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SERFF industry user Manual appendix ii

1. Request an ID to access the SERFF system in the Beta testing environment For inquiries please email serffplanmgmt naic org 3 Under Business click on Federal Plan Management Data Templates SERFF Industry Manual Appendix I Page 28 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Home About SERFF Contact Us Search i National Association a Help insurance Commissioners Overview of QHP Templates Last Updated March 21 2013 On November 20 2012 CMS published CMS Form Number CMS 10433 Initial Plan Data Collection to Support QHP Certification and other Financial Management and Exchange Operations A part of the collection of this data will be in the farm of Microsoft Excel workbooks with embedded Macros which will assist the filing issuers as they gather and enter the required data elements These Microsoft Excel workbooks are referred to as templates and are intended to create a nationwide standard of plan and issuer level data collection for the use of QHP certification exchange operations and oversight activities The templates below represent the final versions that will be used by issuers to use in applying for certification to participate in the Federally facilitated Exchanges and State Partnership Exchanges Most State Based Exchanges will also use these templates Please note that external testing of the template
2. Administrative Data Template Revise Essential Community Providers Template Revise Rates Template Revise www Ww Business Rules Template Revise 3 In Revise Mode the user will be able to Revise any items on the Templates or Supporting Documentation tabs Click the _Revise button next to the item that needs to be updated This will allow the user to make the necessary changes SERFF Industry Manual Appendix I Page 43 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Templates Supporting Correspondence Documentation Schedule Item Status Remove Revision G State QHP Application Attestations Description Digitally sign and attach your attestation G AttestationForm pdf Comment T No Attachment Required ba Bypass Remove attachments to bypass Attachments Sample Attestation signed pdf_ Remove Attach Files Previous Version Name State QHP Application Attestations Comments Attachments Sample Attestation signed pdf 6 After the user clicks on Revise they will see a greyed out Previous Version of their line item below the area where they are making the change That original view of the item will always show no matter what changes are made to this line item in the life of this Binder 7 Once a change has been made a Remove Revision bytton will show This allows the user
3. Component ID e Plan Availability e Plan Disposition Status e Plan State Status Disposition for CELT WY14 125000404 Close Plan Binder Name PBM_v6 0_0312 2013 Plan Year 2014 Market Type Individual Authors TC SERFF Support i x 5 Reviewers SERFFStaff SERFF Tracking Num CELT WY14 State Wyoming State Tracking Num 0312 2013 state 125000404 zzStateSuppo SERFF Status Closed Company Celtic Insurance Company Tracking Num Finish and Company Submit Date Submitted 03 12 2013 02 19 PM Comments Plans approved Plan Name Standard Component ID Plan Availability Plan Disposition Status Plan State Status 12345WY1230001 Approved Plan Approved 12345WY1230002 Plan Disposition Status Plan State Status Approved Plan Approved 12345WY1230003 Plan Disposition Status Plan State Status Disapproved Plan Disapproved Attachments Close SERFF Industry Manual Appendix I Page 47 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Certification Certifications indicate a second level of review In some states certification will be used to indicate a recommendation or determination by the Exchange that the plan s have been accepted for use on the Exchange Multiple Certifications may be submitted as decisions may take place at varying times for plans included in a single Binder The user will receive a message in the Message Center indicating that t
4. Expand All Collapse All o attestation Description Attach your Attestation here Supporting Doc pdf Comment l No Attachment Required ia Bypass Remove attachments to bypass Attachments Completed Fillable 3 odf Remove Attach Files 3 Ifthe user wishes to Bypass a Supporting Documentation item they will click Bypass Plans Associate Fees Templates l Supporting Company Correspondence Documentation and Contact Schedule Items i a attestation a amp Third Party Filer Description Attach your company contract if you are 4 Third Party Filer P Supporting Doc pdf Comment Mot a Third Party Filer l No Attachment Required M Bypass Uncheck to add attachments _ Attach Files SERFF Industry Manual Appendix Il Page 34 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II 4 User Added Supporting Documentation Click the Add Supporting Documents button and complete the Name field After creating and naming the Supporting Documentation item the user may o Upload one or more attachments o Upload one or more attachments and enter a comment o Click No Attachment Required and enter a comment Remove il amp El Name New Supporting Doc tem Comment l No Attachment Required Attachments POFI odf Remove Attach Files 13 Note Users must
5. Issuer ID amp NCQA Org ID amp URAC App Number oo 98765 45678 123456 _add State Save Cancel The company is required to have a HIOS Issuer ID in order to have your company available as a selection when creating a Binder The Accrediting Entity identifiers are not required but should be entered if your company is accredited Enter either the NCQA Org ID the number assigned by NCQA when an issuer applies for accreditation and or a URAC App Number the identifier assigned by URAC when an issuer applies for accreditation For more information regarding adding companies please refer to page 29 of the SERFF User Manual SERFF Industry Manual Appendix I Page 7 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II 7 Adding Company Information to the Company Profile Once a company profile has been retrieved via company search authorized users may edit the company information For more information regarding retrieving a company via the search please refer to page 32 of the SERFF User Manual 1 Open the company profile to be edited Edit Deactivate Back to Search Results Company Information Instance celticinsurance CoCode 80799 Company Name Celtic Insurance Company Address 1100 Walnut Ave Suite 1500 Kansas City Missouri 64106 Telephone Number 816 785 3747 Fax Number 816 460 0191 Compan
6. field etc an error will return The user will then be able to correct the error and revalidate Yalidation Report x BY Invalid select from list Step 3 Finalize Template 1 Once the Validation of the Template is complete the user will Finalize the Template This Finalization step converts the file into XML which is required in order to Validate the Templates with the federal hub using web services and integration with the federal system using SERFF 2 The Finalize button is directly below the Validate button SERFF Industry Manual Appendix I Page 30 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II 3 A dialog box will open which will allow the user to save the Template as XML 2 x Save in E Desktop a My Documents F My Computer Lo My Network Places Confidential Files r v l My Recent Documents D E PAS Implementation Checklists a Computer a My Network Places Confidential fim Files File name save as Eype xm Files xml se Cea 4 Save the document as XML User can rename the file but it is recommended that the Template title be kept in the name for ease of identification 5 Upload the Template into the correct area of the Templates tab Example Administrative Template under the Administrative Data Template section It is important that the user upload the
