Sample Health Care Inbound Message for Self-Funded Customer Setup
Using the below example, you can do the following:
-
Create the parent customer and bill groups for a self-funded health insurance business
-
Create the accounts for the bill groups
-
Create the policies for the bill groups where the policy category is set to Self-Funded
| Person Name | Person Type | Policy | Account |
|---|---|---|---|
| US Energy Corp | Parent Customer | - | - |
| US Energy ACTIVE | Bill Group | Active Employee Health Insurance Policy | Standard |
| Retention | |||
| US Energy COBRA | Bill Group | Active COBRA Employe Health Insurance Policy | Standard |
| Retiree COBRA Employee Health Insurance Policy | Retention | ||
| US Energy RETIREE | Bill Group | Retiree Employee Health Insurance Policy | Standard |
| Retention |
| Bill Group | Source System | Parameter 1 | Parameter 2 | Parameter 3 | Parameter 4 |
|---|---|---|---|---|---|
| US Energy ACTIVE | SMALLPRIME | ACTIVE | SEATTLE | - | - |
| SMALLPRIME | ACTIVE | LOS ANGELES | - | - | |
| US Energy COBRA | SMALLPRIME | COBRA | DALLAS | - | - |
| SMALLPRIME | COBRA | SAN JOSE | - | - | |
| US Energy RETIREE | SMALLPRIME | RETIRED | CHARLOTTE | - | - |
| SMALLPRIME | RETIRED | DETROIT | - | - |
<schema>
<bo>C1-HCInboundMessage</bo>
<characteristics>
<inboundMessageCharacteristic>
<adhocCharacteristicValue></adhocCharacteristicValue>
<characteristicType>C1-EXTBTCT</characteristicType>
<effectiveDate>2019-01-01</effectiveDate>
<characteristicValue>DATAEXT4</characteristicValue>
<characteristicValueForeignKey1>
</characteristicValueForeignKey1>
<characteristicValueFK2></characteristicValueFK2>
<characteristicValueFK3></characteristicValueFK3>
<characteristicValueFk4></characteristicValueFk4>
<characteristicValueFK5></characteristicValueFK5>
</inboundMessageCharacteristic>
</characteristics>
<customerStructureMessage>
<headerData>
<messageType>
C1-HEALTHCARE-INB-MSG-TYPE
</messageType>
<sourceSystem>SMALLPRIME</sourceSystem>
<externalTransactionId>675376</externalTransactionId>
<externalBatchId>898657</externalBatchId>
<externalSourceId>656565</externalSourceId>
</headerData>
<customerStructureData>
<personData>
<sequence>1</sequence>
<personType>PG</personType>
<personName>
<sequence>1</sequence>
<entityName>US Energy Corp</entityName>
<nameType>PRIM</nameType>
</personName>
<identifiers>
<idType>EIN</idType>
<idValue>98-7654329</idValue>
<isPrimary>Y</isPrimary>
</identifiers>
<division>HC</division>
<birthDate>1980-03-24</birthDate>
<sinceDate>2019-01-01</sinceDate>
<accessGroup></accessGroup>
<collectionClass></collectionClass>
<postponeCreditReviewUntil></postponeCreditReviewUntil>
<lastCreditReviewDate></lastCreditReviewDate>
<dragDays></dragDays>
<advanceDepositAmount></advanceDepositAmount>
<advanceDepositGraceDays></advanceDepositGraceDays>
<advanceDepositLevel></advanceDepositLevel>
<address>
<addressEffDate>2019-01-01</addressEffDate>
<addressType>MAIN</addressType>
<mailingName>US Energy Corp</mailingName>
<address1>Saturn Park</address1>
<address2>Saturn Street</address2>
<address3>River Side</address3>
<address4></address4>
<city>San Franciso</city>
<state>CA</state>
<zip>94122</zip>
<country>USA</country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
<addressStatus></addressStatus>
</address>
<email>usencp@example.com</email>
<overrideMailingName1>
US Energy Corporation
