{"text_format":"1","workbook":"xlsx","n_sheets":6,"sheets":["Batch","tested-plans2","Template2","Instructions","list","FAQ"],"not_rendered":{"charts":0,"images":2,"macros":1,"external_links":0,"defined_names":343,"comments":1,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"Batch","index":0,"n_rows":73,"n_cols":72,"rows_kept":73,"cut":false,"hidden":false,"merged":[[38,6,38,7],[23,66,27,66],[2,5,5,5],[2,6,4,6],[18,5,27,5],[18,6,22,6],[23,6,27,6],[6,5,7,5],[6,6,7,6],[23,25,27,25],[23,19,27,19],[23,8,27,8],[23,9,27,9],[23,10,27,10],[23,18,27,18],[23,20,27,20],[23,21,27,21],[23,11,27,11],[23,12,27,12],[23,13,27,13],[23,14,27,14],[23,15,27,15],[23,64,27,64],[28,5,33,5],[29,6,33,6],[23,54,27,54],[23,55,27,55],[23,43,27,43],[23,32,27,32],[23,33,27,33],[23,34,27,34],[23,35,27,35],[23,36,27,36],[23,37,27,37],[23,26,27,26],[23,27,27,27],[23,50,27,50],[23,22,27,22],[36,5,39,5],[37,6,37,7],[39,6,39,7],[23,56,27,56],[23,51,27,51],[23,52,27,52],[23,53,27,53],[23,44,27,44],[23,45,27,45],[23,46,27,46],[23,47,27,47],[23,48,27,48],[23,49,27,49],[23,38,27,38],[23,39,27,39],[23,24,27,24],[23,58,27,58],[0,1,0,2],[1,1,1,2],[23,7,27,7],[33,1,33,2],[23,57,27,57],[23,23,27,23],[23,40,27,40],[23,41,27,41],[23,42,27,42],[23,28,27,28],[23,29,27,29],[23,30,27,30],[23,31,27,31],[23,16,27,16],[23,17,27,17],[34,5,35,5],[34,6,35,6],[32,1,32,2],[14,6,17,6],[15,1,16,2],[22,1,22,2],[9,5,17,5],[9,6,13,6],[17,1,17,2]]}
[null,"UnitedHealthcare\n2025 Medicare Part D Creditable Coverage"]
[null,null,null,null,null,null,null,null,1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,null,null,null,null,null,null,null,null,null,null,null,"Non-Embedded",16,9]
[null,"Step 1","Choose number of plans",null,null,"Group Info","Group Information","Group Name"]
[null,"Step 2","Select PDF output path",null,null,null,null,"Plan Description"]
[null,"Step 3","Enter in-network plan designs",null,null,null,null,"Effective Date"]
[null,"Step 4","Display Results",null,null,null,"PDF of Result?","If yes, choose output path with Browse button."]
[null,null,null,null,null,"Plan Design","Plan Design","How many RX tiers?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"4 - Tiers","How many RX tiers?"]
[null,"Number of plans:",2,null,null,null,null,"Deductible applies to tiers?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"All (Default)","Deductible applies to tiers?"]
[null,null,null,null,null,"PDL","Formulary","Select Precription Drug List",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Essential"]
[null,"PDF Output Location:",null,null,null,"Deductible and OOP","Deductible ($)\n","Does the plan have an Rx Ded?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Rx Only","Does the plan have an Rx Ded?"]
[null,null,null,null,null,null,null,"Embedded or Non-Embedded",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Embedded","Embedded or Non-Embedded"]
[null,null,null,null,null,null,null,"Individual Deductible ($)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,252,"Individual Deductible ($)"]
[null,null,null,null,null,null,null,"Family Deductible ($)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,504,"Family Deductible ($)"]
[null,null,null,null,null,null,null,"Are Preventive Drugs subject to deductible?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"No","Are Preventive Drugs subject to deductible?"]
[null,null,null,null,null,null,"Out-of-Pocket Max ($) \n","Does the Rx plan have an OOP Max?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"No OOP Max","Does the Rx plan have an OOP Max?"]
[null,"To request a custom test, or for determinations for prior years, send an email to: ",null,null,null,null,null,"Embedded or Non-Embedded",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"NA","Embedded or Non-Embedded"]
[null,null,null,null,null,null,null,"Individual ($)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"NA","Individual ($)"]
[null,"Creditable.Coverage@optum.com",null,null,null,null,null,"Family ($)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"NA","Family ($)"]
[null,null,null,null,null,"Copay/Coinsurance","Retail Rx Member Copay($) / Coins.(%)\n","Tier 1",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0.2,"Tier 1"]
[null,null,null,null,null,null,null,"Tier 2",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0.2,"Tier 2"]
[null,null,null,null,null,null,null,"Tier 3",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0.2,"Tier 3"]
[null,null,null,null,null,null,null,"Tier 4",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0.2,"Tier 4"]
[null,null,null,null,null,null,null,"Tier 5 ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0.2,"Tier 5 "]
[null,null,null,null,null,null,"Specialty Member\nCopay($) / Coinsurance(%)\n","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing","Not Required for Testing",null,null,null,null,null,null,"Not Required for Testing",null,null,"Tier 1"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Tier 2"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Tier 3"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Tier 4 "]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Tier 5"]
[null,null,null,null,null,"Preventive","Preventive Drug List","Does this plan have a Core or Expanded Preventive List?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"No - Standard","Does this plan have a Core or Expanded Preventive List?"]
[null,null,null,null,null,null,"Preventive Rx ($)/(%)\n","Tier 1",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0.2,"Tier 1"]
[null,null,null,null,null,null,null,"Tier 2",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0.2,"Tier 2"]
[null,null,null,null,null,null,null,"Tier 3",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0.2,"Tier 3"]
[null,null,null,null,null,null,null,"Tier 4 ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0.2,"Tier 4 "]
[null,null,null,null,null,null,null,"Tier 5",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0.2,"Tier 5"]
[null,null,null,null,null,"HRA","Health Reimbursement Account\n(HRA)","Is this plan an HRA?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"No","Is this plan an HRA?"]
[null,null,null,null,null,null,null,"Employer contribution to HRA (if applicable)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"NA","Employer contribution to HRA (if applicable)"]
[null,null,null,null,null,"Results","Creditability Determination","Pass/Fail/Custom/Validate"]
[null,null,null,null,null,null,"Validation Errors"]
[null,null,null,null,null,null,"Additional Comments (user input)"]
[null,null,null,null,null,null,"PDF Output File Name"]
[]
[null," For instructions on how to use the tool please visit:"]
[null,"https://www.uhc.com/employer/employer-resources/medicare-part-d-creditable-coverage"]
[]
[null,"UHC (in partnership with Optum) has tested UHC's standard plan designs to determine if they are creditable."]
[null,"For HRA plans employer contribution can be considered when determining creditable coverage."]
[]
[null,"Disclaimer: This determination is based on a standard benefit design, and does not constitute a statement of actuarial opinion."]
