Medicare Advantage, Part D, Medicaid

Vlada locked 2027 benefit tables by company (v20261007a), national / state / county x product type x plan type x parent, 2026 all members, 2026 continuing members and the same members in 2027, every benefit as weighted sums

medicare_semantic.benefit_company_cells_v20261007a·live·mart

Rows

427,355

Columns

488

History

N/A

Card

nocolumns only

Typed tools

What it is

1The locked 2027 company benefit cells (Benefits lane, Edition 1.1, locked 2026-10-07): every metric of the locked benefit engine (medicare_semantic.benefit_engine_atoms_v20261007a, base year 2026) rolled up by GROUPING SETS to national, state and county x product type x plan type x parent, keeping the weighted SUMS rather than the averages, so any reader can reproduce the published figure exactly.
2For each metric m: m__s = SUM(weight x m) and m__w = SUM(weight) over the members with m filed, so the value is m__s / m__w (a ratio of weighted sums, never an average of cell values); for metrics with a coverage column, m__c = SUM(weight x coverage) and coverage = m__c / members. members = September 2026 county enrollment on the plan segment; plans = distinct plan segments.
3Metrics: dental, hearing, OTC, eyewear and flex card (offered share, form shares, PMPM dollars if offered and over all members, design known), giveback (offered, token under $10, PMPM), $0 premium share, transportation / fitness / meals / podiatry, deductibles by scope, then premium, MOOP, the medical and Part D deductibles, and every medical cost share (copay and coinsurance by form, low and high ends, switches) and the Part D tier 1/2 copays and tier 4/5 coinsurance.
4Like-for-like allowance dollars on paired members are the sibling table benefit_company_cells_sd_v20261007a.
5Tie-out (company_cells_check.py): 73,986 national values against the report data and 7,250 like-for-like values, 0 mismatches; members roll county to state to national with 0 breaks (30,069,277 members, September 2026).
6Versioned, never replaced; a new lock is a new table.
7Owner: the Benefits lane.

Grain

Key	Grain
N/A	1One row per lvl ('national' \| 'state' \| 'county') x state ('US' on national rows) x county_ssa (county rows only) x bucket (product type; 'ALL' = the company total across product types) x plan_type ('ALL' = every plan type of the bucket) x parent ('ALL' = the market; 'Unaffiliated' when no canonical parent) x per ('b' = 2026 all members, 'f' = 2026 members who continue, 'n' = those same members in their 2027 plan). 2427,355 rows (county b 145,909, f 133,094, n 133,094; state b 4,459, f 4,035, n 4,035; national b 959, f 885, n 885; 3CELLS-MANIFEST.md 2026-10-07).

Key

Grain

N/A

1One row per lvl ('national' | 'state' | 'county') x state ('US' on national rows) x county_ssa (county rows only) x bucket (product type; 'ALL' = the company total across product types) x plan_type ('ALL' = every plan type of the bucket) x parent ('ALL' = the market; 'Unaffiliated' when no canonical parent) x per ('b' = 2026 all members, 'f' = 2026 members who continue, 'n' = those same members in their 2027 plan).
2427,355 rows (county b 145,909, f 133,094, n 133,094; state b 4,459, f 4,035, n 4,035; national b 959, f 885, n 885;
3CELLS-MANIFEST.md 2026-10-07).

Columns (488)

