Help Center
The Bureau of Health Coverage Access, Administration, and Appeals (HCA3) has created a resource account to help answer any questions or resolve any issues with submissions, including reports, applications, and other records required by the laws and regulations. A print-friendly Resource Account Help Guide is also available.
Document Submission Process
HCA3 uses SharePoint and SERFF for collecting documents. If you do not already have a SharePoint site for submissions, please submit a request to RA-INHCA3@pa.gov, with “SharePoint Submission Request” in the subject line.
Help by Topic Area
To help us direct your email to the correct office, please use the tables below to locate the topic area of help required.
When submitting an email request for help please be sure to include the specific Subject Line Language provided for your topic area in the subject line of your email.
The regulatory citation for each topic area is also provided for your reference as additional information can be found by referencing the specific citation in Title 28 of the PA Code.
| Help Topics for Companies | | |
|---|---|---|
| Topic Area | Subject Line Language | Regulatory Citation |
| Annual Reports | Annual Report (insert 4-digit year) e.g., Annual Report 2021 | 28 Pa. Code § 9.604(a) |
| Quarterly Reports | Quarterly Report (insert 4-digit year)-Q(insert quarter #) e.g., Quarterly Report 2021-Q1 | 28 Pa. Code § 9.604(b) |
| Certificate of Authority Application (includes foreign HMOs) | COA-(insert company name) e.g., COA-ABC Company | 28 Pa. Code §§ 9.631, 9.635 |
| Delegation of HMO operations | HMO-Delegation of Operations-(insert company name) e.g., HMO-Delegation of Operations-ABC Company | 28 Pa. Code § 9.634 |
| Use of subnetworks – Approval Request | HMO-Subnetwork-(insert company name) e.g., HMO-Subnetwork-ABC Company | 28 Pa. Code § 9.653 |
| Annual Quality Assurance Plan (for information only) | QA Plan-(insert 4-digit year)-(insert company name) e.g., QA Plan-2021-ABC Company | 28 Pa. Code § 9.674(b)(9) |
| Delegation of Medical Management (for review and approval) | Med Management Delegation-(insert company name) e.g., Med Management Delegation-ABC Company | 28 Pa. Code § 9.675 |
| Service Area Expansion Note: Initial network adequacy filings and QHP network adequacy review filings are to be submitted as part of the applications with which they are associated. | Service Area Expansion-(insert company name) e.g., Service Area Expansion-ABC Company | 28 Pa. Code § 9.679 |
| Access for persons with disabilities (for information only) | ADA Access-(insert company name) e.g., ADA Access-ABC Company | 28 Pa. Code § 9.680 |
| Complaint Procedures | Complaint Procedures-(insert company name) e.g., Complaint Procedures-ABC Company | 28 Pa. Code § 9.702(a)(6) |
| Grievance Procedures | Grievance Procedures-(insert company name) e.g., Grievance Procedures-ABC Company | 28 Pa. Code § 9.702(a)(6) |
| External Grievance request | External Grievance Request-(insert company name) e.g., External Grievance Request-ABC Company | 28 Pa. Code § 9.707(b)(2) |
| Expedited External Review request (in addition to fax or phone as outlined in reg) | EXPEDITED External Review-(insert company name) e.g., EXPEDITED External Review-ABC Company | 28 Pa. Code § 9.709(h) |
| Provider Contracts | Provider Contract-(insert company name) e.g., Provider Contract-ABC Company | 28 Pa. Code § 9.722(a) |
| Amended Provider Contracts | Amended Provider Contract-(insert company name) e.g., Amended Provider Contract-ABC Company | 28 Pa. Code § 9.722(b) |
| IDS Notification and Contract approval | IDS Notification-(insert company name) e.g., IDS Notification-ABC Company | 28 Pa. Code §§ 9.723(b), 9.724(b) & (c), 9.725 |
| New CRE Application Notes: BMC will create a secure SharePoint site for applicants to upload their applications. Mail checks for certification fees to the BMC at the address below. | CRE Certification-(insert company name) e.g., CRE Certification-ABC Company | 28 Pa. Code § 9.743 |
| CRE Renewal Notes: The renewal application should be uploaded to the Company's assigned SharePoint. Mail checks for certification fees to the BMC at the address below. | CRE Renewal-(insert company name) e.g., CRE Renewal-ABC Company | 28 Pa. Code § 9.748(b) |
| Credentialing plan | Credentialing Plan-(insert company name) e.g., Credentialing Plan-ABC Company | 28 Pa. Code § 9.761(b) |
| PPO Credentialing | PPO Application-(insert company name) e.g., PPO Application-ABC Company | 31 Pa. Code Ch. 152 (§§ 152.4 & 152.6) |
| PPO Annual Reporting | PPO Annual Report-(insert year) e.g., PPO Annual Report-2021 | 31 Pa. Code § 152.19 |
| NCQA Documents | NCQA -(insert company name)-(insert doc type) e.g., NCQA-ABC Company-Final Corrective Action Report | |
| Help for Consumers | | |
|---|---|---|
| Topic Area | Subject Line language | Regulatory citation |
| Complaint/Grievance Classification by BMC | Complaints/Grievances Classification | 28 Pa. Code § 9.702(c)(3) |
| Appeal a complaint decision or additional information for an existing appeal | Appeal | 28 Pa. Code § 9.704 |
Written Requests
If you would prefer to submit your request for help or additional information via mail, please be sure to include the topic of your request in your cover letter and use the address below.
Bureau of Health Coverage Access, Administration, and Appeals
1311 Strawberry Square
Harrisburg, PA 17120