[null,"Credibility testing results were calculated using 2025 Medicare Part D defined standard benefit parameters.  "]
[null,"As a courtesy, UnitedHealthcare (UHC) has engaged its partner, Optum, to perform a bulk testing of UHC's standard benefit designs to satisfy the actuarial value test of the creditable coverage determination. "]
[null,"Evaluating specific characteristics of a particular employer/retiree group may yield different results.  "]
[null,"According to CMS guidelines, the employer has the ultimate responsibility to determine/confirm whether its plan, as implemented, offers creditable coverage. "]
[null,"Each employer should consult with its own legal counsel or benefits adviser to determine its specific obligations."]
[]
[null,"Version Number: 2025v1.0"]
[null,"Any unauthorized use, reproduction, publication or transfer of these materials is strictly prohibited.\n"]
[null,"© 2024 Optum.  All rights reserved."]
[]
[]
[]
[]
[]
[]
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[null,{"$f":"NOW()","v":45476.496075462965}]
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[null,{"$f":"IF(LEN(MINUTE(B66))=1,\"0\"&MINUTE(B66),MINUTE(B66))","v":54},{"$f":"IF(LEN(DAY(B64))=1,\"0\"&DAY(B64),DAY(B64))","v":"03"}]
[null,{"$f":"IF(LEN(SECOND(B66))=1,\"0\"&SECOND(B66),SECOND(B66))","v":21},{"$f":"YEAR(B64)","v":2024}]
[null,{"$f":"IF(HOUR(B66)<12,\"AM\",\"PM\")","v":"AM"}]
[null,"pdf?",{"$f":"COUNTIF(I6:BF6,\"Yes\")","v":0}]
[null,"total input",{"$f":"COUNTA(I19:BF19)","v":0}]
[null,"total without error",{"$f":"COUNTIF(I38:BF38,0)","v":0}]

{"sheet":"tested-plans2","index":1,"n_rows":14399,"n_cols":90,"rows_kept":1125,"cut":true,"hidden":true,"merged":[[0,0,0,3],[0,4,0,6],[0,13,0,17],[0,18,0,19],[0,26,0,30],[0,8,0,12],[0,21,0,25]],"bounds":{"rows_first":500,"rows_last":125,"rows_between":500,"halvings":2}}
["Deductible ($)\nIf there are separate ded's for Med and Rx, only the Rx one is relevant.",null,null,null,"OOP Max ($) \n(if Applicable)",null,null,null,"Retail Rx Coinsurance (%)\n",null,null,null,null,"Retail Rx Copay ($)",null,null,null,null,"Preventive Rx",null,null,"Preventive Rx Copay ($) / Coinsurance (%) (leave blank if same cost sharing as retail)",null,null,null,null,"Preventive Rx Copay ($) / Coinsurance (%) (leave blank if same cost sharing as retail)",null,null,null,null,null,null,null,null,null,"Entered Plan Richer than Tested Plan Design?",null,null,null,null,null,null,null,{"$f":"IF(Batch!$BO$19<1,\"Coins\",\"Copay\")","v":"Coins"},{"$f":"IF(Batch!$BO$20<1,\"Coins\",\"Copay\")","v":"Coins"},{"$f":"IF(Batch!$BO$21<1,\"Coins\",\"Copay\")","v":"Coins"},{"$f":"IF(Batch!$BO$22<1,\"Coins\",\"Copay\")","v":"Coins"},{"$f":"IF(Batch!$BO$23<1,\"Coins\",\"Copay\")","v":"Coins"},null,null,null,{"$f":"IF(Batch!$BO$30<1,\"Coins\",\"Copay\")","v":"Coins"},{"$f":"IF(Batch!$BO$31<1,\"Coins\",\"Copay\")","v":"Coins"},{"$f":"IF(Batch!$BO$32<1,\"Coins\",\"Copay\")","v":"Coins"},{"$f":"IF(Batch!$BO$33<1,\"Coins\",\"Copay\")","v":"Coins"},{"$f":"IF(Batch!$BO$34<1,\"Coins\",\"Copay\")","v":"Coins"},null,null,null,null,null,"Entered Plan Less Rich than Tested Plan Design?",null,null,null,null,null,null,null,{"$f":"IF(Batch!$BO$19<1,\"Coins\",\"Copay\")","v":"Coins"},{"$f":"IF(Batch!$BO$20<1,\"Coins\",\"Copay\")","v":"Coins"},{"$f":"IF(Batch!$BO$21<1,\"Coins\",\"Copay\")","v":"Coins"},{"$f":"IF(Batch!$BO$22<1,\"Coins\",\"Copay\")","v":"Coins"},{"$f":"IF(Batch!$BO$23<1,\"Coins\",\"Copay\")","v":"Coins"},null,null,null,{"$f":"IF(Batch!$BO$30<1,\"Coins\",\"Copay\")","v":"Coins"},{"$f":"IF(Batch!$BO$31<1,\"Coins\",\"Copay\")","v":"Coins"},{"$f":"IF(Batch!$BO$32<1,\"Coins\",\"Copay\")","v":"Coins"},{"$f":"IF(Batch!$BO$33<1,\"Coins\",\"Copay\")","v":"Coins"},{"$f":"IF(Batch!$BO$34<1,\"Coins\",\"Copay\")","v":"Coins"},null,null,null,null,null,null,"Final Result"]
["Individual","Family","Applies to (Medical/Pharmacy/Both) ","Embedded (Yes/No)","Individual","Family","Applies to (Medical/Pharmacy/Both) ",null,"Tier 1","Tier 2","Tier 3","Tier 4","Tier 5","Tier 1","Tier 2","Tier 3","Tier 4","Tier 5","Preventive drugs subject to ded?\n(Yes/No)","Prev. list type","Formulary","Tier 1","Tier 2","Tier 3","Tier 4","Tier 5","Tier 1","Tier 2","Tier 3","Tier 4","Tier 5","Result",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Entered Plan Richer? (0=No, 1=Yes)","Tested Plan Result","Entered Plan Result",{"$f":"COUNTIF(BH:BH,\"PASS\")","v":0},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Entered Plan Less Rich? (0=No, 1=Yes)","Tested Plan Result","Entered Plan Result",{"$f":"COUNTIF(CH:CH,\"FAIL\")","v":0},null,{"$f":"IF(AND('tested-plans2'!BI2>0,'tested-plans2'!CI2=0),\"Pass\",IF(AND('tested-plans2'!CI2>0,'tested-plans2'!BI2=0),\"Fail\",\"Custom Test Required\"))","v":"Custom Test Required"},{"$f":"IF(AND(CK2=\"Fail\",Batch!BO35=\"Yes\"),\"Custom Test Required\",'tested-plans2'!CK2)","v":"Custom Test Required"}]