</overrideMailingName1>
<overrideMailingName2>
</overrideMailingName2>
<overrideMailingName3>
</overrideMailingName3>
<phones>
<phoneType>BUSN</phoneType>
<phoneValue>415-555-0100</phoneValue>
</phones>
<relatedPersons>
<idType></idType>
<idValue></idValue>
<personRelationshipType>
</personRelationshipType>
<startDate></startDate>
<endDate></endDate>
<financialRelationshipSw></financialRelationshipSw>
<parentOrChild></parentOrChild>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</relatedPersons>
<characteristics>
<characteristicsList>
<characteristicType>PER_CAT</characteristicType>
<characteristicValue>EMPOLYER</characteristicValue>
<effectiveDate>2019-01-01</effectiveDate>
</characteristicsList>
</characteristics>
</personData>
<personData>
<sequence>2</sequence>
<personType>BG</personType>
<personName>
<sequence>1</sequence>
<entityName>US Energy ACTIVE</entityName>
<nameType>PRIM</nameType>
</personName>
<identifiers>
<idType>EIN</idType>
<idValue>98-7654320</idValue>
<isPrimary>Y</isPrimary>
</identifiers>
<division>HC</division>
<birthDate>1991-05-09</birthDate>
<sinceDate>2019-01-01</sinceDate>
<address>
<addressEffDate>2019-01-01</addressEffDate>
<addressType>MAIN</addressType>
<mailingName>US Energy ACTIVE</mailingName>
<address1>Mars Park</address1>
<address2>Mars Street</address2>
<address3>Lake Side</address3>
<address4></address4>
<city>Los Angeles</city>
<state>CA</state>
<zip>90020</zip>
<country>USA</country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
</address>
<email>usencpa@example.com</email>
<overrideMailingName1></overrideMailingName1>
<overrideMailingName2></overrideMailingName2>
<overrideMailingName3></overrideMailingName3>
<phones>
<phoneType>BUSN</phoneType>
<phoneValue>661-555-0111</phoneValue>
</phones>
<relatedPersons>
<idType>EIN</idType>
<idValue>98-7654329</idValue>
<personRelationshipType></personRelationshipType>
<startDate>2019-01-01</startDate>
<endDate>2019-12-31</endDate>
<financialRelationshipSw>false</financialRelationshipSw>
<parentOrChild>P</parentOrChild>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</relatedPersons>
<characteristics>
<characteristicsList>
<characteristicType>PER_CAT</characteristicType>
<characteristicValue>OTHER</characteristicValue>
<effectiveDate>2019-01-01</effectiveDate>
</characteristicsList>
</characteristics>
<billLevelParameters>
<sequence>1</sequence>
<sourceSystem>SMALLPRIME</sourceSystem>
<billLevelInfo1>ACTIVE</billLevelInfo1>
<billLevelInfo2>SEATTLE</billLevelInfo2>
<effectiveDate>2019-01-01</effectiveDate>
</billLevelParameters>
<billLevelParameters>
<sequence>2</sequence>
<sourceSystem>SMALLPRIME</sourceSystem>
<billLevelInfo1>ACTIVE</billLevelInfo1>
<billLevelInfo2>LOS ANGELES</billLevelInfo2>
<effectiveDate>2019-01-01</effectiveDate>
</billLevelParameters>
<memberData>
<sequence>10</sequence>
<startDate></startDate>
<endDate></endDate>
<repriceAfterDate></repriceAfterDate>
<paidThroughDate></paidThroughDate>
<memberId></memberId>
<memberRelationship></memberRelationship>
<membershipPersonStatus></membershipPersonStatus>
<membershipPersonstatusReason>
</membershipPersonstatusReason>
<autoRenew></autoRenew>
<associatedMemberIdentifierType>
</associatedMemberIdentifierType>
<associatedMemberIdentifier>
</associatedMemberIdentifier>
<exchangeFlag></exchangeFlag>
<exchangeId></exchangeId>
<binderLiabilityAmount></binderLiabilityAmount>
