This file contains Medical Loss Ratio data for the 2016 Reporting Year, including the issuer’s MLR, the MLR standard, and the average rebate per person by state and market.

The Benefits and Cost Sharing PUF (BenCS-PUF) is one of the files that make up the Marketplace PUF. The BenCS-PUF contains plan-level data on essential health benefits, coverage limits, and cost sharing for each QHP and SADP. These data either originate from the Plans & Benefits template (i.e., template field), an Excel-based form used by issuers to describe their plans in the QHP/SADP application process, or were generated by CCIIO for use in data processing (i.e., system-generated).

The Rate PUF (Rate-PUF) is one of the files that make up the Marketplace PUF. The Rate-PUF contains plan-level data on individual rates based on an eligible subscriber’s age, tobacco use, and geographic location. These data either originate from the Rate Table template (i.e., template field), an Excel based form used by issuers to describe their plans in the QHP/SADP application process, or were generated by CCIIO for use in data processing (i.e., system-generated).

The Plan Attributes PUF (Plan-PUF) is one of the files that make up the Marketplace PUF. The Plan-PUF contains plan-level data on maximum out of pocket payments, deductibles, cost sharing, health savings account (HSA) eligibility, formulary ID, and other plan attributes. These data either originate from the Plans & Benefits template (i.e., template field), an Excel based form used by issuers to describe their plans in the QHP/SADP application process, or were generated by CCIIO for use in data processing (i.e., system-generated). The issuer can also import data created in other templates (e.g., Network IDs from the Network ID template, Service Area IDs from the Service Area template, and Formulary IDs from the Prescription Drug template) to use as allowable values for the applicable fields in the Plans & Benefits template, or enter these values manually.

The Plan ID Crosswalk PUF (CW-PUF) is one of the files that make up the Marketplace PUF. The purpose of the CW-PUF is to map QHPs and SADPs offered through the Marketplaces in 2017 to plans that will be offered through the Marketplaces in 2018. These data either originate from the Plan Crosswalk template (i.e., template field), an Excel-based form used by issuers to describe their plans in the QHP application process, or were generated by CCIIO for use in data processing (i.e., system-generated).This data dictionary describes the variables contained in the CW-PUF. Each record relates to a mapping between a plan offered in 2017 and a plan offered in 2018 at the county or county-zip code level.

The Network PUF (Ntwrk-PUF) is one of the seven files that make up the Marketplace PUF. The Ntwrk-PUF contains issuer-level data identifying provider network URLs. These data either originate from the Network ID template (i.e., template field), an Excel based form used by issuers to describe their plans in the QHP/SADP application process, or were generated by CCIIO for use in data processing (i.e., system-generated)

The Service Area PUF (SA-PUF) is one of the files that make up the Marketplace PUF. The SA-PUF contains issuer-level data on the geographic coverage or service area (i.e., where the plan is offered) including state, county, and zip code. These data either originate from the Service Area template (i.e., template field), an Excel based form used by issuers to describe their plans in the QHP/SADP application process, or were generated by CCIIO for use in data processing (i.e., system-generated).

The Business Rules PUF (BR-PUF) is one of the files that make up the Marketplace PUF. The BR-PUF contains plan-level data on the application of rates, such as allowed relationships (e.g., spouse, dependents) and tobacco use. These data either originate from the Business Rules template (i.e., template field), an Excel-based form used by issuers to describe their plans in the QHP/SADP application process, or were generated by CCIIO for use in data processing (i.e., system-generated).