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State
Based Marketplace Data Collection Template: Open Enrollment
Period Weekly/Expanded Reporting and Monthly Medicaid/CHIP
Continuous Coverage Unwinding Reporting
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General
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1
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Total Plan
Selections (net)*
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Count of unique
individuals who have selected a Plan Year (PY) 20XX Marketplace
medical plan. Count includes all new and re-enrolling consumers
(defined in indicators 2 and 3), regardless of whether the
consumer has paid the first month premium. Count does not include
plans that were canceled or terminated. Instant
check:
This metric should total the sum of new consumers (2) and total
re-enrollees (3).
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2
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New Consumers
(net)
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Count of unique
individuals who have selected a (PY) 20XX Marketplace medical
plan, where the consumer had non-canceled (PY) 20XX Marketplace
medical coverage on or after 11/1/20XX. Count
includes consumers who either returned to the Marketplace and
actively selected a (PY) 20XX Marketplace medical coverage or were
automatically enrolled into a (PY) 20XX Marketplace medical
coverage. Count
does not include plans that were canceled or terminated.
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3
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Total
Re-enrollees (net)
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Count of unique
individuals who have selected a (PY) 20XX Marketplace medical
plan, where the consumer had non-canceled (PY) 20XX Marketplace
medical coverage on 11/1/20XX. Count includes consumers who either
returned to the Marketplace and actively selected a (PY) 20XX
Marketplace medical coverage or were automatically enrolled into a
(PY) 20XX Marketplace medical coverage. Count does not include
plans that were canceled or terminated. Instant
check:
This metric should total the sum of active re-enrollees (4) and
automatic re-enrollees (5).
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4
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Active
Re-enrollees (net)*
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Count of unique
individuals who returned to the Marketplace to actively select a
(PY) 20XX Marketplace medical plan, where the consumer had
non-canceled (PY) 20XX Marketplace medical coverage on or after
11/1/20XX. Count does not include plans that were canceled or
terminated.
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5
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Automatic
Re-enrollees (net)*
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Count of unique
individuals who were automatically re-enrolled into a (PY) 20XX
Marketplace medical plan, where the consumer had non-canceled (PY)
20XX Marketplace medical coverage on or after 11/1/20XX. Count
does not include plans that were canceled or terminated.
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6
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Number of Submitted Applications
(gross)*
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Total count of
submitted electronic and paper applications. When a consumer is
renewed into a plan, whether automatic or active, that should be
counted as an application submission. Updated applications should
not be counted as an additional application. *Non-Integrated SBMs
include account transfers or incomplete applications.
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7
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Consumers on
Applications Submitted (gross)*
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Total count of individuals requesting
coverage on submitted applications. Both new consumers and
consumers re-enrolling (automatic and active) in coverage should
be counted. *Non-Integrated
SBMs include account transfers or incomplete applications.
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8
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Consumers
Determined Eligible for Medicaid/CHIP (gross)
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Count of individuals on submitted
applications who are determined or assessed eligible for
enrollment in Medicaid or CHIP. Both new consumers and consumers
re-enrolling (automatic and active) in coverage should be counted.
This count is a subset of Consumers on Applications
Submitted (Indicator 7). Eligibility for Medicaid/CHIP takes
precedence over eligibility for a QHP without financial
assistance. Individuals determined eligible for both Medicaid/CHIP
and a non-financial QHP should be counted, but should not be
counted in Indicator 9.
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9
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Consumers
Eligible for QHP (gross)*
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Count of individuals on submitted
applications who were determined eligible for enrollment in a (PY)
20XX Marketplace medical plan, regardless of whether they applied
for or are eligible for financial assistance. Both new consumers
and consumers re-enrolling (automatic and active) in coverage
should be counted. This count is a subset of Consumers on
Applications Submitted (Indicator 7). Eligibility for
Medicaid/CHIP takes precedence over eligibility for a QHP without
financial assistance. Individuals determined eligible for both
Medicaid/CHIP and a non-financial QHP should not be counted.
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11
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Consumers with a 20XX Plan
Selection as of 11/1/20XX (ONE TIME)
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Count of unique individuals with
non-canceled (PY) 20XX coverage ending on or after November 1,
20XX.
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12
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New Consumers
without a Previous Marketplace Application (net)
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Count of unique individuals with a
non-canceled (PY) 20XX Marketplace medical plan selection, where
the consumer did not submit a (PY) 20XX Marketplace application.
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13
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New Consumers
with a Prior Application but No Plan Selection (net)
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Count of unique individuals with a
non-canceled (PY) 20XX Marketplace medical plan selection, where
the consumer submitted a (PY) 20XX Marketplace but did not make a
plan selection for (PY) 20XX Marketplace medical coverage.
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14
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New Consumers with a Prior Plan
Selection but No Coverage on November 1, 20XX (net)
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Count of unique individual with a
non-canceled (PY) 20XX Marketplace medical plan selection, where
the consumer made a (PY) 20XX Marketplace medical plan
selection but did not have (PY) 20XX Marketplace medical coverage
on or after 11/1/20XX.
