Appendix N: HIOS ID Value Component Definitions

Owned by Kathleen Hart (Unlicensed)
Last updated: Sept 05 2019
1 min read

The following tables provide valid value component requirements requirements for ME992 and MC992. The 16-byte value (CMS field name INSRNC_PLAN_ID) is comprised of several components, each with a specific meaning. All components should be provided in the field.

HIOS_ID or INSRNC_PLAN_ID

  • 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] = Five (5) digit HIOS ID
    • [STATE] = Two (2) digit state code, such as AR, CA, TX, AL, etc. (does include District of Columbia as DC)
    • [Product Iteration] = Three (3) digit number to indicate a unique product designation
    • [Plan Iteration] = Four (4) digit number to indicate a unique plan designation
    • [Variant] = Two (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