Template Policy FAQs

Template Use

Q1
: What is the required or recommended sequence for completing/entering data into the QHP Application templates? Does the sequence matter when the issuer enters the data into each of the QHP templates?
  • There is no overall required sequence for the order of submission of templates. However, CMS recommends issuers consider the following when submitting templates:
    • Issuers should consider completing the Network ID Template, Service Area Template, and Prescription Drug Template before completing the Plans & Benefits and Essential Community Provider (ECP)/Network Adequacy Templates.
      • This is because the network ID, service area ID, and formulary ID in those templates are used in the Plans & Benefits Template. 
      • The issuer should take note of the sequence of network, service area, and formulary IDs for use in linking across templates.  
    • Issuers must submit a Plans & Benefits Template in the Benefits & Service Area Module (for HIOS issuers) or transfer via SERFF (for SERFF issuers) before submitting URLs in the Supplementary Submission Module. URL submission will not be available until the Plans & Benefits Template has been submitted.
For more information about completing templates, please see the QHP Application Instructions.

Q2: Are there character limits on the free text fields in the QHP Application Templates?
  • Yes, there are character limits on at least one string (‘free-text’) field in each of the following templates:
    • Plans and Benefits
    • Service Area
    • Network ID
    • ECP/NA (for write-in providers)
    • Prescription Drug
    • Transparency in Coverage
The maximum length varies by template and field. For specific information about the character limits for each open data field and each template, please review the Data Traceability Matrix, located on the Application Instructions webpage

Template Submission

Q1: What does CMS mean by submitting a template for each "HIOS ID"?
  • QHP and SADP issuers are required to complete and submit separate templates for each HIOS ID for each plan year's data submissions. The reference to each "HIOS ID" means the issuer's Health Insurance Oversight System (HIOS) ID number (issuer ID) and it is unique for each state in which an issuer offers coverage.