AVCalculatorOutputNumber,BeginPrimaryCareCostSharingAfterNumberOfVisits,BeginPrimaryCareDeductibleCoinsuranceAfterNumberOfCopays,BenefitPackageId,BusinessYear,CSRVariationType,ChildOnlyOffering,ChildOnlyPlanId,CompositeRatingOffered,DEHBCombInnOonFamilyMOOP,DEHBCombInnOonFamilyPerGroupMOOP,DEHBCombInnOonFamilyPerPersonMOOP,DEHBCombInnOonIndividualMOOP,DEHBDedCombInnOonFamily,DEHBDedCombInnOonFamilyPerGroup,DEHBDedCombInnOonFamilyPerPerson,DEHBDedCombInnOonIndividual,DEHBDedInnTier1Coinsurance,DEHBDedInnTier1Family,DEHBDedInnTier1FamilyPerGroup,DEHBDedInnTier1FamilyPerPerson,DEHBDedInnTier1Individual,DEHBDedInnTier2Coinsurance,DEHBDedInnTier2Family,DEHBDedInnTier2FamilyPerGroup,DEHBDedInnTier2FamilyPerPerson,DEHBDedInnTier2Individual,DEHBDedOutOfNetFamily,DEHBDedOutOfNetFamilyPerGroup,DEHBDedOutOfNetFamilyPerPerson,DEHBDedOutOfNetIndividual,DEHBInnTier1FamilyMOOP,DEHBInnTier1FamilyPerGroupMOOP,DEHBInnTier1FamilyPerPersonMOOP,DEHBInnTier1IndividualMOOP,DEHBInnTier2FamilyMOOP,DEHBInnTier2FamilyPerGroupMOOP,DEHBInnTier2FamilyPerPersonMOOP,DEHBInnTier2IndividualMOOP,DEHBOutOfNetFamilyMOOP,DEHBOutOfNetFamilyPerGroupMOOP,DEHBOutOfNetFamilyPerPersonMOOP,DEHBOutOfNetIndividualMOOP,DentalOnlyPlan,DiseaseManagementProgramsOffered,EHBPediatricDentalApportionmentQuantity,EHBPercentPremiumS4,EHBPercentTotalPremium,FirstTierUtilization,FormularyId,FormularyURL,HIOSProductId,HPID,HSAOrHRAEmployerContribution,HSAOrHRAEmployerContributionAmount,ImportDate,IndianPlanVariationEstimatedAdvancedPaymentAmountPerEnrollee,InpatientCopaymentMaximumDays,IsGuaranteedRate,IsHSAEligible,IsNewPlan,IsNoticeRequiredForPregnancy,IsReferralRequiredForSpecialist,IssuerActuarialValue,IssuerId,IssuerId2,MEHBCombInnOonFamilyMOOP,MEHBCombInnOonFamilyPerGroupMOOP,MEHBCombInnOonFamilyPerPersonMOOP,MEHBCombInnOonIndividualMOOP,MEHBDedCombInnOonFamily,MEHBDedCombInnOonFamilyPerGroup,MEHBDedCombInnOonFamilyPerPerson,MEHBDedCombInnOonIndividual,MEHBDedInnTier1Coinsurance,MEHBDedInnTier1Family,MEHBDedInnTier1FamilyPerGroup,MEHBDedInnTier1FamilyPerPerson,MEHBDedInnTier1Individual,MEHBDedInnTier2Coinsurance,MEHBDedInnTier2Family,MEHBDedInnTier2FamilyPerGroup,MEHBDedInnTier2FamilyPerPerson,MEHBDedInnTier2Individual,MEHBDedOutOfNetFamily,MEHBDedOutOfNetFamilyPerGroup,MEHBDedOutOfNetFamilyPerPerson,MEHBDedOutOfNetIndividual,MEHBInnTier1FamilyMOOP,MEHBInnTier1FamilyPerGroupMOOP,MEHBInnTier1FamilyPerPersonMOOP,MEHBInnTier1IndividualMOOP,MEHBInnTier2FamilyMOOP,MEHBInnTier2FamilyPerGroupMOOP,MEHBInnTier2FamilyPerPersonMOOP,MEHBInnTier2IndividualMOOP,MEHBOutOfNetFamilyMOOP,MEHBOutOfNetFamilyPerGroupMOOP,MEHBOutOfNetFamilyPerPersonMOOP,MEHBOutOfNetIndividualMOOP,MarketCoverage,MedicalDrugDeductiblesIntegrated,MedicalDrugMaximumOutofPocketIntegrated,MetalLevel,MultipleInNetworkTiers,NationalNetwork,NetworkId,OutOfCountryCoverage,OutOfCountryCoverageDescription,OutOfServiceAreaCoverage,OutOfServiceAreaCoverageDescription,PlanBrochure,PlanEffictiveDate,PlanExpirationDate,PlanId,PlanLevelExclusions,PlanMarketingName,PlanType,QHPNonQHPTypeId,RowNumber,SBCHavingDiabetesCoinsurance,SBCHavingDiabetesCopayment,SBCHavingDiabetesDeductible,SBCHavingDiabetesLimit,SBCHavingaBabyCoinsurance,SBCHavingaBabyCopayment,SBCHavingaBabyDeductible,SBCHavingaBabyLimit,SecondTierUtilization,ServiceAreaId,SourceName,SpecialistRequiringReferral,SpecialtyDrugMaximumCoinsurance,StandardComponentId,StateCode,StateCode2,TEHBCombInnOonFamilyMOOP,TEHBCombInnOonFamilyPerGroupMOOP,TEHBCombInnOonFamilyPerPersonMOOP,TEHBCombInnOonIndividualMOOP,TEHBDedCombInnOonFamily,TEHBDedCombInnOonFamilyPerGroup,TEHBDedCombInnOonFamilyPerPerson,TEHBDedCombInnOonIndividual,TEHBDedInnTier1Coinsurance,TEHBDedInnTier1Family,TEHBDedInnTier1FamilyPerGroup,TEHBDedInnTier1FamilyPerPerson,TEHBDedInnTier1Individual,TEHBDedInnTier2Coinsurance,TEHBDedInnTier2Family,TEHBDedInnTier2FamilyPerGroup,TEHBDedInnTier2FamilyPerPerson,TEHBDedInnTier2Individual,TEHBDedOutOfNetFamily,TEHBDedOutOfNetFamilyPerGroup,TEHBDedOutOfNetFamilyPerPerson,TEHBDedOutOfNetIndividual,TEHBInnTier1FamilyMOOP,TEHBInnTier1FamilyPerGroupMOOP,TEHBInnTier1FamilyPerPersonMOOP,TEHBInnTier1IndividualMOOP,TEHBInnTier2FamilyMOOP,TEHBInnTier2FamilyPerGroupMOOP,TEHBInnTier2FamilyPerPersonMOOP,TEHBInnTier2IndividualMOOP,TEHBOutOfNetFamilyMOOP,TEHBOutOfNetFamilyPerGroupMOOP,TEHBOutOfNetFamilyPerPersonMOOP,TEHBOutOfNetIndividualMOOP,TIN,URLForEnrollmentPayment,URLForSummaryofBenefitsCoverage,UniquePlanDesign,VersionNum,WellnessProgramOffered

