Business Rules

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Business Rules Template v1.5

To validate the template, press Validate button or Ctrl + Shif

Go to cell C1 for instructions

Enter the Issuer Rule on the first row (no Product ID or Plan
For each Product rule, enter only the Product ID and the bus
For each Plan rule, enter only the Plan ID and the business

HIOS Issuer ID*
TIN*

Product ID

Plan ID
(Standard Component)

How are rates for contracts
covering two or more
enrollees calculated?

plate, press Validate button or Ctrl + Shift + V. To finalize the template, press Finalize button or Ctrl + Shift + F.

le on the first row (no Product ID or Plan ID).
ule, enter only the Product ID and the business rules that differ from the Issuer Rule.
enter only the Plan ID and the business rules that differ from the Product or Issuer Rule

What are the
What are the maximum
maximum number of
What are the maximum
number of under age (under under age (under 21) Is there a maximum number of children used
21) dependents used to
dependents used to age for a dependent? to quote a children-only
quote a two parent family?
quote a single
contract?
parent family?

Are domestic partners
How is tobacco status
Are same-sex partners How is age determined
treated the same as
determined for
treated the same as
for rating and eligibility
secondary
subscribers and
secondary subscribers?
purposes?
subscribers?
dependents?

What relationships between primary
and dependent are allowed, and is
the dependent required to live in the
same household as the primary
subscriber?

Is composite rating
available?