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									Health Plan Data Collection and Software Services
 Content Management Portal -Technical Instructions
                                                 08/16/2010




                                            PRA Disclosure Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of
information unless it displays a valid OMB control number. The valid OMB control number for this information
collection is 0938-1086. The time required to complete this information collection is estimated to average (106
hours) or (6,360 minutes) per response, including the time to review instructions, search existing data resources,
gather the data needed, and complete and review the information collection. If you have comments concerning the
accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security
Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.
Content Management Portal – Technical Instructions

Table of Contents
1    Introduction ........................................................................................................................................... 3
2    Enter Portal Plans ................................................................................................................................. 4
3    Provide Benefit Information ................................................................................................................ 5
4    Provide Rate File/Service Area Files .................................................................................................. 6
5    Answer Rating/Eligibility Questions ................................................................................................... 8
6    Provide Rate Test Cases ...................................................................................................................... 9
7    Upload Company Logo and Profile................................................................................................... 10
8    Provide Contact Information ............................................................................................................. 12
9    Appendix A – Sample Benefit Template ........................................................................................... 14
10 Appendix B – Sample Rating Template ............................................................................................ 15
11 Appendix C – Sample Service Area File Template .......................................................................... 17
12 Appendix D – Sample Rating Questions Template ......................................................................... 18
13 COMMONLY ASKED QUESTIONS .................................................................................................... 20




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Content Management Portal – Technical Instructions


1     Introduction
The Content Management Portal (CMP) is a secure site for issuers to log into and enter their initial
individual and small group plan data requirements. The site also supports the sharing of data files, and
the functionality to collect plan data requirements for updates throughout the year (functionality not yet
live). CMP will help to ensure that all issuer requirements are collected up front and accurately. This will
ensure a quick turnaround time to get plan data live on the site.

The issuer will complete the registration process and log onto CMP with a user ID and password. It is
recommended that the issuer designate one point contact person to access CMP and coordinate the data
collection internally. Most of the templates are in Excel 2003 and can be shared internally with the
appropriate resources for completion. If you are using a higher version of Excel please save the file as an
Excel 2003 file. The point contact person can then upload the templates onto CMP when they are
completed. A customer service number 1-877-425-3708 has been made available for anyone who has
questions about the plan data submission process and CMP. Or you can email your question to cmp-
support@ehealth.com.

These technical instructions will provide a step-by-step overview of the data submission requirements in
the CMP tool. The instructions will include clarification on the data entry field requirements, and the
standardized templates to be completed by issuers so that benefits and pricing can be processed quickly
and ready for the 10/1/2010 launch. The “Initial Submission” function of CMP consists of seven sections
as outlined below:




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Content Management Portal – Technical Instructions


2     Enter Portal Plans
This page will allow you to identify each plan unit to be displayed on the Web site. Please enter the Issuer
ID, Product ID, plan name, type, effective & end date, deductible, coinsurance, office visit, member
enrollment and SERFF#.




Data entry format: The following table includes each data entry field on the “Enter Portal Plans” page.

Data Entry                                   Format                                             Validation
Issuer ID                                    5 digit numeric                                    This field is required.
                                             5 Digit alpha numeric
Product ID                                   (2 Character state code plus 3 digit product ID)   This field is required.
Plan Name                                                                                       This field is required.
Plan Type                                    PPO/HMO/POS/EPO/Indemnity                          This field is required.
Effective Date                                                                                  mm/dd/yyyy
End Date                                     Note: end date must be after effective date        mm/dd/yyyy
Deductible                                                                                      This field is required.
                                             Numeric or NA                                      Numeric Only. If
                                                                                                coinsurance not
                                             Note: enter “member” liability (e.g. 80/20 plan    applicable please
Member Coinsurance                           then enter 20)                                     enter NA
                                             Dropdown options:
                                             Not Covered;
                                             No Charge;
                                             No Charge after deductible;
                                             $X Copay;
                                             X% Coinsurance after deductible;
                                             X% Coinsurance before deductible
Primary Care Office Visit                    (The field will also allow free text as well)      This field is required.
Member Enrollment                            6 digit numeric                                    This field is required
SERFF#
System for Electronic Rate and Form Filing   13 Alpha numeric (e.g. AAAA-000000000)             Optional




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Content Management Portal – Technical Instructions


3     Provide Benefit Information
Download the Medical Benefit Template (please refer to Appendix A for to see a completed Sample
Benefit Template).

