TIC URL Automation
Description
(Marketplace) Issuers applying for QHP (Qualified Health Plan) certification, including issuers offering off-Exchange SADPs (stand alone dental plans), must submit a Transparency in Coverage URL in MPMS that leads to a page on the issuer's website where required information is posted. The current review process requires reviewers to manually read and verify the language presented on each TIC URL for compliance, which is both time-consuming and labor-intensive.
Detailed example
Reduce manual review, apply uniform review criteria across all URLs, ensuring that the review is consistent and free from the variability that can occur across multiple reviewers
AI / analytics pattern
Classical/Predictive Machine Learning: Models trained on data to make predictions or classifications based on identified patterns or relationships.
Automation level / stage
a) Pre-deployment – The use case is in a development or acquisition status.
Expected benefit
AI can expedite the process by enabling AI algorithms to rapidly scan URL content, to identify if the required language is present and compliant, reducing the review time compared to manual reading. Additionally, AI can manage and review large volumes of URL content, further accelerating the review process.
Controls / human review
ATO: Not reported; PIA: Not published