Service Area

Issuers must identify the proposed service areas that will be associated with their QHPs, by state and by county. In most cases, HHS will only approve service areas covering full counties. In instances when the issuer proposes a service area that will cover only part of a county, the service area must also indicate associated zip codes. All issuers are required to submit service area information as part of their QHP Application.

Key Changes for PY2023: 
  • You can make changes to your plan’s service area after the initial submission deadline without first submitting a data change request (DCR) for Centers for Medicare & Medicaid Services (CMS) authorization. After the final submission deadline in the PY2023 QHP Data Submission and Certification Timeline bulletin, a DCR is required for any change to QHP data, including service area. 
Tips for the Service Area Section
  • If you are a dual-product issuer, you must create two different service area IDs, one each for QHPs and SADPs, regardless of whether the service area is intended to serve both plan types. 
  • If you are a dual-product issuer, you must use the word “dental” in the service area name for your dental service area to distinguish the dental service area from the QHP service area.
  • If you offer plans in the Individual and SHOP Markets, you must create separate service area IDs for each market, regardless of whether the service area is intended to serve both markets. 
Application Resources

Service Area Data Change Request

For information about submitting a service area data change request, including the requisite documentation, please refer to the Data Change Windows page.