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20
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Cancellations
and Terminations (gross)
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Count of individuals who have canceled
their (PY) 20XX Marketplace medical plan or had their (PY) 20XX
Marketplace medical plan terminated by the issuer or Exchange
during Open Enrollment. All cancellations and terminations should
be counted. For example, if an individual selects a plan in
November and immediately cancels it, then selects another plan in
December and again immediately cancels it, both cancellations
should be counted.
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Financial Assistance/Premiums
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21
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Number of Plan Selections with
Financial Assistance (net)*
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Count of unique individuals with a
non-canceled (PY) 20XX Marketplace medical plan selection, where
the consumer has elected to receive APTC in an amount greater than
$0 and/or receives CSRs. This count includes consumers with APTC
and CSRs (22) , consumers with only APTC (23), and consumers with
only CSRs (24).
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22
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Number of
Plan Selections with both CSR and APTC (net)
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Count of unique individuals with a
non-canceled (PY) 20XX Marketplace medical plan selection, where
the consumer has elected to receive APTC in an amount greater than
$0 and/or receives CSRs. Count includes consumers with APTC and
CSRs. Consumers with only APTC or with only CSRs should not be
counted.
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23
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Number of
Plan Selections with APTC only (net)
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Count of unique
individuals with a non-canceled (PY) 20XX Marketplace medical plan
selection, where the consumer has elected to receive APTC in an
amount greater than $0. Consumers with CSRs should not be counted.
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24
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Number of
Plan Selections with CSR only (net)
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Count of unique
individuals with a non-canceled (PY) 20XX Marketplace medical plan
selection, where the consumer receives CSR in an amount greater
than $0. Count may include consumers who are eligible to receive
APTC but have elected not to receive APTC.
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25
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Number of Plan Selections without
Financial Assistance (net)
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Count of unique individuals with a
non-canceled (PY) 20XX Marketplace medical plan selection, where
the consumer is not eligible to receive APTC, is eligible but
elects not to receive APTC, and/or does not receive CSRs.
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26
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Average
Premium for All Consumers with a Plan Selection (net)
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The average per person monthly
premium for all consumers with a non-canceled (PY) 20XX
Marketplace medical plan selection, before the application of any
APTC.
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27
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Average
Premium for all Consumers with a Plan Selection after APTC (net)
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The average per person monthly premium
for all consumers with a non-canceled (PY) 20XX Marketplace
medical plan selection, after the application of APTC. That is,
where the consumer receives APTC, the policy premium should be
reduced by the APTC amount before being included in the numerator.
The denominator should be the total covered lives.
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28
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Average APTC
Amount for All Consumers with a Plan Selection Receiving APTC
(net)
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The average per person monthly APTC
for all consumers with a non-canceled (PY) 20XX Marketplace
medical plan selection, who have elected to receive an APTC amount
greater than $0.
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29
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Average
Premium after APTC for All Consumers with a Plan Selection
Receiving APTC (net)
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The average per person monthly premium
for all consumers with a non-canceled (PY) 20XX Marketplace
medical plan selection, who have elected to receive an APTC amount
greater than $0, after the application of APTC.
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Demographics
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30
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Number of
Plan Selections where age is 0 - 17 (net)
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Count of unique individuals who have
selected a non-canceled (PY) 20XX Marketplace medical plan and who
are age of 0 - 17. Age represents the recorded age as of the
policy effective coverage date.
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31
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Number of
Plan Selections where age is 18 - 25 (net)
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Count of unique individuals who have
selected a non-canceled (PY) 20XX Marketplace medical plan and who
age of 18 - 25. Age represents the recorded age as of the policy
effective coverage date.
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31.1
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Number of Plan Selections where age is 26 - 34 (net)
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Count of unique individuals who have selected a non-canceled (PY)
20XX Marketplace medical plan and who are age 26 - 34. Age
represents the recorded age as of the policy effective coverage
date.
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32
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Number of
Plan Selections where age is 35 - 44 (net)
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Count of unique individuals who have
selected a non-canceled (PY) 20XX Marketplace medical plan and who
are age of 35 - 44. Age represents the recorded age as of the
policy effective coverage date.
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32.1
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Number of Plan Selections where age is 45 - 54 (net)
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Count of unique individuals who have selected a non-canceled (PY)
20XX Marketplace medical plan and who are age 45 - 54. Age
represents the recorded age as of the policy effective coverage
date.
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33
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Number of
Plan Selections where age is 55 - 64 (net)
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Count of unique individuals who have
selected a non-canceled (PY) 20XX Marketplace medical plan and who
are age of 55 - 64. Age represents the recorded age as of the
policy effective coverage date.
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33.1
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Number of Plan Selections where age is ≥ 65 (net)
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Count of unique individuals who have selected a non-canceled (PY)
20XX Marketplace
medical plan and who are age ≥ 65. Age represents the recorded
age as of the policy effective coverage date.
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34
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Number of
Plan Selections where age is unknown (net)
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Count of unique individuals who have
selected a non-canceled (PY) 20XX Marketplace medical plan and
whose age is unknown. Age represents the recorded age as of the
policy effective coverage date.
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35
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Number of
Plan Selections where gender is Female (net)
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Count of unique
individuals who have selected a non-canceled (PY) 20XX Marketplace
medical plan and whose gender is Female, according to the selected
policy.
