Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: November 14, 2014

Program Area: Distributed Data Collection (DDC) for RA Including HCRP/EDGE Server

Question: If a member moves from one (1) issuer to another issuer due to a plan change or relocation across States, does the Unique Enrollee ID remain the same or should the new issuer generate a new Unique Enrollee ID and can an enrollee hold two (2) Unique Enrollee IDs across two issuers?

Answer: Risk Adjustment (RA) and Reinsurance (RI) diagnoses and payments are only aggregated at the five-digit Health Insurance Oversight System (HIOS) issuer ID level. Issuers must use the same Unique Enrollee ID if the enrollee switches plans within the same issuer and within the same state. Each issuer would assign its own Unique Enrollee ID. The IDs do not need to be maintained if an enrollee moves to a plan with a different HIOS issuer ID within the same organization.

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