Today, in an effort to
facilitate greater access to Marketplace data, CMS released a set of
state-based Marketplace public use files (SBM PUF). Each file contains
data associated with certified qualified health plans (QHPs) and
stand-alone dental plans (SADPs) within state-operated Marketplaces.
While health plan information
including benefits, copayments, premiums, and geographic coverage is
publically available on HealthCare.gov, these downloadable files on the
other hand, will help researchers and other stakeholders conduct timely
benefit and rate analysis.
With that, the SBM PUF is
comprised of the following 2016 Data
and Cost Sharing PUF – Plan-level data on essential health
benefits, coverage limits, and cost sharing.
PUF – Plan-level data on individual rates based on an eligible
subscriber’s age, tobacco use, and geographic location.
Attributes PUF – Plan-level data on maximum out of pocket
payments, deductibles, cost sharing, HSA eligibility, formulary ID, and
other plan attributes.
Rules PUF – Additional information on how an issuer determines
the premiums for a specific application. For example: the
maximum number of dependents used to determine a family rate for
single or two parent families, the maximum age for a dependent,
whether a domestic or same sex partner may be treated as a spouse,
Number of tobacco-free months considered when qualifying for a
Area PUF – Issuer-level data on the geographic coverage or
service area (i.e., where the plan is offered) including state,
county, and zip code.
– Issuer-level data identifying provider network URLs.
To download the files, visit: https://www.cms.gov/CCIIO/Resources/Data-Resources/sbm-puf.html