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{"sheet":"Benefits Package","index":0,"n_rows":129,"n_cols":40,"rows_kept":129,"cut":false,"hidden":false,"merged":[[97,0,97,1],[98,0,98,1],[90,0,90,1],[6,7,6,29],[6,0,6,6],[95,0,95,1],[96,0,96,1],[87,0,87,1],[88,0,88,1],[64,0,64,1],[70,0,70,1],[65,0,65,1],[66,0,66,1],[67,0,67,1],[68,0,68,1],[92,0,92,1],[6,30,6,31],[6,32,6,34],[6,35,6,39],[128,0,128,1],[109,0,109,1],[121,0,121,1],[122,0,122,1],[125,0,125,1],[124,0,124,1],[120,0,120,1],[126,0,126,1],[123,0,123,1],[115,0,115,1],[127,0,127,1],[118,0,118,1],[119,0,119,1],[116,0,116,1],[117,0,117,1],[112,0,112,1],[111,0,111,1],[113,0,113,1],[114,0,114,1],[103,0,103,1],[110,0,110,1],[99,0,99,1],[100,0,100,1],[104,0,104,1],[105,0,105,1],[101,0,101,1],[102,0,102,1],[106,0,106,1],[107,0,107,1],[108,0,108,1],[93,0,93,1],[94,0,94,1],[58,13,58,16],[63,0,63,1],[83,0,83,1],[75,0,75,1],[76,0,76,1],[80,0,80,1],[81,0,81,1],[77,0,77,1],[78,0,78,1],[69,0,69,1],[71,0,71,1],[72,0,72,1],[91,0,91,1],[85,0,85,1],[86,0,86,1],[89,0,89,1],[84,0,84,1],[58,5,58,12],[59,0,59,1],[60,0,60,1],[61,0,61,1],[62,0,62,1],[82,0,82,1],[79,0,79,1],[73,0,73,1],[74,0,74,1],[58,0,58,4]]}
["Plans & Benefits Template",null,null,"To use this template, please review the user guide and instructions."]
["HIOS Issuer ID*",null,null,"You will need to save the latest version of the add-in file (PlansBenefitsAddIn.xlam) on your machine."]
["Issuer State*",null,null,"To create the cost share variance worksheet and enter the cost sharing amounts for both individual and SHOP (small group) markets, use the Create Cost Share Variances macro."]
["Market Coverage*",null,null,"To create additional Benefits Package worksheets, use the Create New Benefits Package macro."]
["Dental Only Plan*",null,null,"To populate the benefits on the Benefits Package worksheet with your State EHB Standards, use the Refresh EHB macro."]
[]
["Plan Identifiers",null,null,null,null,null,null,"Plan Attributes",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Stand Alone Dental Only",null,"Plan Dates",null,null,"Geographic Coverage"]
["HIOS Plan ID*\n(Standard Component)","Plan Marketing Name*","HIOS Product ID*","HPID","Network ID*","Service Area ID*","Formulary ID*","New/Existing Plan?*","Plan Type*","Level of Coverage*","Unique Plan Design?*","Is this a QHP Offered on the Exchange? *","If Off Exchange, is it the Same or Substantially the Same as a Certified Exchange QHP?","If the Same or Substantially the Same as a Certified Exchange QHP, Provide HIOS Plan ID (14-digit Standard Component) for the Certified Exchange QHP","Multi-State Plan*","Notice Required for Pregnancy*","Is a Referral Required for Specialist?*","Specialist(s) Requiring a Referral","Plan Level Exclusions","Limited Cost Sharing Plan Variation - Est Advanced Payment (Optional)","Do You Want a Zero Cost Sharing Plan Variation Created for this Plan?*\n(Y/N)","Does this plan allow Child-Only Enrollments?*\n(Y/N)","Is this a Child-Only plan? \n(Y/N)","If No, enter corresponding plan ID for Child-Only plan","Tobacco Related Wellness Program Offered*","Disease Management Programs Offered","Composite vs. Individual Member Rating (SHOP Plans Only)","Out of Network Coverage","Does the QHP Issuer Operate a Medicaid Health Plan with Substantially the Same Provider Network and Service Area (Y/N)?","EHB as a Percent Premium","EHB Apportionment for Pediatric Dental ","Guaranteed vs. Estimated Rate ","Plan Effective Date*","Plan Expiration Date","Plan vs. Benefit Year","Out of Country Coverage*","Out of Country Coverage Description","Out of Service Area Coverage*","Out of Service Area Coverage Description","National Network*"]
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["Benefit Information",null,null,null,null,"General Information",null,null,null,null,null,null,null,"Deductible and Out of Pocket Exceptions"]
["Benefits",null,"EHB (Autopopulated)","EHB (Issuer)","State-Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Quantitative Limit Units Apply see EHB Benchmark","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible     (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP"]
["Primary Care Visit to Treat an Injury or Illness"]
["Specialist Visit"]
["Other Practitioner Office Visit (Nurse, Physician Assistant)"]
["Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)"]
["Outpatient Surgery Physician/Surgical Services"]
["Hospice Services"]
["Non-Emergency Care When Traveling Outside the U.S."]