It can be saved on your desktop computer and worked on outside of the CMP site to allow other
resources access to enter the data. If you are using a higher version of Excel please save the file as an
Excel 2003 file. We have provided guidelines in the template as to how the benefit descriptions should be
entered so there is a common format across issuers. However, if you are not able to follow the exact
format then you are able to enter free form text in most of the fields.

After the benefit template is completed then it can be uploaded to CMP.

Click “Brochures” link and provide a PDF of the benefit brochure and Exclusions & Limitations for each
plan. If it is the same brochure for all plans then you only need to download the one pdf.




Click on Medical Benefit Template benefit information from the above screen.




Click on Upload. New File to load the pdf of the benefit brochures and E&Ls from the above screen




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Content Management Portal – Technical Instructions


4     Provide Rate File/Service Area Files
This is the page where you will download a rate template and service area template. Before we show you
the rate template you will be asked a few questions to determine which template will work for you. For
multi-state issuers, please complete a separate rate template for each state. Please go through the
Wizard for each state to trigger one template for each state. The templates are in Excel 2003 and can be
saved on your desktop computer and worked on outside of the CMP site to allow other resources access
to enter the data. If you are using a higher version of Excel please save the file as an Excel 2003 file.
(Refer to Appendix B to see a completed Sample Rating Template and Appendix C for Sample Service
Area File Templates)




Online wizard for IFP rating template




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Content Management Portal – Technical Instructions



Online Wizard for SBG rating template




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Content Management Portal – Technical Instructions


5     Answer Rating/Eligibility Questions
Please download and complete the Rating Questions Spreadsheet. This information will be used to
program the rating engine on the site. For multi-state issuers, please download a separate rating/eligibility
questions template for each state. The template is in Excel 2003 and can be saved on your desktop
computer and worked on outside of the CMP site to allow other resources access to enter the data. If you
are using a higher version of Excel please save the file as an Excel 2003 file. (Refer to Appendix D to
see a Sample Rating Questions Template)




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6     Provide Rate Test Cases
Please download our standard template and provide us with rate test cases to check our calculations.
The template is in Excel 2003 and can be saved on your desktop computer and worked on outside of the
CMP site to allow other resources access to enter the data. If you are using a higher version of Excel
please save the file as an Excel 2003 file. A sample test case file is included in the template.




    We recommend the test cases for individual coverage include:
    1. About 100 test cases.
    2. All coverage types.
    3. As much of the service area as possible.
    4. Cover different cases based on boundary eligibility condition.

    We recommend the test cases for the Small Group Product include:
    1. A minimum of 30 test cases.
    2. Different group sizes.
    3. The service area as much as possible.
    4. Different cases based on boundary eligibility condition.




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Content Management Portal – Technical Instructions

7     Upload Company Logo and Profile
     Logo:

Please provide a small logo – Size: 116 X 35 px Preferred Format: .gif file (or .eps file which will be
converted to a .gif)
Please provide a large logo – Size: 232 X 70 px Preferred Format: .gif file (or .eps file which will be
converted to a .gif)




     Company Profile

Please provide a company profile which includes a company overview and facts about the company.
There is a standard format for completing the company profile (see below).




Health Plan Data Collection and Software Services                                             Page 10 of 21
Content Management Portal – Technical Instructions

Company Profile

Company Overview
1025 character maximum




Facts About the Company
Founded In:
Number of Employees:
Description of Coverage Area:
Membership:
Provider Network:
Others
                                        1500 character maximum




Describe any recent Awards or Recognitions:




                                        350 character maximum
Subsidiaries or Affiliates:


Company Address
URL to Company Web site displaying
Individual Plan Information
Customer Service Phone# Ext#
Customer Service TTY Phone# Ext#


Company Overview - A brief description of the company appropriate for consumers should be provided
in this section.
       Founded in – Year the company was founded
       # of Employees – How many individuals are employed by issuer
       Description of Coverage Area – Multi-state issuers list states, and single state issuer list
          regions/areas within the state.
       Membership - Number of covered lives for the most recent completed fiscal quarter.
       Provider Network – Issuer is contracted with which types of provider networks: HMO, EPO,
          POS, PPO




