How to identify members enrolled in qualified health plans, Arkansas Private Option or Arkansas Works (Medicaid Expansion)
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Use the HIOS ID (ME992). A valid HIOS ID is 16 characters (some submitting entities place values in this field that are not 16 characters wide). The presence of a 16 character wide HIOS ID indicates that the member is enrolled in a QHP plan. NOTE: The HIOS ID is not included in a standard data pull. It is available for an additional fee.
To understand the components of a HIOS ID, see below. HOIS IDs ending in 32 or 36 represent Arkansas Private Option or Arkansas Works populations.
HIOS ID value component definitions:
A 16-digit field that serves as a unique plan identifier for a plan and a given variant
Structured as follows: [HIOS ID][State][Product Iteration][Plan Iteration][Variant]
[HIOS ID] = 5-digit HIOS ID
[STATE] = 2-digit state code, such as CA, TX, AL, etc. (does include District of Columbia as DC)
[Product Iteration] = 3-digit number to indicate a unique product designation
[Plan Iteration] = 4-digit number to indicate a unique plan designation
[Variant] = 2-digit number to indicate cost-sharing variant and on/off Exchange
00 = Plan sold off the Exchange [Maximum Out of Pocket (MOOP) values not required for these plans]
01-06 = Plan sold on the Exchange in a given CSR variant
31-36 = On-Exchange Medicaid expansion plans (Arkansas and Iowa only)
The 14-digit version of this ID is often referred to as the “Standard Component ID” or SCID
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