) and a randomly generated password. This information should be used to access the system. Users will be required to customize their password after the first log-in. 1. Log-in to HIOS. 2. Enter the User Name and Password. 3. Enter the Word Verification Code. 4. Select the Log-in Button. 5. Select the Rates & Benefits Information Systems (RBIS) Link on the HIOS Main Page. 6. Select the Link to log-on to the RBIS system on the RBIS Submissions Tab **Note: You will be navigated to the RBIS Log-in Page. 7. Enter the User Name and Password. ** Note: If you forget your password, please click on the Forgot Password link to be redirected to reset the password. 8. Enter the Number Verification Code. ** Note: If the code is not keyed in correctly or if the entry time exceeds the system threshold, the system will require you to request a new Number Verification code. 9. Select the Log In button. The RBIS Log-in Screen is displayed below in Exhibit 6-1. RBIS User Manual Version 11.0 / 25 Mar 2013 Page 10
12 Exhibit 6-1: RBIS Login Screen The HIOS Main Page is displayed below in Exhibit 6-2. RBIS User Manual Version 11.0 / 25 Mar 2013 Page 11
13 Exhibit 6-2: HIOS Main Page First Time User New users who access the system for the first time will be required to customize their password after the first log-in. Users should go to the HIOS Page and follow the instructions provided. If you are experiencing any difficulties or need further assistance, please contact the XOSC. The RBIS First Time User Page is displayed below in Exhibit 6-3. RBIS User Manual Version 11.0 / 25 Mar 2013 Page 12
14 Exhibit 6-3: RBIS First Time User Page 7. PROCESS OVERVIEW The RBIS System is designed to automate the data Submission, Validation and Attestation processes. All tasks must be completed within the Submission window for data to be displayed on Healthcare.gov. 7.1 ROLE OVERVIEW There are three different User roles that can be assigned for RBIS: Submitter Role The User is responsible for and is allowed to submit data for any Issuer for which they have submitter permissions. They will be notified via of any errors during the Submission process. Validator Role The User is responsible for validating that the data submitted is correct. They are allowed to validate products for any Issuer for which they have a Validation role. Attester Role - The User is responsible for attesting to data submitted by all Issuers for which they have permission. The Attester role is limited to the Issuer s Chief Executive Officer (CEO) or Chief Financial Officer (CFO). RBIS User Manual Version 11.0 / 25 Mar 2013 Page 13
15 7.2 SUBMITTER PROCESS The Submission Process in RBIS is represented in Exhibit 7-1 below. Exhibit 7-1: RBIS Submitter Role sent to Issuer with success notification Yes User Uploads Template(s) Does Issuer Pass? Issuer that passed System Validation is now available for attestation Submitter No All Products for the Issuer are available for Issuer Validation sent to Issuer with detailed error information The Submission process starts with downloading the Blank or Pre-populated Templates. The Templates need to be downloaded and saved to the local machine. When the Templates have all the required data populated, the data entered will need to be validated by selecting the Validate Button. When the Template passes Validation, the Validate and Finalized Button will need to be Selected to save a finalized csv file that can be uploaded. The Submission Contacts role in RBIS begins after the User uploads Template(s) into the system. Once uploaded, the Template(s) will go through a series of s. The first set of Validations consists of very brief checks to ensure basic correctness. This includes checking the file name and file format. These Validations occur automatically upon Template upload. The second set of system Validations will cross-check the Template(s) to ensure all the necessary data has been submitted for each Issuer. These Validations run on a pre-set schedule daily and only occur if Templates have successfully passed the first set of Validations. If the Templates fail either of these Validations, the Submission Contact will receive an notifying them that the Template(s) failed. The Submitter will then be required to correct the errors listed in the and resubmit the file in RBIS. Alternatively, the Submitter will receive an if the Template(s) pass. s will be sent to the Submitter for the following reasons: RBIS User Manual Version 11.0 / 25 Mar 2013 Page 14
16 The Template(s) fail Template(s) Validations. The Template(s) fail cross-check Validations. The Template(s) pass both sets of Validations. If there are any issues with data, Submitters may resubmit the Template(s). Resubmissions will overwrite previous Submissions, but will not remove any data during the interim refresh, which will occur every two weeks. If you need a submitted product, region or product availability row removed, please contact the XOSC. If data is resubmitted, it must be revalidated. 7.3 VALATOR PROCESS The Validation Process in RBIS is represented below in Exhibit 7-2. Exhibit 7-2: RBIS Validator Role Display all available products for validation Yes Validator User accesses Data Validation Page Has data for each Issuer the user is associated with passed system validation? Issuer marked as no data to submit for this submission cycle No Yes Display warning message for Issuer s that have not passed system validation User indicates there is no data to report for the Issuer s listed? The Validation Contacts role in RBIS begins when Validation becomes available for Issuer (s) associated with their User. In order for the Validation to become available, data for the Issuer (s) that the user is associated with must pass. Once data has passed System Validation, the data available for each Issuer will be displayed on the Validate Data screen in RBIS and the Validator will receive an . Users will see all Issuer s for which they have permissions. If there is no data to be uploaded for the listed Issuer (s), the Validator may indicate this on the Validate Data Tab. Once Issuer (s) have been marked as no data to report, a new warning message is displayed stating that the user has indicated that there is no data to report for the listed Issuer s. Issuer s must be validated to appear on Healthcare.gov. RBIS User Manual Version 11.0 / 25 Mar 2013 Page 15