[0,0,"Combined with Medical","NA",3500,7000,"Combined with Medical","Embedded",0,0,0,0,0,10,30,50,120,120,"Yes","No","Advantage 4T",0,0,0,0,0,10,30,50,120,120,"Pass",null,null,null,null,{"$f":"IF(OR(AND(DV_DedInd=\"NA\",'tested-plans2'!A3=999999),AND(DV_DedInd<>\"NA\",'tested-plans2'!A3<>999999)),1,0)*IF(IF(Batch!$BO$12=\"NA\",999999,Batch!$BO$12)<='tested-plans2'!$A3,1,0)","v":0},{"$f":"IF(OR(AND(DV_DedFam=\"NA\",'tested-plans2'!B3=999999),AND(DV_DedFam<>\"NA\",'tested-plans2'!B3<>999999)),1,0)*IF(IF(Batch!$BO$13=\"NA\",999999,Batch!$BO$13)<='tested-plans2'!$B3,1,0)","v":0},{"$f":"IF(IF(Batch!$BO$10=\"No Rx Deductible\",\"Rx Only\",Batch!$BO$10)='tested-plans2'!$C3,1,0)","v":0},{"$f":"IF(Batch!$BO$11='tested-plans2'!$D3,1,0)","v":0},{"$f":"IF(OR(AND(DV_OOPMIndv=\"NA\",'tested-plans2'!E3=999999),AND(DV_OOPMIndv<>\"NA\",'tested-plans2'!E3<>999999)),1,0)*IF(IF(Batch!$BO$17=\"NA\",999999,Batch!$BO$17)<='tested-plans2'!$E3,1,0)","v":0},{"$f":"IF(OR(AND(DV_OOPMFam=\"NA\",'tested-plans2'!F3=999999),AND(DV_OOPMFam<>\"NA\",'tested-plans2'!F3<>999999)),1,0)*IF(IF(Batch!$BO$18=\"NA\",999999,Batch!$BO$18)<='tested-plans2'!$F3,1,0)","v":0},{"$f":"IF(IF(Batch!$BO$15=\"No OOP Max\",\"Rx Only\",Batch!$BO$15)='tested-plans2'!$G3,1,0)","v":0},{"$f":"IF(Batch!$BO$16='tested-plans2'!$H3,1,0)","v":0},{"$f":"IF(Batch!$BO$19=0,1,IF(OR(AND(I3>0,AS$1=\"Copay\"),AND(N3>0,AS$1=\"Coins\")),0,IF(Batch!$BO$19<=IF(AS$1=\"Copay\",'tested-plans2'!N3,I3),1,0)))","v":0},{"$f":"IF(Batch!$BO$20=0,1,IF(OR(AND(J3>0,AT$1=\"Copay\"),AND(O3>0,AT$1=\"Coins\")),0,IF(Batch!$BO$20<=IF(AT$1=\"Copay\",'tested-plans2'!O3,J3),1,0)))","v":0},{"$f":"IF(Batch!$BO$21=0,1,IF(OR(AND(K3>0,AU$1=\"Copay\"),AND(P3>0,AU$1=\"Coins\")),0,IF(Batch!$BO$21<=IF(AU$1=\"Copay\",'tested-plans2'!P3,K3),1,0)))","v":0},{"$f":"IF(Batch!$BO$22=0,1,IF(OR(AND(L3>0,AV$1=\"Copay\"),AND(Q3>0,AV$1=\"Coins\")),0,IF(Batch!$BO$22<=IF(AV$1=\"Copay\",'tested-plans2'!Q3,L3),1,0)))","v":0},{"$f":"IF(Batch!$BO$23=0,1,IF(OR(AND(M3>0,AW$1=\"Copay\"),AND(R3>0,AW$1=\"Coins\")),0,IF(Batch!$BO$23<=IF(AW$1=\"Copay\",'tested-plans2'!R3,M3),1,0)))","v":0},{"$f":"IF(OR(Batch!$BO$14=\"NA\",Batch!$BO$14=\"No\"),1,IF(Batch!$BO$14=S3,1,0))","v":1},{"$f":"IF(OR(S3=\"Yes\",Batch!$BO$29=\"Expanded\"),1,IF(Batch!$BO$29='tested-plans2'!T3,1,0))","v":1},{"$f":"IF(Batch!$BO$9='tested-plans2'!U3,1,0)","v":0},{"$f":"IF(Batch!$BO$30=0,1,IF(OR(AND(V3>0,BA$1=\"Copay\"),AND(AA3>0,BA$1=\"Coins\")),0,IF(Batch!$BO$30<=IF(BA$1=\"Copay\",'tested-plans2'!AA3,V3),1,0)))","v":0},{"$f":"IF(Batch!$BO$31=0,1,IF(OR(AND(W3>0,BB$1=\"Copay\"),AND(AB3>0,BB$1=\"Coins\")),0,IF(Batch!$BO$31<=IF(BB$1=\"Copay\",'tested-plans2'!AB3,W3),1,0)))","v":0},{"$f":"IF(Batch!$BO$32=0,1,IF(OR(AND(X3>0,BC$1=\"Copay\"),AND(AC3>0,BC$1=\"Coins\")),0,IF(Batch!$BO$32<=IF(BC$1=\"Copay\",'tested-plans2'!AC3,X3),1,0)))","v":0},{"$f":"IF(Batch!$BO$33=0,1,IF(OR(AND(Y3>0,BD$1=\"Copay\"),AND(AD3>0,BD$1=\"Coins\")),0,IF(Batch!$BO$33<=IF(BD$1=\"Copay\",'tested-plans2'!AD3,Y3),1,0)))","v":0},{"$f":"IF(Batch!$BO$33=0,1,IF(OR(AND(Z3>0,BE$1=\"Copay\"),AND(AE3>0,BE$1=\"Coins\")),0,IF(Batch!$BO$33<=IF(BE$1=\"Copay\",'tested-plans2'!AE3,Z3),1,0)))","v":0},{"$f":"PRODUCT(AK3:BE3)","v":0},{"$f":"UPPER(AF3)","v":"PASS"},{"$f":"IF(AND(BF3=1,BG3=\"PASS\"),\"PASS\",\"\")","v":""},null,null,{"$f":"IF(OR(AND(DV_DedInd=\"NA\",A3=999999),AND(DV_DedInd<>\"NA\",A3<>999999)),1,0)*IF(IF(Batch!$BO$12=\"NA\",999999,Batch!$BO$12)>='tested-plans2'!$A3,1,0)","v":1},{"$f":"IF(OR(AND(DV_DedFam=\"NA\",B3=999999),AND(DV_DedFam<>\"NA\",B3<>999999)),1,0)*IF(IF(Batch!$BO$13=\"NA\",999999,Batch!$BO$13)>='tested-plans2'!$B3,1,0)","v":1},{"$f":"IF(IF(Batch!$BO$10=\"No Rx Deductible\",\"Rx Only\",Batch!$BO$10)='tested-plans2'!$C3,1,0)","v":0},{"$f":"IF(Batch!$BO$11='tested-plans2'!$D3,1,0)","v":0},{"$f":"IF(OR(AND(DV_OOPMIndv=\"NA\",E3=999999),AND(DV_OOPMIndv<>\"NA\",E3<>999999)),1,0)*IF(IF(Batch!$BO$17=\"NA\",999999,Batch!$BO$17)>='tested-plans2'!$E3,1,0)","v":0},{"$f":"IF(OR(AND(DV_OOPMFam=\"NA\",F3=999999),AND(DV_OOPMFam<>\"NA\",F3<>999999)),1,0)*IF(IF(Batch!