Plan Crosswalk
The FFE Plan ID Crosswalk maps PY2024 plan ID and service area combinations to PY2025 plan IDs. These data will facilitate enrollment transactions from CMS to the issuer for enrollees in the Individual Market who have not actively selected a different QHP during Open Enrollment. Starting in PY2025, all issuers will submit Plan ID Crosswalk data via the HIOS MPMS Module. Key Changes for PY2025:
- Issuers must submit their Plan ID Crosswalk Templates, necessary justifications, and state authorization in the Marketplace Plan Management System (MPMS) instead of the Plan Management (PM) Community.
- In MPMS, returning issuers can generate prepopulated Plan ID Crosswalk Templates to submit as part of their QHP Application. The prepopulated templates import an issuer’s plan IDs and associated service areas and network IDs from the prior plan year.
Tips for the Plan ID Crosswalk Section
- Submit the Plan ID Crosswalk Template, justifications, and state authorization in MPMS. Submit separate Plan ID Crosswalk templates in MPMS for SADPs.
- New issuers are not required to submit Plan ID Crosswalk Templates to complete their application unless they will receive plans from a discontinuing issuer, which is a rare situation.
- Issuers are required to provide age off plans for catastrophic and child only plans.
- CMS has deferred the Federally-facilitated Small Business Health Options Program’s (FF-SHOP’s) ability to auto-renew employees for PY2025. Do not submit a Plan ID Crosswalk Template for FF-SHOP plans.
- The 2024 HHS Notice of Benefit and Payment Parameters requires Exchanges to ensure that a consumer whose current year QHP is no longer available be auto re-enrolled into a QHP that has the most similar network compared to the enrollee's current QHP, and that meets the other requirements that also apply to plan crosswalk at 45 CFR 155.335(j). Therefore, issuers should take into account network ID when selecting crosswalk plans, if possible, along with product ID and plan type as has been required in prior years.1
1 For a complete list of plan crosswalk rules, see 45 CFR 155.335(j).
Application Resources
- Instructions
- Template
- Issuers are highly encouraged to use a prepopulated template, which can be generated in the Application Materials tab in the MPMS Module. Any issuers unable to generate this prepopulated template should use the template below.
- PY2025 Plan ID Crosswalk Template
- Justifications/Supporting Documents
- Plan ID Crosswalk State Authorization Form (Updated 4/26/24)
- Frequently Asked Questions
- Instructional Video