{"text_format":"1","workbook":"xlsx","n_sheets":5,"sheets":["Instructions","Setup","Index","Finalize","Enter HIOS Plan ID"],"not_rendered":{"charts":0,"images":10,"macros":1,"external_links":0,"defined_names":29,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"Instructions","index":0,"n_rows":51,"n_cols":6,"rows_kept":51,"cut":false,"hidden":false,"merged":[[46,0,46,8],[40,5,40,8],[31,0,31,8],[32,1,32,4],[32,5,32,8],[40,1,40,4],[18,0,18,8],[22,0,22,8],[21,1,21,4],[21,5,21,8],[25,1,25,4],[25,5,25,8],[9,0,9,8],[12,0,12,8],[15,0,15,8],[16,0,16,8],[17,0,17,8],[0,0,0,8],[2,0,2,8],[3,0,3,8],[6,0,6,8],[4,0,5,8],[1,0,1,8],[7,0,7,8],[8,0,8,8],[11,0,11,8],[13,0,13,8],[51,0,51,8],[14,0,14,8],[20,0,20,8],[24,0,24,8],[43,0,43,8],[44,0,44,8],[10,0,10,8],[39,0,39,8],[36,0,36,8],[28,0,28,8],[35,0,35,8],[38,0,38,8],[74,0,74,8],[57,0,57,8],[45,0,45,8],[47,0,47,8],[48,0,48,8],[49,0,49,8],[50,0,50,8],[52,0,52,8],[53,0,53,8],[54,0,54,8],[55,0,55,8],[56,0,56,8],[66,0,66,8],[67,0,67,8],[68,0,68,8],[69,0,69,8],[70,0,70,8],[71,0,71,8],[72,0,72,8],[73,0,73,8],[58,0,58,8],[59,0,59,8],[60,0,60,8],[61,0,61,8],[62,0,62,8],[63,0,63,8],[64,0,64,8],[65,0,65,8]]}
["Individual Medical Plan Rate Schedule Format"]
["Release Date: 03-29-2024"]
[]
["Purpose"]
["The rate schedule format is for issuers filing individual health plans. This format must be used to submit the rates for these plans in the corresponding rate filing."]
[]
[]
["Instructions"]
["The sheet named \"Enter HIOS Plan ID\" is the rate schedule template required to be used to submit the rates for your plans. The rate schedule Excel file that you submit to the OIC via SERFF must include one \"Enter HIOS Plan ID\" sheet for each plan in your individual market portfolio."]
[]
["Setup Rate Schedules"]
["You may copy and fill out one \"Enter HIOS Plan ID\" sheet for each plan manually or use the macro program on the \"Setup\" sheet."]
[]
["Completing the Rate Schedule"]
["All items highlighted red, as seen below, require a user selection or entry. Alternatively, these fields also accept Excel formulas. Note, you must break the external workbook links prior to submitting the Excel rate schedule in SERFF."]
[]
["Conditional Formatting"]
["Conditional formatting points the user to required fields (red = requires user input, grey = no input required). Some fields become required after the user enters information in a previous cell. For example, if the user selects \"Yes\" in the cell corresponding to area 1 row and \"Available in area\" column, the cell to the right changes to required and the area 1 rate columns become required. Note, workbook calculations must be set to automatic for conditional formatting to operate properly.   "]
[]
[]
["Selection cells require the user to make a selection from a dropdown list. Click the highlighted cell, an arrow will appear to the right of the cell. Click the arrow and select one of the options."]
[null,"Before Selection",null,null,null,"After"]
[]
[]
["Entry cells require the user to type an entry."]
[null,"Before Entry",null,null,null,"After"]
[]
[]
["Do not enter values in cells that are greyed-out:"]
[null,"Example:"]
[]
["Dependent cell requirements: Cells that require entry based on values in another cell."]
[null,"Before Selecting \"Yes\"",null,null,null,"After"]
[]
[]
["Entering rates"]
["Non-smoker and smoker rates: If you do not use a tobacco factor in your rate development or the tobacco factor is 1, then the non-smoker and smoker rates must be the same. Do not leave the smoker rate cells blank, enter \"N/A\", or enter $0."]
[]
["Sheet names"]
["Rename the plan's worksheet so the sheet name matches the HIOS Plan ID"]
[null,"Before",null,null,null,"After"]
[]
[]
["Finalizing the Rate Schedule File"]
["After a rate schedule is completed for each plan in your individual market portfolio, finalize the rate schedule by:"]
["Running the macro program on the \"Finalize\" sheet; or"]
["1. Remove all external data links/connections to other workbooks. Remove external links using Excel's Edit Links command located in the Data tab, Connections group above."]
["2. Delete the Instructions, Setup, and Finalize sheets."]
["3. Save the workbook and rename it \"Rate Schedule DUPLICATE.xlsx\"."]
["4. Save another copy of the workbook in PDF format and name it \"Rate Schedule.pdf\"."]
["5. Submit both Excel and PDF copies in your individual rate filing via SERFF."]

