Sample Group Membership Creation Request and Response in XML Format
Using the below example, you can do the following:
-
Create a group membership
| Entity Name | Person Type | Policy Number | Plan Number | Main Subscriber |
|---|---|---|---|---|
|
REPRC_ SD001_001_P1 |
Person |
REPRC_SD001_ BG1_POL1 |
REPRC_SD001_ BG1_POL01_P1 |
Yes |
<schema>
<responseDetails>
<membershipId></membershipId>
<responseStatus></responseStatus>
<message></message>
</responseDetails>
<simulationSw>N</simulationSw>
<action></action>
<readFilters>
<dateFilter>
<startDate></startDate>
<endDate></endDate>
</dateFilter>
<priceItemFilter>
<priceItemList>
<priceItemCode></priceItemCode>
</priceItemList>
</priceItemFilter>
<responseType></responseType>
</readFilters>
<person>
<personData>
<sequence>1</sequence>
<personType>P</personType>
<personName>
<sequence>1</sequence>
<entityName>REPRC_SD001_001_P1</entityName>
<nameType>PRIM</nameType>
</personName>
<identifiers>
<idType>WEB</idType>
<idValue>REPRC_SD001_001_P1</idValue>
<isPrimary>Y</isPrimary>
</identifiers>
<division>HC</division>
<birthDate>1982-07-07</birthDate>
<sinceDate>2019-01-01</sinceDate>
<collectionClass></collectionClass>
<postponeCreditReviewUntil></postponeCreditReviewUntil>
<lastCreditReviewDate></lastCreditReviewDate>
<dragDays></dragDays>
<advanceDepositAmount></advanceDepositAmount>
<advanceDepositGraceDays></advanceDepositGraceDays>
<advanceDepositLevel></advanceDepositLevel>
<address>
<addressEffDate>2019-01-01</addressEffDate>
<addressType>MAIN</addressType>
<mailingName>MR.SEAN MILLER</mailingName>
<address1>MILLER-CONWAY INC.</address1>
<address2>7014-G SOUTH PARK</address2>
<address3>SCOTTSDALE (WEST-SIDE)</address3>
<address4>ARIZONA</address4>
<city>SCOTTSDALE</city>
<state>ARIZONA</state>
<zip>85250</zip>
<country>USA</country>
<houseType>CAPE COD</houseType>
<streetNumber1>270TH CENTRAL STREET</streetNumber1>
<streetNumber2>MAIN CLIVE ROAD</streetNumber2>
<inCityLimit>Y</inCityLimit>
<taxVendorGeographicalCode></taxVendorGeographicalCode>
<county>MARICOPA</county>
<addressStatus></addressStatus>
</address>
<email>reprc_sd001_001_p1@ssof.com</email>
<overrideMailingName1>
reprc_sd001_001_p1@ssof.com
</overrideMailingName1>
<overrideMailingName2>
reprc_sd001_001_p1@ssof.com
</overrideMailingName2>
<overrideMailingName3>
reprc_sd001_001_p1@ssof.com
</overrideMailingName3>
<phones>
<phoneType>BUSN</phoneType>
<phoneValue>+1.650.555.0185</phoneValue>
<extension>7104</extension>
</phones>
<relatedPersons>
<idType>WEB</idType>
<idValue>FINS_COBRA_109</idValue>
<personRelationshipType>CHILD</personRelationshipType>
<startDate>2020-01-01</startDate>
<endDate>2020-12-31</endDate>
<financialRelationshipSw>FALSE</financialRelationshipSw>
<parentOrChild>P</parentOrChild>
<relatedPersonsCharacteristicsList>
<characteristic>
<characteristicType>RP-GAMBL</characteristicType>
<characteristicValue>DRCT</characteristicValue>
<effectiveDate>2020-01-01</effectiveDate>
</characteristic>
</relatedPersonsCharacteristicsList>
</relatedPersons>
<personCharacteristicList>
<characteristic>
<characteristicType>ZZ-BLAGM</characteristicType>
<characteristicValue>DRCT</characteristicValue>
<effectiveDate>2020-01-01</effectiveDate>
</characteristic>
</personCharacteristicList>
<accountData>
<accountType>ZZS</accountType>
<customerClass>HC</customerClass>
<billCycle>AUT</billCycle>
<billLeadDays></billLeadDays>
<division>HC</division>
<currency>USD</currency>
<setUpDate>2019-01-01</setUpDate>
<acctUsageFlg></acctUsageFlg>
<comments></comments>
<deferAutoPayDt></deferAutoPayDt>
<collectionClass>HC</collectionClass>
<billRouteType>EMAIL</billRouteType>
<billAddressSource>ACCT</billAddressSource>
<accountIdentifiers>
<idType>ACCTNM</idType>
<idValue>FINS_MDCR_SD001_P1_ACC1</idValue>
<isPrimary>TRUE</isPrimary>
</accountIdentifiers>
<characteristics>
<characteristicsList>
<characteristicType>C1OFFRST</characteristicType>
<characteristicValue>1</characteristicValue>
<effectiveDate>2019-01-01</effectiveDate>
</characteristicsList>
</characteristics>
</accountData>
</personData>
</person>
<membership>
<sourceSystem>ZZPRIME</sourceSystem>
<policyNumber>REPRC_SD001_BG1_POL1</policyNumber>
<planNumber>REPRC_SD001_BG1_POL01_P1</planNumber>
<healthPlanCode></healthPlanCode>
<startDate>2020-01-01</startDate
<endDate>2020-12-31</endDate>
<boStatusCd></boStatusCd>
<paidThroughDate>2020-01-01</paidThroughDate>
<membershipType></membershipType>
<mainSubscriber>
<mainSubsIdType>WEB</mainSubsIdType>