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36
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Number of
Plan Selections where gender is Male (net)
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Count of unique
individuals who have selected a non-canceled (PY) 20XX Marketplace
medical plan and whose gender is Male, according to the selected
policy.
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37
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Number of
Plan Selections where gender is Unknown (net)
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Count of unique
individuals who have selected a non-canceled (PY) 20XX Marketplace
medical plan and whose gender is unknown, according to the
selected policy.
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38
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Number of
Plan Selections where Race/Ethnicity is Hispanic or Latino (net)
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Count of unique
individuals who have selected a non-canceled (PY) 20XX Marketplace
medical plan and who have indicated they were Mexican, Mexican
American or Chicano/a, Puerto Rican, Cuban, or “other
ethnicity” on their application.
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39
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Number of
Plan Selections where Race/Ethnicity is White (net)
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Count of unique
individuals who have selected a non-canceled (PY) 20XX Marketplace
medical plan and who have indicated they were white on their
application.
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40
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Number of
Plan Selections where Race/Ethnicity is African American (net)
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Count of unique
individuals who have selected a non-canceled (PY) 20XX Marketplace
Medical plan and who have indicated they were black or African
American on their application.
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41
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Number of
Plan Selections where Race/Ethnicity is Asian (net)
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Count of unique
individuals who have selected a non-canceled (PY) 20XX Marketplace
Medical plan and who have indicated they were Asian Indian,
Chinese, Filipino, Korean, Vietnamese, Japanese, or “other
Asian” on their application.
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42
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Number of
Plan Selections where Race/Ethnicity is Native Hawaiian/Pacific
Islander (net)
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Count of unique
individuals who have selected a non-canceled (PY) 20XX Marketplace
Medical plan and who have indicated they were Guamanian or
Chamorro, Native Hawaiian, Samoan, or Other Pacific Islander on
their application.
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43
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Number of
Plan Selections where Race/Ethnicity is American Indian/Alaska
Native (net)
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Count of unique
individuals who have selected a non-canceled (PY) 20XX Marketplace
Medical plan and who have indicated they were American Indian or
Alaska Native on their application.
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44
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Number of
Plan Selections where Race/Ethnicity is Multi-Racial (net)
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Count of unique
individuals who have selected a non-canceled (PY) 20XX Marketplace
Medical plan and who have indicated more than one distinct racial:
American Indian / Alaska Native, Asian, Native Hawaiian / Pacific
Islander, African-American, and White on their application.
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45
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Number of
Plan Selections where Race/Ethnicity is Unknown (net)
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Count of unique
individuals who have selected a non-canceled (PY) 20XX Marketplace
Medical plan and who did not indicate a race on their application.
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46
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Number of
Plan Selections where Metal Level is Platinum (net)
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Count of unique individuals who have
selected a non-canceled (PY) 20XX Marketplace medical plan where
the metal level is Platinum.
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47
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Number of
Plan Selections where Metal Level is Gold (net)
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Count of unique individuals who have
selected a non-canceled (PY) 20XX Marketplace medical plan where
the metal level is Gold.
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48
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Number of
Plan Selections where Metal Level is Silver (net)
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Count of unique individuals who have
selected a non-canceled (PY) 20XX Marketplace medical plan where
the metal level is Silver.
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49
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Number of
Plan Selections where Metal Level is Bronze (net)
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Count of unique individuals who have
selected a non-canceled (PY) 20XX Marketplace medical plan where
the metal level is Bronze.
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50
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Number of
Plan Selections where Metal Level is Catastrophic (net)
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Count of unique individuals who have
selected a non-canceled (PY) 20XX Marketplace medical plan where
the metal level is Catastrophic.
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51
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Consumers with a Plan Selection and Income < 100%
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Count of unique individuals in households with income less than
100% of FPL who have selected a non-canceled (PY) 20XX Marketplace
medical plan.
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52
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Consumers
with a Plan Selection and Income ≥ 100% FPL and ≤
150% FPL (net)
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Count of unique individuals in
households with income greater than or equal to 100% and less than
or equal to 150% of FPL who have selected a non-canceled (PY) 20XX
Marketplace medical plan.
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53
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Consumers
with a Plan Selection and Income > 150% FPL and ≤
200% FPL (net)
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Count of unique individuals in
households with income greater than 150% and less than or equal to
200% of FPL who have selected a non-canceled (PY) 20XX Marketplace
medical plan.
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54
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Consumers
with a Plan Selection and Income > 200% FPL and ≤
250% FPL (net)
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Count of unique individuals in
households with income greater than 200% and less than or equal to
250% of FPL who have selected a non-canceled (PY) 20XX Marketplace
medical plan.
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54.1
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Consumers
with a Plan Selection and Income > 250% FPL and ≤
300% FPL (net)
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Count of unique individuals in
households with income greater than 250% and less than or equal to
300% of FPL who have selected a non-canceled (PY) 20XX
Marketplace medical plan.
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54.2
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Consumers
with a Plan Selection and Income > 300% FPL and ≤
350% FPL (net)
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Count of unique individuals in
households with income greater than 300% and less than or equal to
350% of FPL who have selected a non-canceled (PY) 20XX
Marketplace medical plan.