Column	Type	Meaning
`lvl`	varchar(8)
`state`	string
`county_ssa`	string
`county_name`	string
`bucket`	string
`plan_type`	string
`parent`	string
`per`	varchar(1)
`members`	double
`plans`	bigint
`dental_pct_offered__s`	double
`dental_pct_offered__w`	double
`dental_pct_max__s`	double
`dental_pct_max__w`	double
`dental_pct_no_max__s`	double
`dental_pct_no_max__w`	double
`dental_pct_card__s`	double
`dental_pct_card__w`	double
`dental_dollars_pmpm_if__s`	double
`dental_dollars_pmpm_if__w`	double
`dental_dollars_pmpm_all__s`	double
`dental_dollars_pmpm_all__w`	double
`dental_design_known__s`	double
`dental_design_known__w`	double
`hearing_pct_offered__s`	double
`hearing_pct_offered__w`	double
`hearing_pct_allowance__s`	double
`hearing_pct_allowance__w`	double
`hearing_pct_copay__s`	double
`hearing_pct_copay__w`	double
`hearing_pct_card__s`	double
`hearing_pct_card__w`	double
`hearing_dollars_pmpm_if__s`	double
`hearing_dollars_pmpm_if__w`	double
`hearing_dollars_pmpm_all__s`	double
`hearing_dollars_pmpm_all__w`	double
`hearing_design_known__s`	double
`hearing_design_known__w`	double
`otc_pct_offered__s`	double
`otc_pct_offered__w`	double
`otc_pct_own__s`	double
`otc_pct_own__w`	double
`otc_pct_card__s`	double
`otc_pct_card__w`	double
`otc_pct_no_amount__s`	double
`otc_pct_no_amount__w`	double
`otc_dollars_pmpm_if__s`	double
`otc_dollars_pmpm_if__w`	double
`otc_dollars_pmpm_all__s`	double
`otc_dollars_pmpm_all__w`	double
`otc_design_known__s`	double
`otc_design_known__w`	double
`eyewear_pct_offered__s`	double
`eyewear_pct_offered__w`	double
`eyewear_pct_allowance__s`	double
`eyewear_pct_allowance__w`	double
`eyewear_pct_card__s`	double
`eyewear_pct_card__w`	double
`eyewear_pct_no_max__s`	double
`eyewear_pct_no_max__w`	double
`eyewear_dollars_pmpm_if__s`	double
`eyewear_dollars_pmpm_if__w`	double
`eyewear_dollars_pmpm_all__s`	double
`eyewear_dollars_pmpm_all__w`	double
`eyewear_design_known__s`	double
`eyewear_design_known__w`	double
`hearing_copay_per_aid__s`	double
`hearing_copay_per_aid__w`	double
`otc_pct_filed_own_zero_card__s`	double
`otc_pct_filed_own_zero_card__w`	double
`card_pct_offered__s`	double
`card_pct_offered__w`	double
`card_dollars_pmpm_if__s`	double
`card_dollars_pmpm_if__w`	double
`card_dollars_pmpm_all__s`	double
`card_dollars_pmpm_all__w`	double
`allowance_total_pmpm_all__s`	double
`allowance_total_pmpm_all__w`	double
`giveback_pct_offered__s`	double
`giveback_pct_offered__w`	double
`giveback_pct_token__s`	double
`giveback_pct_token__w`	double
`giveback_pmpm_if__s`	double
`giveback_pmpm_if__w`	double
`premium_pct_zero__s`	double
`premium_pct_zero__w`	double
`svc_transportation_pct_offered__s`	double
`svc_transportation_pct_offered__w`	double
`svc_transportation_known__s`	double
`svc_transportation_known__w`	double
`svc_fitness_pct_offered__s`	double
`svc_fitness_pct_offered__w`	double
`svc_fitness_known__s`	double
`svc_fitness_known__w`	double
`svc_meals_post_discharge_pct_offered__s`	double
`svc_meals_post_discharge_pct_offered__w`	double
`svc_meals_post_discharge_known__s`	double
`svc_meals_post_discharge_known__w`	double
