Q: How do I use the search tool?
A: Each of the AIS Health Data applications are different, but start by viewing the Help on the AIS Health Data page.

RxB requires you to select one or more search criteria in order to get search results. When you have your criteria ready, just hit the Search button below.

Tip: To learn about a particular insurer, select that company in the Insurer field first, then when you pull down the States options it will show ONLY those states for which that company has plans. And, vice versa, you can select a State first, and then when you pull down the Insurer options it will show only those insurers operating in the selected state. If you select 2 or more insurers, you will see the states in which either of them are operating, and vice versa.

Q: I know that certain insurers are licensed to sell off-exchange small business products in a specific state, but I don’t see all of these products in your database. Why is this?
A: Typically, plans listed on SHOP exchanges are also available off the exchange, via ordinary sales channels. When purchased on the exchange, the plan is “as is.” But group employers of all sizes often want some degree of flexibility in plan design, so insurers will typically offer these clients the opportunity to customize deductibles, coinsurance, networks—and sometimes formularies—to fit their own needs.

The customized plan designs may be modified from one of the “off-the-shelf” products identified in RxB. In these cases the customized SBC is not generated until after a group plan is sold.

RxB intends to add new plans as available. If you know of a commercial risk-based individual or small group plan that is not in the RxB database, please contact AIS at RxBresearch@AIShealth.com.

Q: How do I invite colleagues to share my subscription?
A: If you are the primary purchaser or account holder for your RxB subscription, you may invite up to 4 additional people to access this website and use the data. On the main dashboard go to the upper right corner and click My Account, and then My Subscriptions. You will go to a page that lists your RxB subscription along with any other AIS databases you subscribe to. Next to the name of the database you will see a button that says Invite Users. Click it and view a total of 5 slots in which to enter emails. Simply type the emails of each person you want to invite, and go to the bottom and click Invite. The system will automatically send them instructions for logging on and creating their password. Return to this page at any time to remove/add/change the users you are permitting to share your subscription.

If you are not the original purchaser on the account, you will have to ask that person — the person who invited you — to add another colleague.

Feel free to ask us for help with this process using RxBResearch@aishealth.com.

Q: Why am I not able to access most news articles or In-App Downloads?
A: You must be a licensed user and be logged in to view most RxB content. If your screen has a button that says “Log In” in the upper right corner, you are not logged in. If your screen says “Purchase Now” in the upper right corner, you are viewing the DEMO version of RxB, which has only a small sample of data and does not allow you to view most of the content. Note: To purchase the In-App downloads with prices on them, you still must be an RxB subscriber. These items are offered only to RxB subscribers.

If you are logged in and you cannot access an In-App download that is in .pdf format, you may need to update the version of Adobe Acrobat Reader on your computer or device. Visit http://get.adobe.com/reader to download the appropriate version for your computer, and then try again.

If you are logged in and you want to download an item that has an additional fee, you will be directed to a Shopping Cart and you must make your payment before the item will open up on your screen. Note: this is our intent but some parts of this system may be still under construction; if you have any problems finding the item after you have paid, please contact us for help.

If you are a paid subscriber and you are logged in, and you still can’t access something on the website, try waiting a few minutes and maybe log out and log back in. If you still can’t access it, please contact us for help.

Q: I am trying to search for a particular Insurer in Alabama, but when I select the Insurer, the Alabama option is not available in the State list.
A: When you select Insurer(s), only the states that are applicable to your selected Insurer(s) will be offered. Not all Insurers are selling plans in all states; even if the plan has some membership in a state, they may be foreign members of a plan that is marketing in a different state, or they may be ASO lives.

Note: Within any of the field filters, you may further refine your search by selecting different/additional Insurers, States, Metal Levels or Plan Types by accessing the drop-down links at the top of the column where it says “Select Some Options.”

If you are aware of any currently marketed, ACA-qualified plans that you cannot find in RxB please send an email to RxBresearch@aishealth.com.