$BO$18=\"NA\",999999,Batch!$BO$18)>='tested-plans2'!$F3,1,0)","v":0},{"$f":"IF(IF(Batch!$BO$15=\"No OOP Max\",\"Rx Only\",Batch!$BO$15)='tested-plans2'!$G3,1,0)","v":0},{"$f":"IF(Batch!$BO$16='tested-plans2'!$H3,1,0)","v":0},{"$f":"IF(OR(AND(I3>0,BS$1=\"Copay\"),AND(N3>0,BS$1=\"Coins\")),0,IF(Batch!$BO$19>=IF(BS$1=\"Copay\",N3,I3),1,0))","v":0},{"$f":"IF(OR(AND(J3>0,BT$1=\"Copay\"),AND(O3>0,BT$1=\"Coins\")),0,IF(Batch!$BO$20>=IF(BT$1=\"Copay\",O3,J3),1,0))","v":0},{"$f":"IF(OR(AND(K3>0,BU$1=\"Copay\"),AND(P3>0,BU$1=\"Coins\")),0,IF(Batch!$BO$21>=IF(BU$1=\"Copay\",P3,K3),1,0))","v":0},{"$f":"IF(OR(AND(L3>0,BV$1=\"Copay\"),AND(Q3>0,BV$1=\"Coins\")),0,IF(Batch!$BO$22>=IF(BV$1=\"Copay\",Q3,L3),1,0))","v":0},{"$f":"IF(OR(AND(M3>0,BW$1=\"Copay\"),AND(R3>0,BW$1=\"Coins\")),0,IF(Batch!$BO$23>=IF(BW$1=\"Copay\",R3,M3),1,0))","v":0},{"$f":"IF(OR(Batch!$BO$14=\"NA\",Batch!$BO$14=\"Yes\",AND(Batch!$BO$14=\"No\",OR(DV_PrevDrug=\"No - 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[2800,5600,"Combined with Medical","Embedded",3600,7200,"Combined with Medical","Embedded",0,0,0,0,0,10,35,70,200,200,"No","Core - Buy up","Advantage 4T",0,0,0,0,0,5,5,5,5,5,"Pass",null,null,null,null,{"$f":"IF(OR(AND(DV_DedInd=\"NA\",'tested-plans2'!A14398=999999),AND(DV_DedInd<>\"NA\",'tested-plans2'!A14398<>999999)),1,0)*IF(IF(Batch!$BO$12=\"NA\",999999,Batch!$BO$12)<='tested-plans2'!$A14398,1,0)","v":1},{"$f":"IF(OR(AND(DV_DedFam=\"NA\",'tested-plans2'!B14398=999999),AND(DV_DedFam<>\"NA\",'tested-plans2'!B14398<>999999)),1,0)*IF(IF(Batch!$BO$13=\"NA\",999999,Batch!$BO$13)<='tested-plans2'!$B14398,1,0)","v":1},{"$f":"IF(IF(Batch!$BO$10=\"No Rx Deductible\",\"Rx 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Only\",Batch!$BO$15)='tested-plans2'!$G14398,1,0)","v":0},{"$f":"IF(Batch!$BO$16='tested-plans2'!$H14398,1,0)","v":0},{"$f":"IF(Batch!$BO$19=0,1,IF(OR(AND(I14398>0,AS$1=\"Copay\"),AND(N14398>0,AS$1=\"Coins\")),0,IF(Batch!$BO$19<=IF(AS$1=\"Copay\",'tested-plans2'!N14398,I14398),1,0)))","v":0},{"$f":"IF(Batch!$BO$20=0,1,IF(OR(AND(J14398>0,AT$1=\"Copay\"),AND(O14398>0,AT$1=\"Coins\")),0,IF(Batch!$BO$20<=IF(AT$1=\"Copay\",'tested-plans2'!O14398,J14398),1,0)))","v":0},{"$f":"IF(Batch!$BO$21=0,1,IF(OR(AND(K14398>0,AU$1=\"Copay\"),AND(P14398>0,AU$1=\"Coins\")),0,IF(Batch!$BO$21<=IF(AU$1=\"Copay\",'tested-plans2'!P14398,K14398),1,0)))","v":0},{"$f":"IF(Batch!$BO$22=0,1,IF(OR(AND(L14398>0,AV$1=\"Copay\"),AND(Q14398>0,AV$1=\"Coins\")),0,IF(Batch!$BO$22<=IF(AV$1=\"Copay\",'tested-plans2'!Q14398,L14398),1,0)))","v":0},{"$f":"IF(Batch!$BO$23=0,1,IF(OR(AND(M14398>0,AW$1=\"Copay\"),AND(R14398>0,AW$1=\"Coins\")),0,IF(Batch!$BO$23<=IF(AW$1=\"Copay\",'tested-plans2'!R14398,M14398),1,0)))","v":0},{"$f":"IF(OR(Batch!$BO$14=\"NA\",Batch!$BO$14=\"No\"),1,IF(Batch!$BO$14=S14398,1,0))","v":1},{"$f":"IF(OR(S14398=\"Yes\",Batch!$BO$29=\"Expanded\"),1,IF(Batch!$BO$29='tested-plans2'!T14398,1,0))","v":0},{"$f":"IF(Batch!$BO$9='tested-plans2'!U14398,1,0)","v":0},{"$f":"IF(Batch!$BO$30=0,1,IF(OR(AND(V14398>0,BA$1=\"Copay\"),AND(AA14398>0,BA$1=\"Coins\")),0,IF(Batch!$BO$30<=IF(BA$1=\"Copay\",'tested-plans2'!AA14398,V14398),1,0)))","v":0},{"$f":"IF(Batch!$BO$31=0,1,IF(OR(AND(W14398>0,BB$1=\"Copay\"),AND(AB14398>0,BB$1=\"Coins\")),0,IF(Batch!$BO$31<=IF(BB$1=\"Copay\",'tested-plans2'!AB14398,W14398),1,0)))","v":0},{"$f":"IF(Batch!$BO$32=0,1,IF(OR(AND(X14398>0,BC$1=\"Copay\"),AND(AC14398>0,BC$1=\"Coins\")),0,IF(Batch!$BO$32<=IF(BC$1=\"Copay\",'tested-plans2'!AC14398,X14398),1,0)))","v":0},{"$f":"IF(Batch!$BO$33=0,1,IF(OR(AND(Y14398>0,BD$1=\"Copay\"),AND(AD14398>0,BD$1=\"Coins\")),0,IF(Batch!$BO$33<=IF(BD$1=\"Copay\",'tested-plans2'!AD14398,Y14398),1,0)))","v":0},{"$f":"IF(Batch!$BO$33=0,1,IF(OR(AND(Z14398>0,BE$1=\"Copay\"),AND(AE14398>0,BE$1=\"Coins\")),0,IF(Batch!$BO$33<=IF(BE$1=\"Copay\",'tested-plans2'!AE14398,Z14398),1,0)))","v":0},0,"PASS","",null,null,{"$f":"IF(OR(AND(DV_DedInd=\"NA\",A14398=999999),AND(DV_DedInd<>\"NA\",A14398<>999999)),1,0)*IF(IF(Batch!$BO$12=\"NA\",999999,Batch!$BO$12)>='tested-plans2'!$A14398,1,0)","v":0},{"$f":"IF(OR(AND(DV_DedFam=\"NA\",B14398=999999),AND(DV_DedFam<>\"NA\",B14398<>999999)),1,0)*IF(IF(Batch!$BO$13=\"NA\",999999,Batch!$BO$13)>='tested-plans2'!$B14398,1,0)","v":0},{"$f":"IF(IF(Batch!$BO$10=\"No Rx Deductible\",\"Rx Only\",Batch!$BO$10)='tested-plans2'!$C14398,1,0)","v":0},{"$f":"IF(Batch!$BO$11='tested-plans2'!$D14398,1,0)","v":1},{"$f":"IF(OR(AND(DV_OOPMIndv=\"NA\",E14398=999999),AND(DV_OOPMIndv<>\"NA\",E14398<>999999)),1,0)*IF(IF(Batch!