17 If there are any issues with data, Submitters can resubmit Submissions. Each Submission for an Issuer overwrites previous Submissions. If data is resubmitted, it must be revalidated. 7.4 ATTESTOR PROCESS The Attestation Process in RBIS is represented below in Exhibit 7-3. Exhibit 7-3: RBIS Attester Role Attestation is Available Yes User accesses Attestation Page Do all Issuer s associated with the user have a valid submission or have indicated there is no data to report? User Attests? Yes Attestation is complete for all Issuer s associated with the attester Attester No No Attestation is NOT Available Attestation is not complete for all Issuer s associated with the attester The Attestation Contacts role in RBIS will begin when Attestation becomes available for all Issuer (s) for which the user is associated. Attestation will not be available until all Issuer s associated with the user have a valid Submission or it is indicated that there is no data to report. Once Attestation is available, the Attester must read the Attestation agreement and electronically sign that they attest to the accuracy of the submitted data. Users should use caution when completing Attestation, as it can only be completed one time per Submission window. 7.5 RESUBMISSION PROCESS The resubmission process is much like the Submission process. After an Issuer has resubmitted their data in RBIS, the Templates will go through both Template Validation as well as overall Product/Plan Cross-check Validation. Template specific s will be performed prior to the Cross-check Validations. The resubmission process allows the Issuer to change or update any data currently in the RBIS system. The Issuer may also add new data or correct any previously failed data during this time. For further instructions on the resubmission process please refer to Section HEALTHCARE.GOV REFRESH During the Submission window, which will run 10 weeks, there will be updates to the data displayed on Healthcare.gov. During this time, the Issuer is able to review data submitted during RBIS User Manual Version 11.0 / 25 Mar 2013 Page 16
18 the Submission window on Healthcare.gov. There will be an interim refresh and a final refresh which is detailed below Interim Refresh The Interim Refresh will occur every two weeks during the Submission window. This will be a scheduled process which will occur every 2 weeks of the Submission window. No products currently on Healthcare.gov will be removed. All Issuer and Product data for plans and products that meet the following criteria will move to Healthcare.gov: Validated Attested Open in HIOS Not Suppressed in HIOS Not CCIIO suppressed Not Expired Final Refresh The Final Refresh will occur at the end of the Submission window. Products currently on Healthcare.gov can be removed. All Issuer and Product data for plans and products that meet the following criteria will move to Healthcare.gov: Validated Attested Open in HIOS Not Suppressed in HIOS Not CCIIO suppressed Not Expired RBIS User Manual Version 11.0 / 25 Mar 2013 Page 17
19 8. RBIS HOME PAGE Upon successful login, users will arrive on the RBIS Home Page Welcome Screen. The RBIS Home Page is displayed below in Exhibit 8-1. Exhibit 8-1: RBIS Home Page RBIS User Manual Version 11.0 / 25 Mar 2013 Page 18
20 8.1 RBIS ANNOUNCEMENTS The Home Page of the RBIS web site will display an Announcement section. This section will include helpful information, such as news, status updates, notable dates or events, and more. Additionally, it displays an informational list of all Issuer s for which a user is associated. 8.2 RBIS RELATED LINKS The Home Page of the RBIS web site contains a Related Links section. This section will include links that are useful to the users, such as Healthcare.gov, the CCIIO website, training materials, and more. 8.3 USER ASSOCIATION TABLE The Home Page of the RBIS web site contains a table at the bottom of the page. This provides a convenient opportunity to view and confirm all Issuers and roles for which the user is responsible. 9. SUBMISSION MATERIALS The Submission Materials Tab includes the following information: Instructions and Reference Materials Templates for Submitting Products or Plans Pre-Populated Templates for Submitting Products or Plans 9.1 INSTRUCTIONS AND REFERENCE MATERIALS The links below will allow users to view and access the latest version of the User Manual. The Small Group Market instructions and reference material links are displayed below in Exhibit 9-1. RBIS User Manual Version 11.0 / 25 Mar 2013 Page 19
