CMS-10433 Service Area

Initial Plan Data Collection to Support QHP Certification and other Financial Management and Exchange Operations

B3 ServiceArea.xlsm

QHP Certification

OMB: 0938-1187

Document [xlsx]
Download: xlsx | pdf
Service Area v2.6 Instructions: All fields with an asterisk (*) are required



Click Create Service Area IDs button to create service area ids based on your state


Service Area IDs will populate in the drop-down box in Service Area ID column










HIOS Issuer ID:*



Issuer State:*
















Service Area ID* Service Area Name* State* County Name Partial County
Required:
Enter the Service Area ID
Required:
Enter the Service Area Name
Required:
Does this Service Area cover the entire state?
Required if State is "No":
Select the County - FIPS this Service Area covers
Required if State is "No":
Does this Service Area include a partial county?
File Typeapplication/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified0000-00-00
File Created0000-00-00

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