7. is a name created by the issuer used to identify the plan or group of plans contained within the Binder e Plan Year The Author enters the year the plans are effective for the Exchange Marketplace or in the outside market The Plan Year must not be less than the current year or greater than four years from the current year e Number of Plans to Create The Number of Plans field is used to identify the number of plans that will be contained in the binder The number cannot be modified after completion of the wizard This number must be the same as the total number of Standard Component IDs represented in attached templates 1 250 SERFF Industry Manual Appendix II Page 14 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Market Type Individual or Small Group e Other Authors The Creator or Author of the filing may assign Other Authors to a Binder s Create Plan Binder Asterisk denotes required field State Please Select Binder Name of Plans to Create oe Assign Authors Harrison Donald McDermott Carolyn SERFF Support TC zindustrySupportLS zSERFFStatt rhb Click on the State drop down box and select appropriate State 2 Enter the Binder Name amp Note The Binder Name is an issuer defined name to identify the Plan or group of Plans contained within a Binder The Plan Binder Name is not transmitted to t
8. items for a particular schedule on a filing Search Cancel 3 A user must know the exact SERFF Tracking Number of the filing for which they want to link Schedule Items to a Binder in order to begin the Search 4 The user must enter a SERFF Tracking Number and at least one Schedule Item search criterion o The Schedule Item name can be a partial name user can use the wildcard to pull back results o User can use wildcard in all fields except the SERFF Tracking Number field o Schedule Items from draft SERFF Filings may not be associated to SERFF Plan Binders SERFF Industry Manual Appendix I Page 21 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II SERFF Tracking Number MEIC 1 28285399 Items f tracking number must be Supporting Document tem Name Y used Additionally criteria must be entered in at least one other field The asterisk serves as a wildcard and can be used to pull back all of the items for a particular schedule on a filing A valid complete SERFF Search 5 Click the button 6 Filing details will appear edule SERFF Tracking Number WEIC 1 28285399 Items Rate Schedule tem Name FS A valid complete SERFF tracking number must be Supporting Document Item Name used Additionally criteria must be entered in at least one other field The asterisk ig Serves gs 5 w
9. to undo the most recent revision and set the item back to its original form Save Once all necessary changes have been made the user will click on the _save button Next to the updated item the Draft icon will show This indicates that the item has been updated but not yet submitted to the state State QHP Application Attestations SERFF Industry Manual Appendix II Page 44 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Step 2 Create Amendment 1 Click on the Filing Correspondence tab 2 Click the Create Amendment button Amendment of CELT WY14 125000380 Save Apply Cancel Binder Name PBM_v6 0_0328 2013 Plan Year 2014 Market Type Individual Authors TC SERFF Support z5 SERFF Tracking Num CELT WY 14 125000380 State Wyoming State Tracking Num CREATE OBJ Reviewers Company Celtic Insurance Company Company Tracking Num ObjRes 0312 Date Submitted Comments Changed Items No Templates changed No Supporting Documents changed Add Draft Binder Items Save avnty comoel 3 Fill in Comments section This is required 4 To bring in the changed item s click on the Add Draft Binder Items putton SERFF Industry Manual Appendix I Page 45 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End
10. 07 2013 Binders Transaction Company Company Submitter State SERFF Tracking Binder Name Plan Name Standard Amount Transaction Number Date Name Code Name Number Component ID 03 07 2013 Celtic 80799 Donald Wyoming CELT WY14 125000378 PBM_v6 0_0328 Newco Individual 12345WY1230003 15 00 125000465EFTTESTEFTSEFTFILER201303070924 Insurance Harrison 2013 Plan Silver Company 03 07 2013 Celtic 80799 TC SERFF Wyoming CELT WY14 125000380 PBM_v6 0_0328 12345WY1230003 15 00 12500047 1EFTTESTEFTSEFTFILER201303071417 Insurance Support 2013 Company 03 07 2013 Celtic 80799 TC SERFF Wyoming CELT WY14 125000380 PBM_v6 0_0328 12345WY1230002 15 00 125000470EFTTESTEFTSEFTFILER201303071417 Insurance Support 2013 Company 03 07 2013 Celtic 80799 Donald Wyoming CELT WY14 125000378 PBM_v6 0_0328 Newco Individual 12345WY1230002 15 00 125000464EFTTESTEFTSEFTFILER201303070924 Insurance Harrison 2013 Plan Platinum Company 03 07 2013 Celtic 80799 Donald Wyoming CELT WY14 125000378 PBM_v6 0_0328 Newco Individual 12345WY1230001 15 00 125000463EFTTESTEFTSEFTFILER201303070924 Insurance Harrison 2013 Plan Gold Company subtotal for 03 07 2013 5 transaction s total amount 75 00 Create Binder Step 1 Click Create Binder Filings Plan Management My Binders Create Binder The first step in the Binder Wizard is to accurately complete the following fields e State The state to which the binder will be submitted e Binder Name The Binder Name
11. 9123 State of Domicile Illinois Company Type LAH HHS Issuer ID 80799 Kansas City MO 64106 816 783 8747 Phone Accreditation Information ACOA i NCQA Organization ID 4 Accreditation ch The Accreditation IDs Issuer Name Issuer State Market Type Product Type Accreditation Status Expiration Date entered on the Compl ABC Test Company WY Commercial PPO Commendable 03 01 2014 oN a I after the Binder has b Correspondence Users familiar with SERFF Rate Form Filings will notice that the Correspondence tab is almost unchanged on SERFF Binders Pieces of Correspondence found on SERFF Binders are e Objection Letters e Response Letters e Amendments e Dispositions e Certifications e Filer Notes e Notes to Filer e Notes to Reviewer The following Filing Correspondence items are not available on SERFF Binders e Post Submission Updates e Reminders SERFF Industry Manual Appendix I Page 36 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Responding to an Objection Letter lf a Binder and its collection of plans does not meet all of a state s filing requirements an Objection Letter will be created by the state An Objection Letter requires the Author or another user to submit a Response Letter which may include one or more items within the Binder The Author will receive a message in the Message Center stating that an Objection Lette
12. Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix Il Plan Management View lf a user has the Plan Management role they will see a tab named Plan Management directly to the right of the Filings tab Navigating to this tab will allow the user to access features within the Plan Management section of SERFF When on the Plan Management tab depending on roles assigned to a user the filer will have the option to view My Binders click Create Binder view Plan Management General Instructions or run an EFT Report Settim EFT Report Messages Filings Plan Management Billing My Binders Create Binder Flan Management General Instructions My Binders My Binders is the default view All Binders regardless of status will display in this view My Binders State W Company Name Market Type Binder Name Status Date Submitted Oregon New Health Insurance Co Individual Plan Binder Draft Oregon New Health Insurance Co Small Group Sample Binder Name Draft Binder statuses are as follow Draft S Submitted amp Pending Industry Response Pending State Action Closed SERFF Industry Manual Appendix I Page 11 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Each column is sortable as to make it easier to locate particular Binders For examp
