NCQA Carrier Carrier Subcode - 2013 FEHB Data High 000 ...F5 F5-HMO-DC-003 Aetna HealthFund CDHP and Value Plan F5 F5-HMO-DC-004 Aetna HealthFund CDHP and Value Plan F5 F5-HMO-FL-003

Attachment 3 - 2014 CAHPS FEHB Sub-Code List

NCQA

Org ID

NCQA

Submission

Code

FEHB Plan Name Carrier

Code

Carrier Subcode -

High 000

Carrier Subcode -

Standard 001

Carrier Subcode -

HDHP 002

Carrier Subcode -

CDHP 003

Carrier Subcode -

Basic 004

2013 FEHB Data

Sharing

3317 7154 Aetna HealthFund 22 22-HMO-AA-002 ALL 22'S

Aetna HealthFund CDHP and EP EP-HMO-CT-003

Aetna HealthFund CDHP and

Value Plan EP EP-HMO-CT-004


Value Plan EP EP-HMO-DE-003


Value Plan EP EP-HMO-DE-004


Value Plan EP EP-HMO-MA-003

Aetna HealthFund CDHP and EP EP-HMO-MA-004 Aetna HealthFund CDHP and EP EP-HMO-ME-003


Value Plan EP EP-HMO-ME-004


Value Plan EP EP-HMO-NH-003


Value Plan EP EP-HMO-NH-004


Value Plan EP EP-HMO-NJ-003


Value Plan EP EP-HMO-NJ-004


Value Plan EP EP-HMO-NY-003


Value Plan EP EP-HMO-NY-004


Value Plan EP EP-HMO-RI-003


Value Plan EP EP-HMO-RI-004


Value Plan EP EP-HMO-VT-003


Value Plan EP EP-HMO-VT-004


Value Plan F5 F5-HMO-AL-003


Value Plan F5 F5-HMO-AL-004


Value Plan F5 F5-HMO-AR-003


Value Plan F5 F5-HMO-AR-004


Value Plan F5 F5-HMO-DC-003


Value Plan F5 F5-HMO-DC-004


Value Plan F5 F5-HMO-FL-003


Value Plan F5 F5-HMO-FL-004


Value Plan F5 F5-HMO-GA-003


Value Plan F5 F5-HMO-GA-004


Value Plan F5 F5-HMO-LA-003

1


NCQA

Org ID

NCQA

Submission

Code


Code

Carrier Subcode -

High 000

Carrier Subcode -

Standard 001

Carrier Subcode -

HDHP 002

Carrier Subcode -

CDHP 003

Carrier Subcode -

Basic 004

2013 FEHB Data

Sharing


Value Plan F5 F5-HMO-LA-004


Value Plan F5 F5-HMO-MD-003


Value Plan F5 F5-HMO-MD-004


Value Plan F5 F5-HMO-NC-003


Value Plan F5 F5-HMO-NC-004


Value Plan F5 F5-HMO-TN-003


Value Plan F5 F5-HMO-TN-004


Value Plan F5 F5-HMO-VA-003


Value Plan F5 F5-HMO-VA-004


Value Plan F5 F5-HMO-W V-003


Value Plan F5 F5-HMO-W V-004


Value Plan G5 G5-HMO-AZ-003


Value Plan G5 G5-HMO-AZ-004


Value Plan G5 G5-HMO-CO-003


Value Plan G5 G5-HMO-CO-004


Value Plan G5 G5-HMO-KS-003

Aetna HealthFund CDHP and G5 G5-HMO-KS-004

Aetna HealthFund CDHP and G5 G5-HMO-MI-003

Aetna HealthFund CDHP and G5 G5-HMO-MI-004

Aetna HealthFund CDHP and G5 G5-HMO-MO-003

Aetna HealthFund CDHP and G5 G5-HMO-MO-004

Aetna HealthFund CDHP and G5 G5-HMO-NM-003

Aetna HealthFund CDHP and G5 G5-HMO-NM-004

Aetna HealthFund CDHP and G5 G5-HMO-NV-003

Aetna HealthFund CDHP and G5 G5-HMO-NV-004

Aetna HealthFund CDHP and G5 G5-HMO-SD-003


Value Plan G5 G5-HMO-SD-004


Value Plan G5 G5-HMO-UT-003


Value Plan G5 G5-HMO-UT-004


Value Plan G5 G5-HMO-W A-003


Value Plan G5 G5-HMO-W A-004


Value Plan H4 H4-HMO-IA-003


Value Plan H4 H4-HMO-IA-004

2


NCQA

Org ID

NCQA

Submission

Code


Code

Carrier Subcode -

High 000

Carrier Subcode -

Standard 001

Carrier Subcode -

HDHP 002

Carrier Subcode -

CDHP 003

Carrier Subcode -

Basic 004

2013 FEHB Data

Sharing


Value Plan H4 H4-HMO-ID-003


Value Plan H4 H4-HMO-ID-004


Value Plan H4 H4-HMO-IL-003


Value Plan H4 H4-HMO-IL-004


Value Plan H4 H4-HMO-KY-003


Value Plan H4 H4-HMO-KY-004


Value Plan H4 H4-HMO-MN-003


Value Plan H4 H4-HMO-MN-004


Value Plan H4 H4-HMO-MS-003


Value Plan H4 H4-HMO-MS-004


Value Plan H4 H4-HMO-ND-003


Value Plan H4 H4-HMO-ND-004


Value Plan H4 H4-HMO-OR-003


Value Plan H4 H4-HMO-OR-004


Value Plan H4 H4-HMO-PA-003


Value Plan H4 H4-HMO-PA-004

99 2028 Aetna Open Access 2U 2U-HMO-GA-000