Health Plan Data Collection and Software Services                                      Page 11 of 21
                                                Upload Company Profile
Content Management Portal – Technical Instructions


8    Provide Contact Information




       A. Issuer Name: Issuer name shall be provided as the legal name of the entity registered to
          provide the plan within the coverage area.
       B. IRS Federal Employer Identification Number (EIN): Issuers are required to provide the
          employer identification number under which they pay taxes to the IRS. This element is
          obtained solely to allow for unique identification of the entities, and required verification of
          information.
       C. NAIC Company Code Number: Issuers are required to provide the NAIC Company Code
          number if they have one.
       D. State: State in which plan coverage is offered.
       E. Market type: Indicate whether the product specified is an individual or small group offering.
       F. NAIC Group Code: If a company has an NAIC Group code, we ask that this be provided for
          administrative tracking.
       G. Provider Directory URL – Issuer’s provider seach
       H. Website URL - Universal resource locator for the company website.
       I. Address - The mailing address for the corporation.
       J. Customer Service Phone number and TTY phone - For corporate customer service
       K. Customer service email: For reaching corporate customer service.
       L. Data Submission Contact and backup (Phone Number & E-mail Address): Essential for
          reaching primary person responsible for the initial data entry.
       M. Data Validation Contact and backup (Phone Number & E-mail Address): Person who will
          review and approve the submitted information on the web site before it goes live. This
          validation must be completed by the Chief Exectutive Officer or Chief Financial Officer of the
          company.

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9    Appendix A – Sample Benefit Template

                                                                   Plan Name                    Liberty 1500
                                                         PPO, POS, HMO, EPO,
                    Plan Type                                                                       PPO
                                                         Indemnity
                                                         Y/N
                    Primary Care Physician Required      (PPO = N, POS = Y, HMO = Y,                 N
                                                         EPO = Y, some exceptions)
                    Specialist Referrals Required        Y/N                                         N
                                                         Not Covered
                                                         No Charge
                                                         No Charge after deductible         $30 Copay (Deductible
                    Office Visit for Primary Doctor
                                                         $X Copay                                 Waived)
                                                         X% Coinsurance after
                                                         deductible
                                                         Not Covered
                                                         No Charge
                                                         No Charge after deductible
                                                         $X Copay                           $30 Copay (Deductible
                    Office Visit for Specialist
                                                         X% Coinsurance after                     Waived)
                                                         deductible
                                                         X% Coinsurance before
                                                         None
                                                                                            20% Coinsurance after
                    Coinsurance                          X% after deductible
                                                                                                 deductible
                                                         X% before deductible
                    Individual Deductible                                                           1500
                    Family Deductible                                                               4500
                                                         *(A)ggregate = expenses for all
                                                         covered
                                                         family members are applied to
                    Is accumulation towards the family   the family deductible
                                                         *(S)eparate = Family deductible         Aggregate
                    deductible aggregate or separate?
                                                         amount is typically 2x or 3x the
                                                         individual deductible amount.
                                                         The family deductible can only
                                                         be met when appropriate # of
                    If Separate, how many family
                    members need to satisfy their
                                                         (1/2/3/4/5/All)
                    individual deductible before the
                    family deductible applies?
                    Individual Out-of-Pocket Limit                                                 5000
                    Family Out-of-Pocket Limit                                                     10000
                                                         *(A)ggregate = expenses for all
                                                         covered
                                                         family members are applied to
                    Is accumulation towards the family
                                                         the family Out-of-Pocket
                    out-of-pocket limit aggregate or                                             Aggregate
                                                         *(S)eparate = Family Out-of-
                    separate?
                                                         Pocket amount is typically 2x
                                                         or 3x the individual Out-of-
                                                         Pocket amount. The family Out-
                    If Separate, how many family         of-Pocket can only be met when
                    members need to satisfy their
                    individual out-of-pocket limit       (1/2/3/4/5/All)
                    before the family out-of-pocket
                    limit applies?
                    Does out-of-pocket limit include
                                                                                                     Y
                    deductible?                          Y/N
                    Individual Lifetime Maximum                                                   Unlimited
                    Health Savings Account (HSA)
                                                         Y/N                                         N
                    Eligible
                    Out-of-Network Coverage              Y/N/Emergency Care Only                     Y
                    Out-of-Network authorization         If Y to "Out-of-Network
                                                                                                     N
                    required                             Coverage" then (Y/N)
                    Is Out-of-Network Coverage
                                                         If Y to "Out-of-Network
                    Different than In-Network                                                        Y
                                                         Coverage" then (Y/N)
                    Coverage?
                    Out-of-Network Individual/family     If Y to "Coverage different than
                                                                                                 3000/6000
                    Deductible                           In-Network Coverage" then list
                                                         If Y to "Coverage different than
                                                                                                     40
                    Out-of-Network Coinsurance           In-Network Coverage" then list
                    Out-of-Network Individual/Family     If Y to "Coverage different than
                                                                                               10,000/20,000
                    Annual Out-of-Pocket Limit           In-Network Coverage" then list
                    Out of Country Coverage              Y/N/Emergency Care Only                     Y




