Others titles
- Health Insurance Exchange Public Use Files
- Qualified Health Plan Network PUF
Keywords
- Health Insurance
- Insurance Marketplace
- Network PUF
- Insurance Rate Review
- Insurance Rate Increase
- Insurance Market Competition
- Health Benefits
- Benefits and Cost Sharing PUF
- Exchange PUFs
Health Insurance Provider Network PUF
This dataset shows the issuer-level data identifying provider network URLs by the Centers for Medicare & Medicaid Services (CMS).
Get The Data
- ResearchNon-Commercial, Share-Alike, Attribution Free Forever
- CommercialCommercial Use, Remix & Adapt, White Label Log in to download
Description
The Centers for Medicare & Medicaid Services (CMS) Center for Consumer Information and Insurance Oversight (CCIIO) is releasing the State-Based Marketplace (SBM) PUF (Public Use Files) in order 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 which operate their own Marketplaces that do not rely on the federal information technology platform for QHP eligibility and enrollment functionality. This includes states which operate their own Small Business Health Options Programs (SHOP).
The Network PUF (Ntwrk-PUF) is one of the six files that make up the state-based Marketplace Public Use Files (SBM PUF). The Ntwrk-PUF contains issuer level data identifying provider network URLs. These data originate from the Network ID 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 their System for Electronic Rate and Form Filing (SERFF).
About this Dataset
Data Info
Date Created | 2014-11-27 |
---|---|
Last Modified | 2024-02-06 |
Version | 2024-02-06 |
Update Frequency |
Annual |
Temporal Coverage |
2023 |
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, Network PUF, Insurance Rate Review, Insurance Rate Increase, Insurance Market Competition, Health Benefits, Benefits and Cost Sharing PUF, Exchange PUFs |
Other Titles | Health Insurance Exchange Public Use Files, Qualified Health Plan Network PUF |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
State_Abbreviation | Two-character state abbreviation indicating the state where the plan is offered | string | - |
Issuer_ID | Five-digit numeric code that identifies the issuer organization in the Health Insurance Oversight System (HIOS) | integer | level : Nominal |
Source_Name | Categorical identifier of source of data import | string | - |
Import_Date | Date when data was imported | date | - |
Network_Name | Name of a healthcare provider network | string | - |
Network_ID | Identifier for a healthcare provider network | string | - |
Network_URL | The URL of the network's provider directory | string | - |
Market_Coverage | Categorical indicator of market coverage of plans | string | - |
Is_Dental_Only_Plan | Categorical indicator of dental-only status of plans | boolean | - |
Data Preview
State Abbreviation | Issuer ID | Source Name | Import Date | Network Name | Network ID | Network URL | Market Coverage | Is Dental Only Plan |
AK | 21989 | HIOS | 2023-12-08 | Delta Dental Premier | AKN001 | SHOP (Small Group) | True | |
AK | 21989 | HIOS | 2023-12-08 | Delta Dental PPO | AKN002 | SHOP (Small Group) | True | |
AK | 21989 | HIOS | 2023-12-08 | Delta Dental Premier - Individual | AKN003 | https://www.modahealth.com/ProviderSearch?productCategory=dental&selectedNetwork=DeltaDentalPremier&state=AK | Individual | True |
AK | 21989 | HIOS | 2023-12-08 | Delta Dental PPO - Individual | AKN004 | https://www.modahealth.com/ProviderSearch?productCategory=dental&selectedNetwork=DeltaDentalPPO&state=AK | Individual | True |
AK | 38344 | HIOS | 2023-09-21 | Legacy and Dental Select | AKN001 | https://premera.sapphirecareselect.com/?ci=premeraak&network_id=46 | Individual | False |
AK | 73836 | HIOS | 2023-12-19 | Pioneer - Individual | AKN003 | https://www.modahealth.com/shop/provider-search/medical/ak/Pioneer | Individual | False |
AK | 74819 | HIOS | 2023-12-08 | BEST Life and Health National Network | AKN001 | https://www.bestlife.com/Provider_Search/ | Individual | True |
AL | 12538 | HIOS | 2023-12-09 | BEST Life and Health National Network | ALN001 | https://www.bestlife.com/Provider_Search/ | Individual | True |
AL | 17540 | HIOS | 2023-08-12 | DentalGuard Preferred - Individual | ALN001 | https://dentalexchange.guardiandirect.com/find-a-dentist | Individual | True |
AL | 18239 | HIOS | 2023-09-09 | AL DCP Marketplace Network | ALN001 | https://www.dentaquest.com/en/find-a-dentist | Individual | True |