105 5572 Aetna Open Access 2X 2X-HMO-CA-000

Aetna Open Access C3 C3-HMO-W A-000

442 2139 Aetna Open Access HF HF-HMO-NV-000 W Q-HMO-AZ-000

1683 3128 Aetna Open Access HY HY-HMO-KS-000 HY-HMO-MO-000

1683 3128 Aetna Open Access HY HY-HMO-MO-000 HY-HMO-KS-000

122 2514 Aetna Open Access JC JC-HMO-NY-000 JC-HMO-NY-004

122 2514 Aetna Open Access JC JC-HMO-NY-004 JC-HMO-NY-000

101 2517 Aetna Open Access JN JN-HMO-DC-000

JN-HMO-DC-

000/004, JN-HMO-

MD-000/004, JN-

HMO-VA-000/004

101 2517 Aetna Open Access JN JN-HMO-DC-004

JN-HMO-DC-

000/004, JN-HMO-

MD-000/004, JN-

HMO-VA-000/004

101 2517 Aetna Open Access JN JN-HMO-MD-000

JN-HMO-DC-

000/004, JN-HMO-

MD-000/004, JN-

HMO-VA-000/004

101 2517 Aetna Open Access JN JN-HMO-MD-004

JN-HMO-DC-

000/004, JN-HMO-

MD-000/004, JN-

HMO-VA-000/004

3


NCQA

Org ID

NCQA

Submission

Code


Code

Carrier Subcode -

High 000

Carrier Subcode -

Standard 001

Carrier Subcode -

HDHP 002

Carrier Subcode -

CDHP 003

Carrier Subcode -

Basic 004

2013 FEHB Data

Sharing

101 2517 Aetna Open Access JN JN-HMO-VA-000

JN-HMO-DC-

000/004, JN-HMO-

MD-000/004, JN-

HMO-VA-000/004

101 2517 Aetna Open Access JN JN-HMO-VA-004

JN-HMO-DC-

000/004, JN-HMO-

MD-000/004, JN-

HMO-VA-000/004

121 5575 Aetna Open Access JR JR-HMO-NJ-000

JR-HMO-NJ-

000/004, P3-HMO-

NJ-000/004

121 5575 Aetna Open Access JR JR-HMO-NJ-004

JR-HMO-NJ-

000/004, P3-HMO-

NJ-000/004

1948 3626 Aetna Open Access P3 P3-HMO-DE-000 P3-HMO-DE-004

1948 3626 Aetna Open Access P3 P3-HMO-DE-004 P3-HMO-DE-000

1948 5024 Aetna Open Access P3 P3-HMO-PA-000

P3-HMO-PA-

000/004, YE-HMO-

PA-000

1948 5024 Aetna Open Access P3 P3-HMO-PA-004

P3-HMO-PA-

000/004, YE-HMO-

PA-000

1948 5575 Aetna Open Access P3 P3-HMO-NJ-000

JR-HMO-NJ-

000/004, P3-HMO-

NJ-000/004

1948 5575 Aetna Open Access P3 P3-HMO-NJ-004

JR-HMO-NJ-

000/004, P3-HMO-

NJ-000/004

332 5024 Aetna Open Access YE YE-HMO-PA-000

P3-HMO-PA-

000/004, YE-HMO-

PA-000

1214 1001 Aetna Open Access UB UB-HMO-TN-000

442 2139 Aetna Open Access WQ WQ-HMO-AZ-000 HF-HMO-NV-000

Aetna Value Plan JS JS-HMO-AK-003

Aetna Value Plan JS JS-HMO-CA-003

Aetna Value Plan JS JS-HMO-HI-003

Aetna Value Plan JS JS-HMO-IN-003

Aetna Value Plan JS JS-HMO-OH-003

Aetna Value Plan JS JS-HMO-OK-003

Aetna Value Plan JS JS-HMO-SC-003

Aetna Value Plan JS JS-HMO-TX-003

Aetna Value Plan JS JS-HMO-WI-003

Aetna W hole Health D9 D9-HMO-VA-004

Aetna W hole Health ES ES-HMO-TX-004

Aetna W hole Health F7 F7-HMO-W I-004

Aetna W hole Health J9 J9-HMO-VA-004

1477 3047 Altius Health Plans 9K 9K-HMO-ID-000

9K-HMO-

UT/W Y/ID-

000/002, DK-

HMOUT/W Y/ID-

001

1477 3047 Altius Health Plans 9K 9K-HMO-UT-000

9K-HMO-

UT/W Y/ID-

000/002, DK-

HMOUT/W Y/ID-

001

4


NCQA

Org ID

NCQA

Submission

Code


Code

Carrier Subcode -

High 000

Carrier Subcode -

Standard 001

Carrier Subcode -

HDHP 002

Carrier Subcode -

CDHP 003

Carrier Subcode -

Basic 004

2013 FEHB Data

Sharing

1477 3047 Altius Health Plans 9K 9K-HMO-WY-000

9K-HMO-

UT/W Y/ID-

000/002, DK-

HMOUT/W Y/ID-

001

1477 3047 Altius Health Plans 9K 9K-HMO-ID-002

9K-HMO-

UT/W Y/ID-

000/002, DK-

HMOUT/W Y/ID-

001

1477 3047 Altius Health Plans 9K 9K-HMO-UT-002

9K-HMO-

UT/W Y/ID-

000/002, DK-

HMOUT/W Y/ID-

001

1477 3047 Altius Health Plans 9K 9K-HMO-WY-002

9K-HMO-

UT/W Y/ID-

000/002, DK-

HMOUT/W Y/ID-

001

1477 3047 Altius Health Plans DK DK-HMO-ID-001

9K-HMO-

UT/W Y/ID-

000/002, DK-

HMOUT/W Y/ID-

001

1477 3047 Altius Health Plans DK DK-HMO-UT-001