<binderPayApplicability></binderPayApplicability>
<binderPayGraceDays></binderPayGraceDays>
<binderPayThreshold></binderPayThreshold>
<holdBilling></holdBilling>
<membershipRenewalDate></membershipRenewalDate>
<contractPeriod></contractPeriod>
<membershipIdentifier>
<membershipIdentifierType>
</membershipIdentifierType>
<membershipIdentifierValue>
</membershipIdentifierValue>
</membershipIdentifier>
<isMemberSw></isMemberSw>
<isFinanciallyResponsibleSw>
</isFinanciallyResponsibleSw>
<membershipType></membershipType>
<externalMedicareBeneficiaryId>
</externalMedicareBeneficiaryId>
<mainSubscriber>
<idType></idType>
<idValue></idValue>
<membershipType></membershipType>
</mainSubscriber>
<policyNumber></policyNumber>
<sourceSystem></sourceSystem>
<planNumber></planNumber>
<healthPlanCode></healthPlanCode>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
<membershipRateGuarantee>
<membershipRateGuaranteeList>
<rateGuaranteeStartDate></rateGuaranteeStartDate>
<rateGuaranteeEndDate></rateGuaranteeEndDate>
<rateGuaranteeStatus></rateGuaranteeStatus>
</membershipRateGuaranteeList>
</membershipRateGuarantee>
<membershipPersonCharacteristic>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</membershipPersonCharacteristic>
<benefitData>
<benefitDataList>
<sequence></sequence>
<startDate></startDate>
<endDate></endDate>
<benefitStatus></benefitStatus>
<benefitSourceFlag></benefitSourceFlag>
<benefitTypeFlag></benefitTypeFlag>
<benefitSubTypeFlag></benefitSubTypeFlag>
<planBenefitPackageId></planBenefitPackageId>
<benefitAmount></benefitAmount>
<characteristics>
<characteristicsList>
<characteristicType>
</characteristicType>
<characteristicValue>
</characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</benefitDataList>
</benefitData>
<billableChargeData>
<sequence></sequence>
<accountIdType></accountIdType>
<accountIdValue></accountIdValue>
<chargeType></chargeType>
<startDate></startDate>
<endDate></endDate>
<priceItemCode></priceItemCode>
<description></description>
<recurringMethod></recurringMethod>
<billPeriod></billPeriod>
<frequency></frequency>
<billAfterDt></billAfterDt>
<billableChargeLines>
<descriptionOnBill></descriptionOnBill>
<currencyCode></currencyCode>
<chargeAmount></chargeAmount>
<showOnBillSw></showOnBillSw>
<appearInSummarySw></appearInSummarySw>
<distributionCode></distributionCode>
</billableChargeLines>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</billableChargeData>
</memberData>
<accountData>
<accountType>Standard</accountType>
<customerClass>HC</customerClass>
<billCycle>BK01</billCycle>
<billLeadDays>10</billLeadDays>
<division>HC</division>
<currency>USD</currency>
<setUpDate>2019-01-01</setUpDate>
<acctUsageFlg>USAG</acctUsageFlg>
<comments></comments>
<deferAutoPayDt></deferAutoPayDt>
<collectionClass></collectionClass>
<billRouteType>POSTAL</billRouteType>
<billAddressSource>PER</billAddressSource>
<identifiers>
<idType>ACCT_NM</idType>
<idValue>Standard Account</idValue>
<isPrimary>true</isPrimary>
</identifiers>
<address>
<addressEffDate>2019-01-01</addressEffDate>
<addressType></addressType>
<address1><</address1>
<address2>Fresno</address2>
<address3></address3>
<address4></address4>
<city></city>
<state></state>
<zip></zip>
<country></country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
</address>
<autoPayDetails>
<priority></priority>
<startDate></startDate>
<endDate></endDate>
