Health Plan Accreditation Publications

The 2013 Health Plan Standards and Guidelines and Survey Tool are effective July 1, 2013.

NOTE: Health plans to qualify for health insurance exchanges will be using the 2013 Health Plan Accreditation products. All 2013 Health Plan Accreditation products include the Exchange product line.

Standards and Guidelines for the Health Plans (including Exchange product lines)

Web-based version includes Medicare Advantage.

This publication features in-depth explanations and examples of how to meet the standards, accreditation scoring guidelines and points, accreditation outcomes and reporting categories. Eligibility requirements, application information and policies and procedures are also included.

Note: Purchase of the Standards and Guidelines is not necessary when purchasing the Survey Tool.

2013 Health Plan Standards and Guidelines (Print version)
Item #:10352-100-13
Price: $320 

2013 Health Plan Standards and Guidelines Web-based publication

2013 Health Plan Standards and Guidelines e-pub 

2012 Health Plan Standards and Guidelines
(Print edition)
Item #:10352-100-12
Price: $300

2012 Health Plan Standards and Guidelines Web-based publication 

2012 Health Plan Standards and Guidelines e-pub

2012 Health Plan Standards and Guidelines eReader (single user)

2012 Health Plan Standards and Guidelines Kindle (single user)

Survey Tool for the Accreditation of Health Plans (including Exchange product lines)

The Survey Tool includes all information needed to prepare and submit materials for an NCQA survey. Organizations applying for accreditation must complete the Survey Tool and submit it to NCQA to begin the survey process.

2013 HP Survey Tool (Effective 7/1/13 - )

2012 HP Survey Tool  (Effective 7/1/12 - 6/30/12) 

Application for Health Plan Accreditation

This application provides all materials required to apply for an NCQA survey and includes pricing information, policies and procedures and the survey agreement.

2013 Health Plan and MA Application
(Effective 7/1/13 - )
Item # 10013-150-13
Price: Free

NEW! 2013 Health Plan Add-On Application for Exchanges
Note: This product is applicable to currently Accredited organizations only.
(Effective 1/1/13 -1/1/14)
Item # 10014-150-13
Price: Free

2013 HP Corporate Application
(Effective 7/1/13 - )
Item #: 10012-151-13
Price: Free

2012 Health Plan and MA Application
(Effective 7/1/12 - )
Item # 10013-150-12
Price: Free

2012 HP Corporate Application
(Effective 7/1/12 - )
Item #: 10012-151-12
Price: Free

Accreditation User Group (AUG) Memberships

The AUG is a communication, learning and development platform for members to discuss updates to NCQA Accreditation and Certification products and their application to organizations. Members also have the opportunity to contribute to the enhancement of future products. Membership benefits include newsletters, discount vouchers and up-to-date technical information, as well as the inside track on standards development.

2014 AUG Package
The 2014 AUG membership year follows NCQA’s standards year, which runs July 1, 2013–June 30, 2014. For more information, click here. 

2014 AUG Package 
Item #10703-150-14
Price: $950