Network ID

QHP issuers must assign each of their provider networks—groups of providers providing services in an area—to network IDs using the Network ID Template.

Key Changes for PY2025:
  • The Network ID Template is now submitted in the Network ID section of MPMS.

Tips for the Network ID Section

  • Dual-product issuer must create two different network IDs, one each for qualified health plans (QHPs) and stand-alone dental plans (SADPs), regardless of whether the specific network is intended to serve both plan types. Issuers submitting via the National Association of Insurance Commissioners’ (NAIC’s) System for Electronic Rates & Forms Filing (SERFF) must use the same Network ID Template across all binders or ensure that no network IDs repeat across the binders.
  • Dual-product issuer must use the word “dental” in the network area name for your dental network to distinguish the dental network from the medical network.
  • Issuers who offer plans in the Individual and Small Business Health Options Program (SHOP) markets must create separate network IDs for each market, regardless of whether the network is intended to serve both markets. Issuers submitting via SERFF must use the same Network ID Template across all binders or ensure that no network IDs repeat across the binders.
  • The Network ID Template syncs to the Plans & Benefits Template. Each plan identified in the Plans & Benefits Template must list the network ID that is associated with it.
  • Although a medical QHP or SADP must always be associated with a single Service Area ID and with a single Network ID, networks and service areas may be used for multiple QHPs or SADPs. Issuers should create one template containing all service areas and identify each service area with a unique Service Area ID. Issuers should also complete the Network ID Template and create a unique Network ID for each network. When the Plans & Benefits Template is completed, it will map each plan to a specific service area ID and network ID as entered in the Service Area and Network ID Templates. 
  • Network IDs and service area IDs may both be used for multiple plans and do not have to correspond one to one (for example, an issuer may have a single statewide network, identified with a network ID, assigned to all its plans, but have two service area IDs, each made up of half the state and each assigned to a different plan).
  • If specific providers are available for some of your products but not others, separate network IDs should be established to enable mapping the plans to the applicable network IDs.

Application Resources