21 Exhibit 9-1: Instructions and Reference Materials (Example for the Small Group Market) 9.2 DOWNLOAD SUBMISSION MATERIALS The user can access and download the Submission materials link, under the Submissions Materials Tab, for updating and creating new products. The user can download Pre-populated Templates for completion from this page. Simply select which Template and format to download from the list by clicking on the Template hyperlinks. The Small Group Market Submission materials link is displayed below in Exhibit 9-2. RBIS User Manual Version 11.0 / 25 Mar 2013 Page 20
22 Exhibit 9-2: Download Data Submission Materials (Example from the Small Group Market) 10. ENHANCED SUBMISSION PROCESS This Submission window will feature an enhanced Submission process. Instead of submitting all products and plans as in previous Submission windows, only data that needs to be updated RBIS User Manual Version 11.0 / 25 Mar 2013 Page 21
23 should be included on a Template for Submission. If no changes need to be made, then the plan or product should not be included in the Submission. If data is submitted that results in an error, only that row or rows will need to be resubmitted. All of the other valid data submitted on the Template will not be need to be resubmitted. The exception to this is the Regions Template. A complete resubmission will be required if the Submission results in error. However, if the Template includes data for multiple Issuers, only the one that generated the error will need to be resubmitted. Additionally, a new Delete? column has been added to all Templates. In order to delete data, the column needs to be marked with a Yes. Leaving data off of a submitted Template will not delete the data. In order to edit data, the column needs to be marked with a No. User can then enter the edited data. An example of a Template submitted using the Enhanced Submission Process is displayed below in Exhibit Exhibit 10-1: Example Template Submitted Using the Enhanced Submission Process Deletions of plans and products will not be reflected on Healthcare.gov after the final refresh. Details on how the Enhanced Submission Process will work for each of the individual Templates are provided in their respective sections. RBIS User Manual Version 11.0 / 25 Mar 2013 Page 22
24 11. TEMPLATES 11.1 SMALL GROUP TEMPLATES All Issuers must use official Templates when submitting product data for Healthcare.gov. The following are three available Templates for download by the users that must be completed in order to submit new Product data into RBIS: Benefits Template Regions Template Product Availability Template Benefits Template The Benefits Template provides the capability for users to submit benefits data to RBIS. This Template includes instructions on how users should fill out each field. For example, if the column heading is asking if the Product is HSA-Eligible, the instructions will indicate that the user should enter either Y or N. The Benefits Template for Small Group Products is displayed below in Exhibit Exhibit 11-1: Benefits Template for Small Group Products If the users enter an invalid character or value, the Template will produce the error displayed in Exhibit Pressing Retry will redirect you back to the cell with the invalid entry and allow you to reenter the correct value; selecting Cancel will redirect you back to the cell with the invalid entry and clear the data; and selecting Help will open the Microsoft Office Excel Help screen. RBIS User Manual Version 11.0 / 25 Mar 2013 Page 23
25 Exhibit 11-2: Invalid Data During previous Submissions, instructions were to use 9 9s ( ). The system has been enhanced to recognize No Maximum and the use of 9-9 s ( ) will not be used to represent the value of unlimited for the following: Annual Max Benefit In-Network Annual Deductible (In-Network and Out-of-Network) Annual Medical Out of Pocket Limit (In-Network and Out-of-Network) The Delete? column is new to the Submission process. If a plan s or product s Delete? column is marked with a Yes, all of the data associated with that product or plan will be removed. If a Small Group product is deleted, all of the associated Product Availability data will be removed. If an Individual plan is deleted, all of the associated Rates data will be deleted. Deletions of plans and products will not be reflected on Healthcare.gov after the final refresh. For further instructions on how to download the Benefits Template for Submission, please refer to Section Regions Template The Regions Template provides the capability for users to submit data that defines the regions in which the Issuers operate. The Regions Template requires that the Issuer, Region #, and State Abbreviation fields be complete for each region. Users can also define the region using Zip, County and FIPS County codes. (Federal Information Processing Standards (FIPS) County codes are a five digit federal standard for identifying United States Counties.) The following standards apply when completing the Regions Template: Do not enter both a FIPS code and County. If both are entered, only the FIPS code will be used. If a region is defined only by Zip Code, then leave the FIPS Code and County columns empty. If a region is defined by a combination of Zip Code and County, then fill out both columns. If a region is defined by a combination of Zip Code and FIPS Code, then fill out both columns. If a region is defined only by FIPS Code, then leave the ZIP Code and County columns empty. If your Region covers a state for all zip codes then leave the ZIP Code, FIPS Code and COUNTY columns empty. RBIS User Manual Version 11.0 / 25 Mar 2013 Page 24
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