9K-HMO-

UT/W Y/ID-

000/002, DK-

HMOUT/W Y/ID-

001

1477 3047 Altius Health Plans DK DK-HMO-WY-001

9K-HMO-

UT/W Y/ID-

000/002, DK-

HMOUT/W Y/ID-

001

Anthem Blue Cross Select HMO B3 B3-HMO-CA-000

1480 9821 APWU Health Plan 47 47-FFS-AA-003

1480 9822 APWU Health Plan 47 47-FFS-AA-000

1234 9787 AultCare HMO 3A 3A-HMO-OH-000

1234 9787 AultCare HMO/HDHP 3A 3A-HMO-OH-002

260 6020 Av-Med Health Plan ML ML-HMO-FL-001 ML-HMO-FL-000

260 6020 AvMed Health Plans ML ML-HMO-FL-000 ML-HMO-FL-001

Blue Cross and Blue Shield of

Illinois A2 A2-HMO-IL-000

1801 6523 Blue Cross and Blue Shield

Service Benefit Plan 10 10-FFS-AA-001


Service Benefit Plan 10 10-FFS-DC-001

1801 6527 Blue Cross and Blue Shield 10 10-FFS-MD-001

1801 6529 Blue Cross and Blue Shield 10 10-FFS-VA-001


Service Benefit Plan 10 10-FFS-FL-001


Service Benefit Plan 10 10-FFS-TX-001

5


NCQA

Org ID

NCQA

Submission

Code


Code

Carrier Subcode -

High 000

Carrier Subcode -

Standard 001

Carrier Subcode -

HDHP 002

Carrier Subcode -

CDHP 003

Carrier Subcode -

Basic 004

2013 FEHB Data

Sharing


Service Benefit Plan 10 10-FFS-CA-001


Service Benefit Plan 10 10-FFS-AZ-001


Service Benefit Plan 10 10-FFS-IL-001


Service Benefit Plan 11 11-FFS-AA-004

1801 6524 Blue Cross and Blue Shield 11 11-FFS-DC-004

1801 6526 Blue Cross and Blue Shield 11 11-FFS-MD-004


Service Benefit Plan 11 11-FFS-VA-004


Service Benefit Plan 11 11-FFS-FL-004


Service Benefit Plan 11 11-FFS-TX-004


Service Benefit Plan 11 11-FFS-CA-004


Service Benefit Plan 11 11-FFS-AZ-004

1801 6538 Blue Cross and Blue Shield 11 11-FFS-IL-004

168 1688 Blue Preferred Plus POS 9G 9G-HMO-IL-000 9G-HMO-MO-000

168 1688 Blue Preferred Plus POS 9G 9G-HMO-MO-000 9G-HMO-IL-000

163 1069 Blue Shield of CA Access+HMO SI SI-HMO-CA-000

889 1901 Bluecare Network of MI K5 K5-HMO-MI-000

K5-HMO-MI-000,

LX-HMO-MI-000,

H6-HMO-MI-000,

J3-HMO-MI-000

889 1901 Bluecare Network of MI LX LX-HMO-MI-000

K5-HMO-MI-000,

LX-HMO-MI-000,

H6-HMO-MI-000,

J3-HMO-MI-000

Calvos Selectcare B4 B4-HMO-GU-000

256 1154 Capital Health Plan EA EA-HMO-FL-000

144 4029 CareFirst BlueChoice 2G 2G-HMO-DC-000

2G-HMO-

DC/MD/VA-000 &

2G-HMO-

DC/MD/VA-001

144 4029 CareFirst BlueChoice 2G 2G-HMO-DC-001

2G-HMO-

DC/MD/VA-000 &

2G-HMO-

DC/MD/VA-001

144 4029 CareFirst BlueChoice 2G 2G-HMO-MD-000

2G-HMO-

DC/MD/VA-000 &

2G-HMO-

DC/MD/VA-001

144 4029 CareFirst BlueChoice 2G 2G-HMO-MD-001

2G-HMO-

DC/MD/VA-000 &

2G-HMO-

DC/MD/VA-001

144 4029 CareFirst BlueChoice 2G 2G-HMO-VA-000

2G-HMO-

DC/MD/VA-000 &

2G-HMO-

DC/MD/VA-001

6


NCQA

Org ID

NCQA

Submission

Code


Code

Carrier Subcode -

High 000

Carrier Subcode -

Standard 001

Carrier Subcode -

HDHP 002

Carrier Subcode -

CDHP 003

Carrier Subcode -

Basic 004

2013 FEHB Data

Sharing

144 4029 CareFirst BlueChoice 2G 2G-HMO-VA-001

2G-HMO-

DC/MD/VA-000 &

2G-HMO-

DC/MD/VA-001

CareFirst BlueChoice B6 B6-HMO-DC-002

CareFirst BlueChoice B6 B6-HMO-MD-002

CareFirst BlueChoice B6 B6-HMO-VA-002

9584 9820 CDPHP Universal Benefits, Inc. SG SG-HMO-NY-000 SG-HMO-NY-001

9584 9820 CDPHP Universal Benefits, Inc. SG SG-HMO-NY-001 SG-HMO-NY-000

1854 4401 Compass Rose Health Plan 42 42-FFS-AA-000

116 2171 Coventry Health Care IG IG-HMO-MD-000 IG-HMO-MD-001

116 2171 Coventry Health Care IG IG-HMO-MD-001 IG-HMO-MD-000

Coventry Health Care HDHP GZ GZ-HMO-MD-002

107 1709 Coventry Health Care of Iowa SV SV-HMO-IA-002

107 1709 Coventry Health Care of Iowa SV SV-HMO-IA-000 SV-HMO-IA-000,

SY-HMO-IA-001

