URL Submission

CMS requires issuers to submit URL data for the plans they intend to offer on the Exchange. URL submissions, including updates, are collected in the Supplemental Submission Module (SSM) in the Health Insurance Oversight System (HIOS). The following URLs should be submitted to the SSM:

  • Summary of Benefits and Coverage (SBC)
  • Plan Brochure
  • Payment
  • Formulary
  • Network
  • Transparency in Coverage
  • Machine-Readable & Technical POC

These URLs should lead to live, active webpages that contain accurate issuer marketing information for consumers by the deadlines communicated in the table below. CMS reviews the information provided at each URL to ensure there are no inaccuracies in issuer marketing material when compared to data within an issuer’s submitted QHP Application. CMS also checks that issuers meet provider directory accessibility standards when a network URL is selected. Throughout Open Enrollment and the coverage year, CMS will refresh URL data on HealthCare.gov on an iterative basis; the relevant issuers and states will be notified once URL data is refreshed and available to consumers.

URL Submission Systems and Deadlines

The table below outlines where each URL should be submitted, when the URL should be submitted, and when the data at those URLs should be live and active for plan year (PY) 2023.

URL Submission Systems and Deadlines

URL Type

Submission Location

Submission Deadline

Live and Active Deadline

Transparency in Coverage

SSM

June 15, 2022*

Upon URL Submission

SBC, Plan Brochure, Payment, Formulary, Network

SSM

August 17, 2022

September 21, 2022

Machine-Readable Index.JSON

SSM

June 15, 2022

September 21, 2022

*If you choose to submit a QHP Application for the Early Bird review round, Transparency in Coverage URLs are required by the Early Bird submission deadline, 5/18/22.

Key Changes for PY2023:

  • Machine-Readable URLs and Technical POC Email are submitted in the SSM. 
  • SBC URLs are required to lead directly to the SBC Form.
  • CMS is building new functionality for early submission of Summary of Benefits and Coverage (SBC) and formulary data in the SSM. Starting in July, but by no later than the final submission deadline, issuers can submit SBC and Formulary forms in a PDF format or as a zip file with multiple PDFs in the HIOS SSM.
  • CMS will conduct rolling reviews for Machine-Readable Index URLs, Transparency in Coverage URLs, and Marketing URL (Plan Brochure, Formulary, SBC, Network) Functionality. 

Tips for the URL Collection Section 

  • Verify that at least one Plans & Benefits Template was successfully submitted to the Benefits and Service Area Module in HIOS or transferred via the System for Electronic Rates & Forms Filing (SERFF) to ensure that the HIOS Issuer ID, issuer legal name, and state are present on the Summary page within the SSM.
  • Verify that URLs are functional before you submit them. 
  • Once the SSM is open, you can submit Transparency in Coverage URLs with or without the template. Transparency in Coverage URLs should be live when you submit them.
  • Machine-Readable URLs and Technical POC Email should be submitted by the initial submission deadline and live by the deadline for returning signed QHP Certification Agreements.
  • All other URLs submitted via the SSM (SBC, Plan Brochure, Payment, Network, Formulary, Machine-Readable) should be submitted by the deadline for changing your QHP Application. All URLs must be active and directly route consumers to the appropriate document by the deadline for returning signed QHP Certification Agreements.
  • Please note that the URL requirements described here apply only to on-Exchange plans; URLS for off-Exchange plans should still be submitted to the Rate & Benefits Information System (RBIS). 
Supplemental Submission Module (SSM)

Once an issuer has submitted plan data for certification, it will be able to submit or make changes to URLs associated with its plan data in the SSM. Note that issuers must submit at least one valid Plans & Benefits Template—either submitted in the Benefits & Service Area Module in HIOS for FFE issuers or transferred via the System for Electronic Rates & Forms Filing (SERFF) for issuers in states performing plan management functions and SBE-FPs—to be able to access the SSM in HIOS.

