CMS Pub. 100-05, ch. 6, § 30.3.2

MSP

Insurer

Type Code

Definition

A GHP Hospital and Medical Coverage -or- Other Non-GHP

B GHO

C Preferred Provider Organization (PPO)

D Third Party Administrator arrangement under an Administrative Service Only (ASO)

contract without stop loss from any entity.

E Third Party Administrator arrangement with stop loss insurance issued from any entity.

F Self-Insured/Self-Administered.

G Collectively-Bargained Health and Welfare Fund.

H Multiple Employer Health Plan with at least one employer who has more than 100 full

and/or part-time employees.

I Multiple Employer Health Plan with at least one employer who has more than 20 full

and/or part-time employees.

J GHP Hospitalization Only Plan - A plan that covers only Inpatient hospital services.

K GHP Medical Services Only Plan - A plan that covers only non-inpatient medical

services.

M Medicare Supplemental Plan, Medigap, Medicare Wraparound Plan or Medicare Carve

Out Plan.

R GHP Health Reimbursement Arrangement

S GHP Health Savings Account

SPACES Unknown

NOTE: For MSP occurrences with accretion dates of 4/4/2011 and subsequent, the

only valid Insurer Type Codes are A, J, K, R, S, and spaces.