107 1709 Coventry Health Care of Iowa SY SY-HMO-IA-001 SV-HMO-IA-000,

SY-HMO-IA-001

113 1656 Coventry Health Care of Kansas HA HA-HMO-KS-000

HA-HMO-KS-

000/001, HA-HMO-

MO-000/001

113 1656 Coventry Health Care of Kansas HA HA-HMO-KS-001

HA-HMO-KS-

000/001, HA-HMO-

MO-000/001

113 1656 Coventry Health Care of Kansas HA HA-HMO-MO-000

HA-HMO-KS-

000/001, HA-HMO-

MO-000/001

113 1656 Coventry Health Care of Kansas HA HA-HMO-MO-001 HA-HMO-KS-

000/001, HA-HMO-

113 11150 Coventry Health Care of Kansas

(Kansas City)-HDHP 9H 9H-HMO-KS-002

113 11150 Coventry Health Care of Kansas 9H 9H-HMO-MO-002

1798 6691 Coventry Health Care of BJ BJ-HMO-LA-000 BJ-HMO-LA-001

1798 6691 Coventry Health Care of BJ BJ-HMO-LA-001 BJ-HMO-LA-000

255 7055 Coventry Health Plan of Florida 5E 5E-HMO-FL-000 5E-HMO-FL-

000/001

255 7055 Coventry Health Plan of Florida 5E 5E-HMO-FL-001 5E-HMO-FL-

000/001

255 7055 Coventry Health Plan of Florida J4 J4-HMO-FL-002

313 2375 Dean Health Plan WD W D-HMO-W I-000

195 1202 Fallon Community Health Plan JG JG-HMO-MA-004

Firstcare B7 B7-HMO-TX-000

1305 Firstcare CK CK-HMO-TX-000

Firstcare CN CN-HMO-TX-000

Firstcare CZ CZ-HMO-TX-000

Firstcare ET ET-HMO-TX-000

1942 9799 Foreign Service Benefit Plan 40 40-FFS-AA-000

1772 7215 GEHA Benefit Plan 31 31-FFS-AA-000

7


NCQA

Org ID

NCQA

Submission

Code


Code

Carrier Subcode -

High 000

Carrier Subcode -

Standard 001

Carrier Subcode -

HDHP 002

Carrier Subcode -

CDHP 003

Carrier Subcode -

Basic 004

2013 FEHB Data

Sharing

1772 7216 GEHA Benefit Plan 31 31-FFS-AA-001

1772 7217 GEHA High Deductible Health 34 34-FFS-AA-002

334 1739 Geisinger Health Plan GG GG-HMO-PA-001

1666 3292 GHI Health Plan 80 80-POS-NJ-000

80-POS-NY-

000/001, 80-POS-

NJ-000/001

1666 3292 GHI Health Plan 80 80-POS-NJ-001

80-POS-NY-

000/001, 80-POS-

NJ-000/001

1666 3292 GHI Health Plan 80 80-POS-NY-000

80-POS-NY-

000/001, 80-POS-

NJ-000/001

1666 3292 GHI Health Plan 80 80-POS-NY-001

80-POS-NY-

000/001, 80-POS-

NJ-000/001

1980 6073 GHI HMO Select 6V 6V-HMO-NY-000

1980 6073 GHI HMO Select X4 X4-HMO-NY-000

7363 10461 Globalhealth, Inc. IM IM-HMO-OK-000

393 1157 Grand Valley Health Plan RL RL-HMO-MI-000 RL-HMO-MI-001

393 1157 Grand Valley Health Plan RL RL-HMO-MI-001 RL-HMO-MI-000

1686 2492 Group Health Cooperative 54 54-HMO-ID-000

54-HMO-W A-

000/001, 54-HMO-

ID-000/001

1686 2492 Group Health Cooperative 54 54-HMO-ID-001

54-HMO-W A-

000/001, 54-HMO-

ID-000/001

1686 2492 Group Health Cooperative 54 54-HMO-W A-000

54-HMO-W A-

000/001, 54-HMO-

ID-000/001

1686 2492 Group Health Cooperative 54 54-HMO-WA-001

54-HMO-W A-

000/001, 54-HMO-

ID-000/001

319 1680 Group Health Cooperative WJ W J-HMO-W I-000

365 2379 Health Alliance HMO FX FX-HMO-IA-000 FX-HMO-IA/IL/IN-

000

365 2379 Health Alliance HMO FX FX-HMO-IL-000 FX-HMO-IA/IL/IN-

000

365 2379 Health Alliance HMO FX FX-HMO-IN-000 FX-HMO-IA/IL/IN-

000

Health Alliance HMO K8 K8-HMO-IN-001

Health Alliance HMO K8 K8-HMO-IL-001

Health Alliance HMO K8 K8-HMO-IA-001

205 1668 Health Alliance Plan 52 52-HMO-MI-000 GY-HMO-MI-001

205 1668 Health Alliance Plan GY GY-HMO-MI-001 52-HMO-MI-000

271 1444 Health Net of Arizona, Inc. A7 A7-HMO-AZ-000 A7-HMO-AZ-001

271 1444 Health Net of Arizona, Inc. A7 A7-HMO-AZ-001 A7-HMO-AZ-000

275 4071 Health Net of California LB LB-HMO-CA-000

LB-HMO-CA-

000/001, LP-HMO-

CA-000/001

275 4071 Health Net of California LB LB-HMO-CA-001

LB-HMO-CA-

000/001, LP-HMO-

CA-000/001

275 4071 Health Net of California LP LP-HMO-CA-000

LB-HMO-CA-

