Web-Based Entities

System Flows

The data system flow between the WBE and an exchange depends on the exchange's preferences. For the Federally Facilitated Exchange (FFE), CMS will require redirects and XML communication interface. Individual state run exchanges can use this interface method, use an iFrame interface alone, or a combination of the two.

WBEs will have seven key interactions with health insurance exchanges:

  • New Qualified Health Plan (QHP) enrollment (with or without financial assistance).
  • Consumer returns to continue shopping.
  • Consumer reports changes that impact eligibility.
  • Consumer reports changes that do not impact eligibility.
  • Consumer reports changes resulting in disenrollment.
  • Exchange initiates disenrollment.
  • Consumer volunteers disenrollment out of QHP.

Below illustrates the FFE flow for new QHP enrollment.