3: Existing Individual Exchange 4: Existing CCSB Exchange Other Single, Single, Single, Pull-down list. Single, Pull-down list. 10 words. 1: Yes, 1: Yes, 2: No 2: No list. list. 1: New Network, 1: Yes, 2: New to 2: No Exchange, 3: Existing Individual Exchange 4: Existing CCSB Exchange 16.1.2 Provider network data must be included in this submission for all geographic locations to which applicant is applying for certification as a QHP. Submit provider data according to the data file layout in Appendix I Covered California Provider Data Submission Guide. The provider network submission for 2019 must be consistent with what will be filed to the appropriate regulator for approval if Applicant is selected as a QHP. The Exchange requires the information, as requested, to allow cross-network comparisons and evaluations. No for details provided. Single, Pull-down list. Attachment required 1: Attached (confirming provider data is for plan year2019), 2: Not attached Attached Document(s): 16.1.3 Applicant must complete and upload through SERFF, the Network ID Template located https://www.cms.gov/ No space for details provided. Single, Pull-down list. per Table 1.7 Key Action Dates, 1: Confirmed, template will be completed and uploaded 2: Not confirmed, template will not be completed 16.2 HMO 16.2.1 Network Strategy All questions are required for Applicants that are new entrants or proposing new networks.
3: Existing Individual Exchange 4: Existing CCSB Exchange Other Single, list. 1: Yes, 2: No Single, list. 1: New Network, 2: New to Exchange, 3: Existing Individual Exchange 4: Existing CCSB Exchange Single, Pull-down list. 1: Yes, 2: No Single, Pull-down list. 1: Yes, 2: No 10 words. 16.1.2 Provider network data must be included in this submission for all geographic locations to which applicant is applying for certification as a QHP. Submit provider data according to the data file layout in Appendix I Covered California Provider Data Submission Guide. The provider network submission for 2019 must be consistent with what will be filed to the appropriate regulator for approval if Applicant is selected as a QHP. The Exchange requires the information, as requested, to allow cross-network comparisons and evaluations. No for details provided. Single, Pull-down list. Attachment required 1: Attached (confirming provider data is for plan year2019), 2: Not attached Attached Document(s): 16.1.3 Applicant must complete and upload through SERFF, the Network ID Template located https://www.cms.gov/ No space for details provided. Single, Pull-down list. 1: Confirmed, template will be completed and uploaded per Table 1.7 Key Action Dates, 2: Not confirmed, template will not be completed 16.2 HMO 16.2.1 Network Strategy All questions are required for Applicants that are new entrants or proposing new networks.
CCSB%20QHP%20Certification%20Application%20Plan%20Year%202019%20Quarterly%20Application_Final.docx