000/001, LP-HMO-

CA-000/001

8


NCQA

Org ID

NCQA

Submission

Code


Code

Carrier Subcode -

High 000

Carrier Subcode -

Standard 001

Carrier Subcode -

HDHP 002

Carrier Subcode -

CDHP 003

Carrier Subcode -

Basic 004

2013 FEHB Data

Sharing

275 4071 Health Net of California LP LP-HMO-CA-001

LB-HMO-CA-

000/001, LP-HMO-

CA-000/001

187 1419 Health Plan of Nevada NM NM-HMO-NV-000

1111 6039 HealthAmerica Pennsylvania 26 26-HMO-PA-000

HealthAmerica Pennsylvania -

HDHP Y6 Y6-HMO-PA-002

HealthKeepers, Inc A9 A9-HMO-VA-000

200 7512 HealthPartners High and

Standard Option V3 V3-HMO-IA-000

V3-HMO-

W I/SD/IA/MN/ND-

000 AND 001


Standard Option V3 V3-HMO-IA-001

V3-HMO-

W I/SD/IA/MN/ND-

000 AND 001


Standard Option V3 V3-HMO-MN-000

V3-HMO-

W I/SD/IA/MN/ND-

000 AND 001


Standard Option V3 V3-HMO-MN-001

V3-HMO-

W I/SD/IA/MN/ND-

000 AND 001


Standard Option V3 V3-HMO-ND-000

V3-HMO-

W I/SD/IA/MN/ND-

000 AND 001


Standard Option V3 V3-HMO-ND-001

V3-HMO-

W I/SD/IA/MN/ND-

000 AND 001


Standard Option V3 V3-HMO-SD-000

V3-HMO-

W I/SD/IA/MN/ND-

000 AND 001


Standard Option V3 V3-HMO-SD-001

V3-HMO-

W I/SD/IA/MN/ND-

000 AND 001


Standard Option V3 V3-HMO-W I-000

V3-HMO-

W I/SD/IA/MN/ND-

000 AND 001


Standard Option V3 V3-HMO-WI-001

V3-HMO-

W I/SD/IA/MN/ND-

000 AND 001

204 1640 HealthPlus of MI X5 X5-HMO-MI-000

Sanford Heart of America Health

Plan RU RU-HMO-ND-000

238 1736 HIP Health of Greater New York 51 51-HMO-NY-000 51-HMO-NY-001

238 1736 HIP of Greater New York 51 51-HMO-NY-001 51-HMO-NY-000

1944 9373 HMSA 87 87-POS-HI-000

1208 Humana Benefit Plan of Illinois,

Inc. 9F 9F-HMO-IL-000

1208 Humana Benefit Plan of Illinois,

Inc. AB AB-HMO-IL-000

228 Humana Benefit Plan of

Louisiana, Inc. AE AE-HMO-LA-000


Louisiana, Inc. AE AE-HMO-LA-001


Louisiana, Inc. BC BS-HMO-LA-000


Louisiana, Inc. BC BS-HMO-LA-001

9


NCQA

Org ID

NCQA

Submission

Code


Code

Carrier Subcode -

High 000

Carrier Subcode -

Standard 001

Carrier Subcode -

HDHP 002

Carrier Subcode -

CDHP 003

Carrier Subcode -

Basic 004

2013 FEHB Data

Sharing

81 Humana CoverageFirst 6N 6N-HMO-KY-003

1941 Humana CoverageFirst AD AD-HMO-GA-003

10251 Humana CoverageFirst GB GB-HMO-IL-003

1941 Humana CoverageFirst LM LM-HMO-GA-003

79 Humana CoverageFirst MJ MJ-HMO-FL-003

10251 9351 Humana CoverageFirst MW MW -HMO-IN-003

10251 Humana CoverageFirst MW MW -HMO-IL-003

82 Humana CoverageFirst PH PH-HMO-KS-003

82 Humana CoverageFirst PH PH-HMO-MO-003

79 Humana CoverageFirst QP QP-HMO-FL-003

10247 9354 Humana CoverageFirst TP TP-HMO-TX-003

TU-HMO-TX-003,

TP-HMO-TX-003,

TV-HMO-TX-003

10247 9354 Humana CoverageFirst TU TU-HMO-TX-003

TU-HMO-TX-003,

TP-HMO-TX-003,

TV-HMO-TX-003

10247 9354 Humana CoverageFirst TV TV-HMO-TX-003

TU-HMO-TX-003,

TP-HMO-TX-003,

TV-HMO-TX-003

Humana Employers Health of

Georgia, Inc. CB CB-HMO-GA-000


Georgia, Inc. CB CB-HMO-GA-001

1941 7088 Humana Employers Health of

Georgia, Inc. DG DG-HMO-GA-000

1941 Humana Employers Health of

Georgia, Inc. DG DG-HMO-GA-001


Georgia, Inc. DN DN-HMO-GA-000


Georgia, Inc. DN DN-HMO-GA-001

76 9392 Humana Health Plan Inc. 75 75-HMO-IL-000

75-HMO-IN-000,

75-HMO-IN-001,

75-HMO-IL-000, 75-

HMO-IL-001

76 9392 Humana Health Plan Inc. 75 75-HMO-IN-001

75-HMO-IN-000,

75-HMO-IN-001,

75-HMO-IL-000, 75-

HMO-IL-001

76 9392 Humana Health Plan, Inc. 75 75-HMO-IN-000

75-HMO-IN-000,

75-HMO-IN-001,

75-HMO-IL-000, 75-

HMO-IL-001

76 9392 Humana Health Plan Inc. 75 75-HMO-IN-001

75-HMO-IN-000,

