How to Submit URL Data
Issuers seeking to offer qualified health plans (or QHPs),
including stand-alone dental plans (or SADPs)
on the Federally-facilitated Exchange
must submit a complete QHP Application per CMS guidelines.
As part of the QHP certification process,
issuers are asked to submit issuer- and plan-level URL information to CMS,
including Summary of Benefits and Coverage (or SBC), Payment,
Plan Brochure, Network, Formulary, Transparency in Coverage,
and Machine-Readable URLs.
There are two potential methods for submitting URL information as part of a QHP Application;
the first method is to complete and submit the URL Template,
and the second method is to submit URLs directly into the User Interface (or UI)
of the Health Insurance Oversight System Supplemental Submission Module (or HIOS SSM).
The majority of URLs are submitted via the SSM for on-Exchange plans
for all issuers in Federally-facilitated Exchange (or FFE) states,
states performing plan management functions,
and State-Based Exchanges on the Federal Platform (or SBE-FPs).
For more information on submitting URL information in the SSM,
including a sample URL Template, application instructions,
and quick start and user guides, visit the URLs webpage of the QHP certification website.
CMS recommends using the sample URL Template that is posted to the website as a reference only.
Issuers are encouraged to download the template directly from the SSM
when preparing to complete their templates,
as it will pre-populate most of the information needed for submission.
Before issuers can access the SSM to submit URL information,
CMS must have a record of an issuer having submitted at least one valid Plans & Benefits Template.
For issuers submitting data via the System for Electronic Rates & Forms Filing
(or SERFF), the state must transfer the issuer’s data to HIOS
before the issuer can access the SSM.
To begin submitting URL information,
navigate to the HIOS Benefits & Service Area Module to open the SSM.
Issuers will submit URL information on the URL Data tab of the SSM,
with the exception of the Interoperability URL,
which will be collected in the Interoperability Compliance Web Form
on the Interoperability Data tab.
For more information on Interoperability submission requirements, including instructions,
visit the Interoperability webpage of the QHP certification website.
CMS also requires issuers submit SBC Forms and Formulary Directories
in the SSM for all on-Exchange plans,
in addition to submitting SBC and Formulary URLs.
CMS will review issuers’ SBC Forms and Formulary Directories
to ensure they contain accurate issuer marketing information for consumers,
and that there are no inaccuracies when compared to data within an issuer’s QHP Application.
For more information, including deadlines for submitting these materials,
visit the URLs webpage of the QHP certification website.
There are three sections within the URL Data tab of the SSM:
Download Issuer URL Template File; Upload Issuer URL Template File;
and Search & Update URLs.
The Download Issuer URL Template File section allows issuers to download
a pre-populated version of the URL template,
which will include the proper formatting for all fields to make validation easier,
and contain all URL IDs associated with an issuer’s plans
depending on which templates have been submitted so far.
Within the SSM, issuers are able to submit Transparency in Coverage, Payment, SBC,
Plan Brochure, and Machine-Readable URLs
if the Plans & Benefits Template has been submitted or transferred to HIOS.
In order to submit Network and Formulary URLs,
the Network and Prescription Drug Templates must be submitted, respectively,
in addition to the Plans & Benefits Template.
Issuers are able to choose which URL types to download within a URL Template.
This includes the option to download all URLs, one URL type, or multiple URL types
through the seven toggle buttons in this section.
After clicking the “Generate Issuer URL Template” button,
issuers can download the generated template.
The generated URL Template contains the following fields:
The HIOS Issuer ID; A date/time generation stamp;
A note that URLs can only be edited in the “New URL” column;
The URL Type and URL ID for the URL Type(s) selected for download;
The Market Type (either Healthcare or Dental);
The Product Type (either Individual or SHOP);
The Current URL (if applicable); The New URL;
The Current Technical POC Email; and The New Technical POC Email.
The Market and Product Type fields are only applicable to issuers that submit
their plan information via SERFF; for issuers that submit via HIOS,
these fields will display “N/A.”
The Current and New Technical POC Email fields are only applicable for Machine-Readable URLs;
for all other URL types, these fields will display “N/A.”
Issuers only need to complete the “New URL” and the “New Technical POC Email” columns
in order to submit URL information, and should not change the information
that the template pre-populates.
Please ensure that the URL information being entered is for the correct URL Type,
URL ID, and Market/Product Type combination.
Issuers may choose to leave a “New URL” or “New Technical POC Email” field blank
if they do not wish to submit or update the Current URL or Current Technical POC Email.