$BO$17=\"NA\",999999,Batch!$BO$17)>='tested-plans2'!$E14398,1,0)","v":0},{"$f":"IF(OR(AND(DV_OOPMFam=\"NA\",F14398=999999),AND(DV_OOPMFam<>\"NA\",F14398<>999999)),1,0)*IF(IF(Batch!$BO$18=\"NA\",999999,Batch!$BO$18)>='tested-plans2'!$F14398,1,0)","v":0},{"$f":"IF(IF(Batch!$BO$15=\"No OOP Max\",\"Rx Only\",Batch!$BO$15)='tested-plans2'!$G14398,1,0)","v":0},{"$f":"IF(Batch!$BO$16='tested-plans2'!$H14398,1,0)","v":0},{"$f":"IF(OR(AND(I14398>0,BS$1=\"Copay\"),AND(N14398>0,BS$1=\"Coins\")),0,IF(Batch!$BO$19>=IF(BS$1=\"Copay\",N14398,I14398),1,0))","v":0},{"$f":"IF(OR(AND(J14398>0,BT$1=\"Copay\"),AND(O14398>0,BT$1=\"Coins\")),0,IF(Batch!$BO$20>=IF(BT$1=\"Copay\",O14398,J14398),1,0))","v":0},{"$f":"IF(OR(AND(K14398>0,BU$1=\"Copay\"),AND(P14398>0,BU$1=\"Coins\")),0,IF(Batch!$BO$21>=IF(BU$1=\"Copay\",P14398,K14398),1,0))","v":0},{"$f":"IF(OR(AND(L14398>0,BV$1=\"Copay\"),AND(Q14398>0,BV$1=\"Coins\")),0,IF(Batch!$BO$22>=IF(BV$1=\"Copay\",Q14398,L14398),1,0))","v":0},{"$f":"IF(OR(AND(M14398>0,BW$1=\"Copay\"),AND(R14398>0,BW$1=\"Coins\")),0,IF(Batch!$BO$23>=IF(BW$1=\"Copay\",R14398,M14398),1,0))","v":0},{"$f":"IF(OR(Batch!$BO$14=\"NA\",Batch!$BO$14=\"Yes\",AND(Batch!$BO$14=\"No\",OR(DV_PrevDrug=\"No - Standard\",DV_PrevDrug=\"Don't Know\"))),1,IF(Batch!$BO$14=$S14398,1,0))","v":1},{"$f":"IF(VLOOKUP(Batch!$BO$29,list!$F$11:$G$16,2,FALSE)<=VLOOKUP(T14398,list!$F$11:$G$16,2,FALSE),1,0)","v":0},{"$f":"IF(Batch!$BO$9='tested-plans2'!U14398,1,0)","v":0},{"$f":"IF(OR(AND(V14398>0,CA$1=\"Copay\"),AND(AA14398>0,CA$1=\"Coins\")),0,IF(Batch!$BO$30>=IF(CA$1=\"Copay\",AA14398,V14398),1,0))","v":0},{"$f":"IF(OR(AND(W14398>0,CB$1=\"Copay\"),AND(AB14398>0,CB$1=\"Coins\")),0,IF(Batch!$BO$31>=IF(CB$1=\"Copay\",AB14398,W14398),1,0))","v":0},{"$f":"IF(OR(AND(X14398>0,CC$1=\"Copay\"),AND(AC14398>0,CC$1=\"Coins\")),0,IF(Batch!$BO$32>=IF(CC$1=\"Copay\",AC14398,X14398),1,0))","v":0},{"$f":"IF(OR(AND(Y14398>0,CD$1=\"Copay\"),AND(AD14398>0,CD$1=\"Coins\")),0,IF(Batch!$BO$33>=IF(CD$1=\"Copay\",AD14398,Y14398),1,0))","v":0},{"$f":"IF(OR(AND(Z14398>0,CE$1=\"Copay\"),AND(AE14398>0,CE$1=\"Coins\")),0,IF(Batch!$BO$34>=IF(CE$1=\"Copay\",AE14398,Z14398),1,0))","v":0},0,"Pass",""]
[5000,10000,"Combined with Medical","Embedded",15000,30000,"Combined with Medical","Embedded",0,0,0,0,0,10,35,75,150,150,"No","Core - Buy up","Advantage 4T",0,0,0,0,0,5,5,5,5,5,"Pass",null,null,null,null,{"$f":"IF(OR(AND(DV_DedInd=\"NA\",'tested-plans2'!A14399=999999),AND(DV_DedInd<>\"NA\",'tested-plans2'!A14399<>999999)),1,0)*IF(IF(Batch!$BO$12=\"NA\",999999,Batch!$BO$12)<='tested-plans2'!$A14399,1,0)","v":1},{"$f":"IF(OR(AND(DV_DedFam=\"NA\",'tested-plans2'!B14399=999999),AND(DV_DedFam<>\"NA\",'tested-plans2'!B14399<>999999)),1,0)*IF(IF(Batch!$BO$13=\"NA\",999999,Batch!$BO$13)<='tested-plans2'!$B14399,1,0)","v":1},{"$f":"IF(IF(Batch!$BO$10=\"No Rx Deductible\",\"Rx Only\",Batch!$BO$10)='tested-plans2'!$C14399,1,0)","v":0},{"$f":"IF(Batch!$BO$11='tested-plans2'!$D14399,1,0)","v":1},{"$f":"IF(OR(AND(DV_OOPMIndv=\"NA\",'tested-plans2'!E14399=999999),AND(DV_OOPMIndv<>\"NA\",'tested-plans2'!E14399<>999999)),1,0)*IF(IF(Batch!$BO$17=\"NA\",999999,Batch!$BO$17)<='tested-plans2'!$E14399,1,0)","v":0},{"$f":"IF(OR(AND(DV_OOPMFam=\"NA\",'tested-plans2'!F14399=999999),AND(DV_OOPMFam<>\"NA\",'tested-plans2'!F14399<>999999)),1,0)*IF(IF(Batch!$BO$18=\"NA\",999999,Batch!$BO$18)<='tested-plans2'!$F14399,1,0)","v":0},{"$f":"IF(IF(Batch!$BO$15=\"No OOP Max\",\"Rx Only\",Batch!$BO$15)='tested-plans2'!$G14399,1,0)","v":0},{"$f":"IF(Batch!$BO$16='tested-plans2'!$H14399,1,0)","v":0},{"$f":"IF(Batch!$BO$19=0,1,IF(OR(AND(I14399>0,AS$1=\"Copay\"),AND(N14399>0,AS$1=\"Coins\")),0,IF(Batch!$BO$19<=IF(AS$1=\"Copay\",'tested-plans2'!N14399,I14399),1,0)))","v":0},{"$f":"IF(Batch!$BO$20=0,1,IF(OR(AND(J14399>0,AT$1=\"Copay\"),AND(O14399>0,AT$1=\"Coins\")),0,IF(Batch!$BO$20<=IF(AT$1=\"Copay\",'tested-plans2'!O14399,J14399),1,0)))","v":0},{"$f":"IF(Batch!$BO$21=0,1,IF(OR(AND(K14399>0,AU$1=\"Copay\"),AND(P14399>0,AU$1=\"Coins\")),0,IF(Batch!$BO$21<=IF(AU$1=\"Copay\",'tested-plans2'!P14399,K14399),1,0)))","v":0},{"$f":"IF(Batch!$BO$22=0,1,IF(OR(AND(L14399>0,AV$1=\"Copay\"),AND(Q14399>0,AV$1=\"Coins\")),0,IF(Batch!$BO$22<=IF(AV$1=\"Copay\",'tested-plans2'!Q14399,L14399),1,0)))","v":0},{"$f":"IF(Batch!$BO$23=0,1,IF(OR(AND(M14399>0,AW$1=\"Copay\"),AND(R14399>0,AW$1=\"Coins\")),0,IF(Batch!$BO$23<=IF(AW$1=\"Copay\",'tested-plans2'!R14399,M14399),1,0)))","v":0},{"$f":"IF(OR(Batch!