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10 Appendix B – Sample Rating Template
A). Sample Small Group Rating Template Note: this is one of several similar templates. You will
have to answer the questions presented in this section of CMP and we will auto generate the correct
template for you to complete.

                                                                               Primary Care Office Visit
                                                                                  Member Coinsurance
                                                                                             Deductible
                                                                                    Effective_End_Date 11/30/2010 11/30/2010
                                                                                   Effective_Start_Date 10/1/2010 10/1/2010
                                                                                             Plan_Type HMO       HMO


                                               HIGH_AGE   Gender          MIN_PERSONS MAX_PERSONS HMO 10            HMO 20

        User T ype                LOW _A GE
        Employee Only                      0           29 No Preference              1             50   $356.37      $310.45
        Employee Only                     30           39 No Preference              1             50   $427.64      $372.53
        Employee Only                     40           49 No Preference              1             50   $546.44      $476.02
        Employee Only                     50           54 No Preference              1             50   $699.52      $609.37
        Employee Only                     55           59 No Preference              1             50   $859.93      $749.11
        Employee Only                     60           64 No Preference              1             50   $1,118.37    $974.24
        Employee Only                     65          120 No Preference              1             19   $1,109.18    $966.24
        Employee Only                     65          120 No Preference             20             50   $1,510.10   $1,315.49
        Employee and Spouse                0           29 No Preference              1             50   $949.96      $827.54
        Employee and Spouse               30           39 No Preference              1             50   $1,140.37    $993.41
        Employee and Spouse               40           49 No Preference              1             50   $1,187.89   $1,034.81
        Employee and Spouse               50           54 No Preference              1             50   $1,427.87   $1,243.86
        Employee and Spouse               55           59 No Preference              1             50   $1,825.23   $1,590.01
        Employee and Spouse               60           64 No Preference              1             50   $2,102.00   $1,831.11
        Employee and Spouse               65          120 No Preference              1             19   $2,218.38   $1,932.49
        Employee and Spouse               65          120 No Preference             20             50   $2,957.83   $2,576.65
        Employee and Child(ren)            0           29 No Preference              1             50   $997.84      $869.25
        Employee and Child(ren)           30           39 No Preference              1             50   $1,045.36    $910.65
        Employee and Child(ren)           40           49 No Preference              1             50   $1,116.63    $972.73
        Employee and Child(ren)           50           54 No Preference              1             50   $1,211.67   $1,055.52
        Employee and Child(ren)           55           59 No Preference              1             50   $1,354.22   $1,179.70
        Employee and Child(ren)           60           64 No Preference              1             50   $1,473.00   $1,283.17
        Employee and Child(ren)           65          120 No Preference              1             19   $1,524.63   $1,328.15
        Employee and Child(ren)           65          120 No Preference             20             50   $1,925.53   $1,677.39
        Family                             0           29 No Preference              1             50   $1,431.67   $1,247.17
        Family                            30           39 No Preference              1             50   $1,591.79   $1,386.65
        Family                            40           49 No Preference              1             50   $1,639.31   $1,428.05
        Family                            50           54 No Preference              1             50   $1,924.40   $1,676.40
        Family                            55           59 No Preference              1             50   $2,004.24   $1,745.95
        Family                            60           64 No Preference              1             50   $2,363.71   $2,059.09
        Family                            65          120 No Preference              1             19   $2,633.85   $2,294.42
        Family                            65          120 No Preference             20             50   $3,291.09   $2,866.96




