Accumulators

field name object type validation description primary key accumulator string required a key that defines the uniqueness of this accumulator an example might be memberkey+coverageproduct+accumulatoryear effective since accumulator yyyymmdd required the date from which this current value is effective typically represents the first date of this current accumulator year accumulator year accumulator yyyy required the year that this accumulator applies to this often is the same as plan year, however they may be different for some plans accum year start date accumulator yyyymmdd required the date the accumulator year began plan year start date accumulator yyyymmdd required the date the plan year began combined med rx accumulator enum yesorno required y/n n=values are specific to the coverage product, y=amounts are the sum across medical and rx ind ded paid accumulator decimal as string required amount paid towards individual deductible set to 0 if not applicable ind ded max accumulator decimal as string required individual deductible set to 0 if not applicable ind oop paid accumulator decimal as string required amount paid towards individual oop max set to 0 if not applicable ind oop max accumulator decimal as string required individual oop max set to 0 if not applicable ind copay paid accumulator decimal as string required amound individual paid in copays set to 0 if not applicable fam ded paid accumulator decimal as string required amount paid towards family deductible set to 0 if not applicable fam ded max accumulator decimal as string required family deductible set to 0 if not applicable fam oop paid accumulator decimal as string required amount paid towards family oop max set to 0 if not applicable fam oop max accumulator decimal as string required family oop max set to 0 if not applicable fam copay paid accumulator decimal as string required amound family paid in copays set to 0 if not applicable fam in ded paid accumulator decimal as string required amount paid towards family in network deductible set to 0 if not applicable fam in ded max accumulator decimal as string required family in network deductible set to 0 if not applicable fam in oop paid accumulator decimal as string required amount paid towards family in network oop max set to 0 if not applicable fam in oop max accumulator decimal as string required family in network oop max set to 0 if not applicable fam out ded paid accumulator decimal as string required amount paid towards family out of network deductible set to 0 if not applicable fam out ded max accumulator decimal as string required family out of network deductible set to 0 if not applicable fam out oop paid accumulator decimal as string required amount paid towards family out of network oop max set to 0 if not applicable fam out oop max accumulator decimal as string required family out of network oop max set to 0 if not applicable ind in ded paid accumulator decimal as string required amount paid towards individual in network deductible set to 0 if not applicable ind in ded max accumulator decimal as string required individual in network deductible set to 0 if not applicable ind in oop paid accumulator decimal as string required amount paid towards individual in network oop max set to 0 if not applicable ind in oop max accumulator decimal as string required individual in network oop max set to 0 if not applicable ind out ded paid accumulator decimal as string required amount paid towards individual out of network deductible set to 0 if not applicable ind out ded max accumulator decimal as string required individual out of network deductible set to 0 if not applicable ind out oop paid accumulator decimal as string required amount paid towards individual out of network oop max set to 0 if not applicable ind out oop max accumulator decimal as string required individual out of network oop max set to 0 if not applicable fam lifetime ben paid accumulator decimal as string required amount paid towards family lifetime benefit max set to 0 if not applicable fam lifetime ben max accumulator decimal as string required family lifetime benefit max set to 0 if not applicable ind lifetime ben paid accumulator decimal as string required amount paid towards individual lifetime benefit max set to 0 if not applicable ind lifetime ben max accumulator decimal as string required individual lifetime benefit max set to 0 if not applicable plan paid accumulator decimal as string strongly recommended amount plan paid during accumulator period subscriber primary key subscriber string required the primary key used as the memberprimarykey for the subscriber a row will be considered a subscriber when this subscriberprimarykey matches this memberprimarykey subscriber employer id subscriber string optional employee identifier of subscriber member primary key member string required a key that defines the uniqueness of this member this should match the key used in other datasets member id member string required member identifier (or subscriber if subscriberprimarykey is equivalent to primarykey) often shared among a family this member will be considered the subscriber if the subscriberprimarykey is equal to this row's primarykey) member alternate id member string optional alternative identifier of member member employer id member string optional employee identifier of subscriber member employment status member enum employmentstatus strongly recommended only applies when row is subscriber employment status of subscriber a,d,f,p,s,t,u = active,terminated,full time,part time,self employed,temporary,unemployed member person code member string required person code corresponding to this member often 00 for member and 01, 02, 03, etc for dependents in the order they were registered member relationship member enum relationship required member's relationship to subscriber e g , su = subscriber/self, sp = spouse, ch = child, de = other dependent, etc member ssn member ssn strongly recommended ssn for member some vendors will not be able to accept a family without at least a subscriber ssn member first name member string required first name of member member middle name member string required middle name of member member last name member string required last name of member member preferred first name member string optional preferred first name of member, if applicable and known member prefix member string optional prefix (e g , mr , mrs , dr ) for member member suffix member string optional suffix (e g , jr , sr , iii) for member member pronoun member string optional pronoun (e g , he, she, they) for member member gender member enum gender required gender of member f, m, o, u = female, male, other, unknown member sex member enum sex required sex of member f, m, o, u = female, male, other, unknown member date of birth member yyyymmdd required date of birth of member member address line 1 member string required address line 1 of member member address line 2 member string optional address line 2 of member member address line 3 member string optional address line 3 of member member city member string required city of member member state member enum state required two character state code conforming to the iso 3166 2\ us subdivision codes such as al, ak, az, ar, ca, co, etc member postal code member string required postal code of member may include 6 or 10 characters member country member enum country required two character country code conforming to iso 3166 1 alpha 2 member email member string strongly recommended email address of member member alternate email member string optional alternate email address of member member phone number member numeric strongly recommended phone number of member member phone number type member enum phonenumbertype strongly recommended type of phone number for member coverage primary key coverage string required uniquely identifies the coverage may be a compound id like memberkey+coverageproduct+coverageeffectivedate coverage product coverage enum product required coverage product of member mm = medical, rx = prescription drug, vi = vision, de = dental, fx = flex coverage status coverage enum coveragestatus required coverage status of member a,d,h,i,p,r,s,t = active,deceased,hold,inactive,pending,retired,suspended,terminated coverage level coverage enum coveragelevel required code indicating the coverage level sub, fam, ssp, sch = subscriber only, family, subscriber + spouse, subscriber + child coverage effective date coverage yyyymmdd required effective date of coverage for member coverage termination date coverage yyyymmdd required if this active coverage range is being terminated termination date of coverage for member required if this active coverage range is being terminated plan id plan string required identifier code for the plan plan name plan string required friendly name of the plan plan tpa id plan string strongly recommended id of the third party administrator (tpa) for member plan tpa name plan string strongly recommended name of the third party administrator (tpa) for member plan network id plan string strongly recommended id of the network for member plan network name plan string strongly recommended name of the network for member group block of business id group string required identifier for corresponding block of business, account, or root level division group id group string required identifier for corresponding client/group group name group string required name of group group tin group string required tin (tax id) of group group hierarchy 1 group string optional first level breakdown of group (location) group hierarchy 1 description group string optional description of first level breakdown group hierarchy 2 group string optional second level breakdown of group (division) group hierarchy 2 description group string optional description of second level breakdown custom 1 private accumulator string optional custom field custom 2 private accumulator string optional custom field custom 3 private accumulator string optional custom field custom 4 private accumulator string optional custom field custom 5 private accumulator string optional custom field custom 6 private accumulator string optional custom field custom 7 private accumulator string optional custom field custom 8 private accumulator string optional custom field custom 9 private accumulator string optional custom field custom 10 private accumulator string optional custom field