<mainSubsIdValue>REPRC_SD001_001_P1</mainSubsIdValue>
<membershipType></membershipType>
</mainSubscriber>
<autoRenew>N</autoRenew>
<associatedMemberIdentifierType>
AADHR
</associatedMemberIdentifierType>
<associatedMemberIdentifier>
HLPN022
</associatedMemberIdentifier>
<exchangeFlag>ON</exchangeFlag>
<exchangeId>HLPNFSTEST145</exchangeId>
<binderLiabilityAmount></binderLiabilityAmount>
<binderPayApplicability></binderPayApplicability>
<binderPayGraceDays></binderPayGraceDays>
<binderPayThreshold></binderPayThreshold>
<holdBilling></holdBilling>
<membershipRenewalDate></membershipRenewalDate>
<contractPeriod>0</contractPeriod>
<repriceAfterDate></repriceAfterDate>
<membershipIdentifierList>
<membershipIdentifier>
<membershipIdentifierType>
AADHR
</membershipIdentifierType>
<membershipIdentifierValue>
HLPN022
</membershipIdentifierValue>
</membershipIdentifier>
</membershipIdentifierList>
<membershipCharacteristicList>
<characteristic>
<characteristicType>
BILLLVL1
</characteristicType>
<characteristicValue>
REPRC_SD001_BG1_PARAM1
</characteristicValue>
<effectiveDate>
2020-01-01
</effectiveDate>
</characteristic>
</membershipCharacteristicList>
<membershipRateGuarantee>
<membershipRateGuaranteeList>
<rateGuaranteeStartDate></rateGuaranteeStartDate>
<rateGuaranteeEndDate></rateGuaranteeEndDate>
<rateGuaranteeStatus></rateGuaranteeStatus>
</membershipRateGuaranteeList>
</membershipRateGuarantee>
<memberDataList>
<memberData>
<memberIdType>WEB</memberIdType>
<memberIdValue>REPRC_SD001_001_P1</memberIdValue>
<enrollmentStartDate>2020-01-01</enrollmentStartDate>
<enrollmentEndDate>2020-12-31</enrollmentEndDate>
<memberRelationship>OWNER</memberRelationship>
<membershipPersonStatus></membershipPersonStatus>
<membershipPersonstatusReason></membershipPersonstatusReason>
<memberId>REPRC_SD001_001_M1</memberId>
<financeRespFlag>Y</financeRespFlag>
<isMemberSw>Y</isMemberSw>
<externalMedicareBeneficiaryId>
</externalMedicareBeneficiaryId>
<memberCharacteristicList>
<characteristic>
<characteristicType>
C1SMOKER
</characteristicType>
<characteristicValue>
Y
</characteristicValue>
<effectiveDate>
2020-01-01
</effectiveDate>
</characteristic>
</memberCharacteristicList>
<benefitData>
<benefitDataList>
<sequence>1</sequence>
<startDate>2020-02-01</startDate>
<endDate>2020-10-31</endDate>
<benefitStatus></benefitStatus>
<benefitSourceFlag>CMS</benefitSourceFlag>
<benefitSubTypeFlag>D</benefitSubTypeFlag>
<planBenefitPackageId></planBenefitPackageId>
<benefitAmount>1200.25</benefitAmount>
<benefitCharacteristicsList>
<characteristic>
<characteristicType>C1SMOKER</characteristicType>
<characteristicValue>Y</characteristicValue>
<effectiveDate>2020-01-01</effectiveDate>
</characteristic>
</benefitCharacteristicsList>
<benefitDataList>
</benefitData>
</memberData>
</memberDataList>
<premiumCalculationDetails>
<premiumCalculation>
<priceItemCd></priceItemCd>
<startDt></startDt>
<endDt></endDt>
<calcAmt></calcAmt>
<distAmt></distAmt>
<currencyCd></currencyCd>
<acctIdType></acctIdType>
<acctIdVal></acctIdVal>
<accountId></accountId>
<billableChgId></billableChgId>
<pricingRuleId></pricingRuleId>
<priceAsgnId></priceAsgnId>
<premiumCalcLineDetails>
<premiumCalcLines>
<proFactor></proFactor>
<calcAmt></calcAmt>
<distAmt></distAmt>
<month></month>
<totalCalcAmt></totalCalcAmt>
<currencyCd></currencyCd>
<entityTypeFlg></entityTypeFlg>
<entityId></entityId>
<referenceIdType></referenceIdType>
<referenceIdValue></referenceIdValue>
<pricingParameters></pricingParameters>
<description></description>
</premiumCalcLines>
</premiumCalcLineDetails>
</premiumCalculation>
</premiumCalculationDetails>
</membership>
<accountBalance>
<accountBalanceData>
<accountIdentifierType></accountIdentifierType>
<accountNumber></accountNumber>
<accountId></accountId>
<division></division>
<sourceSystem></sourceSystem>
<c1ExternalTransactionId></c1ExternalTransactionId>
<externalSourceId></externalSourceId>
<accountInfoDtls>
<currentBalance></currentBalance>
<lastBillAmount></lastBillAmount>
<statusCd></statusCd>
<messageText></messageText>
</accountInfoDtls>
</accountBalanceData>
</accountBalance>
</schema>
Note: We have given the above sample to
illustrate how the tags should be nested while sending a group membership
creation request from the external system. However, you should not
seamlessly use this sample in your environment because the required
pre-requisite data may not be available in your environment. In such
case, the system will give erroneous results.