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Roadmap

This roadmap outlines planned features and releases for the Benefit Plan Standard. The dates are tentative and may be adjusted as the community evolves.

Near Term (2025–2026)​

  • Publish v1.0.0 Specification — Completed (2025). The first formal release of the core schema, field definitions, and crosswalk tables.
  • Release v1.1.0 — Completed (May 2026). Expanded accumulators, pharmacy module foundations, and enhanced cost-sharing structures, backward-compatible with v1.0.0. See the v1.1.0 release notes.
  • Release Example Plans — Publish normalized plans for at least ten carriers, covering commercial and Medicare lines of business.
  • Standards Website — Launched at https://benefitplanstandard.org with documentation, governance charter, and adoption resources.
  • Plan v1.2.0 — Formulary Module — Define drug-to-tier mapping, formulary references, NDC/RxNorm identifiers, CMS and carrier formulary ingestion, and drug-level coverage conditions, with GLP-1 and specialty drugs as the driving use case. See the specification roadmap.
  • Gather Community Feedback — Host virtual workshops with carriers, brokers, and insurtechs to refine the next modules.

Medium Term (2026–2027)​

  • Ship the Formulary Module (v1.2.0) — Complete the schema, field definitions, and crosswalk for drug-level formulary coverage.
  • Begin Behavioral Health Module — Define fields for mental health and substance use benefit nuances.
  • Expand Carrier Crosswalk — Incorporate additional carriers (Kaiser, Molina, Oscar, Ambetter, etc.) and update mapping guidance.
  • Build Open Source Ingestion Tools — Provide reference parsers and transformation scripts for PDFs and DOCX documents.

Long Term (2027 and Beyond)​

  • Dental and Vision Modules — Cover annual maximums, orthodontic benefits, eye care, and device allowances.
  • Utilization Management Module — Standardize prior authorization, step therapy, and referral requirements across carriers.
  • Regulatory Alignment — Work with CMS and state regulators to encourage adoption of the standard for public reporting.
  • Certification Program — Establish a certification process for vendors and carriers implementing the standard correctly.
  • Internationalization — Adapt the model for health systems outside the United States.

This roadmap is fluid and will evolve as the community grows. To suggest changes or volunteer to lead a module, please open an issue in the schema repository or join the discussions.