Community rated medical has its own three steps in the RFP Builder, one after the other: tell Plansight about the group, give it the census and the number of plan options, then pick the plan the employer has for each option. Each thing is set in exactly one place. Plansight's rating engine prices every plan in the group's rating area from the census before you choose, so when you pick the current plans you see what each one costs, who is on it, and the plan group total. Those plans then become the employer's current benefits everywhere: the employer profile, the Quotes grid, Market Response, and the presentation.

Where to find it

Open the renewal and start or resume the RFP Builder. After Benefit Types, the wizard shows Community Rated, with Census and Current Plans indented beneath it. They are one workflow, so they sit together in the nav, and each gets a check mark once it is done.

Setting it up

1. Community Rated. Answer: Does this Employer Group currently have a Community Rated Medical Plan? You want to explore community-rated plans for their upcoming plan year? Then complete Employer Details: Current Plan Effective Date, the SIC code, the headquarters address, and the NPN. If the employer profile already shows community-rated medical plans in force, the first question arrives answered Yes.
2. Census. Set How many Medical Plan Options? with the plus and minus buttons. The number saves itself the moment you change it, so there is no separate save to remember. Then give Plansight the census: Upload Census, Get EN Census for Employee Navigator groups, Enter Census Manually, or a census you have already saved for this employer. When the census opens in the review grid, look it over and click Calculate Rates to put it on the renewal.
3. Current Plans. Plansight takes you here as soon as the census is in. While the rating engine builds the rates, you'll see Building the rates for this census; the picker appears by itself when they land, usually in under a minute. There is one card per plan option: Current Community Rated Option #1, #2 and so on.
4. On each card, narrow the list with Carrier, Network, and Deductible if you like, then choose the employer's plan in Plan.
5. Click Save & Continue. The plans are saved as the employer's current benefits, and the wizard moves on to RFP Quoting Documents.

Reading the Current Plans step

• Effective Date at the top shows the quarter and date, then the state, ZIP, FIPS code and rating area. Those decide which plans and rates you're offered.
• Rate basis is Age Banded or Composite for the whole plan group. In New York and Vermont, community-rated plans are sold on a composite basis only, so the step states that rather than offering a choice. Massachusetts starts on Composite. On Composite, each tile shows the four tiers: Employee, + Spouse, + Child(ren), and Family.
• The filters take more than one value. Pick a $1,000 and a $1,500 deductible across two networks, and the Plan list shows every plan that fits. An empty filter means all.
• The Plan list shows each plan's carrier logo, monthly price, and chips for deductible, network and HSA. Sort it by Price (the default) or A–Z, or type in the search box to find a plan by name.
• The tile under each card describes the chosen plan: monthly premium, who is on that option (for example, "3 employees, 2 spouses, 1 child"), deductible, out-of-pocket, network, office visit and generic copays, HSA, and the HIOS ID. "AD" means after deductible.
• Plan group total at the top adds every option together, monthly and annually, along with everyone enrolled.
• Drag a card by its handle to reorder options. The option numbers stay where they are, and the plans move between them.
• Enabled sits on each card when the group has more than one option. Switch an option off when the employer wants fewer options than the RFP allows; a disabled option stays out of the grid and the presentation.

[SCREENSHOT: One option card close up: Carrier and Deductible filters each holding two pill chips, the open Plan dropdown showing logos, prices and Ded/Network/HSA chips, and the Price / A-Z sort.]

Good to know

• The option count lives on the Census step only. Each census row places a person on a plan option, so the count and the census belong together. The Current Plans step draws exactly that many cards.
• The effective date lives on the Community Rated step only. Community rated rates are set by quarter. Move the Current Plan Effective Date into a different quarter, and Plansight re-runs the rates; a date moved within the same quarter keeps the rates it has.
• Verify Plan Details for medical reads. Current medical plans are community rated. With an Edit current plans link back to the Current Plans step. Community rated plans come with their benefit summaries from the carrier filing, so there are no plan documents to attach. Dental, vision, life, and every other benefit type work on Verify Plan Details as they always have.
• Plans already in force load for you. Start a marketing event on an employer whose profile shows community-rated medical plans in force, and the Current Plans step opens with those plans selected, and the option count raised to fit them. Your own picks are never replaced.
• The current plans are the employer's, not one marketing event's. Saving updates the employer profile, which shows a green CR badge on community-rated plans. A second marketing event for the same renewal uses the same current plans rather than starting a second set.
• The renewal follows the current plans. Plansight renews community-rated plans through its own rating engine, carrying each current plan to its plan for the new year. Reorder or change a current plan and the renewal option moves with it, so option 2 on the renewal is always the renewal of option 2's current plan.
• Who is on each option follows the employee. A family is counted on the option the employee is enrolled in. An option with nobody on it is priced as if the whole census enrolled, marked "whole census", and left out of the plan group total.
• A filter never hides your choice without telling you. If you narrow a filter so it excludes the chosen plan, the plan clears, because the filter and the choice would disagree. Widen the filter again and the plan comes back. Your filters are remembered in your browser per renewal and option, and they step aside if they'd ever hide the plan already chosen.
• Current Plans appears when the group has community rated medical today. If you answered No to the first question, there are no current community rated plans to pick, so the Census step leads straight to RFP Quoting Documents. To turn an existing set of traditional current plans into real community rated plans, use Match to the Community Rated Plan Library on the Quotes grid; see How do I change community rated plans from the Quotes grid?
• If the rates take longer than five minutes, the step says The rates are taking longer than expected. They keep building in the background; reload the page to check again.
• Starting from Add Renewal on the employer profile? After the census on Confirm Community Rated Plan Details, Plansight takes you back to the employer profile with Census uploaded. We are building your renewal now. And a progress window while the renewal and its rates finish in the background.
• Saved censuses (choosing one, matching last year's plan options to this year's, and switching between versions) have their own article: How do I save versions of a census and switch between them?

Three short steps, one number set once, and you pick the current plans with the price of every option in front of you.

Page tags: scout#rfpBuilderCommunityRatedPlans, scout#rfpBuilderCommunityRatedPlansCensus, scout#rfpBuilderCommunityRatedCurrentPlans, scout#rfpBuilderPlanDetails