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54.3
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Consumers
with a Plan Selection and Income > 350% FPL and ≤
400% FPL (net)
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Count of unique individuals in
households with income greater than 350% and less than or equal to
400% of FPL who have selected a non-canceled (PY) 20XX
Marketplace medical plan.
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55
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Consumers
with a Plan Selections and Income > 400% FPL (net)
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Count of unique individuals in
households with income greater than 400% who have selected a
non-canceled (PY) 20XX Marketplace medical plan.
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56
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Number of
Plan Selections where Income as a Percent of FPL is Unknown (net)
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Count of unique individuals in
households with non-reported income and who have selected a
non-canceled (PY) 20XX Marketplace medical plan. Count
should include individuals who do not report income because they
are not requesting financial assistance.
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Operations
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5759
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Call Center
Volume
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The total number of incoming calls
received by the call center. Repeat calls from the same number
should be counted separately.
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58
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Call Center
Wait Time (in seconds)
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The average wait time, rounded to the
nearest second, for each incoming call to the call center.
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59
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Calls
Abandoned
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The number of incoming calls
terminated while waiting to speak to a call center representative.
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60
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Average Call
Handle Time (in seconds)
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The average amount of time, rounded to
the nearest second, spent by call center representatives on each
individual call.
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61
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Number of
Website Visits
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The count of webpage and mobile
application visits of each IP address that has not made a webpage
or mobile application visit within the last 30 minutes. For
example, if IP address 147.194.0.3 requests the webpage at 12:30
PM and 1:01 PM, that gets counted as 2 visits. If IP address
147.194.0.3 requests the webpage at 1:24, 1:54, and 1:56, this
counts as 1 visit. At 1:24, there was no previous request within
30 minutes; at 1:54, there was a previous request exactly 30
minutes prior, and at 1:56 there was a previous request at 1:54.
A subsequent request by that same IP address at 3:00 PM would be a
new visit.
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62
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Number of
Website Unique Visitors
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The count of the unique IP addresses
requesting the webpage or mobile application (e.g. IP 147.194.0.3
requests, gets counted as 1 unique visitor). A single person using
dynamic IP address assignment (identified by login to the same
Exchange account or some other method) should still be counted as
two unique visitors if the IP addresses differ at the time of
login.
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63
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Planned
Website Downtime (gross)
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The amount of planned downtime for the
Exchange website, rounded to the nearest second.
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64
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Unplanned
Website Downtime (gross)
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The amount of unplanned downtime for
the Exchange website, rounded to the nearest second.
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65
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Plan
Selections with Any Assistance (net)
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Count of unique individuals who have
selected a non-canceled (PY) 20XX Marketplace medical plan and who
received any form of personal assistance with enrollment.
Assistance may have been provided by a navigator, certified
application counselor (CAC), the call center, in-person assister,
agent, or broker.
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66
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Plan
Selections with Agent/Broker Assistance (net)
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Count of unique individuals who have
selected a non-canceled (PY) 20XX Marketplace medical plan and who
received personal assistance with enrollment from an agent or
broker. This count should only include individuals who
received assistance from an agent or broker.
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67
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Plan
Selections with Other Assistance (net)
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Count of unique individuals who have
selected a non-canceled (PY) 20XX Marketplace medical plan and who
received personal assistance with enrollment from someone other
than an agent or broker. This count should only include
individuals who received assistance from a source other than an
agent or broker. Such assistance may have been provided by a
navigator, certified application counselor (CAC), the call center,
or in-person assister.
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68
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Plan
Selections with No Assistance (net)
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Count of unique individuals who have
selected a non-canceled (PY) 20XX Marketplace medical plan and who
received no personal assistance with enrollment.
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Issuers
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69
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Plan
Selection by Issuer: Issuer 1
|
|
|
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70
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Plan
Selection by Issuer: Issuer 2
|
|
|
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71
|
Plan
Selection by Issuer: Issuer 3
|
|
|
|
72
|
Plan
Selection by Issuer: Issuer 4
|
|
|
73
|
Plan
Selection by Issuer: Issuer 5
|
|
|
74
|
Plan
Selection by Issuer: Issuer 6
|
|
|
75
|
Plan
Selection by Issuer: Issuer 7
|
|
|
76
|
Plan
Selection by Issuer: Issuer 8
|
|
|
77
|
Plan
Selection by Issuer: Issuer 9
|
|
|
78
|
Plan
Selection by Issuer: Issuer 10
|
|
|
79
|
Plan
Selection by Issuer: Issuer 11
|
|
|
80
|
Plan
Selection by Issuer: Issuer 12
|
|
|
81
|
Plan
Selection by Issuer: Issuer 13
|
|
|
82
|
Plan
Selection by Issuer: Issuer 14
|
|
|
83
|
Plan
Selection by Issuer: Issuer 15
|
|
83.1
|
Plan
Selection by Issuer: Issuer 16
|
|
|
83.2
|
Plan
Selection by Issuer: Issuer 17
|
|
|
83.3
|
Plan
Selection by Issuer: Issuer 18
|
|
|
83.4
|
Plan
Selection by Issuer: Issuer 19
|
|
|
83.5
|
Plan
Selection by Issuer: Issuer 20
|
|
|
|
84
|
Name
Issuer 1
|
|
|
85
|
Name
Issuer 2
|
|
|
86
|
Name
Issuer 3
|
|
|
87
|
Name
Issuer 4
|
|
|
88
|
Name
Issuer 5
|
|
|
89
|
Name
Issuer 6
|
|
|
90
|
Name
Issuer 7
|
|
|
91
|
Name
Issuer 8
|
|
|
92
|
Name
Issuer 9
|
|
|
93
|
Name
Issuer 10
|
|
|
94
|
Name
Issuer 11
|
|
|
95
|
Name
Issuer 12
|
|
|
96
|
Name
Issuer 13
|
|
|
97
|
Name
Issuer 14
|
|
|
98
|
Name
Issuer 15
|
|
98.1
|
Name
Issuer 16
|
|
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98.2
|
Name
Issuer 17
|
|
|
98.3
|
Name
Issuer 18
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|
|
98.4
|
Name
Issuer 19
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|
|
98.5
|
Name
Issuer 20
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|
|
Stand-alone
Dental Plans
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|
|
99
|
Total SADP
Plan Selections (net)
|
Count of unique
individuals who have selected a (PY) 20XX SADP. Count
does not include plans that were canceled or terminated.