{"sheet":"Setup","index":1,"n_rows":8,"n_cols":2,"rows_kept":8,"cut":false,"hidden":false,"merged":[[0,0,0,1],[4,0,5,0]]}
["Rate Schedules Setup"]
[]
["STEPS","INSTRUCTIONS"]
["Step 1","To use this macro program, macros must be enabled. If macros are disabled by default, you may have a notification above where you can enable macros."]
["Step 2","Number of Plans:"]
[null,"Enter the number of plans in your individual market portfolio"]
["Step 3","Click the Setup button."]
["Step 4","Setup is complete. A rate schedule has been copied for each plan in your portfolio. Please fill each rate schedule with the corresponding plan's information."]

{"sheet":"Index","index":2,"n_rows":7,"n_cols":7,"rows_kept":7,"cut":false,"hidden":true,"merged":[]}
["YesNoList",null,"ExchStatusList",null,"MetalLevelList",null,"Plan Type"]
["Select one",null,"Select one",null,"Select one",null,"Select one"]
["Yes",null,"In the exchange",null,"Catastrophic",null,"Non-Standardized Plan"]
["No",null,"Outside the exchange",null,"Bronze",null,"Standardized Non-Public Option Plan"]
[null,null,"Both inside and outside the exchange",null,"Silver",null,"Standardized Public Option Plan"]
[null,null,null,null,"Gold"]
[null,null,null,null,"Platinum"]

{"sheet":"Finalize","index":3,"n_rows":5,"n_cols":2,"rows_kept":5,"cut":false,"hidden":false,"merged":[[0,0,0,1]]}
["Finalize for Submission"]
[]
["STEPS","INSTRUCTIONS"]
["Step 1","To use this macro program, macros must be enabled. If macros are disabled by default, you may have a notification above where you can enable macros."]
["Step 2","Click the Finalize button."]

{"sheet":"Enter HIOS Plan ID","index":4,"n_rows":77,"n_cols":19,"rows_kept":77,"cut":false,"hidden":false,"merged":[[24,1,24,9],[24,10,24,18],[15,2,15,18],[16,2,16,18],[17,2,17,18],[18,2,18,18],[19,2,19,18],[0,0,0,18],[1,0,1,18],[20,2,20,18],[21,2,21,18],[12,2,12,18],[13,2,13,18],[14,2,14,18]]}
["Enter Issuer Name"]
["RATE SCHEDULE"]
["Plan Information"]
["Plan Name:",null,"Enter this plan's name"]
["HIOS Plan ID:",null,"Enter this plan's HIOS Plan ID"]
["Effective Date:",null,"2025-01-01"]
["Market Type:",null,"Individual"]
["Exchange Status:",null,"Select one"]
["Metal Level:",null,"Select one"]
["Plan Type:",null,"Select one"]
[]
["Plan Geographic Availability"]
["Area Number","Available in area?","Counties where this plan is available"]
[1,"Yes",{"$f":"IF(B14=\"Yes\", \"Enter the names of all counties in this area where this plan is available, separated each counties with a comma.\",\"\")","v":"Enter the names of all counties in this area where this plan is available, separated each counties with a comma."}]
[2,"Select one",{"$f":"IF(B15=\"Yes\", \"Enter the names of all counties in this area where this plan is available, separated each counties with a comma.\",\"\")","v":""}]
[3,"Select one",{"$f":"IF(B16=\"Yes\", \"Enter the names of all counties in this area where this plan is available, separated each counties with a comma.\",\"\")","v":""}]
[4,"Select one",""]
[5,"Select one",""]
[6,"Select one",""]
[7,"Select one",""]
[8,"Select one",""]
[9,"Select one",""]
[]
["Plan Rates"]
["Age","Non-Smoker Rates",null,null,null,null,null,null,null,null,"Smoker Rates"]
["Band","Area 1","Area 2","Area 3","Area 4","Area 5","Area 6","Area 7","Area 8","Area 9","Area 1","Area 2","Area 3","Area 4","Area 5","Area 6","Area 7","Area 8","Area 9"]
["0-14"]
[15]
[16]
[17]
[18]
[19]
[20]
[21]
[22]
[23]
[24]
[25]
[26]
[27]
[28]
[29]
[30]
[31]
[32]
[33]
[34]
[35]
[36]
[37]
[38]
[39]
[40]
[41]
[42]
[43]
[44]
[45]
[46]
[47]
[48]
[49]
[50]
[51]
[52]
[53]
[54]
[55]
[56]
[57]
[58]
[59]
[60]
[61]
[62]
[63]
["64 and over"]