Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: January 30, 2019

Program Area: CSR Reconciliation (CSR)

Question: On the Policy Summary Record, one of the required fields is 'Self-Only/Other than self-only.' According to the Webinar from February 10th & 12th, it looks like an 'S' should be entered for self-only policies. What should we enter for an Other than self-only policy?

Answer: For the Simplified methodology and Simplified Actuarial Value only, report whether coverage under this policy is self only, or other than self-only. This data element is required only if the methodology is SIMPLIFIED and SIMPLIFIED AV. Valid values are Self (S) or Other (O). The requirements for data element ID 306 "Self Only/Other than self-only" can be found on page 8 of the CSR Reconciliation Issuer to MIDAS Inbound Specification document.

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