Others titles
- Health Insurance Exchange Public Use Files
- Qualified Health Plan Crosswalk PUF
Keywords
- Health Insurance
- Insurance Marketplace
- Business Rules
- Insurance Rate Review
- Insurance Rate Increase
- Insurance Market Competition
- Health Benefits
- Crosswalk PUF
- Exchange PUFs
Health Insurance Plan ID Crosswalk PUF
This dataset shows the plan-level data mapping plans offered in the previous plan year (2023) to plans offered in the current plan year (2024) by the Centers for Medicare & Medicaid Services (CMS).
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Description
The Centers for Medicare & Medicaid Services (CMS) Center for Consumer Information & Insurance Oversight (CCIIO) publishes the Exchange PUFs (Public Use Files) in order to improve transparency and increase access to data on Qualified Health Plans (QHPs) and Stand-alone Dental Plans (SADPs) offered through the Exchange in the individual market and Small Business Health Options Program (SHOP). The PUFs include data from states with Federally-facilitated Exchanges (FFEs), which include states with State Partnership Exchanges (SPEs), and State-based Exchanges that rely on the federal information technology platform for QHP eligibility and enrollment functionality (SBE-FPs). The Exchange PUFs also include data on MultiState Plans (MSPs) and certified off-exchange SADPs. The PUFs do not include data from SBEs that do not rely on the federal platform for QHP eligibility and enrollment functionality.
The Plan ID Crosswalk PUF (CW-PUF) is one of the files that make up the Exchange PUFs. The purpose of the CW-PUF is to map QHPs and SADPs offered through the Exchanges during the previous plan year to plans that will be offered through the Exchanges in the current plan year. These data either originate from the Plan Crosswalk template (i.e., template field), an Excel-based form used by issuers to describe their plans in the QHP application process, or were generated by CCIIO for use in data processing (i.e., system-generated).
About this Dataset
Data Info
Date Created | 2014-11-26 |
---|---|
Last Modified | 2023-11-03 |
Version | 2023-11-03 |
Update Frequency |
Annual |
Temporal Coverage |
2024 |
Spatial Coverage |
United States |
Source | John Snow Labs; Centers for Medicare and Medicaid Services; |
Source License URL | |
Source License Requirements |
N/A |
Source Citation |
N/A |
Keywords | Health Insurance, Insurance Marketplace, Business Rules, Insurance Rate Review, Insurance Rate Increase, Insurance Market Competition, Health Benefits, Crosswalk PUF, Exchange PUFs |
Other Titles | Health Insurance Exchange Public Use Files, Qualified Health Plan Crosswalk PUF |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
State_Abbreviation | Two-character state abbreviation indicating the state where the plan is offered | string | - |
Is_Dental_Plan | Categorical indicator that plan is a stand-alone dental plan (SADP) | boolean | - |
Plan_ID | Fourteen-character alpha-numeric code that identifies the insurance plan in the Health Insurance Oversight System (HIOS) | string | - |
Issuer_ID | Five-digit numeric code that identifies the issuer organization in HIOS for the 2014 plan | integer | level : Nominal |
Is_Multi_State_Plan | Categorical indicator of whether the plan is a multi-state plan | boolean | - |
Metal_Level | Metal level, or coverage category, of the plan based on its actuarial value | string | - |
Is_Child_Adult_Only | The types of child enrollment options for the plan (1=true and 2=false) | boolean | - |
FIPS_Code | Federal Information Processing Standards (FIPS) code assigned to the county within a state that is included in the plan’s service area | integer | level : Nominal |
Crosswalk_Level | Categorical indicator of the crosswalk level (A value of 0 equals Crosswalking to the same Plan ID; a value of 1 equals Crosswalking at the Plan ID level; a value of 2 equals Crosswalking at the Plan ID and county coverage level; a value of 3 equals Crosswalking at the zip-code level for one or more counties; 4 equals Discontinue 2017 plan with no crosswalk) | integer | level : Nominal |
Reason_For_Crosswalk | Categorical indicator of the reason for the crosswalk (a value of 0 equals Renewing the same product/plan combination using the same Plan ID; a value of 1 equals Renewing the same product/plan combination using a different Plan ID; a value of 2 equals Renewing product or renewal in a different plan within the product; a value of 3 equals Continuing product with no plan available in the particular service area under that product and enrollment in a different product; | integer | level : Nominal |
Age_Off_Plan_ID | Fourteen-character alpha-numeric code that identifies the plan available to enrollees who will age-off (i.e., no longer meet the criteria for continued eligibility). | string | - |
Issuer_ID_Age | Five-digit numeric code that identifies the issuer organization in HIOS for the plan | integer | level : Nominal |
Is_Multi_State_Plan_Age | Categorical indicator of whether the age off plan is a multi-state plan | boolean | - |
Metal_Level_Age | Metal level of the age off plan based on its actuarial value | string | - |
Is_Child_Adult_Only_Age | The types of child enrollment options for the age off plan | boolean | - |
Data Preview
State Abbreviation | Is Dental Plan | Plan ID | Issuer ID | Is Multi State Plan | Metal Level | Is Child Adult Only | FIPS Code | Crosswalk Level | Reason For Crosswalk | Age Off Plan ID | Issuer ID Age | Is Multi State Plan Age | Metal Level Age | Is Child Adult Only Age |
NC | False | 11512NC0410003 | 11512 | False | Silver | False | 37007 | 2 | 2 | 11512NC0410024 | 11512 | False | Silver | False |
NC | False | 11512NC0410003 | 11512 | False | Silver | False | 37025 | 2 | 2 | 11512NC0410024 | 11512 | False | Silver | False |
NC | False | 11512NC0410003 | 11512 | False | Silver | False | 37045 | 2 | 2 | 11512NC0410005 | 11512 | False | Silver | False |
NC | False | 11512NC0410003 | 11512 | False | Silver | False | 37071 | 2 | 2 | 11512NC0410005 | 11512 | False | Silver | False |
NC | False | 11512NC0410003 | 11512 | False | Silver | False | 37109 | 2 | 2 | 11512NC0410005 | 11512 | False | Silver | False |
NC | False | 11512NC0410003 | 11512 | False | Silver | False | 37119 | 2 | 2 | 11512NC0410024 | 11512 | False | Silver | False |
NC | False | 11512NC0410003 | 11512 | False | Silver | False | 37159 | 2 | 2 | 11512NC0410024 | 11512 | False | Silver | False |
NC | False | 11512NC0410003 | 11512 | False | Silver | False | 37167 | 2 | 2 | 11512NC0410024 | 11512 | False | Silver | False |
NC | False | 11512NC0410003 | 11512 | False | Silver | False | 37179 | 2 | 2 | 11512NC0410024 | 11512 | False | Silver | False |
NC | False | 11512NC0410004 | 11512 | False | Silver | False | 37007 | 2 | 2 | 11512NC0410024 | 11512 | False | Silver | False |