Data Collection Template

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Overview

Instructions
URL Template

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Sheet 1: Instructions

Workbook Instructions

Instructions for URL Template sheet:

To validate, select the Validate button or press Ctrl + Shift + I.

Upon selecting Validate, rows in the template will be filtered to display only those containing errors.

To remove the error filter and display all rows of data, select the Show Data button or press Ctrl + Shift + S

To validate and finalize, select the Finalize button or press Ctrl + Shift + F.

The XML file will be saved in the same folder as this template

This template should contain all Plan IDs found on the Plan Benefits and Rates templates. Failure to provide all plans will result in a submission validation error.

Values for the URL fields of each Plan ID must be entered. If there is no URL value, enter N/A.

When ready to begin using the template, select the Begin button below or press Ctrl + Shift + B or manually navigate to the next tab titled URL Template.

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Sheet 2: URL Template

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