Public Texas runPlan-year review2026 to 2027
Which values can a broker quote?
- Data kind
- Public carrier documents and CMS files
- Slice
- Plans H0028-030, H5294-014; plan years 2026 and 2027
- As of
- 2026-10-05, run texas-2026-2027
- Confidence floor
- A value read with confidence below 0.7 never decides a change flag.
PDF values checked against CMS
Extraction rules were tuned on these same public Texas documents. The 48 of 48 comparable matches are an in-sample check, not held-out measured accuracy. 2 values are not comparable and 10 were not extracted; both are counted separately in the table. Match rate counts only values both sides state comparably. Not comparable, not extracted, and not in CMS are counted apart.
CMS reports the OTC allowance on a shared card. An OTC match confirms the shared-card figure, not an OTC-only balance.
| Field | Method | Matched | Mismatched | Not comparable | Not extracted | Not in CMS | Match rate |
|---|---|---|---|---|---|---|---|
| Monthly premium | Rules | 4 | 0 | 0 | 0 | 0 | 100% (4 of 4) |
| Medical deductible | Rules | 4 | 0 | 0 | 0 | 0 | 100% (4 of 4) |
| Maximum out-of-pocket (in network) | Rules | 4 | 0 | 0 | 0 | 0 | 100% (4 of 4) |
| Primary care visit | Rules | 4 | 0 | 0 | 0 | 0 | 100% (4 of 4) |
| Specialist visit | Rules | 4 | 0 | 0 | 0 | 0 | 100% (4 of 4) |
| Emergency room | Rules | 4 | 0 | 0 | 0 | 0 | 100% (4 of 4) |
| Urgent care | Rules | 4 | 0 | 0 | 0 | 0 | 100% (4 of 4) |
| Inpatient hospital stay | Rules | 4 | 0 | 0 | 0 | 0 | 100% (4 of 4) |
| Outpatient surgery | Rules | 0 | 0 | 2 | 2 | 0 | No comparable values |
| Drug deductible | Rules | 2 | 0 | 0 | 2 | 0 | 100% (2 of 2) |
| Drug tier 1 | Rules | 2 | 0 | 0 | 2 | 0 | 100% (2 of 2) |
| Drug tier 2 | Rules | 2 | 0 | 0 | 2 | 0 | 100% (2 of 2) |
| Drug tier 3 | Rules | 2 | 0 | 0 | 2 | 0 | 100% (2 of 2) |
| Dental allowance | Rules | 4 | 0 | 0 | 0 | 0 | 100% (4 of 4) |
| Over-the-counter allowance | Rules | 4 | 0 | 0 | 0 | 0 | 100% (4 of 4) |
| All fields | Rules | 48 | 0 | 2 | 10 | 0 | 100% (48 of 48) |
Where the PDF and CMS disagree
No disagreements in this run.
Review queue (23)
High 1
Change flag needs review (1)
A value that can decide a change flag is missing, unclear, read with low confidence, or disagrees with CMS, so the flag is left undecided instead of guessed.
- H5294-014, Drug deductible, 2027: Drug deductible change flag needs review: not found in 2026; not found in 2027
Original recorded reason
drug deductible cannot decide shop again: not found in 2026; not found in 2027
Medium 12
Cannot be checked against CMS (2)
The document and CMS state this value for different periods or units, so the two cannot be checked against each other.
- H0028-030, Outpatient surgery, 2026: PDF says $100.00 per visit, CMS says $0.00 to $100.00 per visit (CMS gives a range) humana-h0028-030-sb-2026, page 4CMS file pbp_b9_outpat_hosp.txt, row 13
- H0028-030, Outpatient surgery, 2027: PDF says $300.00 per visit, CMS says $0.00 to $300.00 per visit (CMS gives a range) humana-h0028-030-sb-2027, page 4CMS file pbp_b9_outpat_hosp.txt, row 13
Not read from the document (10)
The rules could not read this value from the document.
- H5294-014, Outpatient surgery, 2026: No row found on any of 24 pages
- H5294-014, Outpatient surgery, 2027: No row found on any of 20 pages
- H5294-014, Drug deductible, 2026: No row found on any of 24 pages
- H5294-014, Drug deductible, 2027: No row found on any of 20 pages
- H5294-014, Drug tier 1, 2026: No row found on any of 24 pages
- H5294-014, Drug tier 1, 2027: No row found on any of 20 pages
- H5294-014, Drug tier 2, 2026: No row found on any of 24 pages
- H5294-014, Drug tier 2, 2027: No row found on any of 20 pages
- H5294-014, Drug tier 3, 2026: No row found on any of 24 pages
- H5294-014, Drug tier 3, 2027: No row found on any of 20 pages
Low 10
Two values in one cell (10)
One cell held two or more values. The first was kept at lower confidence; read the page to confirm.
- H0028-030, Medical deductible, 2026: Two or more different values: '$0' (page 75), '- The amount you must pay for health care or prescriptions before our plan pays.' (page 173); kept page 75; a row with no readable value may hold a different one humana-h0028-030-eoc-2026, page 75humana-h0028-030-eoc-2026, page 173
- H0028-030, Inpatient hospital stay, 2026: Two or more different values: 'stays $95 copayment per day for days 1 - 5' (page 12), 'Your inpatient cost share will begin' (page 55); kept page 12; a row with no readable value may hold a different one humana-h0028-030-eoc-2026, page 12humana-h0028-030-eoc-2026, page 55
- H0028-030, Drug deductible, 2026: Two or more values in one cell: '$0 deductible for Tier 1, Tier 2and Tier 3; $615 deductible for Tier 4and Tier 5'; took the highest tier deductible value (explicitly labeled highest tier deductible) humana-h0028-030-sb-2026, page 4
- H0028-030, Drug deductible, 2027: Two or more values in one cell: '$0 deductible for Tier 1, Tier 2 and Tier 3; $700 deductible for Tier 4 and Tier 5'; took the highest tier deductible value (explicitly labeled highest tier deductible) humana-h0028-030-sb-2027, page 4
- H0028-030, Drug tier 1, 2026: Two or more values in one cell: 'Preferred Generic $0 $0 $10 $30 $0 $0'; took the first value humana-h0028-030-sb-2026, page 11
- H0028-030, Drug tier 1, 2027: Two or more values in one cell: 'Preferred Generic $0 $0 $10 $30 $0 $0'; took the first value humana-h0028-030-sb-2027, page 11
- H0028-030, Drug tier 2, 2026: Two or more values in one cell: 'Generic $0 $0 $20 $60 $0 $0'; took the first value humana-h0028-030-sb-2026, page 11
- H0028-030, Drug tier 2, 2027: Two or more values in one cell: 'Generic $0 $0 $20 $60 $0 $0'; took the first value humana-h0028-030-sb-2027, page 11
- H0028-030, Drug tier 3, 2026: Two or more values in one cell: 'Preferred Brand $45 $135 $47 $141 $45 $90'; took the first value humana-h0028-030-sb-2026, page 11
- H0028-030, Drug tier 3, 2027: Two or more values in one cell: 'Preferred Brand 17% 17% 17% 17% 17% 15%'; took the first value humana-h0028-030-sb-2027, page 11