T3093 Attachment D~1.xlsx

This file is a bid submission template for Medicare Advantage plan network access matching under Bid Solicitation 25DPP01075, issued by the State Health Benefits Program (SHBP) and School Employees Health Benefits Program (SEHBP). Bidders are required to complete designated cells to provide 2026 Medicare Advantage medical network access match percentages based on provided census data for current SHBP/SEHBP members. The template contains two separate worksheets: one for PPO CMS Access Match for Medicare Advantage plan members and another for PPO CMS Access Match for Medicare Supplement members. The submission requires bidders to calculate and report the percentage of members whose network access requirements meet CMS standards across multiple plan types, including PPO plans with varying copay levels ($10 and $15), HMO plans (Legacy HMO and HMO1525/HMO2030 variants), and plans differentiated by member category (State, Government, and Education).

The template covers a combined total of 194,243 current Medicare Advantage SHBP/SEHBP members across the first worksheet and 34,873 Medicare Supplement members across the second worksheet. Bidders must populate the "Number Satisfying CMS Access Requirement" column for each plan type to determine the overall CMS Access Match Percentage. The file includes all major plan offerings currently available to the three member categories, with Education plans representing the largest membership segment. This network access data submission appears to be a critical evaluation component for assessing bidder capacity to meet federal CMS accessibility standards for the 2026 plan year.