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Content Management Portal – Technical Instructions

B). Sample Individual Rating Template. Note: this is one of several similar templates. You will have
to answer the questions presented in this section of CMP and we will auto generate the correct
template for you to complete.
                                                             Primary Care Office Visit   50
                                                                Member Coinsurance       20
                                                                           Deductible    750
                                                                  Effective_End_Date     2015-07-31
                                                                 Effective_Start_Date    2010-07-21
                                                                           Plan_Type     PPO
User Type             LOW_AGE        HIGH_AGE    Gender            Tobacco?              Signature Plus Plan 80%, $750 Deductible
Adult                            0           5   Male              No Preference                                 $120.21
Adult                            6          14   Male             No Preference                                  $101.42
Adult                           15          19   Male             No Preference                                  $129.53
Adult                           20          24   Male             No Preference                                  $129.53
Adult                           25          29   Male             No Preference                                  $138.86
Adult                           30          34   Male             No Preference                                  $176.29
Adult                           35          39   Male             No Preference                                  $195.08
Adult                           40          44   Male             No Preference                                  $237.18
Adult                           45          49   Male             No Preference                                  $274.74
Adult                           50          54   Male             No Preference                                  $332.38
Adult                           55          59   Male             No Preference                                  $382.38
Adult                           60          64   Male             No Preference                                  $444.82
Adult                            0           5   Female           No Preference                                  $120.21
Adult                            6          14   Female           No Preference                                  $101.42
Adult                           15          19   Female           No Preference                                  $156.09
Adult                           20          24   Female           No Preference                                  $156.09
Adult                           25          29   Female           No Preference                                  $168.52
Adult                           30          34   Female           No Preference                                  $213.86
Adult                           35          39   Female           No Preference                                  $232.51
Adult                           40          44   Female           No Preference                                  $273.06
Adult                           45          49   Female           No Preference                                  $302.72
Adult                           50          54   Female           No Preference                                  $348.06
Adult                           55          59   Female           No Preference                                  $382.38
Adult                           60          64   Female           No Preference                                  $444.82
Child                            0          26   No Preference    No Preference                                  $99.87




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11 Appendix C – Sample Service Area File Template
The service area file templates are the same for Individual and Small Group.

           Region #       ZIP Code COUNT Y
                      1      91901 SAN DIEGO
                      1      91902 SAN DIEGO
                      1      91903 SAN DIEGO
                      1      91905 SAN DIEGO
                      1      91906 SAN DIEGO
                      1      91908 SAN DIEGO
                      1      91909 SAN DIEGO
                      1      91910 SAN DIEGO
                      1      91911 SAN DIEGO
                      1      91912 SAN DIEGO
                      1      91913 SAN DIEGO
                      1      91914 SAN DIEGO
                      1      91915 SAN DIEGO
                      1      91916 SAN DIEGO
                      1      91917 SAN DIEGO
                      1      91921 SAN DIEGO
                      1      91931 SAN DIEGO
                      1      91932 SAN DIEGO




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12 Appendix D – Sample Rating Questions Template
A). Individual Rating Questions Document
   Answer Rating Questions

   This information will be used to program the rating engine on the site. Accurate information is critical in order to quote properly.
   Enter N/A if the questions don't apply.