<percentage></percentage>
<autoPayMethod></autoPayMethod>
<autoPayRouteType></autoPayRouteType>
<autoPaySourceCode></autoPaySourceCode>
<accountNumber></accountNumber>
<expiryMonth></expiryMonth>
<expiryYear></expiryYear>
<name></name>
<maxWithdrawalAmount></maxWithdrawalAmount>
<comments></comments>
</autoPayDetails>
<accountPerson>
<idType></idType>
<idValue></idValue>
<accountRelationshipType>
</accountRelationshipType>
<isFinanciallyResponsible>
</isFinanciallyResponsible>
<personAddressOverride>
<address1></address1>
<address2></address2>
<address3></address3>
<address4></address4>
<city></city>
<postal></postal>
<state></state>
<country></country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
</personAddressOverride>
<accountPersonRouting>
<billRouteType></billRouteType>
<shouldReceiveCopyOfBill>
</shouldReceiveCopyOfBill>
<billFormat></billFormat>
<numberOfBillCopies></numberOfBillCopies>
<receivesNotification></receivesNotification>
<billAddressSource></billAddressSource>
</accountPersonRouting>
</accountPerson>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</accountData>
<accountData>
<accountType>Retention</accountType>
<customerClass>HC</customerClass>
<billCycle>BK02</billCycle>
<billLeadDays>10</billLeadDays>
<division>HC</division>
<currency>USD</currency>
<setUpDate>2019-01-01</setUpDate>
<acctUsageFlg>USAG</acctUsageFlg>
<comments></comments>
<deferAutoPayDt></deferAutoPayDt>
<collectionClass></collectionClass>
<billRouteType>POSTAL</billRouteType>
<billAddressSource>ACOV</billAddressSource>
<identifiers>
<idType>ACCT_NM</idType>
<idValue>Retention Account</idValue>
<isPrimary>true</isPrimary>
</identifiers>
<address>
<addressEffDate>2019-01-01</addressEffDate>
<addressType>OVRD</addressType>
<address1>Jupiter Park<</address1>
<address2>Jupiter Street</address2>
<address3>Near Corporation Bank</address3>
<address4></address4>
<city>Los Angeles</city>
<state>CA</state>
<zip>90020</zip>
<country>USA</country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
</address>
<autoPayDetails>
<priority></priority>
<startDate></startDate>
<endDate></endDate>
<percentage></percentage>
<autoPayMethod></autoPayMethod>
<autoPayRouteType></autoPayRouteType>
<autoPaySourceCode></autoPaySourceCode>
<accountNumber></accountNumber>
<expiryMonth></expiryMonth>
<expiryYear></expiryYear>
<name></name>
<maxWithdrawalAmount></maxWithdrawalAmount>
<comments></comments>
</autoPayDetails>
<accountPerson>
<idType></idType>
<idValue></idValue>
<accountRelationshipType>
</accountRelationshipType>
<isFinanciallyResponsible>
</isFinanciallyResponsible>
<personAddressOverride>
<address1></address1>
<address2></address2>
<address3></address3>
<address4></address4>
<city></city>
<postal></postal>
<state></state>
<country></country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
</personAddressOverride>
<accountPersonRouting>
<billRouteType></billRouteType>
<shouldReceiveCopyOfBill>
</shouldReceiveCopyOfBill>
<billFormat></billFormat>
<numberOfBillCopies></numberOfBillCopies>
<receivesNotification></receivesNotification>
<billAddressSource></billAddressSource>
</accountPersonRouting>
</accountPerson>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</accountData>
<policyData>
<policyType>SELF-FUNDED</policyType>
<sourceSystem>SMALLPRIME</sourceSystem>
<policyNumber>AP234900</policyNumber>
<description>
Active Employee Health Insurance Policy
