For internal use only. Not approved for use with the public. Always verify plan details with CMS and carrier documentation.

Add a New Plan

Basic Info

Plan ID

Year

Plan Name

Organization

Plan Type

Commissionable Lead Plan Verified for accuracy

Counties

Select one or more counties (IN)

Documents

Summary of Benefits URL

Evidence of Coverage URL

Financials

Premium

Giveback

MOOP (In-Network)

MOOP (Out-of-Network)

Medical Deductible

Drug Deductible

Medical Costs

PCP

Specialist

Labs

Diagnostic Radiology

X-rays

ER

Urgent Care

Inpatient

Inpatient Days

Outpatient

Extras

Dental

Dental Notes

Vision

OTC

OTC Notes

Prescription

Prescription

Part D Deductible

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