{"text_format":"2","workbook":"xls","n_sheets":3,"sheets":["EnableMacros","Administrative Data","Names"],"not_rendered":{"charts":0,"images":0,"macros":1,"external_links":1,"defined_names":5,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"run_cost":"one","rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900","formulas":"cached_only"}

{"sheet":"EnableMacros","index":0,"n_rows":23,"n_cols":2,"rows_kept":23,"cut":false,"hidden":false,"merged":[[0,0,0,15],[1,0,1,15],[2,0,2,15]],"flags":["formulas_cached_only"]}
["Administrative Data Template"]
[]
[]
[]
[]
[null,"If you are seeing this sheet, macros are not enabled, please follow the following steps: "]
[]
[]
[null,"If using Excel 2003:"]
[null,"1. Set the macro security setting to Medium (Recommended) or Low.  To change the macro security setting, select Tools-> "]
[null,"       Macro->Security."]
[null,"2. If the macro security setting is set to Medium, select Enable Macros when opening the workbook."]
[]
[]
[null,"If using Excel 2007 and 2010:"]
[null,"1. Set the macro security setting to Disable macros with notifications (Recommended) or Enable all macros. To change"]
[null,"    the macro security setting, click the Office Button and select Excel Option -> Trust Center -> Trust Center Settings -> "]
[null,"    Macro Settings."]
[null,"2. If the macro security setting is set to Disable macros with notifications, click the Option button and select Enable this "]
[null,"    content."]
[]
[]
[null,"Note: This screen will flash momentarily when you save or finalize this workbook."]

{"sheet":"Administrative Data","index":1,"n_rows":82,"n_cols":6,"rows_kept":82,"cut":false,"hidden":true,"merged":[],"flags":["formulas_cached_only"]}
["Administrative Data v2.8","Instructions:","The QHP Application requires submission of certain administrative data that will be utilized for operational purposes."]
[null,null,"This information includes identifying information and contact information. "]
[null,null,"Some of this information will be pre-populated based on the information you have previously entered in HIOS.                "]
[null,null,"All fields marked with an asterik (*) are required. Depending on the Proposed Exchange Market Coverage selected, certain additional fields may be required.  "]
[null,null,"On validation, missing or incorrect data is highlighted."]
["Issuer ID:*",null,"Proposed Exchange Market Coverage:*"]
["Issuer State:*",null,"Current Sales Market:*"]
[]
["1. Administrative Data "]
["Company Legal Name:*","Issuer Legal Name:*","Issuer Marketing Name:*"]
[]
[]
["Associated Health Plan ID:","TIN:*","NAIC Company Code:","NAIC Group Code:"]
[]
[]
["2. Company Address "]
["Address:*","Address 2 (optional): ","City:*","State:*","Zip Code:*"]
[]
[]
["3. Issuer Address"]
["Address:*","Address 2 (optional): ","City:*","State:*","Zip Code:*"]
[]
[]
["4. Select Your Primary Contact:*"]
[]
[]
["5. Issuer Individual Market Contact"]
["First Name:","Last Name:","E-mail Address:","Phone Number: ","Phone Extension: "]
[]
[]
["6. Issuer SHOP (Small Group) Contact"]
["First Name:","Last Name:","E-mail Address:","Phone Number: ","Phone Extension: "]
[]
[]
["7. CEO"]
["First Name:* ","Last Name:* ","E-mail Address:* ","Phone Number:* ","Phone Extension: "]
[]
[]
["8. CFO "]
["First Name:* ","Last Name:* ","E-mail Address:* ","Phone Number:* ","Phone Extension: "]
[]
[]
["9.  Customer Service - Individual Market "]
["Customer Service Phone:","Customer Service Phone Extension: ","Customer Service Toll Free:","Customer Service TTY:","Customer Service URL:"]
[]
[]
["10.  Customer Service - SHOP (Small Group)"]
["Customer Service Phone:","Customer Service Phone Extension: ","Customer Service Toll Free:","Customer Service TTY:","Customer Service URL:"]
[]
[]
["11.  Contacts"]
["Contact Type","First Name","Last Name","Phone Number","Extension","E-mail Address"]
["Enrollment Contact"]
["Online Enrollment Center Contact (Primary)"]
["Online Enrollment Center Contact (Backup)"]
["System Contact"]
["Appeals/Grievances Contact"]
["Customer Service Operations Contact"]
["User Access Contact"]
["Backup User Access Contact"]
["Marketing Contact"]
["Medical Director"]
["Chief Dental Director"]
["Pharmacy Benefit Manager"]
["Government Relations Contact"]
["HIPAA Security Officer"]
["Complaints Tracking Contact"]
["Quality Contact"]
["Compliance Officer"]
["Payment Contact"]
["APTC/CSR Contact"]
["Financial Reporting Contact"]
["Financial Transfers Contact"]
["Risk Corridors Contact"]
["Risk Adjustment Contact"]
["Reinsurance Contact"]
[]
["12. Third Party Administrator(s):"]
["Do you have a TPA for the following processes:"]
["Enrollment*"]
["Claims Processing*"]
["Edge Server Host*"]

{"sheet":"Names","index":2,"n_rows":59,"n_cols":3,"rows_kept":59,"cut":false,"hidden":true,"merged":[],"flags":["formulas_cached_only"]}
["AK","Individual","Individual"]
["AL","SHOP (Small Group)","Small Group"]
["AR","Both","Both"]
["AS"]
["AZ"]
["CA"]
["CO"]
["CT"]
["DC"]
["DE"]
["FL"]
["FM"]
["GA"]
["GU"]
["HI"]
["IA"]
["ID"]
["IL"]
["IN"]
["KS"]
["KY"]
["LA"]
["MA"]
["MD"]
["ME"]
["MH"]
["MI"]
["MN"]
["MO"]
["MP"]
["MS"]
["MT"]
["NC"]
["ND"]
["NE"]
["NH"]
["NJ"]
["NM"]
["NV"]
["NY"]
["OH"]
["OK"]
["OR"]
["PA"]
["PR"]
["PW"]
["RI"]
["SC"]
["SD"]
["TN"]
["TX"]
["UT"]
["VA"]
["VI"]
["VT"]
["WA"]
["WI"]
["WV"]
["WY"]