13. End User Training Appendix II Available Draft Items l State QHF Application Attestations Supporting Document 18 Select item or items that have been amended and need to be included in the Response Letter by putting a check in the box to the left of the item title Add 19 Click the button 20 The item will be brought into the Response Letter Supporting Documentation Item Changes Save 21 Click the Save ton 22 To submit to the state click the Submit button 23 Once the Response Letter has been submitted the time stamp will update on the Correspondence tab Response Created On Response Submitted On 03 25 2015 03 25 2013 04 20 PM SERFF Industry Manual Appendix II Page 41 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Amendments This is only used when the Amendment is not in response to an Objection Letter for example the filer has decided to add a schedule item Step 1 Revise Add Schedule Item 1 The user will click on Revise Filings Plan Management Messages Billing Settings Filing Rules Templates My Binders Create Binder Plan Management General Instructions EFT Report inter ite ae Wyoming View Binder Log Binder Name PBM_v6 0_0321 2013 SERFF Tracking Num CELT WYv1i4 125000525 SERFF Status Submitted Plan Year 2014 State Tracking Num Date Submitted 05 21 2013 Mar
14. SERFF INDUSTRY USER MANUAL APPENDIX I v6 0 Updated 03 29 2013 SERFF Providing flexibility promoting uniformity SERFF End User Training Appendix II Table of Contents MUOU Olas eseettaen egestas ite eee chested atelier tees ye eat emeedas ee aan 2 Conventions Used In This Manual cccccccecececececececaeeecececuceeeeee 2 SEREFF Binder Tracking Number cccccecceeeeceeeeeceteeeteeeteeeteeeeees 3 SERFF Plan Management Transaction Fe S ccccceceseeeeeteeeeeees 3 SERFF Plan Management Roles iz ciciscevacunxexncccusvinantessvonerienniensave 4 BS ELEN S acetate cece hase dase arn enc eutectic aoeane dt ea anaioernens 5 Message Settings scanansacisaetsaceataaiadiesassecannetsanieintstanenineumieiatenestanadan 5 CS OIA AUN SS a EE E eatin annette 7 Messages anana a a aa 10 Pian Management VICW rorritririene annene 11 Plan Management General Instructions ccceceeeeeeeeeeeeeeeeeeees 12 Generate EFT Report n snnoensennoenesnrsrrrnrnerronrrerrenrrnrrerrrrrrerrerene 13 Create BIG GM ica eters ceovarciscsscoenecaseucsannadowseecietundeuassaesenneoundadansexcenatvaueians 14 Binder Wizard cece cc cccceccecececeaeececeaececeaeuceceaeaeuceaeaeuceavaeseeananeneas 14 Binder at a Glance 2 0 cece cece ec ccececucucucucucucucecucucucucucucececeeececenenenes 17 PaSA cee vac eine oetlenes tack lela dasha E 19 Associate Schedule ItOMS ccccccececececcececececececaeaeaecenecece
15. User Training Appendix II Available Draft Items l State QHP Application Attestations Supporting Document 2 Cancel Add r 5 Select item s that have been amended and need to be included in the Amendment by putting a check in the box to the left of the item title Add Click the nad button 7 The updated item s will now show in the Amendment Letter Save 8 Click the button 9 To submit to the state click the button H SERFF Industry Manual Appendix Il Page 46 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Disposition When a Disposition is created for a Binder the SERFF status of that Binder is changed to Closed The Disposition can be found on the Correspondence Tab of the Binder The user will receive a message in the Message Center indicating that there is a Disposition on the Binder View a Disposition 1 Click on the Binder Correspondence tab Plans Associate Fees Templates Supporting Company Schedule Items Documentation and Contact 2 Click the blue link under Dispositions Dispositions Status Created By Created On Submitted By Date Submitted Submitted zzSERFFStaff zzStateSupportTC 03 19 2013 zzSERFFStaff zzStateSupportTC 03 19 2013 11 48 AM The Disposition lists each plan including the following corresponding data e Plan Name e Standard
16. XML version of the template and not the XLS Administrative Data Template Description Collects general company and contact information Template Attachment wy admin Template xml Template Errors Comments SERFF Industry Manual Appendix I Page 31 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix Il 6 Once the user is finished uploading all the Templates the user will click the button 7 After all of the Templates are uploaded the user must validate at the Binder level by Validate clicking the button for the Templates to be validated by the federal system 8 The user must then select the appropriate Templates to be validated 9 Once the Validate button has been clicked users will see the Pending Validation icon displayed to the left of the Template title This icon will show until the Template is successfully validated or validation fails Administrative Data Template i Essential Community Providers Template amp Note There are specific icons for every Template status Icon Legend oe Pending Validation a Successfully Validated a Validation Failed 4 Draft 10 The templates will either be successfully validated or the validation will fail If the validation fails the user will see the Validation Failed icon next to the Template Essential Community Providers Template 11 If Validation f
17. ailed user will need to remove the incorrect template correct any issues within the template and complete steps 1 through 5 Then the user will upload the corrected Template into SERFF to submit for Validation with the federal system again 12 If the Template passes Validation the Successfully Validated icon will appear Administrative Data Template Essential Community Providers Template 13 Regardless of the Validation successful or failed the user will receive a message in their Message Center when the Validation comes back amp Note The state will only see successfully validated Templates If the validation ona Template ever fails the state will not see the Template SERFF Industry Manual Appendix I Page 32 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Note Final validation with the federal system is not immediate Timeframes could range from minutes to several hours amp Note As a best practice any large file should be compressed Zipped to speed upload Supporting Documentation The Supporting Documentation tab contains several state specific requirements as well as Federal requirements to be completed by the issuer Two of these Federal requirements will be Part Unified Rate Review Template URRT and Part III Actuarial Memorandum which are also market wide reforms To update Supporting Documenta
18. ained within the Binder The plans are identified on the Fees Tab by the Standard Component ID The user will need to check Plan Management General Instructions for the specific state to know if they assess fees per plan Adding Fees Edit 1 Click the button 2 Add the necessary fees for each plan in the Binder amp Note To submit a Binder all fees must be greater than 0 00 or Bypassed 3 Add Fee Description if necessary Templates For the purposes of SERFF Plan Management a template is a Microsoft Excel workbook developed by CCIIO used to collect a large amount of plan and issuer level data for the use of QHP certification Exchange operations and oversight activities Issuers should download the templates from their source and complete them on the desktop initiating any validation checks within the Excel templates themselves Templates generally have additional validation that is performed upon upload into the SERFF system The validation checks are created and managed by the regulatory body providing the data collection template and are initiated in SERFF via web services All the Templates are Federal Templates at this time There are eight Federal Templates configured on the Templates tab Depending on the Exchange model of the state to which the user is creating the Binder the user may have eight templates but there may be fewer Some State based Exchanges have elected to implement fewer Templat
