Business Rules PUF - 2014

data.healthcare.gov | Last Updated 11 Dec 2017

The Business Rules PUF (BR-PUF) is one of the seven 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).

This dataset has the following 23 columns:

Column NameAPI Column NameData TypeDescriptionSample Values
Business YearbusinessyeartextYear for which plan provides coverage to enrollees
State CodestatecodetextTwo-character state abbreviation indicating the state where the plan is offered
Issuer IDissueridtextFive-digit numeric code that identifies the issuer organization in the Health Insurance Oversight System (HIOS)
Source NamesourcenametextCategorical identifier of source of data import
Version NumberversionnumtextInteger value for version of data import
Import Dateimportdatecalendar_dateDate of data import
Issuer ID (repeated)issuerid2textFive-digit numeric code that identifies the issuer organization in HIOS
Tax Identification NumbertintextTax ID Number of issuer
Product IDproductidtextTen-character alpha-numeric code that identifies an insurance product within HIOS
Standard Component IDstandardcomponentidtextFourteen-character alpha-numeric code that identifies an insurance plan within HIOS
Enrollee Contract Rate Determination RuleenrolleecontractratedeterminationruletextDescription of enrollee contract rule for determining rates
Two Parent Family Max Dependents RuletwoparentfamilymaxdependentsruletextThe maximum number of dependents used to rate a policy in a two parent family
Single Parent Family Max Dependents RulesingleparentfamilymaxdependentsruletextThe maximum number of dependents used to rate a policy in a single parent family
Dependent Maximum Age RuledependentmaximumagruletextInteger value for the maximum age for which an insurance plan could be issued for a child, if applicable
Children Only Contract Max Children RulechildrenonlycontractmaxchildrenruletextThe maximum number of children used to rate a child-only policy
Domestic Partner As Spouse IndicatordomesticpartnerasspouseindicatortextCategorical indicator for whether a domestic partner is treated the same as secondary subscribers
Same Sex Partner As Spouse IndicatorsamesexpartnerasspouseindicatortextCategorical indicator for whether a same sex partner is treated the same as secondary subscribers
Age Determination RuleagedeterminationruletextCategorical indicator for the method used to determine the person's age at the time of an application
Minimum Tobacco Free Months RuleminimumtobaccofreemonthsruletextInteger value for the number of tobacco-free months considered when qualifying an enrollee for the non-tobacco insurance rate, if applicable
Cohabitation RulecohabitationruletextCategorical indicator that identifies which family relationships are allowed for enrollees and whether cohabitation is required
Row NumberrownumbertextInteger value for template row number associated with this data record
Market CoveragemarketcoveragetextCategorical indicator of market coverage of plans submitted with this template
Dental-Only Plan IndicatordentalonlytextCategorical indicator that plan is a stand-alone dental plan