75-HMO-IN-001,

75-HMO-IL-000, 75-

HMO-IL-001

Humana Health Plan of Ohio A6 A6-HMO-IN-000

Humana Health Plan of Ohio A6 A6-HMO-IN-001

Humana Health Plan of Ohio A6 A6-HMO-KY-000

Humana Health Plan of Ohio A6 A6-HMO-KY-001

Humana Health Plan of Ohio A6 A6-HMO-OH-000

Humana Health Plan of Ohio A6 A6-HMO-OH-001

Humana Health Plan of Texas EW EW-HMO-TX-000

Humana Health Plan of Texas EW EW-HMO-TX-002

Humana Health Plan of Texas UC UC-HMO-TX-000

10


NCQA

Org ID

NCQA

Submission

Code


Code

Carrier Subcode -

High 000

Carrier Subcode -

Standard 001

Carrier Subcode -

HDHP 002

Carrier Subcode -

CDHP 003

Carrier Subcode -

Basic 004

2013 FEHB Data

Sharing

Humana Health Plan of Texas UC UC-HMO-TX-001

83 10957 Humana Health Plan of Texas UR UR-HMO-TX-000 UR-HMO-TX-001

83 10957 Humana Health Plan of Texas UR UR-HMO-TX-001 UR-HMO-TX-000

Humana Health Plan of Texas UU UU-HMO-TX-000

Humana Health Plan of Texas UU UU-HMO-TX-001

Humana Health Plan, Inc. BF BF-HMO-AZ-000

Humana Health Plan, Inc C7 C7-HMO-AZ-000

14751 Humana Health Plan, Inc GJ GJ-HMO-TN-000

14751 Humana Health Plan, Inc. GJ GJ-HMO-TN-001

81 Humana Health Plan, Inc. MH MH-HMO-IN-000

81 Humana Health Plan, Inc. MH MH-HMO-IN-001

81 Humana Health Plan, Inc. MH MH-HMO-KY-000

81 Humana Health Plan, Inc. MH MH-HMO-KY-001

81 Humana Health Plan, Inc. MI MI-HMO-KY-000

81 Humana Health Plan, Inc. MI MI-HMO-KY-001

82 9425 Humana Health Plan, Inc. MS MS-HMO-KS-000

MS-HMO-KS-

000/001, MS-HMO-

MO-000/001

82 9425 Humana Health Plan, Inc. MS MS-HMO-KS-001

MS-HMO-KS-

000/001, MS-HMO-

MO-000/001

82 9425 Humana Health Plan, Inc. MS MS-HMO-MO-000

MS-HMO-KS-

000/001, MS-HMO-

MO-000/001

82 9425 Humana Health Plan, Inc. MS MS-HMO-MO-001

MS-HMO-KS-

000/001, MS-HMO-

MO-000/001

1271 6820 Humana Health Plans of Puerto

Rico, Inc. ZJ ZJ-HMO-PR-000

79 6779 Humana Medical Plan, Inc. EE EE-HMO-FL-000 EE-HMO-FL-001

79 6779 Humana Medical Plan, Inc. EE EE-HMO-FL-001 EE-HMO-FL-000

Humana Medical Plan, Inc. EX EX-HMO-FL-001

Humana Medical Plan, Inc. LL LL-HMO-FL-000

Humana Medical Plan, Inc. LL LL-HMO-FL-001

Humana Value Plan MJ MJ-HMO-FL-004

Humana Value Plan QP QP-HMO-FL-004

1941 Humana Value Plan AD AD-HMO-GA-004

1941 Humana Value Plan LM LM-HMO-GA-004

10251 Humana Value Plan GB GB-HMO-IL-004

10251 Humana Value Plan MW MW -HMO-IL-004

10251 Humana Value Plan MW MW -HMO-IN-004

82 Humana Value Plan PH PH-HMO-KS-004

82 Humana Value Plan PH PH-HMO-MO-004

10247 Humana Value Plan TV TV-HMO-TX-004

10247 Humana Value Plan TP TP-HMO-TX-004

10247 Humana Value Plan TU TU-HMO-TX-004

241 7650 Independent Health Assoc QA QA-HMO-NY-000

241 7650 Independent Health Assoc QA QA-HMO-NY-002

Independent Health Association C5 C5-HMO-NY-001

131 1461 Kaiser Foundation Health Plan

Mid-Atlantic States E3 E3-HMO-DC-000

E3-HMO-DC-

000/001, E3-HMO-

MD-000/001, E3-

HMO-VA-000/001

11


NCQA

Org ID

NCQA

Submission

Code


Code

Carrier Subcode -

High 000

Carrier Subcode -

Standard 001

Carrier Subcode -

HDHP 002

Carrier Subcode -

CDHP 003

Carrier Subcode -

Basic 004

2013 FEHB Data

Sharing


Mid-Atlantic States E3 E3-HMO-DC-001

E3-HMO-DC-

000/001, E3-HMO-

MD-000/001, E3-

HMO-VA-000/001


Mid-Atlantic States E3 E3-HMO-MD-000

E3-HMO-DC-

000/001, E3-HMO-

MD-000/001, E3-

HMO-VA-000/001


Mid-Atlantic States E3 E3-HMO-MD-001

E3-HMO-DC-

000/001, E3-HMO-

MD-000/001, E3-


Mid-Atlantic States E3 E3-HMO-VA-000

E3-HMO-DC-

000/001, E3-HMO-

MD-000/001, E3-

HMO-VA-000/001


Mid-Atlantic States E3 E3-HMO-VA-001