Issuers do not need to submit every URL type within their template each time
in order to pass the SSM’s validations.
Depending on what type of product an issuer is offering, some URLs are required,
while the remainder are optional.
For issuers offering QHPs, the following URLs are required for all on-Exchange URL IDs:
SBC, Network, Formulary, Transparency in Coverage, Machine-Readable
For issuers offering SADPs, the following URLs are required for all on-Exchange URL IDs:
Network, Transparency in Coverage, Machine-Readable
Keep in mind that since Network, Transparency in Coverage,
and Machine-Readable URLs are required for all issuers,
they must either be submitted together,
or a Transparency in Coverage URL and Machine-Readable URL must be submitted
before any Network URLs can be submitted.
Although issuers are not required to include every URL type in each of their submissions,
issuers must submit all required URLs for each URL type that is included in a given template.
If issuers attempt to submit a template that does not include required URLs
for the selected URL types, the entire template will fail validation.
Issuers should only include URL types for which they intend to submit all required URLs.
When filling out the URL Template, certain special characters are not permitted
and will cause the template upload to fail.
Please be sure that each URL begins with “http://” or “https://”,
and contains no commas, spaces, greater than or less than signs, single quotes,
or consecutive hyphens.
Machine-readable URLs must begin with “https://” and must end in “.json”.
Issuers can submit their completed URL Template
using the Upload Issuer URL Template File section of the URL Data tab
by clicking “Upload” after selecting their URL Template from their computer.
If the submission is successful, a green checkmark will appear
and note that the file was submitted successfully.
If the upload fails for any reason, a red X will appear and an error report will be available
for download, which will detail which URLs failed validation and why.
CMS recommends using this method for initial URL submissions and bulk updates.
The Search & Update URLs section allows issuers to view and submit URLs
directly into the module’s UI. Issuers should first select a URL type
and then use the predictive text search field to search for a URL ID.
Issuers can enter full or partial strings of characters to search for specific URLs,
or alternatively, leave the field blank and click the magnifying glass
to return all URL IDs for the selected URL type.
URL information can be entered in the New URL column,
and will follow the same conventions for validation
as the Upload Issuer URL Template File section.
Issuers can submit a single URL or multiple URLs,
before selecting the “Update” button to submit.
A pop-up box will appear to confirm the changes the issuer intends to make.
If successful, a green checkmark will appear below the section banner
and will state that the URL changes were loaded successfully.
Issuers may also choose to delete a URL by selecting the “Delete URL” checkbox.
This checkbox is only enabled for SBC, Transparency in Coverage,
Machine-Readable, or Formulary URLs that are associated with an off-Exchange plan,
as well as all Payment and Plan Brochure URLs, since these URL types are optional.
If the submission fails for any reason, such as including invalid characters
in the new URL, a red X will appear below the section banner instead.
Issuers can also review which URLs failed validations and the reasons for failure.
CMS recommends using this method for quick URL updates.
For both the Upload Issuer URL Template File and Search & Update URLs sections,
if the submission fails for any one URL, none of the changes submitted will be stored.
In order for URLs to be properly updated, the entire submission must pass the SSM’s validations.
Once the SSM is open for each plan year’s submission,
it will remain open for the remainder of the plan year for updates.
Please note that while CMS does not require a state authorization form
or a data change request in order for issuers to update URL information,
state approval is still required.
By submitting URL updates in the SSM,
issuers are attesting that their state has approved the changes.
Issuers can view URL information after submission within the SSM,
as well as Plan Preview, approximately 30 minutes after submission.
States will continue to manage oversight of issuer URL submissions,
and can view their issuers’ URL data in either Plan Preview
or the HIOS State Evaluation Module.
When submitting URL data, please keep in mind that different URL types
have different submission deadlines.
Transparency in Coverage and Machine-Readable URLs
must be submitted by the initial application deadline;
Transparency in Coverage URLs should be live and active upon submission,
while Machine-Readable URLs must be live and active by the deadline for issuers to return signed agreements to CMS.
All other URLs that are submitted in the SSM should be submitted by the final application deadline,
and should be live and active by the deadline for issuers to return signed agreements to CMS.
As a reminder, the URL requirements laid out here apply only to on-Exchange plans;
off-Exchange plan URLs should still be submitted to
the Rates and Benefits Information System (or RBIS).
If you have questions regarding how to submit URL data,
please contact the Marketplace Service Desk at CMS_FEPS@cms.hhs.gov,
or 855-CMS-1515.
For more information about the QHP certification process,
visit www.qhpcertification.cms.gov.