business_year | state_code | issuer_id | source_name | version_number | import_date | issuer_id_repeated | state_code_repeated | plan_id | plan_id_standard_component_id_with_variant | benefit_name | copay_in_network_tier_1 | copay_in_network_tier_2 | copay_out_of_network | coinsurance_in_network_tier_1 | coinsurance_in_network_tier_2 | coinsurance_out_of_network | ehb_indicator | state_required_benefit_indicator | is_this_benefit_covered | quantitative_limit_on_service | limit_quantity | limit_unit | minimum_stay | exclusions | benefit_explanation | ehb_variance_reason | is_subject_to_deductible_tier_1 | is_subject_to_deductible_tier_2 | is_excluded_from_in_network_moop | is_excluded_from_out_of_network_moop | _row_number |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
2014 | KS | 94248 | SERFF | 6 | 01/23/2014 12:49:01 PM | 94248 | KS | 94248KS0170004 | 94248KS0170004-02 | Hearing Aids | Not Covered | 96 | |||||||||||||||||||
2014 | IN | 50816 | HIOS | 9 | 11/26/2013 01:14:08 PM | 50816 | IN | 50816IN0130032 | 50816IN0130032-00 | Acupuncture | Not Covered | 100 | |||||||||||||||||||
2014 | FL | 56503 | HIOS | 6 | 03/19/2014 07:06:49 AM | 56503 | FL | 56503FL1160001 | 56503FL1160001-01 | Diabetes Education | 123 | ||||||||||||||||||||
2014 | TN | 14002 | HIOS | 7 | 01/29/2014 08:00:05 AM | 14002 | TN | 14002TN0330015 | 14002TN0330015-04 | Basic Dental Care - Adult | 113 | ||||||||||||||||||||
2014 | FL | 16842 | HIOS | 6 | 01/17/2014 09:36:20 AM | 16842 | FL | 16842FL0120041 | 16842FL0120041-03 | Hearing Aids | Not Covered | 96 | |||||||||||||||||||
2014 | WI | 87416 | HIOS | 6 | 10/15/2013 07:27:56 AM | 87416 | WI | 87416WI0010022 | 87416WI0010022-04 | Routine Foot Care | 99 | ||||||||||||||||||||
2014 | TN | 14002 | HIOS | 7 | 01/29/2014 08:00:05 AM | 14002 | TN | 14002TN0340005 | 14002TN0340005-01 | Bariatric Surgery | 79 | ||||||||||||||||||||
2014 | OH | 29276 | SERFF | 8 | 07/28/2014 02:39:22 PM | 29276 | OH | 29276OH0740011 | 29276OH0740011-03 | Acupuncture | 100 | ||||||||||||||||||||
2014 | TN | 66842 | HIOS | 5 | 10/15/2013 07:27:56 AM | 66842 | TN | 66842TN0030005 | 66842TN0030005-05 | Bariatric Surgery | 79 | ||||||||||||||||||||
2014 | MT | 32225 | SERFF | 3 | 08/26/2013 12:29:34 PM | 32225 | MT | 32225MT0010002 | 32225MT0010002-05 | Hearing Aids | 96 | ||||||||||||||||||||
2014 | TN | 14002 | HIOS | 7 | 01/29/2014 08:00:05 AM | 14002 | TN | 14002TN0320007 | 14002TN0320007-01 | Cosmetic Surgery | 80 | ||||||||||||||||||||
2014 | PA | 75729 | HIOS | 11 | 12/20/2013 07:30:10 AM | 75729 | PA | 75729PA0012605 | 75729PA0012605-04 | Radiation | 122 | ||||||||||||||||||||
2014 | NC | 11512 | HIOS | 9 | 01/29/2014 08:00:05 AM | 11512 | NC | 11512NC0110008 | 11512NC0110008-01 | Cosmetic Surgery | 80 | ||||||||||||||||||||
2014 | NC | 55440 | HIOS | 4 | 09/17/2013 04:07:07 PM | 55440 | NC | 55440NC0160001 | 55440NC0160001-00 | Basic Dental Care - Adult | 113 | ||||||||||||||||||||
2014 | AR | 70525 | SERFF | 8 | 01/23/2014 12:49:01 PM | 70525 | AR | 70525AR0070004 | 70525AR0070004-02 | Weight Loss Programs | 101 | ||||||||||||||||||||
2014 | ID | 17859 | SERFF | 4 | 01/24/2014 09:49:15 AM | 17859 | ID | 17859ID0010001 | 17859ID0010001-01 | Accidental Dental | 118 | ||||||||||||||||||||
2014 | FL | 56503 | HIOS | 6 | 03/19/2014 07:06:49 AM | 56503 | FL | 56503FL1240001 | 56503FL1240001-06 | Major Dental Care - Adult | 115 | ||||||||||||||||||||
2014 | WI | 87416 | HIOS | 6 | 10/15/2013 07:27:56 AM | 87416 | WI | 87416WI0010015 | 87416WI0010015-01 | Orthodontia - Adult | 114 | ||||||||||||||||||||
2014 | FL | 16842 | HIOS | 6 | 01/17/2014 09:36:20 AM | 16842 | FL | 16842FL0070107 | 16842FL0070107-01 | Acupuncture | Not Covered | 100 | |||||||||||||||||||
2014 | TN | 14002 | HIOS | 7 | 01/29/2014 08:00:05 AM | 14002 | TN | 14002TN0330017 | 14002TN0330017-04 | Acupuncture | 100 |