["Routine Dental Services (Adult)"]
["Infertility Treatment"]
["Long-Term/Custodial Nursing Home Care"]
["Private-Duty Nursing"]
["Routine Eye Exam (Adult)"]
["Urgent Care Centers or Facilities"]
["Home Health Care Services"]
["Emergency Room Services"]
["Emergency Transportation/Ambulance"]
["Inpatient Hospital Services (e.g., Hospital Stay)"]
["Inpatient Physician and Surgical Services"]
["Bariatric Surgery"]
["Cosmetic Surgery"]
["Skilled Nursing Facility"]
["Prenatal and Postnatal Care"]
["Delivery and All Inpatient Services for Maternity Care"]
["Mental/ Behavioral Health Outpatient Services"]
["Mental/ Behavioral Health Inpatient Services"]
["Substance Abuse Disorder Outpatient Services"]
["Substance Abuse Disorder Inpatient Services"]
["Generic Drugs"]
["Preferred Brand Drugs"]
["Non-Preferred Brand Drugs"]
["Specialty Drugs"]
["Outpatient Rehabilitation Services"]
["Habilitation Services"]
["Chiropractic Care"]
["Durable Medical Equipment"]
["Hearing Aids"]
["Imaging (CT/PET Scans, MRIs)"]
["Preventive Care/Screening/Immunization"]
["Routine Foot Care"]
["Acupuncture"]
["Weight Loss Programs"]
["Routine Eye Exam for Children"]
["Eye Glasses for Children"]
["Dental Check-Up for Children"]
["Rehabilitative Speech Therapy"]
["Rehabilitative Occupational and Rehabilitative Physical Therapy"]
["Well Baby Visits and Care"]
["Laboratory Outpatient and Professional Services"]
["X-rays and Diagnostic Imaging"]
["Basic Dental Care – Child"]
["Orthodontia – Child"]
["Major Dental Care – Child"]
["Basic Dental Care – Adult"]
["Orthodontia – Adult"]
["Major Dental Care – Adult"]
["Abortion for Which Public Funding is Prohibited"]
["Transplant"]
["Accidental Dental"]
["Dialysis"]
["Allergy Treatment"]
["Chemotherapy"]
["Radiation"]
["Diabetes Education"]
["Prosthetic Devices"]
["Infusion Therapy"]
["Treatment for Temporomandibular Joint Disorders"]
["Nutritional Counseling"]
["Reconstructive Surgery"]
["Additional State-Required Benefits"]

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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"SBC Scenario",null,null,null,null,null,null,null,"Maximum Out of Pocket for Medical EHB Benefits",null,null,null,null,null,null,null,null,null,null,null,"Maximum Out of Pocket for Drug EHB Benefits",null,null,null,null,null,null,null,null,null,null,null,"Maximum Out of Pocket for Medical and Drug EHB Benefits (Total)",null,null,null,null,null,null,null,null,null,null,null,"Medical EHB Deductible",null,null,null,null,null,null,null,null,null,null,null,null,null,"Drug EHB Deductible",null,null,null,null,null,null,null,null,null,null,null,null,null,"Combined Medical and Drug EHB Deductible",null,null,null,null,null,null,null,null,null,null,null,null,null,"Primary Care Visit to Treat an Injury or Illness",null,null,null,null,null,null,null,"Specialist Visit",null,null,null,null,null,"Other Practitioner Office Visit (Nurse, Physician Assistant)",null,null,null,null,null,"Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)",null,null,null,null,null,null,null,"Outpatient Surgery Physician/Surgical Services",null,null,null,null,null,null,null,"Hospice Services",null,null,null,null,null,"Non-Emergency Care When Traveling Outside the U.S.",null,null,null,null,null,"Routine Dental Services (Adult)",null,null,null,null,null,"Infertility Treatment",null,null,null,null,null,"Long-Term/Custodial Nursing Home Care",null,null,null,null,null,"Private-Duty Nursing",null,null,null,null,null,"Routine Eye Exam (Adult)",null,null,null,null,null,"Urgent Care Centers or Facilities",null,null,null,null,null,"Home Health Care Services",null,null,null,null,null,"Emergency Room Services",null,null,null,null,null,"Emergency Transportation/Ambulance",null,null,null,null,null,"Inpatient Hospital Services (e.g., Hospital