10 words. Single, 20 10 words. Nothing list. Nothing Nothing required required required 1: Applicant, 2: Hospital, 3: N/A 10 words. Single, 20 10 words. Nothing list. words. Nothing required Nothing required 1: Applicant, 2: Hospital, required 3: N/A 10 Single, 20 10 words. Nothing list. words. Nothing required Nothing required 1: Applicant, 2: Hospital, required 3: N/A 10 words. Single, 20 10 words. Nothing list. words. Nothing required Nothing required 1: Applicant, 2: Hospital, required 3: N/A 10 words. Single, 20 10 words. Nothing list. words. Nothing required Nothing required 1: Applicant, 2: Hospital, required 3: N/A 10 words. Single, 20 10 Nothing list. words. Nothing required Nothing required 1: Applicant, 2: Hospital, required 3: N/A 16.5.3.3 Identify the number of participating providers who have terminated from the provider network betweenJanuary 1, 2017 and December 31, 2017, by rating region. Indicate reason for provider termination: non-agreement on rates, non-compliance with contract provisions, re-design of network or other (explain). No space for details provided. Terminated by Terminated by Reason Issuer Provider Region 1 Integer. Integer. 20 words. Region 2 Integer. Integer. 20 Region 3 Integer. Integer. 20 Region 4 Integer. Integer. 20 Region 5 Integer. Integer. 20 Region 6 Integer. Integer. 20 words. Region 7 Integer. Integer. 20 words. Region 8 Integer. Integer. 20 words.
10 words. Nothing required Single, list. 1: Applicant, 2: Hospital, 3: N/A 20 Nothing required 10 words. Nothing required 10 words. Nothing required Single, list. 1: Applicant, 2: Hospital, 3: N/A 20 words. Nothing required 10 words. Nothing required 10 Nothing required Single, list. 1: Applicant, 2: Hospital, 3: N/A 20 words. Nothing required 10 words. Nothing required 10 words. Nothing required Single, list. 1: Applicant, 2: Hospital, 3: N/A 20 words. Nothing required 10 words. Nothing required 10 words. Nothing required Single, list. 1: Applicant, 2: Hospital, 3: N/A 20 words. Nothing required 10 words. Nothing required 10 words. Nothing required Single, list. 1: Applicant, 2: Hospital, 3: N/A 20 words. Nothing required 10 Nothing required 16.5.3.3 Identify the number of participating providers who have terminated from the provider network betweenJanuary 1, 2017 and December 31, 2017, by rating region. Indicate reason for provider termination: non-agreement on rates, non-compliance with contract provisions, re-design of network or other (explain). No space for details provided. Terminated by Issuer Terminated by Provider Reason Region 1 Integer. Integer. 20 words. Region 2 Integer. Integer. 20 Region 3 Integer. Integer. 20 Region 4 Integer. Integer. 20 Region 5 Integer. Integer. 20 Region 6 Integer. Integer. 20 words. Region 7 Integer. Integer. 20 words. Region 8 Integer. Integer. 20 words.
CCSB%20QHP%20Certification%20Application%20Plan%20Year%202019%20Quarterly%20Application_Final.docx