</description>
<advancedLevelFundingEligibility>
</advancedLevelFundingEligibility>
<startDate>2019-01-01</startDate>
<endDate>2019-12-31</endDate>
<runOutEndDate>2020-03-31</runOutEndDate>
<runOutAdminOption>NROA</runOutAdminOption>
<renewalDate></renewalDate>
<advanceDepositApplSW></advanceDepositApplSW>
<advanceDepositAmount></advanceDepositAmount>
<advanceDepositGraceDays></advanceDepositGraceDays>
<advanceDepositAccountIdentifierType>
</advanceDepositAccountIdentifierType>
<advanceDepositAccountIdentifierValue>
</advanceDepositAccountIdentifierValue>
<policyPersons>
<idType></idType>
<idValue></idValue>
<policyPerRole></policyPerRole>
<startDate></startDate>
<endDate></endDate>
</policyPersons>
<terminationInformation>
<terminateDate></terminateDate>
<terminationReason></terminationReason>
</terminationInformation>
<reinstateInformation>
<reinstatementDate></reinstatementDate>
<reinstateReason></reinstateReason>
</reinstateInformation>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
<planData>
<planNumber></planNumber>
<priceItemCode></priceItemCode>
<planName></planName>
<priceItemCode></priceItemCode>
<planName></planName>
<pricingRuleTypeList>
<pricingRuleType></pricingRuleType>
</pricingRuleTypeList>
<startDate></startDate>
<endDate></endDate>
<primaryPlanSw></primaryPlanSw>
<benefitTypeFlag></benefitTypeFlag>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
<policyPlanProrationRuleList>
<effectiveDate></effectiveDate>
<prorationEventType></prorationEventType>
<prorationType></prorationType>
<numberOfDays></numberOfDays>
<membershipType></membershipType>
</policyPlanProrationRuleList>
</planData>
</policyData>
</personData>
<personData>
<sequence>3</sequence>
<personType>BG</personType>
<personName>
<sequence>1</sequence>
<entityName>US Energy COBRA</entityName>
<nameType>PRIM</nameType>
</personName>
<identifiers>
<idType>EIN</idType>
<idValue>98-7654321</idValue>
<isPrimary>Y</isPrimary>
</identifiers>
<division>HC</division>
<birthDate>1976-01-12</birthDate>
<sinceDate>2019-01-01</sinceDate>
<address>
<addressEffDate>2019-01-01</addressEffDate>
<addressType>MAIN</addressType>
<mailingName>US Energy COBRA</mailingName>
<address1>Venus Park</address1>
<address2>Venus Street</address2>
<address3>Lake Side</address3>
<address4></address4>
<city>Los Angeles</city>
<state>CA</state>
<zip>90020</zip>
<country>USA</country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
</address>
<email>usencpco@example.com</email>
<overrideMailingName1></overrideMailingName1>
<overrideMailingName2></overrideMailingName2>
<overrideMailingName3></overrideMailingName3>
<phones>
<phoneType>BUSN</phoneType>
<phoneValue>213-555-0175</phoneValue>
</phones>
<relatedPersons>
<idType>EIN</idType>
<idValue>98-7654329</idValue>
<personRelationshipType></personRelationshipType>
<startDate>2019-01-01</startDate>
<endDate>2019-12-31</endDate>
<financialRelationshipSw>
false
</financialRelationshipSw>
<parentOrChild>P</parentOrChild>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</relatedPersons>
<characteristics>
<characteristicsList>
<characteristicType>PER_CAT</characteristicType>
<characteristicValue>OTHER</characteristicValue>
<effectiveDate>2019-01-01</effectiveDate>
</characteristicsList>
</characteristics>
<billLevelParameters>
<sequence>15</sequence>
<sourceSystem>SMALLPRIME</sourceSystem>
<billLevelInfo1>COBRA</billLevelInfo1>