Stay)",null,null,null,null,null,null,"Inpatient Physician and Surgical Services",null,null,null,null,null,"Bariatric Surgery",null,null,null,null,null,"Cosmetic Surgery",null,null,null,null,null,"Skilled Nursing Facility",null,null,null,null,null,"Prenatal and Postnatal Care",null,null,null,null,null,"Delivery and All Inpatient Services for Maternity Care",null,null,null,null,null,"Mental/ Behavioral Health Outpatient Services",null,null,null,null,null,"Substance Abuse Disorder Outpatient Services",null,null,null,null,null,"Mental/ Behavioral Health Inpatient Services",null,null,null,null,null,"Substance Abuse Disorder Inpatient Services",null,null,null,null,null,"Generic Drugs",null,null,null,null,null,"Preferred Brand Drugs",null,null,null,null,null,"Non-Preferred Brand Drugs",null,null,null,null,null,"Specialty Drugs",null,null,null,null,null,null,"Outpatient Rehabilitation Services",null,null,null,null,null,"Habilitation Services",null,null,null,null,null,"Chiropractic Care",null,null,null,null,null,"Durable Medical Equipment",null,null,null,null,null,"Hearing Aids",null,null,null,null,null,"Imaging (CT/PET Scans, MRIs)",null,null,null,null,null,"Preventive Care/Screening/Immunization",null,null,null,null,null,"Routine Foot Care",null,null,null,null,null,"Acupuncture",null,null,null,null,null,"Weight Loss Programs",null,null,null,null,null,"Routine Eye Exam for Children",null,null,null,null,null,"Eye Glasses for Children",null,null,null,null,null,"Dental Check-Up for Children",null,null,null,null,null,"Rehabilitative Speech Therapy",null,null,null,null,null,"Rehabilitative Occupational and Rehabilitative Physical Therapy",null,null,null,null,null,"Well Baby Visits and Care",null,null,null,null,null,"Laboratory Outpatient and Professional Services",null,null,null,null,null,"X-rays and Diagnostic Imaging",null,null,null,null,null,"Basic Dental Care – Child",null,null,null,null,null,"Orthodontia – Child",null,null,null,null,null,"Major Dental Care – Child",null,null,null,null,null,"Basic Dental Care – Adult",null,null,null,null,null,"Orthodontia – Adult",null,null,null,null,null,"Major Dental Care – Adult",null,null,null,null,null,"Abortion for Which Public Funding is Prohibited",null,null,null,null,null,"Transplant",null,null,null,null,null,"Accidental Dental",null,null,null,null,null,"Dialysis",null,null,null,null,null,"Allergy Testing",null,null,null,null,null,"Chemotherapy",null,null,null,null,null,"Radiation",null,null,null,null,null,"Diabetes Education",null,null,null,null,null,"Prosthetic Devices",null,null,null,null,null,"Infusion Therapy",null,null,null,null,null,"Treatment for Temporomandibular Joint Disorders",null,null,null,null,null,"Nutritional Counseling",null,null,null,null,null,"Reconstructive Surgery",null,null,null,null,null,"Additional State-Required Benefits"]
["Plan Cost Sharing Attributes",null,null,null,null,null,null,null,null,null,null,null,"HSA/HRA Detail",null,null,"URLs",null,null,"Having a Baby",null,null,null,"Having Diabetes",null,null,null,"In Network",null,null,"In Network (Tier 2)",null,null,"Out of Network",null,null,"Combined In/Out Network",null,null,"In Network",null,null,"In Network (Tier 2)",null,null,"Out of Network",null,null,"Combined In/Out Network",null,null,"In Network",null,null,"In Network (Tier 2)",null,null,"Out of Network",null,null,"Combined In/Out Network",null,null,"In Network",null,null,null,"In Network\n(Tier 2)",null,null,null,"Out of Network",null,null,"Combined In/Out Network",null,null,"In Network",null,null,null,"In Network (Tier 2)",null,null,null,"Out of Network",null,null,"Combined In/Out Network",null,null,"In Network",null,null,null,"In Network (Tier 2)",null,null,null,"Out of Network",null,null,"Combined In/Out Network",null,null,"Copay",null,null,"Coinsurance",null,null,"AV Calculator Additional Benefit Design",null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Coinsurance for AV Calculator",null,"Copay",null,null,"Coinsurance",null,null,"Coinsurance for AV Calculator",null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"AV Calculator Additional Benefit Design","Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"AV Calculator Additional Benefit Design","Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance",null,null,"Copay",null,null,"Coinsurance"]