Changes can be made through the SSM in two different ways:

  1. Submitting through a simple URL template, which can be downloaded from the module
  2. Submitting through a Search & Update capability available within the SSM User Interface (UI)

Issuers are not required to submit a data change request (DCR) or state authorization form in order to make their URL changes in the SSM. However, issuers must still comply with all state regulations before making any URL changes in the SSM. By submitting a URL change, issuers are attesting that the change(s) have been approved by the applicable state. 

Formulary Directory Submission

CMS requires issuers to submit plan marketing URLs, including Formulary URLs, for the plans they intend to offer on the Exchange. Beginning in PY2023, issuers can also submit their Formulary Directories in the HIOS SSM (in addition to their Formulary URLs) for all URL IDs; issuers can submit their Formulary Directories in PDF format as early as July 12, but by no later than the final submission deadline.

CMS reviews formularies to ensure that they contain accurate issuer marketing information for consumers and that there are no inaccuracies when compared to data within an issuer’s submitted QHP Application. CMS will perform reviews on the Formulary Directories and release review results in the PM Community. Please refer to the QHP URL Reviews Checklist for additional information on the Formulary Review.

SBC Form Submission

Beginning in PY2023, QHP issuers can submit their SBC Forms (in addition to SBC URLs) in the HIOS SSM for all plans they intend to offer on the Exchange; issuers can submit their SBC Forms as early as July 12, but by no later than the final submission deadline.

CMS reviews SBCs to ensure that they contain accurate issuer marketing information for consumers and that there are no inaccuracies when compared to data within an issuer’s submitted QHP Application. CMS will perform reviews on the SBC Forms and release review results in the PM Community. Please refer to the QHP URL Reviews Checklist for additional guidance on the SBC Review. 

SBC Instructions and Template 

Authorized for use for plan or policy years that begin on or after January 1, 2021.

Issuers offering health insurance coverage on the Exchange must provide applicants, enrollees, and policyholders with an accurate Summary of Benefits and Coverage (SBC). Issuers are required to provide the SBC in a manner compliant with the standards set forth in 45 CFR 147.200, which implements section 2715 of the Public Health Service Act, as added by the Patient Protection and Affordable Care Act (PPACA). Specifically, issuers must fully comply with the requirements of § 147.200(a)(3), which requires issuers to “provide an SBC in the form, and in accordance with the instructions for completing the SBC, that are specified by the Secretary in guidance.” Instructions for completing the SBC are below.
Please refer to the Summary of Benefits and Coverage and Uniform Glossary section of the CCIIO website for additional information, including the approved SBC Template for issuers to use when completing their SBCs. Additional regulatory guidance related to SBCs can be found in the 2023 Letter to Issuers.

Tips for URL Submission within the SSM

  • Issuers should ensure they have either Validator or Submitter access to the Benefits & Service Area Module in HIOS in order to enter the SSM to make URL changes, regardless of whether they submit in HIOS or SERFF.
  • To submit a few URL changes, CMS recommends using the Search & Update capability in the user interface to upload changes. 
  • To change multiple URLs at once, issuers can download a pre-populated template within the SSM, which will contain existing URL data. Issuers should enter the desired URL into the “New URL” column next to the current URL that requires changes.
    • Note that only URLs entered in the “New URL” column will be stored in the system upon submission.
    • This method is recommended when submitting URL data for the first time each plan year. For your reference, a copy of the issuer URL template can be found below. CMS strongly recommends using this only as a reference; for URL submissions and updates, please download a pre-populated version of the template within the SSM.
  • All URLs entered in the SSM must start with either “http://” or “https://” and cannot contain commas or spaces.
  • Machine-Readable URLs submitted in the SSM must start with “https://” and end with “.json”.
  • States can review issuer URL changes made in the SSM via the HIOS State Evaluation Module or Plan Preview.
  • For more detailed instructions including screen shots, please see the Issuer Application Instructions, User Guide, and Quick Start Guide below.

Application Resources