                                     Question                                            Example                    Answer                        Additional Notes
   The following questions are for applications with a primary adult applicant [not a child(ren)-only application]:
   Is student status considered for eligibility?                                                         Y/N                          N
   What is the maximum age for a dependent who is not a full time student?                         18 means <=18             25       Years Old
   What is the maximum age for a dependent who is a full time student?                             23 means <=23             25       Years Old
   What is the minimum spouse age range?                                                           18 means >=18             18       Years Old
   What is the maximum spouse age range?                                                           64 means <=64             64       Years Old
   What is the minimum primary adult applicant age?                                                18 means >=18             18       Years Old
   What is the maximum primary adult applicant age?                                                64 means <=64             64       Years Old
   Can domestic partners be covered under this plan (Quote for same sex couples)?                        Y/N                          N
                                                                                                No; Oldest as primary;
   Do spouses need to be quoted in age order?                                                                               Oldest as primary
                                                                                                 Youngest as primary
   What is the minimum dependent age(adult)?                                                        0 means >=0              42       Days Old
   The following questions are for child(ren)-only rating:
   Do you allow child-only rates?                                                                        Y/N                          Y
   IF N to the question above, please skip the following section.
   What is the minimum primary age?                                                                 0 means >=0             42        Days Old
   Can multiple children be quoted on one application, or should each child be a
                                                                                                        S/M                           S
   single applicant?
   What is the maximum age for a non-student dependent?                                            18 means <=18                      Years Old
   What is the maximum age for a student dependent?                                                23 means <=23                      Years Old
   What is the minimum dependent age(child)?                                                        0 means >=0                       Years Old
   Is the primary applicant quoted with adult or child rate?                                        (if applicable)               adult
                                                                                                No; Oldest as primary;
   Do children need to be quoted in age order?                                                                                        No
                                                                                                 Youngest as primary
   Do children get smoker rates?                                                                         Y/N                          N
                                                                                                   No; Primary + 3
   Is there a limit on number of children when calculating rate?                                                                   No
                                                                                                      Maximum
   Additional Questions:
   Is US citizenship required for plan membership?                                                       Y/N                          N
                                                                                                          Y/N
   Does the applicant have to reside within the state for a certain period of time
                                                                                                 If Y, please specify                 N
   before coverage will be extended?
                                                                                                      requirement
   Do you have smoker rates?                                                                             Y/N                          Y
   If yes, does one smoker in family mean all family members get smoker rate?                            Y/N                          N
                                                                                                  By Zip Code; By
   How do you define your service area?                                                           County; By Zip +          By Zip + County
                                                                                                  County; All State
   How often do rate updates typically occur?                                                     Quarterly, Yearly               Yearly
   Is there a source (other than rate files) to verify the rate results (rating engine disk,
                                                                                                      Web site           Test Cases
   Web site, test cases)?
   Do you charge any fees? If so please specifiy the type of fee (e.g. application                        Y/N
                                                                                                                                    Y
   fee, administrative fee, etc.)                                                                If Y, please explain
   Will you obtain and pay for medical records?                                                           Y/N                       N
                                                                                               Any day; 1st and 15th of
   What effective dates are available?                                                          the month; 1st of the
                                                                                                         month          1st of the month

   What are the A.M. Best Rating, A.M. Best ID and Rating Date of your company?
                                                                                                  A, 06006, 6/16/08      B++ / 68616 / 11-19-08
   Please identify any other non-health related questions (not listed in this
   document) that are used to determine eligibility?                                                    None             None

   Issuers in different states may apply a variety of specific non-medical conditions
   for membership, or for the application of different pricing schemes. For example,
   plans may be limited to non-smokers, available only to particular occupations, or
   be subject to any number of limits. Please identify (not listed in this document)
   where such categorical determinations exist?
                                                                                                        None             None




Health Plan Data Collection and Software Services                                                                                                                    Page 18 of 21
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B). Small Group Rating Questions Document
    Answer Rating Questions


    This information will be used to program the rating engine on the site. Accurate information is critical in order to quote properly.
    Enter N/A if the questions do not apply.


    Rating Questions                                                                             Example                         Answers
    Is the service area based on the employer or employee location?                          Employer/Employee                   Employer

    Is the rate based on the employer or employee location?                                  Employer/Employee                   Employer
                                                                                              By Zip Code Only;
                                                                                               By County Only:
                                                                                                                              By Zip + County
    Do you use zip code or county to determine rating region? (If zip code is used, are       By Zip + County;
    there any special rules for zip codes that span across multiple counties?)                    All State
    Eligibility Questions                                                                        Example                         Answers

    What are the minimum participation requirements?                                               75%                             51%

    What are the minimum contribution requirements?                                                50%                              N/A

    What is the minimum length of time in business rule?                                           None                             N/A

    Is there a minimum or maximum age requirement for an employee?                                 None                             N/A

    Effective Dates: Do not quote more than 90 days prior to the effective date.                     90                             90


                               Basic Info          Field                   Value                   Notes


                                               CARRIER_NAME Lighthouse
                                                  STATE_ABBR NM
                                                 CARRIER_URL