["HIOS Plan ID* \n(Standard Component + Variant)","Plan Marketing Name*","Level of Coverage*\n(Metal Level)","CSR Variation Type*","Issuer Actuarial Value","AV Calculator Output Number*","Medical & Drug Deductibles Integrated?*","Medical & Drug Maximum Out of Pocket Integrated?*","Out of Network Coverage?*","Multiple In Network Tiers?*","1st Tier Utilization*","2nd Tier Utilization","HSA Eligible*","HSA/HRA Employer Contribution","HSA/HRA Employer Contribution Amount","URL for Summary of Benefits & Coverage","URL for Enrollment Payment","Plan Brochure","Deductible","Copayment","Coinsurance","Limit","Deductible","Copayment","Coinsurance","Limit","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","Default Coinsurance","Individual","Per Person in Family","Family","Default Coinsurance","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","Default Coinsurance","Individual","Per Person in Family","Family","Default Coinsurance","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","Default Coinsurance","Individual","Per Person in Family","Family","Default Coinsurance","Individual","Per Person in Family","Family","Individual","Per Person in Family","Family","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","Begin Primary Care Cost-Sharing After a Set Number of Visits? ","Begin Primary Care Deductible/ Coinsurance After a Set Number of Copays? ","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","Maximum Number of Days for Charging an Inpatient Copay?  ","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","Maximum Coinsurance for Specialty Drugs","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network"]

{"sheet":"Sheet1","index":2,"n_rows":59,"n_cols":17,"rows_kept":59,"cut":false,"hidden":true,"merged":[]}
["AK","Individual",null,null,null,"Guaranteed Rate","corresponds to limit unit"]
["AL","SHOP (Small Group)",null,null,"Covered","Estimated Rate","Click here to select"]
["AR",null,null,null,"Not Covered"]
["AS"]
["AZ",null,null,null,null,null,"Non-EHB",null,"Standard Plan Variation",null,null,null,"Same as Certified Exchange QHP"]
["CA",null,null,null,null,null,"Substituted",null,"Zero Cost Sharing Plan Variation",null,null,null,"Substantially the same as Certified Exchange QHP"]
["CO",null,null,"Indemnity","Bronze",null,"Substantially Equal",null,"Limited Cost Sharing Plan Variation",null,null,null,"No"]
["CT",null,null,"PPO","Silver",null,"Using Alternate Benchmark",null,"73% AV Level Silver Plan"]
["DC",null,null,"HMO","Gold","On the Exchange","Other Law/Regulation",null,"87% AV Level Silver Plan"]
["DE","Yes","New","POS","Platinum","Off the Exchange","Additional EHB Benefit",null,"94% AV Level Silver Plan",null,null,null,"Individual Member Rating Only"]
["FL","No","Existing","EPO","Catastrophic","Both","Dental Only Plan Available",null,null,null,null,null,"Accepts both Composite and Individual Rating Based on Employer's Preference/Employee Choice "]
["FM"]
["GA","Allows Adult and Child-Only",null,null,"corresponds to column U",null,"No",null,null,null,null,null,"Not Applicable"]
["GU","Allows Adult-Only",null,null,"Click here to select",null,"Yes",null,null,null,null,null,"No Charge"]
["HI","Allows Child-Only",null,null,null,null,"Yes and additional limits listed in plan brochure",null,null,null,null,null,"No Charge after deductible"]