19. al Instructions EFT Report sve rony comen Wyoming View Binder Log Binder Name PBM_v6 0_0321 20135 SERFF Tracking Num CELT WY 14 125000525 SERFF Status Submitted Plan Year 2014 State Tracking Num Date Submitted 03 21 2013 Market Type Individual Company Tracking Num IndustryTraining_03 21 2013 Company Status Submitted Plans Individual Market Authors TC SERFF Support Reviewers k Templates Supporting Benefits Group Revise Administrative Data Template Revise Essential Community Providers Template Revise Rates Template Revise Www Ww Business Rules Template Revise 7 In Revise Mode the user will be able to Revise anything on the Templates or Supporting Documentation tabs 8 Click the _Revise_ button next to the item that needs to be updated Supporting Correspondence Documentation Revise State QHP Application Attestations 9 This will allow the user to make the necessary changes SERFF Industry Manual Appendix I Page 39 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II f anaia Supporting eines y Documentation Expand All Collapse All Schedule Item Status Remove Revision State QHP Application Attestations Description Digitally sign and attach your attestation A AttestationForm pdf Comment r No Attachment Required Byp
20. andard Availability Plan Plan State Action Date Name Component ID Disposition Status Status Certified 12345WY1230001 Approved Plan 03 12 2013 02 23 PM Approved Certified 12345WY1230002 Approved Plan 03 12 2013 02 23 PM Approved Certification 12345WY1230003 Disapproved Plan 03 12 2013 02 23 PM Denied Disapproved Date Submitted 03 12 2013 02 23 PM Comments enter comments Attachments Close SERFF Industry Manual Appendix I Page 49 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved
21. ass Remove attachments to bypass Attachments sample Attestation signed pdf Remove Attach Files Previous Version Name State QHP Application Attestations Comments Attachments Sample Attestation signed pdf 10 After the user clicks on Revise they will see a greyed out Previous Version of their line item below the area where they are making the change That original view of the item will always show no matter what changes are made to this line item in the life of this Binder 11 Once a change has been made a _ Remove Revision bytton will show This allows the user to undo the most recent revision and set the item back to its original form Save 12 Once all necessary changes have been made the user will click the button 13 Next to the updated item the Draft icon will show This indicates that the item has been updated but not yet submitted to the state E Compliance Plan and Organizational Chart Cover Sheet amp Step 3 Create Response Letter 14 To submit the changes to the state return to the Correspondence Tab 15 Click on the Respond button to open the Response Leiter 16 Fill in the Comment section This is a required field 17 To bring in the changed item s click on the Add Draft Binder Items pytion SERFF Industry Manual Appendix I Page 40 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF
22. ation of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Step 1 Complete Template 1 Expand the Template line item to access the link to the SERFF HIX page to access the Templates Essential Community Providers Template Description This is a federal data collection template for provider and street address information about the Essential Community providers in issuer networks To download the latest version please visit the SERFF website at htto www serff com hix htm Please upload the XML version of the template created by the Finalize action and not the Excel file itself 2 Scroll down to Documentation section Business Technical Federal Plan Management Data Templates Please use the HIXTechQuestions naic org e mail to SERFF Plan Management Blueprint Responses Plan Management Scope Change Summary Inform the SERFF Team of your intention to use the SERFF Plan Management Scope v 2 Health API Exchange Plan Management and SERFF How the Inform the SERFF Team of who will be working on the Pieces Fit project be they State employees consultants or vendors Crosswalk Request application ID for the Beta testing environment Map Goals Swim Lanes of Proposed Exchange Models SERFF Plan Management Project General Timeline a APT is for states n of NAIC SERFF and SERFF Plan Management innia ting a State B I Exchange only At mjet this time we are not offering web services to
23. e 316 783 8990 Ext Ex 123 555 4567 Fax Ext Ex 123 555 4567 Save Cancel Message Settings Choose on the left hand side of the screen Messages on the right are messages that will be received messages on the left are messages that will not be received It s recommended that users opt in to all new Binder messages SERFF Industry Manual Appendix I Page 5 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Filing Activity Messages Filing Activity Messages Hel Added Schedule tem for Binder Billing Low Block Warning Binder Amendment Letter Submitted Compact Filing Acknowledge Included State Binder Certification Letter Submitted Effectrve implementation Date Updated Binder Disposition Letter Submitted Disposition Submitted Binder Filer Note Deleted Public Access Defaults Restored Binder Filer Note Saved Filing Reopened Binder Note To Filer Submitted 66 Filing Submitted with Default Public Access Binder Note To Reviewer Deleted Filer Note Created Binder Note To Reviewer Submitted 3 Industry Reminder Notification Generated Binder Objection Letter Submitted Note To Filer Submitted 4 To move a message highlight the message and click on the appropriate arrow to move the message Messages related to Plan Management are as follows e Added Schedule Item for Binder e Binder Amendment Letter Submitted e Binder Certi
24. e Binder will be created Note Only companies that have the Licensed States data configured will show in this drop down 2 Select the Contact for the Binder 3 Click Next to move to the next step of the Binder Wizard Page 16 of 49 SERFF Industry Manual Appendix II Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Step 3 Enter Standard Component ID s Enter Plan Data amp Confirm State Oregon Company New Health Insurance Co Binder Name Sample Binder Name Contact Laura Lacey Plan Year 2014 Market Type Small Group Asterisk denotes required field Standard Component ID 2 Standard Component ID Plan 1 42390R0231 Plan 2 42390R0232 The Standard Component IDs must match the Standard Component IDs on the templates uploaded Plan 3 42390R0233 to this Plan Binder Previous Finish Cancel 1 Enter the Standard Component ID amp Note The Standard Component ID is an ID assigned by HIOS once the product has been registered with HIOS 2 Click Finish amp Note The Standard Component IDs must match the Standard Component IDs on the templates uploaded to this Plan Binder Binder at a Glance Binder at a Glance contains key information about the Binder and is always displayed at the top of the page regardless of where the Author is working Binder Name Sample Binder Name SERFF Trackin
25. each plan select the Schedule Item s that should be associated to that plan by clicking the checkbox to the left of the line item SERFF Industry Manual Appendix I Page 23 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II 47390R0231 Form Schedule Items E Form Form Form Action Action Specific Readability Attachments Number Type _ Name Data _ Score n m 3 OTH Form i Initial 45 ppFi pdf Supporting Document Items E Document Name Attachments m Cover Letter or Explanatory Memorandum Comments E 3694 Certification of Compliance EA POF pdf m 31366 Standards for Small Employer Health Benefit Plans E POFS pdf completed Fillable 1 odf 4 7390R0737 Form Schedule Items C Form Form Form Action Action Specific Readability Attachments Sumber Type Mame Data Score a 3 OTH Form 1 Initial 45 poi pdt Supporting Document Items E Document Name Attachments C aver teter SF Esplana Memorandum i l o oe COmnMMENTS 3694 Certification of Compliance E4 PDF2 pdf 3136b Standards for Small Employer Health Benefit Plans EA POFS pdf Completed Fillable 1 pdf 11 Click the button SERFF Industry Manual Appendix I Page 24 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix Il 42390R0203 Form Schedule Items E Fo
