Application Submission

HIOS: Issuers submitting their applications or any rate data via HIOS should follow the timeline and processes outlined in the Letter to Issuers. For more information on navigating and submitting through HIOS, see the HIOS user guides.

SERFF: Issuers submitting their applications via SERFF should follow state guidance on the timeline and process for submission. Current SERFF users can access the plan management functionality at the following site, using their existing ID and password.

Questions related to SERFF functionality should be directed to the SERFF Help Desk at serffhelp@naic.org.

Additional Tips for Submitting Your QHP Application

  • Access the appropriate HIOS Plan Management Module in the CMS Portal:
    • To submit the QHP Application in HIOS, select “Plan Management and Market Wide Functions” at the bottom of the HIOS Portal page
  • Double-check file names and formats:
    • Ensure file names follow prescribed naming conventions as specified in each chapter of the QHP Application Instructions
    • Ensure template files are saved in the correct format as specified in each chapter of the QHP Application Instructions
  • Check with your state regulatory body for additional requirements:
    • Some states require issuers to submit to SERFF in addition to HIOS. Follow guidance from your state insurance regulator
  • Ensure your application has a status of “cross-validation complete” before the submission deadline(s):
    • Step 1: Validate all three QHP modules (Issuer, Benefits and Service Area, and Rating)
    • Step 2: When validating the Issuer Module, select “Submit Section” at the bottom of each screen then click “Next.” Repeat this step for the Benefits and Service Area Module and Rating Module
    • Step 3: On the final Issuer Module validation review page, click “Submit Application”
    • Step 4: After validating the Issuer Module, return to the “Final Submission” page
    • Step 5: Click “Cross Validate” and then “Submit”
      • Issuers are only required to be in the “cross validation complete” status for the Rates Table Template deadline and any submission deadline that follows.

Issuers are only required to be in the “cross validation complete” status for the Rates Table Template deadline and any submission deadline that follows.The table below indicates the system(s) in which issuers seeking certification of QHPs should submit their applications and supporting data for PY2021, for both the individual and SHOP markets.

State

System for Collecting QHP Applications— Individual Market

System for Collecting QHP Applications— SHOP Market

Alabama

HIOS

HIOS

Alaska

HIOS

HIOS

Arizona

HIOS

HIOS

Arkansas

SERFF

SERFF

California

State system + SERFF

State system + SERFF

Colorado

SERFF

SERFF

Connecticut

State system + SERFF

State system + SERFF

Delaware

SERFF

SERFF

District of Columbia

State system + SERFF

State system + SERFF

Florida

State system + HIOS

State system + HIOS

Georgia

HIOS

HIOS

Hawaii

SERFF

SERFF

Idaho

SERFF

SERFF

Illinois

SERFF

SERFF

Indiana

HIOS

HIOS

Iowa

SERFF

SERFF

Kansas

SERFF

SERFF

Kentucky

SERFF

SERFF

Louisiana

HIOS

HIOS

Maine

SERFF

SERFF

Maryland

SERFF

SERFF

Massachusetts

SERFF

SERFF

Michigan

SERFF

SERFF

Minnesota

SERFF

SERFF

Mississippi

HIOS

HIOS

Missouri*

HIOS

HIOS

Montana

SERFF

SERFF

Nebraska

SERFF

SERFF

Nevada

State system + SERFF

State system + SERFF

New Hampshire

SERFF

SERFF

New Jersey

SERFF

SERFF

New Mexico

SERFF

SERFF

New York

State system + SERFF

State system + SERFF

North Carolina

HIOS

HIOS

North Dakota

HIOS

HIOS

Ohio

SERFF

SERFF

Oklahoma*

HIOS

HIOS

Oregon

SERFF

SERFF

Pennsylvania

SERFF

SERFF

Rhode Island

SERFF

SERFF

South Carolina

HIOS

HIOS

South Dakota

SERFF

SERFF

Tennessee

HIOS

HIOS

Texas*

HIOS

HIOS

Utah

SERFF

SERFF

Vermont

SERFF

SERFF

Virginia

SERFF

SERFF

Washington

State system + SERFF

State system + SERFF

West Virginia

SERFF

SERFF

Wisconsin

HIOS

HIOS

Wyoming*

HIOS

HIOS

*These states currently do not have the authority to enforce or are not otherwise enforcing the Affordable Care Act market reform provisions pursuant to 45 CFR 150.101. Issuers in these states should refer to the 2021 Form Filing Instructions.