Plan Preview FAQs

General Questions

Q1: Who can use Plan Preview?

  • All issuers seeking certification to offer QHPs on HealthCare.gov, including stand-alone dental plans (SADPs), can use Plan Preview. Issuer users will be able to access Plan Preview if they have a HIOS role of Submitter and/or Validator in any of the QHP modules (Issuer, Rating, and Benefits and Service Area.)

    In states where consumers apply and enroll using HealthCare.gov, state users with a HIOS State Reviewer role can also use Plan Preview.

    Issuers and states are encouraged to login into the CMS Enterprise Portal to ensure their HIOS login information and user role is accurate prior to the start of the QHP Application submission window.

Q2: When can issuers start testing in Plan Preview?

  • Issuers submitting in HIOS can view their plan data in Plan Preview once their Issuer and Benefits & Service Area Modules are validated, and their Business Rules Template is submitted. Issuers submitting in the System for Electronic Rates & Forms Filing (SERFF) can view their plan data in Plan Preview once all required templates—except the Rates Table Template—have been transferred to HIOS.

    Since the modules and templates described above are required by the initial submission deadline of each QHP certification cycle, issuers will be able to test in Plan Preview no later than the initial submission deadline. 

Q3: When should I use Plan Preview?

  • Plan Preview lets issuers preview plan data similar to how it appears to consumers in Plan Compare on HealthCare.gov. Users can input different scenarios to verify that rates, business rules, and cost sharing display correctly to consumers before plan data is reviewed by CMS.

    Issuers are encouraged to test rating scenarios in Plan Preview as soon as their QHP Application data is available in HIOS (see question “When can issuers start testing in Plan Preview?”) to make sure plan data will display to consumers as intended. Issuers are also encouraged to test rating scenarios in Plan Preview after each submission window (Early Bird, Initial, Secondary, and Final) and to test as many scenarios as possible to ensure data accuracy.

    Using Plan Preview can help reduce display errors and the need for data corrections. For example, issuers can input different scenarios to verify the correct handling of rates, business rules, or cost sharing.

Q4: How can I get help with additional Plan Preview questions?

  • You can submit a help desk ticket by sending an email to CMS_FEPS@cms.hhs.gov. In your email, please include the following information:
    • Use email subject line: “QHP Plan Preview Question”
      • Make sure your email includes the following:
      • HIOS issuer ID
      • Issuer name
      • Issuer state
      • Impacted Plan IDs
      • A screenshot of the issue or error message
      • Date of the error
      • The data element in question (please refer to the Plan Preview User Guide)
      • A detailed description of the problem, including zip code, county, smoking status, and birthdates used in the scenario; what appeared in Plan Preview; and what the user expected to see
      • Preferred contact information for follow-up

Display Questions

Q1: Is there a difference between what will display in Plan Preview and what will display for consumers on HealthCare.gov?

  • The only difference between what displays on Plan Preview and what displays on HealthCare.gov is that some fields are static in Plan Preview but will not be static on HealthCare.gov. There fields are: Estimated Total Yearly Costs; Add Your Medical Providers; Add Your Prescription Drugs; Medical Providers In-Network; and Drugs Covered/Not Covered.

Q2: Why don’t my plans show up?

  • There are 3 common issues that may cause plans not to show up when testing in Plan Preview.
    1. Service Area: Your plans may not show up if there are errors with your Service Area Template. Begin by looking at the Plans and Benefits Template to see what service area the plan is located in. Next, open the Service Area Template and determine if the service area ID is state-wide or county specific. All zip codes within a particular county that is within the service area for this plan should display.  
    2. Rating Area: The rating area associated with the county must be listed on the Rates Table Template for the particular county or the rates for the plan in that county zip code will not display. There are helpful files on CMS’ website that you can use to find a particular rating area for a specific county. 
    3. Correct Birthdate: An individual’s age at the time of the effective date can often cause confusion for an individual or issuer.  When testing plans, make sure to input the correct birthdate. For example, Child-Only plans will not display for enrollees born before 2003. Catastrophic plans won’t display for enrollees born before 1993. 

Q3: After we submit our updated template data, how long does it take before Plan Preview is updated to reflect the change?

  • Changes submitted into HIOS will usually appear in Plan Preview within 24 hours after their Issuer and Benefits & Service Area Modules are validated, and their Business Rules Template is submitted.

    Changes submitted into SERFF will usually appear in Plan Preview within 24 hours after all Templates—except for the Rates Table Template—are successfully transferred by the state to HIOS. SERFF issuers who do not see their data changes reflected in Plan Preview after 48 hours are encouraged to contact their state.

Q4: Why do only some of the benefits we submitted on our Plans and Benefits Template displaying on Plan Preview?

  • Only a subset of EHBs and non-EHBs display in Plan Preview because the module is intended to reflect what displays on HealthCare.gov in Plan Compare. In Plan Compare, only a subset of benefits displays to streamline the consumer shopping experience. Plan Preview and Plan Compare display the same set of EHBs and non-EHBs for all issuers. 

Q5: Why are tobacco rates not showing up?

  • When "Not Applicable” is selected for “How is tobacco status determined for subscribers and dependents?” in the Business Rules Template, the plan is treated as having identical rates for tobacco and non-tobacco. To enable tobacco rates to appear in Plan Preview, change the selection for the tobacco months field in the Business Rules Template to “No tobacco use for at least X months.”

Q6: What is the minimum age of an enrollee for a tobacco rate to display in Plan Preview?

  • Plan Preview displays the tobacco rate whenever one exists, regardless of the age of the enrollee. In Plan Compare on HealthCare.gov, only enrollees ages 18+ can select that they use tobacco, so only enrollees ages 18+ will have tobacco premiums. 

Q7: Why doesn’t my plan display adult and/or child dental benefits?

  • Most dental benefit display questions stem from confusion about what a plan must cover to have a green checkmark next to “Adult dental” or “Child dental.” Your plan must cover three dental benefits for “Adult dental” to display with a green checkmark. Confirm that your plan covers the follow benefits for adults:

    • Routine Dental Care 
    • Basic Dental Care
    • Major Dental Care

Your plan must also cover three dental benefits for “Child dental” to display with a green checkmark. Confirm that your plan covers the following benefits for children: 

    • Dental Check-Up
    • Major Dental Care
    • Basic Dental Care

If a plan only offers one or two of the child dental and/or adult dental benefits listed above, “Child dental” with a yellow checkmark and/or “Adult dental” with a yellow check mark will display. 

Q8: How do I test my pediatric only dental plans?

  • Enter the child’s birthdate, gender, zip code, and county in the “Primary Subscriber” section and click “Update Plan Results.”

Q9: Where is the customer service phone number in Plan Preview pulled from?

  • Administrative information displayed on the www.HealthCare.gov website and Plan Preview is pulled from the Issuer General Information Fields and the Marketplace General Information Fields in HIOS. This applies to all QHP and SADP plan issuers, including those who file through SERFF. 

Q10: Why am I returned to the Plan Preview page to re-enter demographic information when an available plan is highlighted, and the “View Plan” button is clicked? This happens when I am entering a primary subscriber with dependents. 

  • Using Chrome or Firefox when in the Plan Preview Module should prevent this error. Also, try clearing the browsing history and/or closing the browser and then reopening it.