E3-HMO-DC-

000/001, E3-HMO-

MD-000/001, E3-

HMO-VA-000/001

133 1530 Kaiser Foundation Health Plan of

California 59 59-HMO-CA-000 59-HMO-CA-001







Kaiser Foundation Health Plan of

California KC KC-HMO-CA-004


Colorado 65 65-HMO-CO-000 65-HMO-CO-001


Colorado 65 65-HMO-CO-001 65-HMO-CO-000


Georgia F8 F8-HMO-GA-000 F8-HMO-GA-001


Georgia, Inc. F8 F8-HMO-GA-001 F8-HMO-GA-000


Hawaii 63 63-HMO-HI-000 63-HMO-HI-001


Hawaii 63 63-HMO-HI-001 63-HMO-HI-000


Northwest 57 57-HMO-OR-000

57-HMO-OR-

000/001, 57-HMO-

W A-000/001


Northwest 57 57-HMO-OR-001

57-HMO-OR-

000/001, 57-HMO-

W A-000/001


Northwest 57 57-HMO-W A-000

57-HMO-OR-

000/001, 57-HMO-

W A-000/001


Northwest 57 57-HMO-WA-001

57-HMO-OR-

000/001, 57-HMO-

W A-000/001


Ohio 64 64-HMO-OH-000 64-HMO-OH-001


Ohio 64 64-HMO-OH-001 64-HMO-OH-000

12


NCQA

Org ID

NCQA

Submission

Code


Code

Carrier Subcode -

High 000

Carrier Subcode -

Standard 001

Carrier Subcode -

HDHP 002

Carrier Subcode -

CDHP 003

Carrier Subcode -

Basic 004

2013 FEHB Data

Sharing

1577 3046 KPS Health Plans L1 L1-HMO-WA-001 L1-HMO-W A-001,

VT-HMO-WA-000

1577 3046 KPS Health Plans L1 L1-HMO-W A-002

1577 3046 KPS Health Plans VT VT-HMO-W A-000 L1-HMO-W A-001,

VT-HMO-WA-000

25 1627 Lovelace Health Plan Q1 Q1-HMO-NM-000

1540 2499 M.D. IPA JP JP-HMO-DC-000 JP-HMO-

DC/MD/VA-000

1540 2499 M.D. IPA JP JP-HMO-MD-000 JP-HMO-

DC/MD/VA-000

1540 2499 M.D. IPA JP JP-HMO-VA-000 JP-HMO-

DC/MD/VA-000

576 3029 MercyCare HMO EY EY-HMO-WI-000

6684 7465 MHBP - Consumer Option 48 48-FFS-AA-002

6684 7464 MHBP - Std 45 45-FFS-AA-001

6684 8963 MHBP - Value Plan 41 41-FFS-AA-001

240 5021 MVP Health Care GA GA-HMO-NY-000

GA-HMO-NY-

000/001, M9-HMO-

NY-000/001, MX-

HMO-NY-000/001,

MF-HMO-NY-

000/001, GV-HMO-

NY-000/001

240 5021 MVP Health Care GA GA-HMO-NY-001

GA-HMO-NY-

000/001, M9-HMO-

NY-000/001, MX-

HMO-NY-000/001,

MF-HMO-NY-

000/001, GV-HMO-

NY-000/001

240 5021 MVP Health Care M9 M9-HMO-NY-000

GA-HMO-NY-

000/001, M9-HMO-

NY-000/001, MX-

HMO-NY-000/001,

MF-HMO-NY-

000/001, GV-HMO-

NY-000/001

240 5021 MVP Health Care M9 M9-HMO-NY-001

GA-HMO-NY-

000/001, M9-HMO-

NY-000/001, MX-

HMO-NY-000/001,

MF-HMO-NY-

000/001, GV-HMO-

NY-000/001

13


NCQA

Org ID

NCQA

Submission

Code


Code

Carrier Subcode -

High 000

Carrier Subcode -

Standard 001

Carrier Subcode -

HDHP 002

Carrier Subcode -

CDHP 003

Carrier Subcode -

Basic 004

2013 FEHB Data

Sharing

240 5021 MVP Health Care MF MF-HMO-NY-000

GA-HMO-NY-

000/001, M9-HMO-

NY-000/001, MX-

HMO-NY-000/001,

MF-HMO-NY-

000/001, GV-HMO-

NY-000/001

240 5021 MVP Health Care MF MF-HMO-NY-001

GA-HMO-NY-

000/001, M9-HMO-

NY-000/001, MX-

HMO-NY-000/001,

MF-HMO-NY-

000/001, GV-HMO-

NY-000/001

240 5021 MVP Health Care MX MX-HMO-NY-000

GA-HMO-NY-

000/001, M9-HMO-

NY-000/001, MX-

HMO-NY-000/001,

MF-HMO-NY-

000/001, GV-HMO-

NY-000/001

240 5021 MVP Health Care MX MX-HMO-NY-001

GA-HMO-NY-

000/001, M9-HMO-

NY-000/001, MX-

HMO-NY-000/001,

MF-HMO-NY-

000/001, GV-HMO-

NY-000/001

240 5021 MVP Health Care - Western

Region GV GV-HMO-NY-000

GA-HMO-NY-

000/001, M9-HMO-

NY-000/001, MX-

HMO-NY-000/001,

MF-HMO-NY-

000/001, GV-HMO-

NY-000/001

240 5021 MVP Health Care - Western

Region GV GV-HMO-NY-001

GA-HMO-NY-

000/001, M9-HMO-

NY-000/001, MX-

HMO-NY-000/001,

MF-HMO-NY-

000/001, GV-HMO-

NY-000/001

1783 10812 NALC 32 32-FFS-AA-000

NALC 32 32-FFS-AA-003

NALC KM KM-FFS-AA-004

1618 5051 Optima Health Plan 9R 9R-HMO-VA-000 9R-HMO-VA-000.