Q: I want to know what is the highest and lowest Rx Copay for each formulary tier for my selected Insurers and States. What is the best way to do this?
A: Once you have selected your plans and gotten your Search Results, see the Filter drop-down menu at the top of the results and select Copay. You will then view just the Copay fields for the selected plans. If you click next to the field name at the top of the column, a tiny arrow will appear that allows you to sort your selection from smallest to largest, or vice versa (just click it again to change direction). The sort will re-order your entire selection, regardless of how many pages it is. In this manner you can easily assess the current out-of-pocket costs for prescriptions in any specified market. You will also see an Average of your specific selection at the bottom of the search results for all numeric fields.

Q: But I want to view the Copays and Coinsurance for my plans side-by-side. Is that possible?
A: Yes. Instead of selecting the Copay or Coinsurance filter, decide whether you want to view the data per Formulary Tier (Generic/Brand Preferred/Non-Preferred/Specialty) or via Pharmacy (Retail/Mail) or via In-Network vs. Out-of-Network benefits. Within any of these filters you can view both the Rx Copay and Rx Coinsurance side by side. Note: If a plan has $0 for Copay or Coinsurance, that does not mean drugs are available without a Copay; check to see if there is a Coinsurance required instead (and vice versa).

Q: I want my filter to be more specific than the options you have offered. For instance, how can I find out how many of the plans in my selection have the highest allowed out-of-pocket limit for the plan year?
A: You may filter other fields by typing in a word or number that you want to appear in all records. To find out how many of the plans in your select have an OOP Limit of $6,350, type 6350 in the box at the top of the column and hit return. This works for Text fields and Numeric fields.

Q: I am trying to narrow down my search to only Small Group plans, so I selected “No” for both On Individual Exchange and Off Individual Exchange. My search turned up empty. Why is this?
A: Since many SHOP/small group plans are also available on individual markets, those plans would be excluded via your search criteria. Try instead to select “Yes” for On SHOP Exchange, and then in a separate search select “Yes” for Off Small Group Exchange. (If you select Yes for both at the same time you will only get plans that meet Both of those criteria, when you may prefer to get plans that meet Either criteria.)

Q: I did a search, but I’m only seeing a few fields in my results. How do I see more?
A: Once you are satisfied with the set of plans that you have selected, you can view different aspects of those records using the Filter by Drop-Down menu at the top of your search results page. RxB will allow you to view the benefit parameters of your selected set of plans’ by the following filters: Deductibles, Copays, Coinsurance, Retail Pharmacy, Mail-Order, Generic Tier, Brand Preferred Tier, Non-Preferred Tier, Specialty Tier, In-Network or Out-of-Network benefits.

Q: Are the notes on limitations and exceptions repeated verbatim from the summary of benefits and coverage?
A: Not usually. Notes on limitations and exceptions, as well as copay/coinsurance per tier, and other narrative information are edited by AIS researchers to bring more comparability, consistency and clarity. Some plan documents are confusing even to us, so when necessary we contact the health plans for further explanations.

Q: Why is the name of a plan sometimes different from the name with which I am familiar?
A: Names of health plans are as described on the SBC or whatever plan documentation is used; plan names often appear differently in different marketing materials published by the insurers.

Q: I noticed that a plan with the same HIOS ID from last year has a different deductible and out-of-pocket maximum this year. Can a plan actually keep the same HIOS ID year-over-year but increase the cost-sharing requirements?

A: Health plan issuers renewing exact product/plan combination must comply with the “same plan” standards as defined in 45 CFR § 144.103. Issuers should use the same HIOS Plan ID if the same plan was offered the previous plan year and remains available for the upcoming plan year. An insurer can raise the deductible and OOP maximum if the increases are in accordance with the federal limits (or the state’s, if the state’s limits are different). For 2017, the OOP maximum increases to $7,150 for individual coverage, $14,300 for family coverage.

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