`svc_meals_any_pct_offered__s`	double
`svc_meals_any_pct_offered__w`	double
`svc_meals_any_known__s`	double
`svc_meals_any_known__w`	double
`svc_podiatry_pct_offered__s`	double
`svc_podiatry_pct_offered__w`	double
`svc_podiatry_known__s`	double
`svc_podiatry_known__w`	double
`svc_transportation_trips__s`	double
`svc_transportation_trips__w`	double
`svc_transportation_pct_unlimited__s`	double
`svc_transportation_pct_unlimited__w`	double
`svc_podiatry_visits__s`	double
`svc_podiatry_visits__w`	double
`deductible_pct_none__s`	double
`deductible_pct_none__w`	double
`deductible_pct_partb__s`	double
`deductible_pct_partb__w`	double
`deductible_pct_plan__s`	double
`deductible_pct_plan__w`	double
`deductible_plan_amount__s`	double
`deductible_plan_amount__w`	double
`deductible_design_known__s`	double
`deductible_design_known__w`	double
`deductible_pct_scope_oon__s`	double
`deductible_pct_scope_oon__w`	double
`premium__s`	double
`premium__w`	double
`moop__s`	double
`moop__w`	double
`medical_deductible__s`	double
`medical_deductible__w`	double
`partd_deductible__s`	double
`partd_deductible__w`	double
`primary_care__s`	double
`primary_care__w`	double
`specialist__s`	double
`specialist__w`	double
`telehealth__s`	double
`telehealth__w`	double
`mental_health_ind__s`	double
`mental_health_ind__w`	double
`er__s`	double
`er__w`	double
`urgent__s`	double
`urgent__w`	double
`ambulance_ground__s`	double
`ambulance_ground__w`	double
`hosp_5day__s`	double
`hosp_5day__w`	double
`inpatient__s`	double
`inpatient__w`	double
`snf__s`	double
`snf__w`	double
`outpatient_hosp__s`	double
`outpatient_hosp__w`	double
`asc__s`	double
`asc__w`	double
`imaging_complex__s`	double
`imaging_complex__w`	double
`radiology__s`	double
`radiology__w`	double
`lab__s`	double
`lab__w`	double
`physical_therapy__s`	double
`physical_therapy__w`	double
`dme__s`	double
`dme__w`	double
`partb_drugs__s`	double
`partb_drugs__w`	double
`partb_insulin__s`	double
`partb_insulin__w`	double
`dialysis__s`	double
`dialysis__w`	double
`partd_tier1_copay__s`	double
`partd_tier1_copay__w`	double
`partd_tier2_copay__s`	double
`partd_tier2_copay__w`	double
`partd_tier4_coins__s`	double
`partd_tier4_coins__w`	double
`partd_tier5_coins__s`	double
`partd_tier5_coins__w`	double
`primary_care_pct_copay__s`	double
`primary_care_pct_copay__w`	double
`primary_care_pct_coins__s`	double
`primary_care_pct_coins__w`	double
`primary_care_coins__s`	double
`primary_care_coins__w`	double
`specialist_pct_copay__s`	double
`specialist_pct_copay__w`	double
`specialist_pct_coins__s`	double
`specialist_pct_coins__w`	double
`specialist_coins__s`	double
`specialist_coins__w`	double
`telehealth_pct_copay__s`	double
`telehealth_pct_copay__w`	double
`telehealth_pct_coins__s`	double
`telehealth_pct_coins__w`	double
`telehealth_coins__s`	double
`telehealth_coins__w`	double
`mental_health_ind_pct_copay__s`	double
`mental_health_ind_pct_copay__w`	double
`mental_health_ind_pct_coins__s`	double
`mental_health_ind_pct_coins__w`	double
`mental_health_ind_coins__s`	double
`mental_health_ind_coins__w`	double
`physical_therapy_pct_copay__s`	double
`physical_therapy_pct_copay__w`	double