$BO$14=\"NA\",Batch!$BO$14=\"No\"),1,IF(Batch!$BO$14=S14399,1,0))","v":1},{"$f":"IF(OR(S14399=\"Yes\",Batch!$BO$29=\"Expanded\"),1,IF(Batch!$BO$29='tested-plans2'!T14399,1,0))","v":0},{"$f":"IF(Batch!$BO$9='tested-plans2'!U14399,1,0)","v":0},{"$f":"IF(Batch!$BO$30=0,1,IF(OR(AND(V14399>0,BA$1=\"Copay\"),AND(AA14399>0,BA$1=\"Coins\")),0,IF(Batch!$BO$30<=IF(BA$1=\"Copay\",'tested-plans2'!AA14399,V14399),1,0)))","v":0},{"$f":"IF(Batch!$BO$31=0,1,IF(OR(AND(W14399>0,BB$1=\"Copay\"),AND(AB14399>0,BB$1=\"Coins\")),0,IF(Batch!$BO$31<=IF(BB$1=\"Copay\",'tested-plans2'!AB14399,W14399),1,0)))","v":0},{"$f":"IF(Batch!$BO$32=0,1,IF(OR(AND(X14399>0,BC$1=\"Copay\"),AND(AC14399>0,BC$1=\"Coins\")),0,IF(Batch!$BO$32<=IF(BC$1=\"Copay\",'tested-plans2'!AC14399,X14399),1,0)))","v":0},{"$f":"IF(Batch!$BO$33=0,1,IF(OR(AND(Y14399>0,BD$1=\"Copay\"),AND(AD14399>0,BD$1=\"Coins\")),0,IF(Batch!$BO$33<=IF(BD$1=\"Copay\",'tested-plans2'!AD14399,Y14399),1,0)))","v":0},{"$f":"IF(Batch!$BO$33=0,1,IF(OR(AND(Z14399>0,BE$1=\"Copay\"),AND(AE14399>0,BE$1=\"Coins\")),0,IF(Batch!$BO$33<=IF(BE$1=\"Copay\",'tested-plans2'!AE14399,Z14399),1,0)))","v":0},0,"PASS","",null,null,{"$f":"IF(OR(AND(DV_DedInd=\"NA\",A14399=999999),AND(DV_DedInd<>\"NA\",A14399<>999999)),1,0)*IF(IF(Batch!$BO$12=\"NA\",999999,Batch!$BO$12)>='tested-plans2'!$A14399,1,0)","v":0},{"$f":"IF(OR(AND(DV_DedFam=\"NA\",B14399=999999),AND(DV_DedFam<>\"NA\",B14399<>999999)),1,0)*IF(IF(Batch!$BO$13=\"NA\",999999,Batch!$BO$13)>='tested-plans2'!$B14399,1,0)","v":0},{"$f":"IF(IF(Batch!$BO$10=\"No Rx Deductible\",\"Rx Only\",Batch!$BO$10)='tested-plans2'!$C14399,1,0)","v":0},{"$f":"IF(Batch!$BO$11='tested-plans2'!$D14399,1,0)","v":1},{"$f":"IF(OR(AND(DV_OOPMIndv=\"NA\",E14399=999999),AND(DV_OOPMIndv<>\"NA\",E14399<>999999)),1,0)*IF(IF(Batch!$BO$17=\"NA\",999999,Batch!$BO$17)>='tested-plans2'!$E14399,1,0)","v":0},{"$f":"IF(OR(AND(DV_OOPMFam=\"NA\",F14399=999999),AND(DV_OOPMFam<>\"NA\",F14399<>999999)),1,0)*IF(IF(Batch!$BO$18=\"NA\",999999,Batch!$BO$18)>='tested-plans2'!$F14399,1,0)","v":0},{"$f":"IF(IF(Batch!$BO$15=\"No OOP Max\",\"Rx Only\",Batch!$BO$15)='tested-plans2'!$G14399,1,0)","v":0},{"$f":"IF(Batch!$BO$16='tested-plans2'!$H14399,1,0)","v":0},{"$f":"IF(OR(AND(I14399>0,BS$1=\"Copay\"),AND(N14399>0,BS$1=\"Coins\")),0,IF(Batch!$BO$19>=IF(BS$1=\"Copay\",N14399,I14399),1,0))","v":0},{"$f":"IF(OR(AND(J14399>0,BT$1=\"Copay\"),AND(O14399>0,BT$1=\"Coins\")),0,IF(Batch!$BO$20>=IF(BT$1=\"Copay\",O14399,J14399),1,0))","v":0},{"$f":"IF(OR(AND(K14399>0,BU$1=\"Copay\"),AND(P14399>0,BU$1=\"Coins\")),0,IF(Batch!$BO$21>=IF(BU$1=\"Copay\",P14399,K14399),1,0))","v":0},{"$f":"IF(OR(AND(L14399>0,BV$1=\"Copay\"),AND(Q14399>0,BV$1=\"Coins\")),0,IF(Batch!$BO$22>=IF(BV$1=\"Copay\",Q14399,L14399),1,0))","v":0},{"$f":"IF(OR(AND(M14399>0,BW$1=\"Copay\"),AND(R14399>0,BW$1=\"Coins\")),0,IF(Batch!$BO$23>=IF(BW$1=\"Copay\",R14399,M14399),1,0))","v":0},{"$f":"IF(OR(Batch!$BO$14=\"NA\",Batch!$BO$14=\"Yes\",AND(Batch!$BO$14=\"No\",OR(DV_PrevDrug=\"No - Standard\",DV_PrevDrug=\"Don't Know\"))),1,IF(Batch!$BO$14=$S14399,1,0))","v":1},{"$f":"IF(VLOOKUP(Batch!$BO$29,list!$F$11:$G$16,2,FALSE)<=VLOOKUP(T14399,list!$F$11:$G$16,2,FALSE),1,0)","v":0},{"$f":"IF(Batch!$BO$9='tested-plans2'!U14399,1,0)","v":0},{"$f":"IF(OR(AND(V14399>0,CA$1=\"Copay\"),AND(AA14399>0,CA$1=\"Coins\")),0,IF(Batch!$BO$30>=IF(CA$1=\"Copay\",AA14399,V14399),1,0))","v":0},{"$f":"IF(OR(AND(W14399>0,CB$1=\"Copay\"),AND(AB14399>0,CB$1=\"Coins\")),0,IF(Batch!$BO$31>=IF(CB$1=\"Copay\",AB14399,W14399),1,0))","v":0},{"$f":"IF(OR(AND(X14399>0,CC$1=\"Copay\"),AND(AC14399>0,CC$1=\"Coins\")),0,IF(Batch!$BO$32>=IF(CC$1=\"Copay\",AC14399,X14399),1,0))","v":0},{"$f":"IF(OR(AND(Y14399>0,CD$1=\"Copay\"),AND(AD14399>0,CD$1=\"Coins\")),0,IF(Batch!$BO$33>=IF(CD$1=\"Copay\",AD14399,Y14399),1,0))","v":0},{"$f":"IF(OR(AND(Z14399>0,CE$1=\"Copay\"),AND(AE14399>0,CE$1=\"Coins\")),0,IF(Batch!$BO$34>=IF(CE$1=\"Copay\",AE14399,Z14399),1,0))","v":0},0,"Pass",""]

{"sheet":"Template2","index":2,"n_rows":50,"n_cols":8,"rows_kept":50,"cut":false,"hidden":true,"merged":[[0,1,0,9],[2,5,2,8],[3,5,4,5],[3,6,4,6],[15,6,19,6],[15,5,19,5],[6,5,14,5],[11,6,14,6],[6,6,10,6],[8,1,32,3],[29,6,32,8],[20,5,25,5],[21,6,25,6],[26,5,27,5],[26,6,27,6],[29,5,32,5]]}
[null,"UnitedHealthcare\n2025 Medicare Part D Creditable Coverage"]
[]
[]
[null,"Date:",null,null,null,"Plan Design","Plan Design","How many RX tiers?"]
[null,"Group Name:",null,null,null,null,null,"Deductible applies to tiers?"]
