All fields with an asterisk ( * ) are required. To validate press Validate button or Ctrl + Shift + I. To finalize, press Finalize button or Ctrl + Shift + F.
If you are I, a and community rating state, Family Option under option Age and fill in allenter. columns. If macros are disabled, press and hold the ALT key and press the F, then then N key. After that, select select the Enable All Content by pressing (note that you can also press the C key to select "Enable All Content") Instructions can be found in cells B1 through B5. If you are not community rating state, select 0-20 under Age and provide an Individual Rate for every age band. If Tobacco is Tobacco User/Non-Tobacco User, you must give a rate for Tobacco Use and Non-Tobacco Use. To add a new sheet, press the Add Sheet button, or Ctrl + Shift + H. All plans must have the same dates on a sheet. HIOS Issuer ID* 43633 Federal TIN* 00-0000000 Rate Effective Date* Rate Expiration Date*
Plan ID*
Required: Enter the 14-character Plan ID
1/1/2017 12/31/2017
Rating Area ID*
Tobacco*
Required: Select the Rating Area ID
Require: Select if Tobacco use of subscriber is used to determine if a person is eligible for a rate from a plan
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
43633PR0010003 Rating Area 1
Tobacco User/Non-Tobacco User
Age*
Individual Rate*
Individual Tobacco Rate*
Required: Required: Select the age of a subscriber eligible for the Enter the rate of an Individual Non-Tobacco or rate No Preference enrollee on a plan
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