Small Business Health Options Program (SHOP) FAQ
Guidance for FAQ regarding Issuer Participation Requirements and Other
Program Area: Small Business Health Options Program (SHOP)
Question: Are plans offered on exchange and off exchange supposed to have the same HIOS Plan ID? For example, would the on exchange plan ID be 12345OH010002 and the off exchange plan would be 12345OH010002 as well?
Answer: Yes, plans with the same benefits and cost shares offered on exchange and off exchange are supposed to have the same HIOS ID. On the Plan & Benefits Template, when the issuer chooses 'Both' for 'Exchange Plan?' then the template will allow the issuer to input a SCID and it will pre-populate two variants (12345OH010002-00 and 12345OH010002-01), one for off exchange and the other for exchange. They are both the 'same plan' and have the same ID. The variant code is what distinguishes whether a plan is sold on or off the exchange.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: May 08, 2014
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