Data Changes and Application Corrections FAQs
QHP Application Corrections
Q1: Can issuers add new plans after the initial submission deadline?
- No. After the initial submission deadline, issuers cannot add new plans to a Qualified Health Plan (QHP) Application or change an off-Exchange plan to both on- and off-Exchange.
Q2: If an issuer is making a change to its application in response to a correction identified by CMS, is the issuer required to submit a data change request?
- Before the final submission deadline to make changes to an issuer’s QHP Application, issuers are not required to submit a data change request (DCR) in response to a correction identified by CMS. After the final submission deadline to make changes to a QHP Application, issuers are required to submit a DCR to CMS in response to a CMS-identified correction, unless otherwise indicated by CMS. CMS will notify an issuer if the DCR requirement is waived, such as CMS direction to an issuer to enter a limited data correction window. For more information on submitting a DCR, please refer to: https://www.qhpcertification.cms.gov/s/QHP.
Q3: How should an issuer respond to corrections identified during the QHP Application submission window?
- To address QHP Application review results, issuers should respond by either correcting their QHP Applications or providing adequate justification to demonstrate that corrections are not required. Errors and corrections must be addressed before the affected plans can be certified and/or displayed on HealthCare.gov.
Application templates should be submitted through the appropriate submission system. All issuers are required to submit their Plan ID Crosswalk Template and supporting documentation in the PM Community. For all other templates, issuers in FFE states should submit their revised templates and other supporting documents through Health Insurance Oversight System (HIOS). Issuers in states performing plan management functions as well as state based exchanges and submitting through the System for Electronic Rates & Forms Filing (SERFF) should coordinate with regulators to ensure submission and transfer of the updated data to CMS.
Issuers may upload revised data templates and other supporting documents (and states may transfer them) on an as-needed basis up until the final data submission deadline if the group status in HIOS is not in Submitted - Under Review.
Other
Q1: How do issuers make changes to incorrect customer service numbers listed on HealthCare.gov for their organization?
- Administrative information displayed on the HealthCare.gov website will be pulled from Issuer Marketplace Information Fields in the Health Insurance Oversight System (HIOS). The issuer name displaying on HealthCare.gov is from the value submitted for HIOS “Issuer Marketplace Marketing Name.” If that field is blank, then the value for “Issuer Marketing Name” displays. If both fields are blank, then the value for “Issuer Legal Name” displays. The display logic for issuer names applies to all issuers, including those who file through the System for Electronic Rates and Forms Filing (SERFF).
Changes to administrative data, including customer service numbers, should be made in the View Issuer Submitted Data Tab of the HIOS Plan Finder Product Data Collection module. Issuers can make such changes at any time. If an issuer needs to change their Issuer Marketplace Marketing Name or customer service information (phone number or URL), please note the following:
You must have a submitter role in HIOS to make changes. Instructions on how to update fields in the HIOS Plan Finder Module are contained in Section 3.2 of the HIOS Plan Finder—Issuer User Manual.