[null,"Plan Description:",null,null,null,"PDL","Formulary","Select Prescription Drug List?"]
[null,"Effective Date:",null,null,null,"Deductible and OOP","Deductible ($)\n","Does the plan have an Rx Ded?"]
[null,null,null,null,null,null,null,"Embedded or Non-Embedded"]
[null,"Prescription drug coverage is creditable if the actuarial value of the coverage equals or exceeds the actuarial value of standard prescription drug coverage under Medicare Part D, as demonstrated through the use of generally accepted actuarial principles and in accordance with Centers for Medicare and Medicaid Services (CMS) actuarial guidelines. In general, the actuarial equivalence test measures whether the expected amount of paid claims under the employer's prescription drug coverage is at least as much as the expected amount of paid claims under the standard Part D benefit.\n\nMember Notices: Employers must provide creditable or non-creditable coverage notices to all Medicare eligible individuals who are covered under, or who apply for, the entity's prescription drug plan (Part D eligibles), whether active employees or retirees, at least once a year prior to October 15.  This information is essential to an individual's decision to enroll in a Medicare Part D prescription drug plan.  CMS publishes model disclosure communication templates that can be accessed here:\nhttps://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/Model-Notice-Letters\n\nCMS Disclosure: In addition, employers are required to provide CMS with their plan's creditable or non-creditable coverage status annually via an online form: https://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/CCDisclosureForm\n\nCMS requires that the disclosure be provided within\n-60 days after the beginning date of the Plan Year for which the entity is providing the Disclosure to CMS Form;\n-30 days after the termination of the prescription drug plan; and\n-30 days after any change in the creditable coverage status of the prescription drug plan.",null,null,null,null,null,"Individual Deductible ($)"]
[null,null,null,null,null,null,null,"Family Deductible ($)"]
[null,null,null,null,null,null,null,"Are Preventive Drugs subject to deductible?"]
[null,null,null,null,null,null,"Out-of-Pocket Max ($) \n","Does the Rx plan have an OOP Max?"]
[null,null,null,null,null,null,null,"Embedded or Non-Embedded"]
[null,null,null,null,null,null,null,"Individual ($)"]
[null,null,null,null,null,null,null,"Family ($)"]
[null,null,null,null,null,"Copay           Coinsurance","Retail Rx Member Copay($) / Coins.(%)","Tier 1"]
[null,null,null,null,null,null,null,"Tier 2"]
[null,null,null,null,null,null,null,"Tier 3"]
[null,null,null,null,null,null,null,"Tier 4"]
[null,null,null,null,null,null,null,"Tier 5 "]
[null,null,null,null,null,"Preventive","Preventive Drug List","Does this plan have a Core or Expanded Preventive List?"]
[null,null,null,null,null,null,"Prev Rx ($)/(%)\n","Tier 1"]
[null,null,null,null,null,null,null,"Tier 2"]
[null,null,null,null,null,null,null,"Tier 3"]
[null,null,null,null,null,null,null,"Tier 4"]
[null,null,null,null,null,null,null,"Tier 5"]
[null,null,null,null,null,"HRA","Health Reimbursement Account\n(HRA)","Is this plan an HRA?"]
[null,null,null,null,null,null,null,"Employer contribution to HRA (if applicable)"]
[]
[null,null,null,null,null,"Additional Comments"]
[]
[]
[]
[]
[]
[]
[]
[null,"UHC (in partnership with Optum) has tested UHC's standard plan designs to determine if they are creditable."]
[null,"For HRA plans employer contribution can be considered when determining creditable coverage."]
[]
[null,"Disclaimer: This determination is based on a standard benefit design, and does not constitute a statement of actuarial opinion."]
[null,"Credibility testing results were calculated using 2025 Medicare Part D defined standard benefit parameters.  "]
[null,"As a courtesy, UnitedHealthcare (UHC) has engaged its partner, Optum, to perform a bulk testing of UHC's standard benefit designs to satisfy the actuarial value test of the creditable coverage determination. "]
[null,"Evaluating specific characteristics of a particular employer/retiree group may yield different results.  "]
[null,"According to CMS guidelines, the employer has the ultimate responsibility to determine/confirm whether its plan, as implemented, offers creditable coverage. "]
[null,"Each employer should consult with its own legal counsel or benefits adviser to determine its specific obligations."]
