The Centers for Medicare & Medicaid Services (CMS) Center for Consumer Information and Insurance Oversight (CCIIO) is releasing the State-Based Marketplace (SBM) Public Use Files (PUF) to improve the transparency and increase access to the SBM data. The SBM PUF includes data on Qualified Health Plans (QHPs) and Stand-alone Dental Plans (SADPs) offered in states that operate their own Marketplaces that do not rely on the federal information technology platform for QHP eligibility and enrollment functionality. This includes states that operate their own Small Business Health Options Programs (SHOPs).
The Business Rules PUF (BR-PUF) is one of the six files that make up the SBM PUF. The BR-PUF contains plan-level data on how rates are applied depending on allowed relationships (e.g., spouse, dependents) and tobacco use.
These data originate from the Business Rules template (i.e., template field), an Excel based form used by issuers to describe their plans in the QHP/SADP application process, and were provided by the National Association of Insurance Commissioners (NAIC) by extracting the information from its System for Electronic Rate and Form Filing (SERFF).