1. No category

Plan Management
for Industry and State
Nick Fosgate
Product Support Supervisor
(816) 783-8456
[email protected]
Brandy Woltkamp
Senior Application Support Analyst
(816) 783-8744
[email protected]
Objective
• At the end of this session, you will be able to:
– Understand the basic workflow for QHPs using
SERFF as the transmission vehicle
– Create and submit a binder
– Review and transfer a binder to the exchange
body
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Plan Management
Plan Year 2016
Federal Templates
Federal Supporting Documentation
State Supporting Documentation
State Deadlines
– http://www.serff.com/documents/plan_year_201
6_state_deadlines.pdf
State Plan Management Information
State Type
Collect Data
Transmit Data/Plan
Preview
FFM
HIOS
HIOS
FFM with SERFF
Review
HIOS/SERFF
HIOS
States Participating
in Plan
Management
SERFF
HIOS
Bifurcated States
SERFF
HIOS/State Based
System
State Supported
SERFF/State
Specific System
State Based System
Plan
Management
Workflow
Binder Messages
Messages View
• All messages through SERFF are shown in
this area
– Rate and Form
– Binder
Company Profile
• Add HIOS ID and accreditation entity
information to the company profile
Company Search
Company Profile
Company Profile
Company Profile
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State License Number
HIOS Issuer ID
NCQA Org ID
URAC App Number
Plan Management
My Binders
My Binders
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State
Company Name
Market Type
Binder Name
Company Tracking Number
SERFF Status
Date Submitted
Plan Management
Search
Search
Plan Management
General Instructions
Plan Management
General Instructions
Plan Management
Create Binder
Create Binder
Create Binder
Binder at a Glance
Plans View
Templates View
Federal Templates
• Complete the Excel version of the Federal
Template
• Click on Validate to run initial validation
contained within the template
• Click Finalize
– XML is generated
– Upload XML to SERFF
Templates View
Templates View
Upload XML of Federal Template
Template
Validation
Federal Validation
Services
Federal Validation
Services
Template Errors
Associate Schedule
Items View
Associate Schedule
Items
Associate Schedule
Items
Associate Schedule
Items
Associate Schedule
Items
Fees View
Supporting
Documentation
View
Company and
Contact View
Correspondence
View
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Objection Letters
Amendment Letters
Dispositions
Certifications
Binder Notes
Binder Options
Amendment
Amendment
Amendment
Amendment
Amendment
Amendment
Amendment
Amendment
Questions?
Plan Management
View
Plan Management
Search
Search
State Review
Plans
State Review
Associate Schedule
Items
State Review
Fees
State Review
Templates
State Review
Supporting
Documentation
State Review
Company and Contact
State Options
State Options
Objection Letter
Objection Letter
Questions?
Response Letter
Response Letter
Response Letter
Response Letter
Response Letter
Response Letter
Response Letter
Response Letter
Response Letter
Response Letter
Draft Items
Questions?
Disposition
Disposition
Certification
Certification
Transfer
Transfer
Transfer Report
Transfer Report
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SERFF Tracking Number
Binder Name
Standard Component ID
Plan Disposition Status
Certification Status
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Transferred By
Date Transferred
Transfer Status
Action Needed
Transfer
Transfer
Public Access
Public Access
EFT Report
EFT Report
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Transaction Date
Company Name
Company Code
Submitter Name
Plan Year
SERFF Tracking
Number
• Binder Name
• Plan Name
• Standard Component
ID
• Amount
• Transaction Number
Questions?