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Product A – service area A,C,D,E,F,G,L,X,Z Product B – service area A, B, C, D, K, L, N, Q Product C – service area A-Z Benefits Covered Same benefit package as State EHB Benchmark – no pediatric dental (QHP) Same benefit package as State EHB Benchmark – pediatric dental (nonQHP) Same benefit package as State EHB Benchmark – no pediatric dental (QHP) Network Type PPO PPO HMO Plans Plan A1 – 2,000/ 3,000 indiv/fam ded plan pays 60 service areas: A, D, E Plan B1 – 1,500/ 2,225 indiv/fam ded pays 70 service areas: A, B, C, D Plan A1 – 2,500/ 4,000 indiv/fam ded pays 65 service areas: A - L Plan A2 – 1,500/ 2,225 indiv/fam ded pays 70 service areas C, F, G, L, X, Plan B2 – 1,000/ 1,750 indiv/fam ded pays 80 service areas A, B, K, L, N, Q Plan A2 – 1,500/ 2,500 indiv/fam ded pays 75 Plan A3 – Gold: service areas A - N Plan A3 – 1,000/ 1,750 indiv/fam ded pays 80 Service areas A, C, X, Z Plan A3 – 500/ 1,000 indiv/fam ded pays 85 Service areas A – Z Who to Ask in CCIIO Questions related to HIOS IDs are to be directed to: Brian James, Division Director, Non-Exchange Insurance Issuer Data Collection email: Brian.James cms.hhs.gov work phone: 301-492-4234 Questions related to Uniform Rate Review Template and Actuarial Memorandum submissions are to be directed to: Brent Plemons, Deputy Director, Rate Review Division email: Brent.Plemons cms.hhs.gov work phone: 301-492-4120 Questions related to Direct Enforcement Form Filing submissions are to be directed to: Mary Nugent, Deputy Director, Compliance and Enforcement Division email: Mary.Nugent cms.hhs.gov work phone: 410-786-8816 Federal Definitions for Health Insurance Products and Plans Questions.
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