|
|
100
|
Number of
SADP
Plan Selections where age is 0 - 17 (net)
|
Count of unique
individuals who have selected a non-canceled (PY) 20XX SADP and
who are age 0 - 17. Age represents the recorded age
as of the policy effective coverage date.
|
|
101
|
Number of
SADP Plan
Selections where age 18 - 25 (net)
|
Count of unique
individuals who have selected a non-canceled (PY) 20XX SADP and
who are age 18 - 25. Age represents the recorded age
as of the policy effective coverage date.
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101.1
|
Number of SADP Plan Selections where age is 26 - 34 (net)
|
Count of unique individuals who have selected a non-canceled (PY)
20XX SADP
and who are age 26 - 34. Age represents the recorded age as of the
policy effective coverage date.
|
|
|
102
|
Number of
SADP
Plan Selections where age 35 - 44 (net)
|
Count of unique
individuals who have selected a non-canceled (PY) 20XX SADP and
who are age 35 - 44. Age represents the recorded age
as of the policy effective coverage date.
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102.1
|
Number of SADP Plan Selections where age is 45 - 54 (net)
|
Count of unique individuals who have selected a non-canceled (PY)
20XX SADP
and who are age 45 - 54. Age represents the recorded age as of the
policy effective coverage date.
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|
102.2
|
Number of SADP Plan Selections where age is 55 - 64 (net)
|
Count of unique individuals who have selected a non-canceled (PY)
20XX SADP
and who are age 55 - 64. Age represents the recorded age as of the
policy effective coverage date.
|
|
|
103
|
Number of
SADP
Plan Selections where age ≥65
(net)
|
Count of unique
individuals who have selected a non-canceled (PY) 20XX SADP and
who are age ≥65.
Age represents the recorded age as of the policy
effective coverage date.
|
|
104
|
Number of
SADP Plan
Selections where age is unknown (net)
|
Count of unique
individuals who have selected a non-canceled (PY) 20XX SADP and
whose age is unknown. Age represents the recorded
age as of the policy effective coverage date.
|
|
105
|
Number of
SADP Plan
Selections where gender is Female (net)
|
Count of unique
individuals who have selected a non-canceled (PY) 20XX SADP and
whose gender is Female, according to the selected policy.
|
|
106
|
Number of
SADP Plan
Selections where gender is Male (net)
|
Count of unique
individuals who have selected a non-canceled (PY) 20XX SADP and
whose gender is Male, according to the selected policy.
|
|
107
|
Number of
SADP Plan
Selections where gender is unknown (net)
|
Count of unique
individuals who have selected a non-canceled (PY) 20XX SADP and
whose gender is unknown, according to the selected policy.
