Health Insurance Plan ID Crosswalk PUF

$179 / year

This dataset shows the plan-level data mapping plans offered in the previous plan year (2017) to plans offered in the current plan year (2018) by the Centers for Medicare & Medicaid Services (CMS).

Complexity

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).

Date Created

2014-11-26

Last Modified

2019-05-01

Version

2019-05-01

Update Frequency

Annual

Temporal Coverage

2019

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

NameDescriptionTypeConstraints
State_AbbreviationTwo-character state abbreviation indicating the state where the plan is offeredstring-
Is_Dental_PlanCategorical indicator that plan is a stand-alone dental plan (SADP)boolean-
Plan_IDFourteen-character alpha-numeric code that identifies the insurance plan in the Health Insurance Oversight System (HIOS)string-
Issuer_IDFive-digit numeric code that identifies the issuer organization in HIOS for the 2014 planintegerlevel : Nominal
Is_Multi_State_PlanCategorical indicator of whether the plan is a multi-state planboolean-
Metal_LevelMetal level, or coverage category, of the plan based on its actuarial valuestring-
Is_Child_Adult_OnlyThe types of child enrollment options for the plan (1=true and 2=false)boolean-
FIPS_CodeFederal Information Processing Standards (FIPS) code assigned to the county within a state that is included in the plan’s service areaintegerlevel : Nominal
Crosswalk_LevelCategorical 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)integerlevel : Nominal
Reason_For_CrosswalkCategorical 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;integerlevel : Nominal
Age_Off_Plan_IDFourteen-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_AgeFive-digit numeric code that identifies the issuer organization in HIOS for the planintegerlevel : Nominal
Is_Multi_State_Plan_AgeCategorical indicator of whether the age off plan is a multi-state planboolean-
Metal_Level_AgeMetal level of the age off plan based on its actuarial valuestring-
Is_Child_Adult_Only_AgeThe types of child enrollment options for the age off planboolean-
State AbbreviationIs Dental PlanPlan IDIssuer IDIs Multi State PlanMetal LevelIs Child Adult OnlyFIPS CodeCrosswalk LevelReason For CrosswalkAge Off Plan IDIssuer ID AgeIs Multi State Plan AgeMetal Level AgeIs Child Adult Only Age
AKFalse38344AK054000338344FalseGold20130000000XX0000000TrueTrue
AKFalse38344AK054000338344FalseGold20160000000XX0000000TrueTrue
AKFalse38344AK054000338344FalseGold20200000000XX0000000TrueTrue
AKFalse38344AK054000338344FalseGold20500000000XX0000000TrueTrue
AKFalse38344AK054000338344FalseGold20600000000XX0000000TrueTrue
AKFalse38344AK054000338344FalseGold20680000000XX0000000TrueTrue
AKFalse38344AK054000338344FalseGold20700000000XX0000000TrueTrue
AKFalse38344AK054000338344FalseGold20900000000XX0000000TrueTrue
AKFalse38344AK054000338344FalseGold21000000000XX0000000TrueTrue
AKFalse38344AK054000338344FalseGold21050000000XX0000000TrueTrue