26. either click No Attachment Required or upload an attachment before entering a comment Company and Contacts The Company and Contact tab displays the company and contact information for the Binder The accreditation information provided by NCQA and URAQ is displayed on the Company and Contact Tab of the Binder These Accreditation IDs are entered on the Company maintenance screen If an NCQA or URAQ ID is added after the Binder has been created it will not be reflected on that Binder but will show on Binders created after that action Updating Binder Company and Contact Information 1 Click on the dropdown arrow next to the Contact or Company Contact Anthony Shelton 2 Select the new Company or Contact 3 Click the Change button to update the information SERFF Industry Manual Appendix I Page 35 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II a ie Se Plans Associate Fees Templates Su pporting com pany Correspondence Schedule Items Documentation and Contact Binder Contact Information Contact Anthony Shelton Anthony Shelton ashelton celticinsurance com 1100 Walnut Ave 816 783 8787 Phone Suite 1500 Kansas City MO 64106 Binder Company Information Company Celtic Insurance Company Celtic Insurance Company CoCode 380799 1100 Walnut Ave Group Code Suite 1500 Group Name FEIN Number 08 079
27. es because their Exchange counterpart and or DOI may account for the data currently in other manners SERFF Industry Manual Appendix I Page 26 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved eee p _Expand All _Collapse All Plans Benefits Template Service Area Template Network Template Prescription Drug Template Administrative Data Template Essential Community Providers Template Rates Template Business Rules Template SERFF End User Training Appendix II Supporting Correspondence Documentation Icon Legend ae Pending Validation a Successfully Validated ae Validation Failed Draft Template Descriptions O Plans Benefits Template Collects plan and benefit data Attachments include instructions and an add in file Prescription Drug Template Collects formulary data for plans Network Template Information identifying a provider network Service Area Template Information identifying the geographic service area Administrative Data Template Collects general company and contact information Essential Community Provider Template Collects identifying information for Essential Community Providers Rates Template Collects rating table information Business Rules Template Collects supporting business rules for rates SERFF Industry Manual Appendix Il Page 27 of 49 Copyright 2013 National Associ
28. fication Letter Submitted e Binder Disposition Letter Submitted e Binder Objection Letter Submitted e Binder Primary Reviewer Changed e Binder Reopened e Binder State Info Changed e Plan State Status Updated e Review Status updated for Binder For more information regarding SERFF Message Settings please refer to page 146 of the SERFF User Manual SERFF Industry Manual Appendix I Page 6 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix Il Companies Each Instance within SERFF could have one to many companies configured The company information contains the following e NAIC Company Code CoCode e Company Name e Address e City e State e Postal Code e Telephone Number e FEIN e State of Domicile Company information for an Instance can be accessed and edited by clicking the Companies link under the Settings tab Please note that only a user with the Configuration Manager role can edit an existing Company Profile When creating a Binder the information for the company comes from data entered here For the Company to appear in the Binder Wizard the company must have the Configuration Manager for that Instance configure the state information in the Licensed States section This process must be completed for each state to which the company is filing Binder submissions Licensed States State State ID Number HIOS
29. g Hum WEIC OR14 125002554 SERFF Status Draft Plan Year 27014 State Tracking Num Date Submitted Mot Submitted Market Type Small Group Company Tracking Num Company Status Authors Laura Lacey Reviewers SERFF Industry Manual Appendix I Page 17 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II The Binder at a Glance contains the following fields e State e View Binder Log Allows user to view the Binder Log This log contains a record of key activity that has occurred on the Binder e Binder Name The issuer defined name of the plans being submitted to the state e SERFF Tracking Tr Num This number is defined by SERFF It will differ from SERFF Filing tracking numbers by containing four extra numbers and letters in the middle of the tracking number e SERFF Status This value is assigned by the SERFF application and automatically updates as activity occurs on a filing This field has two main purposes 1 Give state and industry a common measure as to where the filing is in the process and 2 give the SERFF application a mechanism to control activities that can take place on a filing Draft Binder has been assigned a tracking number but has not been completed and submitted to the state 7 Submitted to State The Binder has passed all applicable validations and Author has submitted the Binder to the state State can now access t
30. he Exchange 3 Enter the Plan Year amp Note The Plan Year is the year the Plan is being sold in the marketplace It must not be less than the current year or greater than 4 years from the current year 4 Enter the number of plans you wish to create amp Note Once out of the Binder Wizard the number of plans in a Binder cannot be changed 5 Click on the Market Type drop down box and select appropriate Market Type for the binder SERFF Industry Manual Appendix II Page 15 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II 6 Assign Other Authors if needed Other Authors can also be added later in the process Highlight the name of the Other Author and click on the button 7 Click on the button to advance to Step 2 Note If the Author clicks on the button all information completed at Step 1 will be lost amp Step 2 Select Company and Contact Select a Company amp Contact Asterisk denotes required field n Companies Company New Health Insurance Co p Only companie HIOS I er ID II Contact Laura Lacey i display in this list If a company is not displaying in this list and it should Previous Next Cancel lavigate to the company maintenance screen under Next Cancel the Settings t populate the HIOS Issuer ID with the correct value Select the Company for which th
31. he filing e Assigned State has assigned the Binder to one or more reviewers e Pending Industry Response There are one or more open Objection Letters on the Binder that need a response from the issuer e Pending State Action One or more Objection Letters have been responded to by the issuer Binder is still open amp Closed The state has created a Disposition indicating the final action of the Binder and its collection of plans Reopened The state has reopened the Binder SERFF Industry Manual Appendix Il Page 18 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Plans Tab The Plans Tab contains the Standard Component ID Plan Name Metal Level and Availability of the Plans included in the Binder The following field data will be imported from the Plans and Benefits Template once a Binder has been submitted e Plan Name e Metal Level e Availability On Exchange Off Exchange Both e Unique Plan Design indicator View Binder Lo Binder Name Sample Binder Name SERFF Tracking Num NEIC OR14 125002554 SERFF Status Draft Plan Year 2014 State Tracking Num Date Submitted Not Submitted Market Type Small Group Company Tracking Num Company Status Please Select x Authors Laura Lacey Reviewers Plans f Associate rf Fees i Templates i Supporting ep Company F Correspondence i Schedule Items Documen