[]
[null,"Version Number: 2025v1.0"]
[null,"Any unauthorized use, reproduction, publication or transfer of these materials is strictly prohibited.\n"]
[null,"© 2024 Optum.  All rights reserved."]

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["United Healthcare\nInstructions"]
[]
["Requirements","Requirements for the Model"]
[null,"Required inputs:"]
[null,null,"In-network Deductible"]
[null,null,"In-network Out-of-Pocket Maximum"]
[null,null,"In-network Copays and/or Coinsurance"]
[null,null,"Prescription Drug List (Advantage or Essential)"]
[null,null,"Preventive Drug List (Core or Expanded, if applicable)"]
[null,null,"Employer contribution for HRA plans"]
[]
[null,"Not required for testing:"]
[null,null,"Mail-order copays is assumed 2.5 times of retail copays"]
[null,null,"Per regulatory guidance, Employer contributions for HSA cannot be taken into account"]
[null,null,"Out-of-Network benefits"]
[]
[]
["Enable Macros","Enable Macros Prior to Using the Model"]
[null,"Upon opening the workbook, you may see a prompt in a yellow bar at the top of the file, asking you to \"Enable Content\". You will need to click on Enable Content prior to entering any plan information. Not doing so may result in Input Validation errors."]
[]
[]
[null,"Note: If you do not see the security warning, macros should already be enabled."]
[]
["Determine Creditbility","Determine if your Plan is Creditable"]
[null,"Step 1: Enter the number of plan designs to be tested in cell C8. Maximum of 50 plans can be looked up at once."]
[null,"Step 2: Chose location to export PDFs of plan design and creditability in cell C10 by using the \"Browse...\" button"]
[null,"Step 3: Input In-Network plan designs, starting with the first plan in column I. This will include:"]
[null,null,"Plan Information such as Group Name, Plan Description, and Effective Date"]
[null,null,"Whether you want to save results with a PDF created of the specific plan"]
[null,null,"Plan Design"]
[null,null,"Deductible"]
[null,null,"Out-of-Pocket Maximum"]
[null,null,"Prescription Drug List"]
[null,null,"Copays/Coinsurance"]
[null,null,"Preventive Drug List"]
[null,null,"HRA features"]
[null,"     *See Step 3 Detailed Instructions Document for more information on how to enter your plan design."]
[null,"Step 4: Click the \"Display Creditibility Results\" button to lookup the result. Row 36 will display one of the following:"]
[null,null,"Pass"]
[null,null,"Fail"]
[null,null,"Custom Test Required"]
[null,null,"Please Validate Inputs - This means required inputs are missing. Complete Step 3 and rerun."]
[]
[]
["Custom Tests","Requesting a Custom Test"]
[null,"If you need to request a custom test because the tool has given a \"Custom Test Required\" determination, please send the PDF of the plan design to: "]
[]
[null,null,"Creditable.Coverage@optum.com"]
[]
[]
["Prior  Year Creditibility","Determine Creditibility for Prior Years"]
[null,"If you need to test plans with an effective date prior to 1/1/2025, please send the plan design to:"]
[null,null,"Creditable.Coverage@optum.com"]

{"sheet":"list","index":4,"n_rows":16,"n_cols":11,"rows_kept":16,"cut":false,"hidden":true,"merged":[]}
[]
[null,"Embedded",null,null,"Ded Applies","OOP Applies","Prev List",null,"2 - Tiers",null,"All (Default)"]
[null,"Yes",1,null,"No Rx Deductible","No OOP Max","ACA (Default)",null,"3 - Tiers",null,"Tier 2 +"]
[null,"No",0,null,"Rx Only","Rx Only","Core",null,"4 - Tiers",null,"Tier 3 +"]
[null,null,null,null,"Combined with Medical","Combined with Medical","Expanded",null,"5 - Tiers"]
[]
[null,"Preventive Rx s.t. ded",null,null,"HRA"]
[null,"Yes",0,null,"Yes"]
[null,"No",1,null,"No"]
[]
[null,null,null,null,"Core Preventive List","Core - Buy up",0,null,"Advantage"]
[null,null,null,null,"Expanded Preventive Drug List","Expanded - Buy up",1,null,"Essential"]
[null,null,null,null,"Custom Preventive List","Custom",99,null,"Don't Know"]
[null,null,null,null,"No","No",99]
[null,null,null,null,null,"No - Standard",99]
[null,null,null,null,null,"Don't Know",99]

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["United Healthcare\nFrequently Asked Questions"]
[]
[1,"The lookup tool produced a result of \"Custom Test Required.\"  What should I do?"]
[null,"If your test comes back with Custom Test Required, confirm you are using the most recent version of the tool (within this workbook, the version number is located at the bottom left of the \"Input\" tab).  The newest version of the tool is always posted on .  "]
[null,"https://www.uhc.com/employer/employer-resources/medicare-part-d-creditable-coverage"]
[null,"Once confirmed, please complete the input tab and email the request (showing custom test required) to the creditable coverage mailbox and Optum will complete the testing.\nNote: the lookup tool is updated on a weekly basis in September.  "]
[]
[2,"The tool displays \"Please validate inputs.\"  What should I do?"]
[null,"Please confirm all information has been entered into Step 3. If all information has been entered and it is still not working, close out the tool. Go to the webiste and re-download the tool, and save to your desktop. Make sure to press enable content on the yellow band when first opening the tool. Also, ensure that your macros are enabled, and try again. Instructions are provided underneath the link to the tool on the website."]
[]
[3,"Why did my plan fail last year but pass this year? Why did my plan pass last year but fail this year?"]
[null,"Optum regularly reviews UHC claims experience and develops a standard set of assumptions to be used when determining whether a UHC plan meets the creditable coverage requirement.  The availability of a more credible data set involving high dollar deductible plans this year allowed us to review and modify certain assumptions. For example, certain high deductible health plans that did not meet the creditable coverage requirement last year may be credible this year based on the revised assumptions."]
[]
[4,"I need to test plans prior to 2025. Can I use this tool?"]
[null,"The plans will need to be tested by Optum as previous plan look up tools are not available for download. For results with an effective date before 1/1/2025, please (1)complete all steps on the Batch tab, (2)indicate plan year being tested on Input column, cell I5 and (3) send the request to the Creditable Coverage Mailbox.  If available, please also provide both the medical and Rx summary of benefits for this plan. Once these are received, Optum will perform a custom test of the plan."]
[]
[5,"Does UHC or Optum send notice letters?"]
[null,"UHC and Optum do not create or modify member notices.  The employer can provide a copy of the pre-written notice or letter to UHG, and UHG will print and mail notices to members for a fee.  CMS provides model notices (templates) that employers can use "]
[null,"https://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/Model-Notice-Letters.html"]
[null,"Once the notice has been drafted, please reach out to your account management team or sales representative with a specific estimate of number of employees and sheet count based on the employer’s letter (example: 2 sheets to 100 members)."]
[]
[6,"I need Massachusetts Minimum Creditable Coverage Testing"]
[null,"UHC does provide Massachusetts Minimum Creditable Coverage testing and MA1099-HC Forms to MA resident subscribers with a fee. Please reach out to the MA MCC mailbox at MA_MCC@uhc.com for more details."]