["IA",null,null,null,null,null,null,null,null,null,null,null,"$X"]
["ID",null,null,null,"On Exchange",null,"Calendar Benefit Year",null,"Not Applicable",null,null,null,"$X Copay after deductible"]
["IL",null,null,null,"Both (On/Off)",null,"Plan Benefit Year",null,"$X Copay per Day",null,null,null,"$X Copay before deductible"]
["IN",null,null,null,null,null,null,null,"$X Copay per Day after Deductible",null,null,null,"$X Copay per Day"]
["KS","94% AV Level Silver Plan",null,null,null,null,null,null,"$X Copay per Day Before Deductible",null,null,null,"$X Copay per Day after Deductible"]
["KY",null,null,null,null,null,null,null,"$X Copay per Stay",null,null,null,"$X Copay per Day Before Deductible"]
["LA",null,null,null,null,null,null,null,"$X Copay per Stay After Deductible",null,null,null,"$X Copay per Stay"]
["MA",null,null,"Not Applicable","Not Applicable","Not Applicable","Not Applicable",null,"$X Copay per Stay Before Deductible",null,null,null,"$X Copay per Stay After Deductible"]
["MD",null,null,"No Charge","No Charge","No Charge","No Charge",null,null,null,null,null,"$X Copay per Stay Before Deductible"]
["ME",null,null,"No Charge after deductible","No Charge after deductible","No Charge after deductible","No Charge after deductible"]
["MH",null,null,"$X","$X","X%","X%"]
["MI",null,null,"$X Copay after deductible","$X Copay after deductible","X% Coinsurance after deductible","X% Coinsurance after deductible",null,null,null,null,null,"Not Applicable"]
["MN",null,null,"$X Copay before deductible","$X Copay before deductible",null,null,null,null,null,null,null,"No In-Network Tier 2"]
["MO",null,null,null,null,null,null,"Not Applicable",null,null,null,null,"No Charge"]
["MP",null,null,null,null,"Not Applicable",null,"No In-Network Tier 2",null,null,null,null,"No Charge after deductible"]
["MS",null,null,null,null,"No Charge",null,"No Charge",null,null,null,null,"$X"]
["MT",null,null,null,null,"No Charge after deductible",null,"No Charge after deductible",null,null,null,null,"$X Copay after deductible",null,null,null,"Not Applicable"]
["NC",null,null,"No In-Network Tier 2",null,"$X",null,"$X",null,null,null,null,"$X Copay before deductible",null,null,null,"No In-Network Tier 2"]
["ND",null,null,"Not Applicable","No In-Network Tier 2","$X Copay after deductible",null,"$X Copay after deductible",null,null,null,null,"$X Copay per Day",null,null,null,"$X Copay per Day"]
["NE",null,null,"No Charge","Not Applicable","$X Copay before deductible",null,"$X Copay before deductible",null,null,null,null,"$X Copay per Day after Deductible",null,null,null,"$X Copay per Day after Deductible"]
["NH",null,null,"No Charge after deductible","No Charge","$X Copay per Day after Deductible",null,"$X Copay per Day after Deductible",null,null,null,null,"$X Copay per Day Before Deductible",null,null,null,"$X Copay per Day Before Deductible"]
["NJ",null,null,"$X","No Charge after deductible","$X Copay per Day Before Deductible",null,"$X Copay per Day Before Deductible",null,null,null,null,"$X Copay per Stay",null,null,null,"$X Copay per Stay"]
["NM","Yes","$X","$X Copay after deductible","X%","$X Copay per Stay After Deductible",null,"$X Copay per Stay After Deductible",null,null,null,null,"$X Copay per Stay After Deductible",null,null,null,"$X Copay per Stay After Deductible"]
["NV","No","Not Applicable","$X Copay before deductible","X% Coinsurance after deductible","$X Copay per Stay Before Deductible",null,"$X Copay per Stay Before Deductible",null,null,null,null,"$X Copay per Stay Before Deductible",null,null,null,"$X Copay per Stay Before Deductible"]
["NY"]
["OH"]
["OK"]
["OR"]
["PA"]
["PR"]
["PW"]
["RI"]
["SC"]
["SD"]
["TN"]
["TX"]
["UT"]
["VA"]
["VI"]
["VT"]
["WA"]
["WI"]
["WV"]
["WY"]