32. here is a Certification Viewing a Certification 1 Click on the Binder Correspondence tab _e_ __ ee ee eeee ees e Plans Associate Schedule Items 2 Click the blue link under Certifications Templates Supporting Documentation Company and Contact Certifications Status Created By Created On Submitted By Date Submitted Submitted zzSERFFStaff zzStateSupporntTC 03 19 2013 zzSERFFStaff zzStateSupporntTC 03 19 2013 11 51 AM The Certification lists each Plan including the following corresponding data e Certify This identifies each Plan as being Certified Certification Denied or Not Determined e Plan Name e Standard Component ID e Plan Availability e Plan Disposition Status e Plan State Status e Action Date The date the Plan was certified or denied certification SERFF Industry Manual Appendix II Page 48 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Certification for CELT WY14 125000404 Coe Plan Binder Name PBM_v6 0_0312 2013 Plan Year 2014 Market Type Individual Authors TC SERFF Support racki a 2 Reviewers zzSERFFStaff SERFF T ngNum CELT WY14 State Wyoming State Tracking Num 0312 2013 state 125000404 zzStateSuppo SERFF Status Closed Company Celtic Insurance Company Tracking Num Finish and Company Submit Plans Certify Plan St
33. ildcard and can be used to pull back all of the items for Product Name Filing for Manual eee oa eu iat ling g Details TOI H166 Group Health Major Medical SERFF Tr Num NEIC 1282853599 Sub TOL H16G 0030 Small Group Only POS Co Tr Hum Date Submitted 03 15 2013 Filing Type Form SERFF Status Submitted to State Form Schedule Action Action Specific Readability Attachments i Name Data 5core C 3 OTH Form 1 Initial 45 PDFi pdf is SERFF Industry Manual Appendix I Page 22 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II 7 Select the Schedule Item s that should be associated to one or more plans found within the Binder by clicking the checkbox to the left of the line item Form Schedule Supporting Documents T Form Form Form Action Action Specific Readability Attachments Number Type Mame Data Score 3 OTH Form 1 Initial 45 PDFi pdf amp Note User may have more than one tab from which to select Schedule items The user will need to click on the appropriate tabs to select all items that need to be associated with a Binder i Form Schedule Supporting Documents nett nett Action Specific Readability Attachments Number Type Mame Data Score m 3 OTH Form 1 Initial 45 poFi pdt Next 8 Click the Hast button 9 Each plan will be listed with the selected Schedule Items 10 For
34. ket Type Individual Company Tracking Num IndustryTraining_03 21 2013 Company Status Submitted Plans Individual Market Authors TC SERFF Support Reviewers Plans Associate Fees i Templates i Supporting i Company i Correspondence j Schedule Items Documentation and Contact Standard Component ID Plan Name Metal Level Availability State Status Disposition Status 12345WY1230001 Newco Individual Flan Gold Gold On Exchange 12345WY1230002 Newco Individual Plan Platinum Platinum Off Exchange al 12345W71230003 Newco Individual Plan Silver Silver On Exchange Icon Legend Certified Certification Denied Pi Unique Plan Design 2 The Binder will now be in Revise Mode SERFF Industry Manual Appendix I Page 42 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Filings Plan Management Messages Billing Settings Filing Rules Templates My Binders Create Binder Plan Management General Instructions EFT Report Wyoming View Binder Log Binder Name PBM_vw6 0_0321 2013 SERFF Tracking Num CELT WY 14 125000525 SERFF Status Submitted Plan Year 2014 State Tracking Num Date Submitted 03 21 2013 Market Type Individual Company Tracking Num IndustryTraining_03 21 2013 Company Status Submitted Plans Individual Market Authors TC SERFF Support Reviewers Templates Supporting Correspondence Documentation Benefits Group Revise
35. le the user will be able to group and view all Binders that are Pending Industry Response Or the user could sort by Market Type and look at all Binders for the Individual Market Create Binder The user will be directed to the Binder Wizard and initiate the Binder creation process by clicking on Create Binder Plan Management General Instructions Plan Management General Instructions provides a listing of all the states utilizing Plan Management By clicking on a specific state a user will be directed to the respective General Instructions page Industry users should review Plan Management General Instructions for state specific submission instructions prior to submitting any Binders Plan Management General Instructions Att State Name Instance Name EA Alabama OlabamaLcite Alaska 4laskaLH EA Grizona ArizonalH California CalforniaLAH SERFF Industry Manual Appendix Il Page 12 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II EFT Report The EFT Report allows users to view all EFT transactions for SERFF Filings and Binders This report is utilized to reconcile SERFF filing activity with a company s bank statement The EFT Report link can be accessed on the Plan Management tab Filings Plan Management Messages Billing Settings My Binders Create Binder Plan Management General Instructions EFT Report Or from the Filings tab if
36. n and Contact State QHP Application Attestations Icon Legend amp No Action Taken Satisfied D Bypassed Lil Draft Supporting Document Item amp User Added Billing Filing Rules Templates nt General Instructions FT R i Wyoming View Binder Log Binder Name PBM_v6 0_0321 2013 SERFF Tracking Num CELT Wy14 125000525 SERFF Status Submitted Plan Year 2014 State Tracking Num Date Submitted 05 21 2013 Market Type Individual Company Tracking Num IndustryTraining_03 21 2013 Company Status Submitted Plans Individual Market Authors TC SERFF Support Reviewers Plans Associate Fees Templates Supporting Company Correspondence f Schedule Items Documentation and Contact l Standard Component ID Plan Name Metal Level Availability State Status Disposition Status 12345WY 1230001 Newco Individual Plan Gold Gold On Exchange 12345WY1230002 Newco Individual Plan Platinum Platinum Off Exchange at 12345WY 1230003 Newco Individual Plan Silver Silver On Exchange Icon Legend Certified Certification Denied Pi Unique Plan Design 6 This will but the Binder into Revise Mode SERFF Industry Manual Appendix I Page 38 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Filings Plan Management Messages Billing Settings Filing Rules Templates My Binders Create Binder Plan Management Gener
37. r has been received Step 1 Review the State s Objections 1 The user will receive a message in their Message Center indicating that there is an Objection on their Binder 2 The user will go to the Correspondence tab to view the Objection Leiter Status Submitted By Submitted On Responded By Respon Pending Industry Response zzSERFFStaff zzStateSupportTC 05 21 2015 11 57 AM _Respond 3 The user will click on the letter status the blue hyperlink to open the Objection Letter Objection Letter for CELT WY14 125000526 _ Close Binder Name PBM_v6 0_0321 2013 Plan Year 2014 Market Type Individual o TE SERIF Suppor SERFF Tracking Num CELT WY14 i State Wyoming State Tracking Num Reviewers 125000526 Company Celtic Insurance Company Tracking Num IndustryTraining_03 21 Company 2015 Objection Letter Date 03 21 2013 Date Submitted 03 21 2013 11 57 AM Respond By Date 03 22 2013 Objection Letter Status Pending Industry Response Comments Please sign attestation ALL ISSUES WILL BE DOCUMENTED HERE mE SERFF Industry Manual Appendix I Page 37 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II 7 Step 2 Update Item s 4 After reviewing the Objection Letter the user will go to the part of the Binder that needs to be corrected Supporting Company Correspondence Documentatio
