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Life Health > Health Insurance

Getting into the HHS exchange menus: A how-to guide

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Health plan administrators — and brokers who help with administration — may discover that they have surprising new data-entry obligations.

See also: Feds: HHS exchange agent who fibs could owe $250,000 fine

Officials at one of the main agencies involved with making the Patient Protection and Affordable Care Act (PPACA) machinery run, the Center for Consumer Information & Insurance Oversight (CCIIO), have published tips on plan information data entry in a new guide on the CCIIO website.

CCIIO is part of the Centers for Medicare & Medicaid Services (CMS), which is part of the U.S. Department of Health and Human Services (HHS).

CCIIO is supposed to manage the parts of PPACA that affect commercial health insurance.

CCIIO wants plans to put insurance company and product information into the Health Insurance Oversight System (HIOS). Cost-sharing and benefit information goes into a separate HIOS add-on, the Rate and Benefits Information System (RBIS).

Because CCIIO is using the information for market analysis, not just to create plan menus for consumers, the agency wants coverage providers to enter information for closed plans, and very small plans, as well as for actively marketed plans, officials say.

CCIIO also wants information on any multiple employer welfare arrangements (MEWAs) that offer state-regulated individual or small-group products, and it also wants information on plans offered solely to limited populations, or to members of specific associations, officials say.

Either the organization’s chief executive officer or the chief financial officer must attest to the accuracy and completeness of the data.

See also: Feds post 2015 PPACA technical documents


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