`physical_therapy_pct_coins__s`	double
`physical_therapy_pct_coins__w`	double
`physical_therapy_coins__s`	double
`physical_therapy_coins__w`	double
`er_pct_copay__s`	double
`er_pct_copay__w`	double
`er_pct_coins__s`	double
`er_pct_coins__w`	double
`er_coins__s`	double
`er_coins__w`	double
`urgent_pct_copay__s`	double
`urgent_pct_copay__w`	double
`urgent_pct_coins__s`	double
`urgent_pct_coins__w`	double
`urgent_coins__s`	double
`urgent_coins__w`	double
`ambulance_ground_pct_copay__s`	double
`ambulance_ground_pct_copay__w`	double
`ambulance_ground_pct_coins__s`	double
`ambulance_ground_pct_coins__w`	double
`ambulance_ground_coins__s`	double
`ambulance_ground_coins__w`	double
`outpatient_hosp_pct_copay__s`	double
`outpatient_hosp_pct_copay__w`	double
`outpatient_hosp_pct_coins__s`	double
`outpatient_hosp_pct_coins__w`	double
`outpatient_hosp_coins__s`	double
`outpatient_hosp_coins__w`	double
`imaging_complex_pct_copay__s`	double
`imaging_complex_pct_copay__w`	double
`imaging_complex_pct_coins__s`	double
`imaging_complex_pct_coins__w`	double
`imaging_complex_coins__s`	double
`imaging_complex_coins__w`	double
`radiology_pct_copay__s`	double
`radiology_pct_copay__w`	double
`radiology_pct_coins__s`	double
`radiology_pct_coins__w`	double
`radiology_coins__s`	double
`radiology_coins__w`	double
`lab_pct_copay__s`	double
`lab_pct_copay__w`	double
`lab_pct_coins__s`	double
`lab_pct_coins__w`	double
`lab_coins__s`	double
`lab_coins__w`	double
`inpatient_pct_copay__s`	double
`inpatient_pct_copay__w`	double
`inpatient_pct_coins__s`	double
`inpatient_pct_coins__w`	double
`inpatient_coins__s`	double
`inpatient_coins__w`	double
`snf_pct_copay__s`	double
`snf_pct_copay__w`	double
`snf_pct_coins__s`	double
`snf_pct_coins__w`	double
`snf_coins__s`	double
`snf_coins__w`	double
`primary_care_ll_known__s`	double
`primary_care_ll_known__w`	double
`primary_care_llc_from__s`	double
`primary_care_llc_from__w`	double
`primary_care_llc_to__s`	double
`primary_care_llc_to__w`	double
`primary_care_lli_from__s`	double
`primary_care_lli_from__w`	double
`primary_care_lli_to__s`	double
`primary_care_lli_to__w`	double
`primary_care_sw_coins__s`	double
`primary_care_sw_coins__w`	double
`primary_care_sw_copay__s`	double
`primary_care_sw_copay__w`	double
`specialist_ll_known__s`	double
`specialist_ll_known__w`	double
`specialist_llc_from__s`	double
`specialist_llc_from__w`	double
`specialist_llc_to__s`	double
`specialist_llc_to__w`	double
`specialist_lli_from__s`	double
`specialist_lli_from__w`	double
`specialist_lli_to__s`	double
`specialist_lli_to__w`	double
`specialist_sw_coins__s`	double
`specialist_sw_coins__w`	double
`specialist_sw_copay__s`	double
`specialist_sw_copay__w`	double
`telehealth_ll_known__s`	double
`telehealth_ll_known__w`	double
`telehealth_llc_from__s`	double
`telehealth_llc_from__w`	double
`telehealth_llc_to__s`	double
`telehealth_llc_to__w`	double
`telehealth_lli_from__s`	double
`telehealth_lli_from__w`	double
`telehealth_lli_to__s`	double
`telehealth_lli_to__w`	double
`telehealth_sw_coins__s`	double
`telehealth_sw_coins__w`	double
`telehealth_sw_copay__s`	double
