RBIS_SG_Regions_Template_v1

RBIS_SG_Regions_Template_v1.xls

Health Care Reform Insurance Web Portal and Supporting Authority Contained in Sections 1103 and 10102 of The Patient Protection and Affordability Care Act, P.L. 111-148 (PPACA)

RBIS_SG_Regions_Template_v1

OMB: 0938-1086

Document [xlsx]
Download: xlsx | pdf

Overview

Region Definitions
Region Definitions examples


Sheet 1: Region Definitions

Please enter the region details for your service area below. Sample data is shown.























































If a region is defined only by Zip Code, then leave the FIPS Code and County columns empty;























































If a region is defined by a combination of Zip Code and County, then fill out both columns;























































If a region is defined by a combination of Zip Code and FIPS Code, then fill out both columns;























































If a region is defined only by FIPS Code, then leave the ZIP Code and County columns empty;























































If your service area covers a state for all zip codes then leave the ZIP Code, FIPS Code and COUNTY columns empty.









































































































































































Service Area Details for Small Group
















































































































Issuer ID Region # ZIP Code FIPS Code County State Abbr AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA MA MD ME MI MN MS MO MT NE NV NH NJ MN NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Sheet 2: Region Definitions examples

Please enter the region details for your service area below. Sample data is shown.
























































If a region is defined only by Zip Code, then leave the FIPS Code and County columns empty;
























































If a region is defined by a combination of Zip Code and County, then fill out both columns;
























































If a region is defined by a combination of Zip Code and FIPS Code, then fill out both columns;
























































If a region is defined only by FIPS Code, then leave the ZIP Code and County columns empty;
























































If your service area covers a state for all zip codes then leave the ZIP Code, FIPS Code and COUNTY columns empty.












































































































































































Service Area Details for Small Group


















































































































Issuer ID Region # ZIP Code FIPS Code County State Abbr Explanation AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA MA MD ME MI MN MS MO MT NE NV NH NJ MN NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
73836 1

VALDEZ CORDOVA AK Region defined only by County


















































73836 11 99550

AK Region defined only by Zip Code


















































73836 3 99513
ANCHORAGE AK Region defined by combination of Zip Code and County


















































73836 3 99516
ANCHORAGE AK Region defined by combination of Zip Code and County


















































73836 4 55953

AK Region defined only by Zip Code


















































73836 9


AK Region covers entire state


















































74000 1


AK Region covers entire state


















































39424 1
001
OR Region defined only by FIPS Code(s)


















































39424 1
003
OR Region defined only by FIPS Code(s)


















































39424 1
031
OR Region defined only by FIPS Code(s)


















































39424 2 97204 051
OR Region defined by combination of Zip Code and FIPS Code


















































39424 3 97229 051
OR Region defined by combination of Zip Code and FIPS Code


















































File Typeapplication/vnd.ms-excel
AuthorCGI
Last Modified ByCGI Federal
File Modified2011-08-12
File Created2011-08-11

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