                                   Rating          RAF                Min Group Size          Max Group Size      Type of Rating (i.e. Tabular, Composite)
                                                    1.10                      1                      5                            Tabular
                                                    1.00                      6                      15                           Tabular
                                                    1.00                     16                      50                           Tabular




        Step-by-Step Rate Calculation
      Please specify the steps or provide
         examples to generate the rates.                            This field is optional




                        Additional Notes
                                 (If any)




Health Plan Data Collection and Software Services                                                                                               Page 19 of 21
Content Management Portal – Technical Instructions


13 COMMONLY ASKED QUESTIONS

   1. You developed our plans and they are ready to go live on 10/1, but we now have some plan
      data updates to make for 11/1 (or later). How should I submit my plan updates?

   We will be accepting plan updates immediately following the 10/1 launch date. You will be required to
   return to the CMP site and utilize the Maintenance function (not yet available). You will receive
   instructions in September. Meanwhile, we you will need to contact us at 1-877-425-3708:
         If you are having a plan or benefit update, but not replacing plans then let us know which
            plans are impacted and the effective date of the changes. We will add a disclaimer to the site
            letting the consumer know that the issuer is in the processes of updating plan or pricing.
         If you are replacing existing plans with new ones then we will need to shut down the old plans
            for anyone requesting an effective date during the cancellation period. Please let us know
            what plans are impacted and the cancellation date.

   2. My plan data is currently on the eHealthinsurance.com site, and I heard this data can be
      transferred to the HHS site?

   All eHealth issuers will soon get a notice asking for permission to transfer the plan data from eHealth
   to the HHS site.
   The eHealth plan data will not be transferred from eHealth to HHS until all updates have already been
   made for 10/1/10 effective dates. We anticipate this data will be transferred around the beginning of
   September.
   Meanwhile, please work to add any additional plans through CMP to meet the plan number
   requirement. You may add these plans by clicking on the initial submission tab. Make sure not to
   add plans that are already on the eHealth site!
   Once the eHealth plan data is transferred to the HHS site, you will need to return to CMP to add the
   following data for the plans transferred from eHealth:
           a. Issuer ID
           b. Product ID
           c. Member Enrollment
           d. SERFF# (System for Electronic Rate and Form Filing)


   3. We are not going to be able to submit the plan data by the 9/3 submission deadline?

   This means you will not be able to comply with the 9/3 submission deadline and there is no guarantee
   your plans will go live on 10/1. However, please continue to submit your plan data after the deadline
   and we will continue to process your data for a later launch.


   4. Do I send you a pdf of the entire plan brochure, or just the summary of benefits?

   We only need a summary of the benefits, but sometimes the issuer wants us to load the entire benefit
   brochure which is ok.




Health Plan Data Collection and Software Services                                          Page 20 of 21
Content Management Portal – Technical Instructions

   5. I do not have pdfs of the exclusions and limitations?

   Quite often the benefit brochure will speak to exclusions and limitations and many issuers use this
   brochure for E&Ls.

   6. It will take quite some time to complete these rating templates. Can I just send you our
      rate file?

   You are required to utilize the rating template in order to be compliant.

   7. What is the purpose of CMP?

   The Content Management Portal (CMP) is the portal that issuers will use for their initial plan data
   submission, and it will also be used for plan data updates after the 10/1 go live date. Issuers must
   comply with the plan data requirements programmed into CMP.

   8. Can I get a second User ID for CMP?

   We are only issuing one user ID and password per issuer or issuer/state to ensure that the issuer has
   one point person managing the plan data submission.

   9. I just submitted my plan data on CMP but realized I made a mistake. How can I correct it?

   We can allow you access to make changes. But before we do, please contact us and let us know
   what you will be changing.

   10. I just submitted my data, when do you think it will be ready for me to review on the q/a
       site?

   The plan data must be developed and then tested. We will notify you as soon as it is available for
   you to review. We will not go live with your data without your approval.

   11. I am reviewing the plans you developed on the HHS site and have found some bugs. What
       do I do?

   Send us an email with a list of your concerns. Our email address is cmp-support@ehealth.com.




Health Plan Data Collection and Software Services                                          Page 21 of 21

								
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