Qualified Health Plan Enrollee Experience Survey

• PIA Validation (PIA Refresh/Annual Review)

The Qualified Health Plan (QHP) Enrollee Experience Survey (EES) exists in response to Section 1311(c)(4) of the Patient Protection and Affordable Care Act (PPACA). The Act requires the United States Department of Health and Human Services Secretary to develop an enrollee satisfaction survey system that assesses consumer experience with QHPs offered through a Health Insurance Exchange. It also requires a public display of information by each Marketplace to allow individuals to assess enrollee experience among comparable plans. 

The goals of the survey are to provide comparable and useful information to consumers about the quality of health care services and enrollee experience with QHPs offered through the Exchanges, facilitate oversight of QHP issuer compliance with quality reporting standards, and provide actionable information that QHP issuers can use to improve quality and performance. This webpage provides Vendor Applicants, Conditionally Approved Vendors, Approved Vendors, and Public Use File Users with a multipurpose interface to support survey data submissions.

The type of information to be collected and maintained includes:

Contact Us Page - Name, e-mail address

Vendor - vendor name, address, point of contact name, point of contact e-mail address, point of contact phone number, and username 

System Administrators - User Account Name, Device Identifier (Internet Protocol (IP) address), and events logged.

The QHP website/application utilizes and inherits CMS' Identity Management (IDM) system for identity management and authentication for the protection of PII data. IDM is leveraged by CMS business applications used across CMS. Users of all business applications that integrate with IDM can use a single set of user credentials to access any integrated application. CMS IDM incorporates Multi-factor Authentication (MFA) into user authentication. MFA is an authentication method that requires the user to provide two or more verification factors to gain access to the QHP website/application. This includes the user providing account username, password and a six-digest code delivered by text message to a mobile device. 

The Qualified Health Plan (QHP) Enrollee Experience Survey (EES) exists in a response to Section 1311(c)(4) of the Patient Protection and Affordable Care Act (PPACA) that requires the United States Department of Health and Human Services Secretary to develop an Enrollee Experience Survey system that assesses consumer experience with QHPs offered through a Health Insurance Exchange. It also requires public display of information by each Marketplace to allow individuals to assess enrollee experience among comparable plans.

As a condition of certification and participation in the Exchanges, CMS requires that QHP issuers submit QHP Enrollee Experience Survey response data and Quality Rating System (QRS) clinical measure data for their respective QHPs offered through an Exchange in accordance with CMS guidelines. Exchanges are also required to display QHP quality rating information on their respective websites.

The goals of the QRS and the QHP Enrollee Experience Survey are to:

Provide comparable and useful information to consumers about the quality of health care services and enrollee experience with QHPs offered through the Exchanges,

Facilitate oversight of QHP issuer compliance with quality reporting standards set forth in the PPACA and implementing regulations, and

Provide actionable information that QHP issuers can use to improve quality and performance.

The QHP Enrollee Experience Survey web application provides a centralized web site that will allow QHP Issuers to attest to the survey eligibility criteria or report ineligibility status, includes details on how prospective survey vendors can apply to become an approved vendor and allows approved vendors the ability to login and submit survey data. It will also include functionality that will allow the QHP Enrollee Survey team to manage submissions and manage the meta data of the web application.

The QHP ESS web application has a user centric design and is architected using serverless technologies in Amazon Web Services (AWS).

The QHP website/application utilizes and inherits CMS' Identity Management (IDM) system for identity management and authentication for the protection of PII data. IDM is leveraged by CMS business applications used across CMS. Users of all business applications that integrate with IDM can use a single set of user credentials to access any integrated application. CMS IDM incorporates Multi-factor Authentication (MFA) into user authentication. MFA is an authentication method that requires the user to provide two or more verification factors to gain access to the QHP website/application. This includes the user providing account username, password and a six-digest code delivered by text message to a mobile device.

• Device Identifiers
• Name
• E-Mail Address
• Mailing Address
• Phone Numbers
• Other - User account name, Password

• Online

• Other - Not applicable.   PII is not from a government source.

• Private Sector
• Other - Vendors

• Private Sector: QHP Survey Vendors will collect, and thus have immediate access to, PII for the QHP issuers. The QHP Issuers will have access to the PII after data collection for quality improvement purposes. The intent of the program is to collect quality of care data from beneficiaries to focus issuers’ quality improvement programs. The PII will support those efforts.

• Users: Users will only have access to their specific PII
• Administrators: Administrators require access to Vendor PII to maintain and control access to the website.
• Contractors: Contractors are direct and fulfill the roles of administrator and require access to PII to fulfill their contract responsibilities.

PII within QHP EES is maintained as long as needed to support providing information to consumers about the quality of health care services and enrollee experience the Health Insurance Exchanges.

QHP operates in accordance with National Archives and Records Administration (NARA) General Records Schedule DAA-GRS-2013-0002.

As required by regulation, HHS must ask NARA for a variance when not following the retention periods outlined by these schedules (36 CFR 1228.40(c)). 

PII is secured in the system using administrative, technical, and physical controls, in accordance with policies and regulations detailed in the CMS Information Security Acceptable Risk Safeguards-Minimum Security Requirements (ARS). 

Administrative: Administrative controls include role-based permissions to access Center for Consumer Information and Oversight (CCIIO) Customer Relations Management System (CCRMS) web pages and applications, request and authentication through the CMS Enterprise Identity Management (EIDM) system, periodic review of users and deletion of non-active accounts, security and network policies and procedures as well as security and privacy training regarding securing PII.

Technical: Technical controls include role-based access, inactivity timeout, multi-factor authentication. data encrypted at rest, data encrypted while being transmitted electronically, network firewall, anti-virus/malware prevention, intrusion detection/prevention technologies, centralized event log monitoring and event alerts. 

Physical: CCRMS, being hosted in the cloud inherit physical security controls from the Federal Risk and Authorization Management Program (FedRAMP) Salesforce Cloud and Amazon Web Services Cloud.