Document Name Document Type
Form CMS-10433 Administrative Data Template QHP Certification Form and Instruction
Form CMS-10433 Plan Benefits Template QHP Certification Form and Instruction
Form CMS-10433 Network ID Template QHP Certification Form and Instruction
Form CMS-10433 Plans and Benefits Template QHP Certification Form and Instruction
Form CMS-10433 Prescriptions Drug Formulary Template QHP Certification Form and Instruction
Form CMS-10433 Rate Table Template QHP Certification Form and Instruction
Form CMS-10433 Service Area Template QHP Certification Form and Instruction
Form CMs-10433 Business Rules Template QHP Certification Form and Instruction
Form CMS-10433 QHP Certification Instrument Screenshots QHP Certification Form and Instruction
Form CMS-10433 Reinsurance Program and Risk Adjustment Program QHP Certification Form and Instruction
K_ECP_Data_Elements_508.pdf Other-Data Elements
CMS-10433 Administrative Data Template A_Accreditation_Administrative_Web_Form_508.pdf Form and Instruction
CMS-10433 Plan Benefits Template C_Plan_ID_Crosswalk_PY2025_Template_508.pdf Form and Instruction
CMS-10433 Network ID Template B_URL_Template_508.pdf Form and Instruction
CMS-10433 Plans and Benefits Template D_Plans_and_Benefits_Template_508.pdf Form and Instruction
CMS-10433 Prescriptions Drug Formulary Template E_Prescription_Drug_Template_508.pdf Form and Instruction
CMS-10433 Rate Table Template G_Rates_Table_Template_508.pdf Form and Instruction
CMS-10433 Service Area Template I_Service_Area_Template_508.pdf Form and Instruction
CMs-10433 Business Rules Template H_Business_Rules_Template_508.pdf Form and Instruction
CMS-10433 QHP Certification Instrument Screenshots J_Interoperability_Web_Form_508.pdf Form and Instruction
CMS-10433 Reinsurance Program and Risk Adjustment Program F_RA_Programs_Payment_Ops_Data_508.pdf Form and Instruction

            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.