Others titles

  • Health Insurance Exchange Public Use Files
  • Qualified Health Plan Service Area PUF

Keywords

  • Health Insurance
  • Insurance Marketplace
  • Service Area PUF
  • Insurance Market Competition
  • Health Benefits
  • Service Area
  • Service Area PUF
  • Exchange PUFs

Health Insurance Service Area PUF

This dataset shows the Issuer-level data on geographic service areas including state, county, and zip code 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 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 Option Program (SHOP).

The PUFs (Public Use Files) 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 Service Area PUF (SA-PUF) is one of the files that make up the Exchange PUFs. The SA-PUF contains issuer-level data on geographic service areas including state, county, and zip code. These data either originate from the Service Area template (i.e., template field), an Excel based form used by issuers to describe their plans in the QHP/SADP application process, or were generated by CCIIO for use in data processing (i.e., system-generated). 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

2014-11-26

Last Modified

2020-10-21

Version

2020-10-21

Update Frequency

Annual

Temporal Coverage

2021

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, Service Area PUF, Insurance Market Competition, Health Benefits, Service Area, Service Area PUF, Exchange PUFs

Other Titles

Health Insurance Exchange Public Use Files, Qualified Health Plan Service Area PUF

Data Fields

Name Description Type Constraints
State_AbbreviationTwo-character state abbreviation indicating the state where the plan is offeredstring-
Issuer_IdFive-digit numeric code that identifies the issuer organization in the Health Insurance Oversight System (HIOS)integerlevel : Nominal
Source_NameCategorical identifier of source of data importstring-
Import_DateDate when data was importeddatetime-
Service_Area_IdIdentifier for a service areastring-
Service_Area_NameName of a service areastring-
Is_Cover_Entire_StateCategorical indicator of whether entire state is covered by the service areaboolean-
CountyFederal Information Processing Standards (FIPS) code assigned to the county within a state that is covered by the service areaintegerlevel : Nominal
Is_Partial_CountyCategorical indicator of whether entire county is covered by the service areaboolean-
ZIP_CodeZip codes within the partial-county region covered by the service areastring-
Partial_County_JustificationThe justification given for creating a partial-county region for inclusion in a Service Area.string-
Market_CoverageCategorical indicator of market coverage of plansstring-
Is_Dental_Only_PlanCategorical indicator of dental-only status of plansboolean-

Data Preview

State AbbreviationIssuer IdSource NameImport DateService Area IdService Area NameIs Cover Entire StateCountyIs Partial CountyZIP CodePartial County JustificationMarket CoverageIs Dental Only Plan
WI69589HIOS2020-07-21T03:20:30WIS001GLIC PPO Indiv On and Off ExchangeFalse55033FalseIndividualTrue
WI69589HIOS2020-07-21T03:20:30WIS001GLIC PPO Indiv On and Off ExchangeFalse55037FalseIndividualTrue
WI69589HIOS2020-07-21T03:20:30WIS001GLIC PPO Indiv On and Off ExchangeFalse55039FalseIndividualTrue
WI69589HIOS2020-07-21T03:20:30WIS001GLIC PPO Indiv On and Off ExchangeFalse55041FalseIndividualTrue
WI69589HIOS2020-07-21T03:20:30WIS001GLIC PPO Indiv On and Off ExchangeFalse55043FalseIndividualTrue
WI69589HIOS2020-07-21T03:20:30WIS001GLIC PPO Indiv On and Off ExchangeFalse55045FalseIndividualTrue
WI69589HIOS2020-07-21T03:20:30WIS001GLIC PPO Indiv On and Off ExchangeFalse55047FalseIndividualTrue
WI69589HIOS2020-07-21T03:20:30WIS001GLIC PPO Indiv On and Off ExchangeFalse55049FalseIndividualTrue
WI69589HIOS2020-07-21T03:20:30WIS001GLIC PPO Indiv On and Off ExchangeFalse55055FalseIndividualTrue
WI69589HIOS2020-07-21T03:20:30WIS001GLIC PPO Indiv On and Off ExchangeFalse55057FalseIndividualTrue