`telehealth_sw_copay__w`	double
`mental_health_ind_ll_known__s`	double
`mental_health_ind_ll_known__w`	double
`mental_health_ind_llc_from__s`	double
`mental_health_ind_llc_from__w`	double
`mental_health_ind_llc_to__s`	double
`mental_health_ind_llc_to__w`	double
`mental_health_ind_lli_from__s`	double
`mental_health_ind_lli_from__w`	double
`mental_health_ind_lli_to__s`	double
`mental_health_ind_lli_to__w`	double
`mental_health_ind_sw_coins__s`	double
`mental_health_ind_sw_coins__w`	double
`mental_health_ind_sw_copay__s`	double
`mental_health_ind_sw_copay__w`	double
`physical_therapy_ll_known__s`	double
`physical_therapy_ll_known__w`	double
`physical_therapy_llc_from__s`	double
`physical_therapy_llc_from__w`	double
`physical_therapy_llc_to__s`	double
`physical_therapy_llc_to__w`	double
`physical_therapy_lli_from__s`	double
`physical_therapy_lli_from__w`	double
`physical_therapy_lli_to__s`	double
`physical_therapy_lli_to__w`	double
`physical_therapy_sw_coins__s`	double
`physical_therapy_sw_coins__w`	double
`physical_therapy_sw_copay__s`	double
`physical_therapy_sw_copay__w`	double
`er_ll_known__s`	double
`er_ll_known__w`	double
`er_llc_from__s`	double
`er_llc_from__w`	double
`er_llc_to__s`	double
`er_llc_to__w`	double
`er_lli_from__s`	double
`er_lli_from__w`	double
`er_lli_to__s`	double
`er_lli_to__w`	double
`er_sw_coins__s`	double
`er_sw_coins__w`	double
`er_sw_copay__s`	double
`er_sw_copay__w`	double
`urgent_ll_known__s`	double
`urgent_ll_known__w`	double
`urgent_llc_from__s`	double
`urgent_llc_from__w`	double
`urgent_llc_to__s`	double
`urgent_llc_to__w`	double
`urgent_lli_from__s`	double
`urgent_lli_from__w`	double
`urgent_lli_to__s`	double
`urgent_lli_to__w`	double
`urgent_sw_coins__s`	double
`urgent_sw_coins__w`	double
`urgent_sw_copay__s`	double
`urgent_sw_copay__w`	double
`ambulance_ground_ll_known__s`	double
`ambulance_ground_ll_known__w`	double
`ambulance_ground_llc_from__s`	double
`ambulance_ground_llc_from__w`	double
`ambulance_ground_llc_to__s`	double
`ambulance_ground_llc_to__w`	double
`ambulance_ground_lli_from__s`	double
`ambulance_ground_lli_from__w`	double
`ambulance_ground_lli_to__s`	double
`ambulance_ground_lli_to__w`	double
`ambulance_ground_sw_coins__s`	double
`ambulance_ground_sw_coins__w`	double
`ambulance_ground_sw_copay__s`	double
`ambulance_ground_sw_copay__w`	double
`outpatient_hosp_ll_known__s`	double
`outpatient_hosp_ll_known__w`	double
`outpatient_hosp_llc_from__s`	double
`outpatient_hosp_llc_from__w`	double
`outpatient_hosp_llc_to__s`	double
`outpatient_hosp_llc_to__w`	double
`outpatient_hosp_lli_from__s`	double
`outpatient_hosp_lli_from__w`	double
`outpatient_hosp_lli_to__s`	double
`outpatient_hosp_lli_to__w`	double
`outpatient_hosp_sw_coins__s`	double
`outpatient_hosp_sw_coins__w`	double
`outpatient_hosp_sw_copay__s`	double
`outpatient_hosp_sw_copay__w`	double
`imaging_complex_ll_known__s`	double
`imaging_complex_ll_known__w`	double
`imaging_complex_llc_from__s`	double
`imaging_complex_llc_from__w`	double
`imaging_complex_llc_to__s`	double
`imaging_complex_llc_to__w`	double
`imaging_complex_lli_from__s`	double