1,1,0,10,2016,Zero Cost Sharing Plan Variation,Allows Adult and Child-Only,,No,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,No,"Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pregnancy",,,1,60%,TXF201,https://www.myprime.com/content/dam/prime/memberportal/forms/AuthorForms/IVL/2016/2016_TX_5T_EX.pdf,33602TX078,,,,11/21/2015 6:31,$0.00 ,0,,No,New,No,Yes,100.00%,33602,33602,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,Individual,Yes,Yes,Bronze,Yes,No,TXN004,Yes,"This plan does not cover any services and/or supplies provided to a member outside of the United States, if the member traveled to the location for the purposes of receiving medical services, supplies, or drugs.",Yes,Coverage outside our service area is available for Emergency and Urgent Care services only.,http://www.bcbstx.com/pdf/sbc/2016-texas-plan-overview.pdf,1/1/2016,,33602TX0780063-02,,"Blue Cross Blue Shield Basic 103, a Multi-State Plan",HMO,On the Exchange,11,$0 ,$0 ,$0 ,$80 ,$0 ,$0 ,$0 ,$200 ,40%,TXS064,OPM,All,,33602TX0780063,TX,TX,,$0 per group,$0 per person,$0 ,,$0 per group,$0 per person,$0 ,0%,,$0 per group,$0 per person,$0 ,0%,,$0 per group,$0 per person,$0 ,,$0 per group,$0 per person,$0 ,,$0 per group,$0 per person,$0 ,,$0 per group,$0 per person,$0 ,,$0 per group,$0 per person,$0 ,36-1236610,https://retailweb.hcsc.net/retailshoppingcart/TX/exchange_referred,http://www.bcbstx.com/PDF/sbc/33602TX0780003-02.PDF,Yes,6,

BusinessYear,StateCode,IssuerId,SourceName,VersionNum,ImportDate,IssuerId2,FederalTIN,RateEffectiveDate,RateExpirationDate,PlanId,RatingAreaId,Tobacco,Age,IndividualRate,IndividualTobaccoRate,Couple,PrimarySubscriberAndOneDependent,PrimarySubscriberAndTwoDependents,PrimarySubscriberAndThreeOrMoreDependents,CoupleAndOneDependent,CoupleAndTwoDependents,CoupleAndThreeOrMoreDependents,RowNumber

2016,AK,73836,HIOS,4,2015-08-23 12:37:12,73836,93-0989307,2016-10-01,2016-12-31,73836AK0880002,Rating Area 1,No Preference,55,1049.25,,,,,,,,,1245

BusinessYear,StateCode,IssuerId,SourceName,VersionNum,ImportDate,IssuerId2,StateCode2,ServiceAreaId,ServiceAreaName,CoverEntireState,County,PartialCounty,ZipCodes,PartialCountyJustification,RowNumber,MarketCoverage,DentalOnlyPlan

2016,NJ,10191,HIOS,6,11/18/2015 7:25,10191,NJ,NJS004,PCMH,No,34037,No,,,36,,

BusinessYear,StateCode,IssuerId,SourceName,VersionNum,ImportDate,IssuerId2,StateCode2,NetworkName,NetworkId,NetworkURL,RowNumber,MarketCoverage,DentalOnlyPlan

2016,AK,21989,HIOS,4,8/22/2015 15:09,21989,AK,Delta Dental Premier,AKN001,https://www.modahealth.com/ProviderSearch/faces/webpages/home.xhtml,13,,

AL,01,001,Autauga County,H1

AL,01,003,Baldwin County,H1