|
Metal Level
by Age and Income
|
|
|
108
|
Silver plans
selected by consumers age 0 - 17 (net)
|
|
|
109
|
Silver plans
selected by consumers age 18 - 25 (net)
|
|
109.1
|
Silver plans selected by consumers age 26 - 34 (net)
|
|
|
|
110
|
Silver plans
selected by consumers age 35 - 44 (net)
|
|
110.1
|
Silver plans selected by consumers age 45 - 54 (net)
|
|
|
110.2
|
Silver plans selected by consumers age 55 - 64 (net)
|
|
|
|
111
|
Silver plans
selected by consumers age ≥65
(net)
|
|
|
112
|
Silver plans
selected by consumers age is unknown (net)
|
|
|
113
|
Bronze plans
selected by consumers age 0 - 17 (net)
|
|
|
114
|
Bronze plans
selected by consumers age 18 - 25 (net)
|
|
114.1
|
Bronze plans selected by consumers age 26 - 34 (net)
|
|
|
|
115
|
Bronze plans
selected by consumers age 35 - 44 (net)
|
|
115.1
|
Bronze plans selected by consumers age 45 - 54 (net)
|
|
|
115.2
|
Bronze plans selected by consumers age 55 - 64 (net)
|
|
|
|
116
|
Bronze plans
selected by consumers age ≥65
(net)
|
|
|
117
|
Bronze plans
selected by consumers age is unknown (net)
|
|
117.1
|
Gold Plans
selected by consumers ages 0-17 (net) [Optional]
|
N/A; This metric
is optional
|
|
117.2
|
Gold Plans
selected by consumers ages 18-25 (net) [Optional]
|
N/A; This metric
is optional
|
|
117.3
|
Gold Plans
selected by consumers ages 26-34 (net) [Optional]
|
N/A; This metric
is optional
|
|
117.5
|
Gold Plans
selected by consumers ages 45-54 (net) [Optional]
|
N/A; This metric
is optional
|
|
117.6
|
Gold Plans
selected by consumers ages 55-64 (net) [Optional]
|
N/A; This metric
is optional
|
|
117.7
|
Gold Plans
selected by consumers ages ≥
65 (net)
[Optional]
|
N/A; This metric
is optional
|
|
117.8
|
Gold Plans
selected by consumers whose age is unknown (net) [Optional]
|
N/A; This metric
is optional
|
|
118
|
Silver plans selected by consumers with income < 100% FPL
(net)
|
|
|
|
119
|
Silver plans
selected by consumers with income ≥ 100% FPL and ≤
150% FPL (net)
|
|
|
120
|
Silver plans
selected by consumers with income > 150% FPL and ≤
200% FPL (net)
|
|
|
121
|
Silver plans
selected by consumers with income > 200% FPL and ≤
250% FPL (net)
|
|
|
121.1
|
Silver plans
selected by consumers with income > 250% PL and ≤
300% FPL (net)
|
|
|
121.2
|
Silver plans
selected by consumers with income > 300% FPL and ≤
350% FPL (net)
|
|
|
121.3
|
Silver plans
selected by consumers with income > 350% FPL and ≤
400% FPL (net)
|
|
|
122
|
Silver plans
selected by consumers with income > 400% (net)
|
|
|
123
|
Silver plans
selected by consumers whose income is unknown (net)
|
|
124
|
Bronze plans selected by consumers with income < 100% FPL
(net)
|
|
|
|
125
|
Bronze plans
selected by consumers with income ≥ 100% FPL and ≤
150% FPL (net)
|
|
|
126
|
Bronze plans
selected by consumers with income > 150% FPL and ≤
200% FPL (net)
|
|
|
127
|
Bronze plans
selected by consumers with income > 200% FPL and ≤
250% FPL (net)
|
|
|
127.1
|
Bronze plans
selected by consumers with income > 250% FPL and ≤
300% FPL (net)
|
|
|
127.2
|
Bronze plans
selected by consumers with income > 300% FPL and ≤
350% FPL (net)
|
|
|
127.3
|
Bronze plans
selected by consumers with income > 350% FPL and ≤
400% FPL (net)
|
|
|
128
|
Bronze plans
selected by consumers with income > 400% (net)
|
|
|
129
|
Bronze plans
selected by consumers whose income is unknown (net)
|
|
129.1
|
Gold plans selected by consumers with
income < 100% FPL (net) [Optional]
|
N/A; This metric is optional.
|
|
129.2
|
Gold plans selected by consumers with
income ≥ 100% FPL and ≤ 150% FPL (net) [Optional]
|
N/A; This metric is optional.
|
|
129.3
|
Gold plans selected by consumers with
income > 150% FPL and ≤ 200% FPL (net) [Optional]
|
N/A; This metric is optional.
|
|
129.4
|
Gold plans selected by consumers with
income > 200% FPL and ≤ 250% FPL (net) [Optional]
|
N/A; This metric is optional.
|
|
129.5
|
Gold plans selected by consumers with
income > 250% FPL and ≤ 300% FPL (net) [Optional]
|
N/A; This metric is optional.
|
|
129.6
|
Gold plans selected by consumers with
income > 300% FPL and ≤ 350% FPL (net) [Optional]
|
N/A; This metric is optional.
|
|
129.7
|
Gold plans selected by consumers with
income > 350% FPL and ≤ 400% FPL (net) [Optional]
|
N/A; This metric is optional.
|
|
129.8
|
Gold plans selected by consumers with
income > 400% FPL (net) [Optional]
|
N/A; This metric is optional.
|
|
129.9
|
Gold plans selected by consumers whose
income is unknown (net) [Optional]
|
N/A; This metric is optional.
