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

Issue Date: November 10, 2015

Program Area: Vendor Management, Payments, and Collections (VMPC)

Question: Will the production version of the HIX 820 transaction include Small Business Health Options Plan (SHOP) Enrollment data and include SHOP HIX 820 and Federally-facilitated Exchange (FFE) HIX 820 information in the same transaction?

Answer: SHOP Issuers participating in the SHOP Market will continue to receive separate HIX 820 transactions for premium aggregation. Issuers that belong to both the FFE and FF-SHOP Market will receive HIX 820 transactions from the Individual Market with program-level data regarding SHOP User Fees (UF) and policy-level details related to the Individual Market.

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