Tip: Identifying Members in Qualified Health Plans and Arkansas Marketplace Exchange Plans
Number | 0046 |
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Submitting Entities | All |
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Add Date | Feb 7, 2020 |
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Update Date | Dec 30, 2021 Aug 10, 2023 |
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Update | A new field is available after March 2023 on Member/Enrollment records for qualified health plan identification. When ME001_CAT = QHP, the record represents a qualified health plan. The original process still works but this label should make the selection easier for the data users. Included in the August 2023 Data Tips email. Updated for the December Data Tips email. |
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Description | How to identify members enrolled in qualified health plans (QHP) and differentiate the Arkansas Marketplace Exchange plans subset
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Action / Resolution | Use the field,ME001_CAT, to identify members enrolled in qualified health plans. When ME001_CAT = QHP, the record represents a qualified health plan which includes qualified health plans and Arkansas Marketplace exchange plans. An alternative process: 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, Arkansas Private Option, or Arkansas Works 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. HIOS ID value component definitions:
Members who fall into this group are the Arkansas Medicaid Expansion members. There is no member ID or key to link the records across submitting entities. If members must be linked across submitting entities, it is recommended that the Study_ID (ME998+ME013) be used. Arkansas Medicaid member record overlap: Records for members enrolled in these plans will be present in both the commercial entity member data and the Arkansas Medicaid member data. Arkansas Medicaid member records associated with these commercial entity members are identified as: Submitting Entity ID (ME001) = 99MCD1 and Product ID (ME040) = 06. It is recommended that the commercial entity enrollment records by used in analytic projects. The Arkansas Medicaid records have duplicative information. See also: Tip: Identifying Arkansas Medicaid Members in Health Care Independence Programs (HCIP)
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Category 1 | Arkansas Works/QHP |
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Category 2 | Data Selection |
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Tip / Issue | Tip |
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