2021 RBIS URL CollectionTemplate v1.0 |
|
|
|
HIOS Issuer ID * |
12345 |
|
|
Market Coverage * |
Small Group |
|
|
|
|
URL data or an indication of "N/A, NA, or Not Applicable" must be provided for all Plan IDs submitted to RBIS |
|
|
- |
For data collection within RBIS, only Off Exchange plans (variant type 00) are collected here. |
|
|
|
* indicates the field is required |
|
|
|
|
|
|
|
|
|
|
|
Plan ID * |
Plan-level payment URL * |
Off Exchange Plan Variant (00) Summary of Benefits and Coverage URL * |
Off Exchange Plan Variant (00) Brochure URL * |
23456VA0100999 |
https://www.insuranceprovider.com/abc.html |
https://www.insuranceprovider.com/planxyz_sbc.pdf |
https://www.insuranceprovider.com/brochure.pdf |
12345VA0100001 |
https://www.insuranceprovider.com/abc.html |
https://www.insuranceprovider.com/planxyz_sbc.pdf |
|
12345VA0100002 |
https://www.insuranceprovider.com/abc.html |
|
https://www.insuranceprovider.com/brochure.pdf |
12345VA0100003 |
|
https://www.insuranceprovider.com/planxyz_sbc.pdf |
https://www.insuranceprovider.com/brochure.pdf |
12345VA0100004 |
https://www.insuranceprovider.com/abc.html |
https://www.insuranceprovider.com/planxyz_sbc.pdf |
https://www.insuranceprovider.com/brochure.pdf |
12345VA0100005 |
na |
N/A |
Not Applicable |
12345VA0100002 |
https://www.insuranceprovider.com/abc.html |
https://www.insuranceprovider.com/planxyz_sbc.pdf |
https://www.insuranceprovider.com/brochure.pdf |
|
|
|
|