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.