|
|
|
Consumer
Type by Age, Metal Level, and Income
|
|
130
|
New consumers
who are age 0 - 17(net)
|
|
|
131
|
Active
re-enrollees who are age 0 - 17(net)
|
|
|
132
|
Automatic
re-enrollees who are age 0 - 17(net)
|
|
|
133
|
New consumers
who are age 18 - 25 (net)
|
|
|
134
|
Active
re-enrollees who are age 18 - 25 (net)
|
|
|
135
|
Automatic
re-enrollees who are age 18 – 25 (net)
|
|
136
|
New consumers who are age 26 - 34 (net)
|
|
|
137
|
Active re-enrollees who are age 26 - 34 (net)
|
|
|
138
|
Automatic re-enrollees who are age 26 - 34 (net)
|
|
|
|
138.1
|
New consumers
who are age 35 - 44 (net)
|
|
|
138.2
|
Active
re-enrollees who are age 35 - 44 (net)
|
|
|
138.3
|
Automatic
re-enrollees who are age 35 - 44
|
|
138.4
|
New consumers who are age 45 - 54 (net)
|
|
|
138.5
|
Active re-enrollees who are age 45 - 54 (net)
|
|
|
138.6
|
Automatic re-enrollees who are age 45 - 54 (net)
|
|
|
138.7
|
New consumers who are age 55 - 64 (net)
|
|
|
138.8
|
Active re-enrollees who are age 55 - 64 (net)
|
|
|
138.9
|
Automatic re-enrollees who are age 55 - 64 (net)
|
|
|
|
139
|
New consumers
who are age ≥65
(net)
|
|
|
140
|
Active
re-enrollees who are age ≥65
(net)
|
|
|
141
|
Automatic
re-enrollees who are age ≥65(net)
|
|
|
142
|
New consumers
whose age is unknown (net)
|
|
|
143
|
Active
re-enrollees whose age is unknown (net)
|
|
|
144
|
Automatic
re-enrollees whose age is unknown (net)
|
|
|
145
|
New consumers
who selected a silver plan (net)
|
|
|
146
|
Active
re-enrollees who selected a silver plan (net)
|
|
|
147
|
Automatic
re-enrollees who selected a silver plan (net)
|
|
|
148
|
New consumers
who selected a bronze plan (net)
|
|
|
149
|
Active
re-enrollees who selected a bronze plan (net)
|
|
|
150
|
Automatic
re-enrollees who selected a bronze plan (net)
|
|
150.1
|
New consumers who selected a gold plan
(net) [Optional]
|
N/A; This metric is optional.
|
|
150.2
|
Active re-enrollees who selected a gold
plan (net) [Optional]
|
N/A; This metric is optional.
|
|
150.3
|
Automatic re-enrollees who selected a
gold plan (net) [Optional]
|
N/A; This metric is optional.
|
|
151
|
New consumers whose income is < 100% FPL (net)
|
|
|
152
|
Active re-enrollees whose income is < 100% FPL (net)
|
|
|
153
|
Automatic Re-enrollees whose income is < 100% FPL (net)
|
|
|
154
|
New consumers whose income is ≥ 100% FPL and ≤ 150% FPL
(net)
|
|
|
155
|
Active re-enrollees whose income is ≥ 100% FPL and ≤ 150%
FPL (net)
|
|
|
156
|
Automatic Re-enrollees whose income is ≥ 100% FPL and ≤
150% FPL (net)
|
|
|
|
157
|
New consumers
whose income is > 150% FPL and ≤
200% FPL (net)
|
|
|
158
|
Active
re-enrollees whose income is 150% FPL and ≤
200% FPL (net)
|
|
|
159
|
Automatic
Re-enrollees whose income is > 150% FPL and ≤
200% FPL (net)
|
|
|
159.1
|
New consumers
whose income is > 200% FPL and ≤
250% FPL (net)
|
|
|
159.2
|
Active
re-enrollees whose income is > 200% FPL and ≤
250% FPL (net)
|
|
|
159.3
|
Automatic
Re-enrollees whose income is > 200% FPL and ≤
250% FPL (net)
|
|
|
160
|
New consumers
whose income is > 250% FPL and ≤
300% FPL (net)
|
|
|
161
|
Active
re-enrollees whose income is > 250% FPL and ≤
300% FPL (net)
|
|
|
162
|
Automatic
Re-enrollees whose income is > 250% FPL and ≤
300% FPL (net)
|
|
|
162.1
|
New consumers
whose income is > 300% FPL and ≤
350% FPL (net)
|
|
|
162.2
|
Active
re-enrollees whose income is . 300% FPL and ≤
350% FPL (net)
|
|
|
162.3
|
Automatic
Re-enrollees whose income is 300% FPL and ≤
350% FPL (net)
|
|
|
162.4
|
New consumers
whose income is > 350% FPL and ≤
400% FPL
|
|
|
162.5
|
Active
re-enrollees whose income is > 350% FPL and ≤
400% FPL (net)
|
|
|
162.6
|
Automatic
Re-enrollees whose income is > 350% FPL and ≤
400% FPL (net)
|
|
|
163
|
New consumers
whose income is > 400% FPL (net)
|
|
|
164
|
Active
re-enrollees whose income is > 400% FPL (net)
|
|
|
165
|
Automatic
Re-enrollees whose income is 400% FPL (net)
|
|
|
166
|
New consumers
whose income is unknown (net)
|
|
|
167
|
Active
re-enrollees whose income is unknown (net)
|
|
|
168
|
Automatic
Re-enrollees whose income is unknown (net)
|
|
Basic Health
Plan Program – only for states with BHP
|
|
169
|
Total BHP Enrollees (net)*
|
Count of
individuals who have enrolled in BHP. Count does not include
enrollments that were canceled or terminated, or individuals
enrolled in Medicaid/CHIP programs that are not BHP.
|
|
|
170
|
New BHP
Enrollees (New
Enrollees) (net)
|
Count of unique
individuals who have enrolled in BHP who were not enrolled in an
exchange-facilitated program (i.e. BHP, QHP, or any other
integrated programs, like Medicaid) immediately prior to this BHP
enrollment.