38. rm Form Form Action Action Specific Readability Attachments Number Type Mame Data Score oO 3 OTH Form 1 Initial 45 PDFi pdf Supporting Document Items wi Document Name Attachments r Cover Letter or Explanatory Memorandum COMUNE nES ri 3894 Certification of Compliance EA FDF2 pdf r 3136b Standards for Small Employer Health Benefit Plans EA POF pdf completed Fillable 1 pdf save feenee 12 Once the Schedule Items have been associated to the plan s users may take several actions by using the buttons seen above the Associated Schedule Items o Associate Schedule Items from SERFF rate form filings by clicking the button o Select one to multiple Schedule Items to remove from each plan by clicking the Remove button o Copy one Schedule Item to one or more plans by clicking the Copy button o View the associated Schedule Items By Plan or by Schedule Items Plans l Associate Fees l Templates l Supporting Company Correspondence Schedule Items Documentation and Contact iE By Plans C By Schedule tems Form Schedule Items SERFF Tracking Number Form Name Form Sumber Attachments Filing Status M NEIC 128285399 Form 1 3 P PDFLpdf Submitted to State SERFF Industry Manual Appendix ll Page 25 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Fees The Fees Tab allows the user to enter Fee information for each plan cont
39. s and Binders Users receive messages for all events on Filings or Binders to which they have authored or have access to via SERFF roles Messages are identified by a distinct subject line Once the message is opened additional information is displayed and the user can link directly to the Filing or Binder referenced The access the Message Center has a new location The Message Center now has its own tab The tab is located between the Plan Management Tab and the Settings Tab Plan Management Billing Once the user clicks on the Messages tab the Message Center will be viewable Messages Most Recently Viewed Filings Remove Message Messages Messages 1 2 of 2 First Previous Next Last Unread Subject Tracking Number From On amp Public Access Set by Default for 4LL4 128285205 Submitted to Kansas Attn zSERFFStaff 4LL4 128285205 zSERFFStaff Mar 7 zIndustrySupportLsS zIndustrySupportLsS 2013 Public Access Set by Default for ALL4 128284932 Submitted to Kansas Attn zSERFFStaff ALL4A 128284932 zSERFFStaff Feb 25 zIndustrySupportLsS zIndustrySupportlsS 2013 Messages 1 2 0f 2 First Previous Next Last Remove Message All messages related to QHP submissions will appear in the Message Center along with messages for Filings For more information regarding the Message Center please refer to page 142 of the SERFF User Manual SERFF Industry Manual Appendix I Page 10 of 49 Copyright 2013 National
40. s will occur through the month of March the results of which may lead to minor changes in the templates to be used for final QHP application submission The plans and benefits template will be released with the latest add in file versions of the state specific benchmark data and AV calculator Administrative Template Collects general company and contact 3 21 Administrative Data Template information Po RIN Re eg Eee el e ee Community Providers Te mpate OCE Chea SHTET Plan Benefit Template Collects plan and benefit data Plans and Benefits Template Attachments include instructions and an Instructions add in file Plans Benefits Add In 4 Scroll down to view all Templates 5 Click on the Template to download and complete Step 2 Validate Template 1 Once Template is complete user will need to Validate The Validate button is in the upper left corner of the Template The Validate button is executing internal validation on the template locally ensuring required fields are completed 2 Once the user clicks on Validate a pop up box will appear to let the user know that the Template is valid SERFF Industry Manual Appendix I Page 29 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Microsoft Excel E4 This Template is Valid 3 If there are any errors in the Template blank required field incorrect data in
41. senanes 20 PS See EE cei ce entre eee ee 26 LEMPA Sree ect ececee sence npumust tea decuen eiaceciseauatluedatouuleeneiueceaeteicecn 26 Supporting DOCUMENTATION cece ceccceececeeeeeeeteseeseeetaueeseeeeaneeees 33 Company Gc C OMA CL swxsenccceascsincatanamventasas EREA ET OERE 35 COMie SPONGES NCE eara a eanceania eaten uesnneeue acuusenetania 36 Responding to an Objection Letter cecceceeceeeeeeeeeeeeees 37 Amendments 0 cccccececececeecececeececeaeaeececeaeceeaeaeaeeaeavaesenataeneees 42 LD SIO SHO ING ei cen A AERAR 47 SSI UNOS ceed eects ane ce cca a a aa e Sapseeae eect bers 48 SERFF Industry Manual Appendix I Page 1 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Introduction The System for Electronic Rate and Form Filing SERFF is a smart Internet application designed to provide an efficient process for rate and form filing With the release of v6 0 SERFF Plan Management functionality has been introduced for Qualified Health Plan QHP submissions Using SERFF issuers can create and submit QHPs to states that have implemented SERFF for Plan Management for review approval and certification Conventions Used In This Manual The following special features are included in this appendix to assist readers Bold fonts are used to emphasize an idea or a representation The green pointer hand is used represent a ta
42. sk the user may perform The red pointer hand is used to represent a note of special interest SERFF Industry Manual Appendix I Page 2 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II SERFF Binder Tracking Number The SERFF Binder represents a collection of templates and plan data on behalf of one company sent to one state To ensure uniqueness and searching capabilities each SERFF Binder has a unique SERFF Tracking Number The SERFF Tracking number is comprised of three parts Instance Identifier State and Binder Year Unique Numeric Identifier Characters ABCD WY14 000004382 1 Instance Identifier A unique four character ID assigned to an instance by the SERFF Help Desk Both states and industry are assigned Instance Identifiers 2 State and Binder Year Identifier The specific state the Binder is submitted to as well as the applicable plan year for the QHPs being submitted 3 Numeric Value Numeric string that wnen combined with an Instance Identifier and the state and Binder year identifier create a unique SERFF Binder Tracking Number This portion of the tracking number is created by the SERFF system Plan Management Transaction Fees SERFF will assess a transaction fee per plan submitted on a Binder For example if you have a Binder with one plan you will be assessed one transaction fee If you have a Binder with three plans yo
43. tation and Contact Standard Component ID Plan Name Metal Level Availability State Status Disposition Status 42390R0231 42390R0232 O 42390R0233 The Standard Component ID is populated from the value entered in the Wizard and is the only field editable on the Plans Tab These IDs are assigned by HIOS and entered by the industry user amp Note The Standard Component ID can be only be updated until templates have been uploaded and validated Upon template validation the user will be unable to edit the Standard Component IDs on the Plans tab amp Note It is very important that the Standard Component ID is entered exactly as generated by HIOS as it will be verified against the Plans and Benefits Template when uploaded At any time after Binder submission a state user may update each Plan s State Status If updated the State Status will be viewable by the industry user SERFF Industry Manual Appendix I Page 19 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Once the state has completed its review and submitted the closing Disposition each plan s Disposition Status will be viewable by the industry user After the state entity has submitted a Certification plans within the Binder will be indicated as Certified or Certification Denied Icon Legend Certified Certification Denied Pi Unique Plan Design Associate Sched
