About this Dataset

Network Adequacy Waiver Request - Vision

This dataset includes information related to network adequacy waiver requests filed by vision plans. Related datasets are available for major medical PPO and EPO plans: Major medical • Network Adequacy Waiver Request - Facility based Physicians & Providers. This dataset relates to waiver requests for networks used for major medical PPO and EPO plans and includes data on facility-based physicians and providers. • Network Adequacy Waiver Request - Major Medical. This dataset relates to waiver requests for networks used for major medical PPO and EPO plans and includes data on physicians, providers, and facilities, other than facility-based physicians and providers. Insurers offering vision benefits through a preferred or exclusive provider benefit plan (also called PPO and EPO plans) are required to demonstrate that the health insurance network meets Texas network adequacy standards. When a network does not meet these requirements and has a deficiency in a county for a specific physician or provider specialty type, an insurer may apply for a waiver to continue operating within its service area. The commissioner of the Texas Department of Insurance (TDI) may grant the waiver following a public hearing and consideration of relevant testimony and information. Anyone may attend the public hearing and offer testimony. Learn more about how to submit information related to a waiver request or participate in a hearing here: Network Adequacy Standards Waivers.
Organization: City of Austin
Last updated: 2024-04-25T10:55:15.518634
Tags: county, health, hearing, insurance, network, network-adequacy, ophthalmologist, optometrist, providers, serff, specialty, status, tdi, therapeutic-optometrist, vision, waiver

Tables

Table 1

@usgov.city_of_austin_network_adequacy_waiver_request_vision.table_1

269.27 kB
57,055 rows
18 columns

CREATE TABLE table_1 (
  "serff_tracking_no" VARCHAR  -- SERFF Tracking No.,
  "naic_no" BIGINT  -- NAIC No.,
  "insurer" VARCHAR,
  "network_id" VARCHAR,
  "network_name" VARCHAR,
  "county_type" VARCHAR,
  "county" VARCHAR,
  "specialty_type" VARCHAR,
  "percentage_of_insureds_with_sufficient_choice" VARCHAR,
  "reason_preferred_providers_not_available" VARCHAR,
  "access_plan_summary" VARCHAR,
  "comments" VARCHAR,
  "are_network_adequacy_standards_met" VARCHAR  -- Are Network Adequacy Standards Met?,
  "hearing_date" TIMESTAMP,
  "waiver_status" VARCHAR,
  "waiver_decision_date" TIMESTAMP,
  "waiver_start_date" TIMESTAMP,
  "waiver_end_date" TIMESTAMP
);