|
|
171
|
BHP
Re-enrollees (net)
|
Count of unique
individuals who have enrolled in BHP who were enrolled in an
exchange-facilitated program (i.e. BHP, QHP, or any other
integrated programs, like Medicaid) immediately prior to this BHP
enrollment.
|
172
|
Consumers
Eligible for BHP (gross)*
|
Count of all
individuals determined or assessed eligible for BHP. Only
individuals on submitted applications and requesting coverage are
included. Count all individuals determined/assessed eligible even
if the individual does not subsequently enroll in coverage.
|
|
|
173
|
Consumers
enrolled in BHP as of 11/1/20XX (ONE TIME)
|
Count of unique
individuals with non-canceled BHP coverage ending as
of 11/1/20XX .
|
|
174
|
Number of
Plan Selections where age is 0 - 17 (net)
|
Count of unique
individuals who have non-canceled BHP coverage and who are age 0 -
17. Age represents the recorded age as of the policy
effective coverage date.
|
|
175
|
Number of BHP
Enrollees where
age 18 - 25 (net)
|
Count of unique
individuals who have non-canceled BHP coverage and who are age 18
- 25. Age represents the recorded age as of the
policy effective coverage date.
|
175.1
|
Number of BHP Enrollees where age is 26 - 34 (net)
|
Count of unique individuals who have non-canceled BHP coverage and
who are age 26 - 34. Age represents the recorded age as of the
policy effective coverage date.
|
|
|
176
|
Number BHP
Enrollees where
age 35 - 44 (net)
|
Count of unique
individuals who have non-canceled BHP coverage and who are age 35
- 44. Age represents the recorded age as of the
policy effective coverage date.
|
176.1
|
Number of BHP Enrollees where age is 45 - 54 (net)
|
Count of unique individuals who have non-canceled BHP coverage and
who are age 45 - 54. Age represents the recorded age as of the
policy effective coverage date.
|
|
|
177
|
Number of BHP
Enrollees where
age ≥55
(net)
|
Count of unique
individuals who have non-canceled BHP coverage and who are age
≥55.
Age represents the recorded age as of the policy
effective coverage date.
|
|
178
|
Number of BHP
Enrollees where
age is unknown (net)
|
Count of unique
individuals who have non-canceled BHP coverage and whose age is
unknown. Age represents the recorded age as of the
policy effective coverage date.
|
|
179
|
Number of BHP
Enrollees where
gender is Female (net)
|
Count of unique
individuals who have non-canceled BHP coverage and whose
gender is Female,
according to the selected policy.
|
|
180
|
Number of BHP
Enrollees where
gender is Male (net)
|
Count of unique
individuals who have non-canceled BHP coverage and whose
gender is Male,
according to the selected policy.
|
|
181
|
Number of BHP
Enrollees where
gender is unknown (net)
|
Count of unique
individuals who have non-canceled BHP coverage and whose gender is
unknown, according to the selected policy.
|
|
182
|
Number of BHP
Enrollees where
Race/Ethnicity is Hispanic or Latino (net)
|
Count of unique
individuals who have non-canceled BHP coverage and
who have indicated they are
Mexican, Mexican American or Chicano/a, Puerto
Rican, Cuban, or “other ethnicity” on their
application.
|
|
183
|
Number of
Plan Selections where Race/Ethnicity is White (net)
|
Count of unique
individuals who have non-canceled BHP coverage and
who have indicated they are
white on their application.
|
|
184
|
Number of BHP
Enrollees where
Race/Ethnicity is African American (net)
|
Count of unique
individuals who have non-canceled BHP coverage and
who have indicated they are
black or African American on their application.
|
|
185
|
Number of BHP
Enrollees where
Race/Ethnicity is Asian (net)
|
Count of unique
individuals who have non-canceled BHP coverage and
who have indicated they are
Asian Indian, Chinese, Filipino, Korean, Vietnamese,
Japanese, or "other Asian" on their application.
|
|
186
|
Number of BHP
Enrollees where
Race/Ethnicity is Native Hawaiian/Pacific Islander (net)
|
Count of unique
individuals who have non-canceled BHP coverage and
who have indicated they are Guamanian or Chamorro, Native
Hawaiian, Samoan, or Other Pacific Islander on their application.
|
|
187
|
Number of BHP
Enrollees where
Race/Ethnicity is American Indian/Alaska Native (net)
|
Count of unique
individuals who have non-canceled BHP coverage and
who have indicated they are American
Indian or Alaska Native on their application.
|
|
188
|
Number of BHP
Enrollees where
Race/Ethnicity is Multi-Racial (net)
|
Count of unique
individuals who have non-canceled BHP coverage and
who have indicated more than one distinct racial group as defined
above: American Indian / Alaska Native, Asian, Native Hawaiian /
Pacific Islander, African-American, and White, on their
application.
|
|
189
|
Number of BHP
Enrollees where
Race/Ethnicity is Unknown (net)
|
Count of unique
individuals who have non-canceled BHP coverage and
who did not indicate a race on their application.
|
* Medicaid/CHIP
continuous coverage unwinding reporting metrics from May 2023 through
July 2024. The metrics identified should include those applications,
consumers, and plan selections received and/or processed due to a
Medicaid/CHIP denial or termination.