`imaging_complex_lli_from__w`	double
`imaging_complex_lli_to__s`	double
`imaging_complex_lli_to__w`	double
`imaging_complex_sw_coins__s`	double
`imaging_complex_sw_coins__w`	double
`imaging_complex_sw_copay__s`	double
`imaging_complex_sw_copay__w`	double
`radiology_ll_known__s`	double
`radiology_ll_known__w`	double
`radiology_llc_from__s`	double
`radiology_llc_from__w`	double
`radiology_llc_to__s`	double
`radiology_llc_to__w`	double
`radiology_lli_from__s`	double
`radiology_lli_from__w`	double
`radiology_lli_to__s`	double
`radiology_lli_to__w`	double
`radiology_sw_coins__s`	double
`radiology_sw_coins__w`	double
`radiology_sw_copay__s`	double
`radiology_sw_copay__w`	double
`lab_ll_known__s`	double
`lab_ll_known__w`	double
`lab_llc_from__s`	double
`lab_llc_from__w`	double
`lab_llc_to__s`	double
`lab_llc_to__w`	double
`lab_lli_from__s`	double
`lab_lli_from__w`	double
`lab_lli_to__s`	double
`lab_lli_to__w`	double
`lab_sw_coins__s`	double
`lab_sw_coins__w`	double
`lab_sw_copay__s`	double
`lab_sw_copay__w`	double
`inpatient_ll_known__s`	double
`inpatient_ll_known__w`	double
`inpatient_llc_from__s`	double
`inpatient_llc_from__w`	double
`inpatient_llc_to__s`	double
`inpatient_llc_to__w`	double
`inpatient_lli_from__s`	double
`inpatient_lli_from__w`	double
`inpatient_lli_to__s`	double
`inpatient_lli_to__w`	double
`inpatient_sw_coins__s`	double
`inpatient_sw_coins__w`	double
`inpatient_sw_copay__s`	double
`inpatient_sw_copay__w`	double
`snf_ll_known__s`	double
`snf_ll_known__w`	double
`snf_llc_from__s`	double
`snf_llc_from__w`	double
`snf_llc_to__s`	double
`snf_llc_to__w`	double
`snf_lli_from__s`	double
`snf_lli_from__w`	double
`snf_lli_to__s`	double
`snf_lli_to__w`	double
`snf_sw_coins__s`	double
`snf_sw_coins__w`	double
`snf_sw_copay__s`	double
`snf_sw_copay__w`	double
`premium__c`	double
`moop__c`	double
`medical_deductible__c`	double
`partd_deductible__c`	double
`primary_care__c`	double
`specialist__c`	double
`telehealth__c`	double
`mental_health_ind__c`	double
`er__c`	double
`urgent__c`	double
`ambulance_ground__c`	double
`hosp_5day__c`	double
`inpatient__c`	double
`snf__c`	double
`outpatient_hosp__c`	double
`asc__c`	double
`imaging_complex__c`	double
`radiology__c`	double
`lab__c`	double
`physical_therapy__c`	double
`dme__c`	double
`partb_drugs__c`	double
`partb_insulin__c`	double
`dialysis__c`	double
`partd_tier1_copay__c`	double
`partd_tier2_copay__c`	double
`partd_tier4_coins__c`	double
`partd_tier5_coins__c`	double

Query it

describe_data_source(source_fqn="medicare_semantic.benefit_company_cells_v20261007a")     # the card, live
query_substrate(sql="SELECT * FROM medicare_semantic.benefit_company_cells_v20261007a WHERE <filter> LIMIT 100")

Item	Value
Typed tools that read it	none; raw SQL
Identity key	`lvl,state,county_ssa,bucket,plan_type,parent,per`
Join	`how_to_join(source_fqn="medicare_semantic.benefit_company_cells_v20261007a")`
Raw door	Athena (read-only via query_substrate): medicare_semantic.benefit_company_cells_v20261007a

This page as markdown: /docs-md/data/medicare_semantic_benefit_company_cells_v20261007a.md · every page in one file: /llms-full.txt