44. ted by other users on the instance Industry PM Plan Management Read Allows an Industry User read only access Only to the Plan Management workspace with view only access and no editing Capabilities on the Binder For more information regarding SERFF User Admin please refer to page 37 of the SERFF User Manual SERFF Industry Manual Appendix I Page 4 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Settings Message Settings The Industry Plan Management User role in SERFF will generate several message related to Binders The user will not automatically be opted in to all of the new message types The user will need to go into their Message Settings and select the Plan Management message types they would like to receive Updating Message Settings 1 Click on the Settings tab Filings Plan Management Messages Billing Settings Filing Rules Templates User Preferences Instance Preferences Companies Contacts Request New User Request User Update Request User Deactivate Contact Contact Inf ti i ee Contact Information Message Sali Last Name Current User Preferences First Name User Email Address serffhelp naic org Ex name domain com Address 1100 Walnut City Kansas City State Missouri z Postal Code 64106 Phon
45. the user has Rate and Form roles Filings Plan Management Messages Billing Open Filings My Draft Filings Search Create Filing EFT Report My Workfolder My Generate EFT Report EFT Report 1 Click the Se button 2 The EFT Report dialog box will open 3 Inthe EFT Report dialog box select a date range Report type and Report format SERFF EFT Reports Please choose the parameters for your report Begin Date inclusive G End Date inclusive m Report type Detail report Summary report Report format web page csv file SERFF Industry Manual Appendix I Page 13 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II 4 The EFT Report results will include transactions from both the Filings module and the Plan Management module of SERFF if there is any activity SERFF EFT Reports FT Detail Report for dates 03 01 2013 to 03 27 2013 03 07 2013 Filings Transaction Company Company Submitter State SERFF Tracking Type Of Sub Type of Filing Type Amount Transaction Number Date Name Code Name Number Insurance Insurance 03 07 2013 Celtic 80799 Donald S CELT 127696657 HO3G Group Health H03G 000 Health Form Rate 50 00 127696657EFTTESTEFTSEFTFILER201303071015 Insurance Harrison Accidental Death amp Accidental Death amp Company Dismemberment Dismemberment subtotal for 03 07 2013 1 transaction s total amount 50 00 03
46. tion the Plan Binder must be in Edit or Revise mode Revise mode is only available post submission Plans Associate Fees Templates su pporting Schedule Items Documentation Correspondence l D Compliance Flan and Organizational Chart Cover Sheet il A S Essential Community Provider Supplemental Response Form Al A Program Attestations for SPE FFE Issuers al amp SHOP tying justification al amp Partial Service Area justification l A Unique Plan Design Supporting Documentation and Justification Al 2 EHB Substituted Benefit Actuarial Equivalent Justification Al i Formulary Inadequate Category Class Count Justification al 2 Limited Cost Sharing Plan Vanation Estimated Advance Payment Supporting Documentation and Justification l 2 Part Unified Rate Review URR Template Part Ill Actuarial Memorandum SERFF Industry Manual Appendix I Page 33 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II 1 The user will expand the item they wish to Satisfy or Bypass 2 If the user wisher to satisfy they will do one of three things o Upload one or more attachments o Upload one or more attachments and enter a comment No Attachment Required o Click and enter a comment Plans l Associate Fees Templates Supporting Company Correspondence Schedule Items Documentation and Contact
47. u will be assessed three transaction fees SERFF offers several pricing structures to meet the business needs of our customers Pre paid filing blocks and Pay As You Go are options for filing entities Industry users can monitor the balance of their pre paid filing blocks on the Billing tab which is located in the SERFF Filings module For more information regarding SERFF Billing please refer to page 13 of the SERFF User Manual SERFF Industry Manual Appendix I Page 3 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Plan Management Roles The ability to perform Plan Management functions within SERFF is based on the roles assigned to a SERFF User Name Some users may have a role assigned to their ID that permits greater access while other users may have a role with limited access to SERFF Plan Management functions Roles have pre determined permissions within the SERFF application that dictate role related responsibilities The SERFF Help Desk maintains and assigns roles for all users Below is a table that explains the permissions associated with each state SERFF Plan Management User role Industry Plan Management User Allows an Industry User to view create and submit Binders respond to state submitted correspondence submit correspondence to the state add Fees and add Authors An Industry Plan Management User can view but cannot edit Binders crea
48. ule Items Associating Schedule Items allows the user to link submitted Rate and Form Schedule Items to each plan within a Binder This functionality will eliminate the need for users to attach Rate and Form filing attachments to the Binder s Supporting Documentation tab By Associating schedule Items the state will be able to view SERFF Filing attachments without leaving the Plan Management workspace as they review a Binder amp Note In order to associate Schedule Items a Binder must be in View mode Binder cannot be in Edit mode Plans Associa te Fees Templates Supporting Company Correspondence Schedule Items Documentation and Contact GO By Plans C By Schedule Items Add Remove Copy Select All Deselect All 42390R0231 No associated items 42390R0232 No associated items 42390R0233 No associated items Step 1 Search for Rate and Form Filing to Associate Items _Add 1 Click on button SERFF Industry Manual Appendix I Page 20 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II 2 Search for SERFF Rate and Form Filing and Schedule Item s Schedule Item Search Items A valid complete SERFF tracking number must be Supporting Document item Name oT used Additionally criteria must be entered in at least one other field The asterisk Serle as 5 wildcard and can be used ta pull back all of the
49. y Type LAH Group Code 0 Group Name FEIN Number 08 0799123 State of Domicile Illinois Active Active Licensed States State State ID Number i HIOS Issuer ID i NCOA Org ID URAC App Num ber Wyoming 50799 20000 HI 001565 Arkansas 46121 5547 7045 Edit 2 Click the a button to open the fields for changes 3 Make the necessary changes to the Company Information and enter the Licensed State information for each state to which the user will be submitting binders SERFF Industry Manual Appendix Il Page 8 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Licensed States State State ID Number HIOS Issuer ID NCQA Org ID URAC App Number amp Alabama gt 98765 45678 123456 Add State Save Cancel 4 Once all Licensed State information has been added click the button Click Save to finalize or Cancel to discard the changes made lf one or more draft filings include the edited company the user will be presented with a list of affected filings This list will not display if this company is not listed on any current draft filings SERFF Industry Manual Appendix I Page 9 of 49 Copyright 2013 National Association of Insurance Commissioners All rights reserved SERFF End User Training Appendix II Messages The Message Center contains notifications about activity on SERFF Filing

SERFF industry user Manual appendix ii

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