Products/CMS Plan Submission

CMS Plan Submission

Manage and submit Medicare Advantage plan bids, PBPs, and formularies to CMS HPMS.

Open CMS HPMS Portal
PBP Submission Deadline Approaching — PY2026 Plan Benefit Package submissions are due to CMS HPMS by June 2, 2025.
14 days
Plan Year
Showing PY 2025 submissions
Total Submissions
28
Across all plans & types
Accepted by CMS
19
67.9% acceptance rate
Pending / In Review
6
Awaiting CMS response
Rejected / Error
3
Require resubmission
Submission Status by Plan
PY 2025
Plan ID Plan Name Type PBP Formulary Rate/Bid Network Action
H1234-001
EkloBlue Classic HMO
Arizona · Service Area AZ-001
 HMO Accepted Validated Submitted Accepted Review
H1234-002
EkloPrime PPO Flex
Nevada · Service Area NV-002
 PPO Rejected Validated Submitted Validated Review
H1234-003
EkloPlus PACE
California · Service Area CA-003
 PACE Accepted Accepted Accepted Accepted Review
H1234-004
EkloSelect HMO-POS
Texas · Service Area TX-004
 HMO Draft Draft Draft Draft Review
H1234-005
EkloValue SNP (C-SNP)
Florida · Service Area FL-005
 HMO Submitted Submitted Submitted Validated Review
H1234-006
EkloChoice PPO National
Nationwide · Multi-State
 PPO Accepted Accepted Submitted Accepted Review
Recent Submission History
Date & Time Plan ID Submission Type Submitted By CMS Response Response Code Status
May 18, 2025 · 2:14 PM H1234-002 PBP Submission Maria Reyes Cost sharing exceeds CMS allowable limits for benefit category 01A ERR-4421 Rejected
May 15, 2025 · 9:07 AM H1234-001 PBP Submission James Liu Submission received and validated successfully ACC-200 Accepted
May 14, 2025 · 11:43 AM H1234-003 Formulary Submission Sarah Park All 1,842 drug records accepted; formulary validated ACC-200 Accepted
May 12, 2025 · 3:55 PM H1234-005 Rate/Bid Submission Maria Reyes Under CMS actuarial review. Expected response: May 26. PEND-102 In Review
May 10, 2025 · 8:30 AM H1234-006 Network Adequacy James Liu Network standards met for all 37 counties ACC-200 Accepted
EkloBlue Classic HMO
H1234-001 · Arizona · HMO
PBP Validated
Contract #
H1234
Plan #
001
Service Area
AZ-001
Plan Year
2025
Validation Results
3 Warnings
Preventive dental benefit coverage description is missing
PBP Section B14 → Dental Services → Description
Transportation benefit authorization requirement not specified
PBP Section B15 → Transportation → Auth Required
OTC allowance amount rounds to nearest $5; consider updating to $100
PBP Section B13 → OTC → Quarterly Allowance
PBP Form Preview
Plan ID
H1234-001
Plan Name
EkloBlue Classic HMO
Service Area
AZ-001 (Maricopa, Pima, Pinal)
Plan Type
Medicare Advantage HMO (01)
Benefit Category
01A — Inpatient Hospital
Part C Premium
$0.00 / month
Part D Premium
$22.40 / month
MOOP (In-Network)
$3,400 / year
Inpatient Copay
$0 days 1-6, $310 day 7+
CMS Validation
✓ Schema valid · 3 warnings
Submission Deadlines — PY 2025
PBP Submission Completed May 15
Formulary Submission In Review May 20
Rate/Bid Submission Due Jun 2 14 days
Network Adequacy Completed May 10
Submission Checklist
✓
PBP form validated (3 warnings)
✓
Formulary file validated (1,842 records)
!
Rate/Bid not yet submitted
✓
Network adequacy confirmed (99.2%)
!
Service area attestation pending
✓
CMS HPMS account linked
Open in CMS HPMS Portal
Submission requires two-factor authentication via CMS HPMS
CMS Submission Guide
The CMS Submission module manages the end-to-end lifecycle of Medicare Advantage plan submissions to the CMS Health Plan Management System (HPMS). Each plan year requires four core submission types:
  • PBP — Plan Benefit Package defining all covered benefits and cost sharing
  • Formulary — Complete drug list with tiers, restrictions, and coverage rules
  • Rate/Bid — Actuarial bid and monthly premium rates submitted to CMS
  • Network — Provider network adequacy documentation by county/specialty
Use the plan year selector to switch between submission cycles. Select any plan row to view its validation status and PBP preview in the right panel.
CMS validates submissions in real time. Validation messages are categorized:
  • Error (red) — Must be resolved before CMS will accept the submission. Plan is rejected.
  • Warning (amber) — CMS will accept but flags for review. Correct when possible.
  • Info (blue) — Advisory note, no action required but recommended.
Common CMS Response Codes:
  • ACC-200 — Accepted; submission complete
  • PEND-102 — Pending review; awaiting CMS actuarial team
  • ERR-4421 — Cost sharing limit exceeded for benefit category
  • ERR-2201 — Service area county FIPS code mismatch
CMS publishes annual submission deadlines in the Plan Year Call Letter. Typical PY timeline:
  • Feb–Mar — CMS releases bid instructions and benefit templates
  • Apr–May — PBP and Formulary submissions due
  • Jun 2 — Rate/Bid submission deadline (hard cutoff)
  • Jun–Jul — CMS actuarial review period
  • Aug — CMS issues bid reviews; corrections accepted
  • Sep — Final plan parameters confirmed
  • Oct 1 — AEP begins; plans available for enrollment
Missing the Rate/Bid deadline may result in loss of contract year or civil monetary penalties.
  • Run Validate All at least 2 weeks before deadlines to allow correction time.
  • Use the HPMS Portal link to check submission status directly — CMS may take 48–72 hours to update.
  • For rejected submissions, fix the flagged fields and resubmit. CMS does not penalize resubmissions before the deadline.
  • Save the CMS Response Code for every submission as your tracking reference.
  • Ensure the submitter's HPMS user account has the Bid Submission role assigned.
  • Export the validation report for your compliance records before submitting.
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