Health Insurance Issuer Submission of the Preliminary Justification

Rate Increase Disclosure and Review Reporting Requirements (45 CFR Part 154)

Preliminary Justification Submission Function

Health Insurance Issuer Submission of the Preliminary Justification

OMB: 0938-1141

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Exhibit A: Screenshot Illustration of the HIOS Rate Review Data Collection System:



Initial HIOS Sign-In screen.

Content Placeholder 3





HIOS Main Page Menu



Picture 2





Rate Review System Module Selected



Content Placeholder 2



Rate Review Submission Tab Selected

Content Placeholder 3

First Preliminary Justification Upload Screen (Issuers will use this Screen to locate products already stored in the HIOS system through the Plan Finder Reporting Requirements)

Content Placeholder 4







Second Preliminary Justification Upload Screen (Issuers will use this screen to upload the three parts of the Preliminary Justification.

Picture 2 Picture 2



Preliminary Justification Submission Confirmation



Picture 6



Submission of Supplemental Information Function



Picture 2















Submission of Supplemental Information Function (continued)



Picture 2





Modify Function



Picture 2

9


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorCMS
File Modified0000-00-00
File Created2021-01-31

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