9R-HMO-VA-001 1618 5051 Optima Health Plan 9R 9R-HMO-VA-001

14


NCQA

Org ID

NCQA

Submission

Code


Code

Carrier Subcode -

High 000

Carrier Subcode -

Standard 001

Carrier Subcode -

HDHP 002

Carrier Subcode -

CDHP 003

Carrier Subcode -

Basic 004

2013 FEHB Data

Sharing

2207 9214 Panama Canal Area Benefit Plan 43 43-FFS-AA-000

427 7059 Physicians Health Plan of

Northern Indiana DQ DQ-HMO-IN-000

434 1993 Physicians Plus LW LW-HMO-WI-000

1777 Piedmont Community Healthcare 2C 2C-POS-VA-000

579 4103 Presbyterian Health Plan P2 P2-HMO-NM-000

14958 10292 QualChoice DH DH-HMO-AR-000 DH-HMO-AR-000,

DH-HMO-AR-001 14958 10292 QualChoice DH DH-HMO-AR-001

1782 9798 Rural Carrier Benefit Plan 38 38-FFS-AA-000

1857 7578 SAMBA 44 44-FFS-AA-000

1857 9380 SAMBA 44 44-FFS-AA-001

1182 4297 Sanford Health Plan AU AU-POS-IA-000

AU-POS-IA-

000/001, AU-POS-

SD-000/001, C9-

HMO-ND-000/001

1182 4297 Sanford Health Plan AU AU-POS-IA-001

AU-POS-IA-

000/001, AU-POS-

SD-000/001, C9-

HMO-ND-000/001

1182 4297 Sanford Health Plan AU AU-POS-SD-000

AU-POS-IA-

000/001, AU-POS-

SD-000/001, C9-

HMO-ND-000/001

1182 4297 Sanford Health Plan AU AU-POS-SD-001

AU-POS-IA-

000/001, AU-POS-

SD-000/001, C9-

HMO-ND-000/001

1182 4297 Sanford Health Plan C9 C9-HMO-ND-000

AU-POS-IA-

000/001, AU-POS-

SD-000/001, C9-

HMO-ND-000/001

1182 4297 Sanford Health Plan C9 C9-HMO-ND-001

AU-POS-IA-

000/001, AU-POS-

SD-000/001, C9-

HMO-ND-000/001

335 Scott & White Health Plan A8 A8-HMO-TX-001

317 2003 SelectHealth SF SF-HMO-ID-000

SF-HMO-ID-

000/001, SF-HMO-

UT-000/001

317 2003 SelectHealth SF SF-HMO-ID-001

SF-HMO-ID-

000/001, SF-HMO-

UT-000/001

317 2003 SelectHealth SF SF-HMO-UT-000

SF-HMO-ID-

000/001, SF-HMO-

UT-000/001

317 2003 SelectHealth SF SF-HMO-UT-001

SF-HMO-ID-

000/001, SF-HMO-

UT-000/001

1476 2158 TakeCare JK JK-HMO-GU-000 JK-HMO-GU-

000/001

1476 2158 TakeCare JK JK-HMO-GU-001 JK-HMO-GU-

000/001

TakeCare KX KX-HMO-GU-002

210 1906 The Health Plan of the Upper

Ohio Valley U4 U4-HMO-OH-000 U4-HMO-WV-000

15


NCQA

Org ID

NCQA

Submission

Code


Code

Carrier Subcode -

High 000

Carrier Subcode -

Standard 001

Carrier Subcode -

HDHP 002

Carrier Subcode -

CDHP 003

Carrier Subcode -

Basic 004

2013 FEHB Data

Sharing

210 1906 The Health Plan of the Upper

Ohio Valley U4 U4-HMO-W V-000 U4-HMO-OH-000

20530 Total Health Care USA, Inc. A5 A5-HMO-MI-000

1803 3504 Triple-S Salud, Inc. 85 85-POS-VI-000 89-POS-PR-000

1803 3504 Triple-S Salud, Inc. 89 89-POS-PR-000 85-POS-VI-000

Union Health Service 76 76-HMO-IL-000

1388 2106 United Healthcare of the

Midwest, Inc. B9 B9-HMO-IL-000 B9-HMO-MO-000

1388 2106 United Healthcare of the

Midwest, Inc. B9 B9-HMO-MO-000 B9-HMO-IL-000

336 9801 UnitedHealthcare Benefits of

Texas, Inc. GF GF-HMO-TX-000

272 10525 UnitedHealthcare of California CY CY-HMO-CA-000 CY-HMO-CA-001

272 10525 UnitedHealthcare of California CY CY-HMO-CA-001 CY-HMO-CA-000

302 10651 UnitedHealthcare Plan of the

River Valley Inc. YH YH-HMO-IA-000 YH-HMO-IL-000

302 10651 UnitedHealthcare Plan of the

River Valley Inc. YH YH-HMO-IL-000 YH-HMO-IA-000

1254 10630 UPMC Health Plan 8W 8W -HMO-PA-000 UW -HMO-PA-001

1254 10630 UPMC Health Plan UW UW -HMO-PA-001 8W-HMO-PA-000

16

NCQA Carrier Carrier Subcode - 2013 FEHB Data High 000 ...F5 F5-HMO-DC-003 Aetna HealthFund CDHP and Value Plan F5 F5-HMO-DC-004 Aetna HealthFund CDHP and Value Plan F5 F5-HMO-FL-003

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