<billLevelInfo2>DALLAS</billLevelInfo2>
<effectiveDate>2019-01-01</effectiveDate>
</billLevelParameters>
<billLevelParameters>
<sequence>16</sequence>
<sourceSystem>SMALLPRIME</sourceSystem>
<billLevelInfo1>COBRA</billLevelInfo1>
<billLevelInfo2>SAN JOSE</billLevelInfo2>
<effectiveDate>2019-01-01</effectiveDate>
</billLevelParameters>
<memberData>
<sequence>20</sequence>
<startDate></startDate>
<endDate></endDate>
<repriceAfterDate></repriceAfterDate>
<paidThroughDate></paidThroughDate>
<memberId></memberId>
<memberRelationship></memberRelationship>
<membershipPersonStatus></membershipPersonStatus>
<membershipPersonstatusReason>
</membershipPersonstatusReason>
<autoRenew></autoRenew>
<associatedMemberIdentifierType>
</associatedMemberIdentifierType>
<associatedMemberIdentifier>
</associatedMemberIdentifier>
<exchangeFlag></exchangeFlag>
<exchangeId></exchangeId>
<binderLiabilityAmount></binderLiabilityAmount>
<binderPayApplicability></binderPayApplicability>
<binderPayGraceDays></binderPayGraceDays>
<binderPayThreshold></binderPayThreshold>
<holdBilling></holdBilling>
<membershipRenewalDate></membershipRenewalDate>
<contractPeriod></contractPeriod>
<membershipIdentifier>
<membershipIdentifierType>
</membershipIdentifierType>
<membershipIdentifierValue>
</membershipIdentifierValue>
</membershipIdentifier>
<isMemberSw></isMemberSw>
<isFinanciallyResponsibleSw>
</isFinanciallyResponsibleSw>
<membershipType></membershipType>
<externalMedicareBeneficiaryId>
</externalMedicareBeneficiaryId>
<mainSubscriber>
<idType></idType>
<idValue></idValue>
<membershipType></membershipType>
</mainSubscriber>
<policyNumber></policyNumber>
<sourceSystem></sourceSystem>
<planNumber></planNumber>
<healthPlanCode></healthPlanCode>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
<membershipRateGuarantee>
<membershipRateGuaranteeList>
<rateGuaranteeStartDate></rateGuaranteeStartDate>
<rateGuaranteeEndDate></rateGuaranteeEndDate>
<rateGuaranteeStatus></rateGuaranteeStatus>
</membershipRateGuaranteeList>
</membershipRateGuarantee>
<membershipPersonCharacteristic>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</membershipPersonCharacteristic>
<benefitData>
<benefitDataList>
<sequence></sequence>
<startDate></startDate>
<endDate></endDate>
<benefitStatus></benefitStatus>
<benefitSourceFlag></benefitSourceFlag>
<benefitTypeFlag></benefitTypeFlag>
<benefitSubTypeFlag></benefitSubTypeFlag>
<planBenefitPackageId></planBenefitPackageId>
<benefitAmount></benefitAmount>
<characteristics>
<characteristicsList>
<characteristicType>
</characteristicType>
<characteristicValue>
</characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</benefitDataList>
</benefitData>
<billableChargeData>
<sequence></sequence>
<accountIdType></accountIdType>
<accountIdValue></accountIdValue>
<chargeType></chargeType>
<startDate></startDate>
<endDate></endDate>
<priceItemCode></priceItemCode>
<description></description>
<recurringMethod></recurringMethod>
<billPeriod></billPeriod>
<frequency></frequency>
<billAfterDt></billAfterDt>
<billableChargeLines>
<descriptionOnBill></descriptionOnBill>
<currencyCode></currencyCode>
<chargeAmount></chargeAmount>
<showOnBillSw></showOnBillSw>
<appearInSummarySw></appearInSummarySw>
<distributionCode></distributionCode>
</billableChargeLines>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</billableChargeData>
</memberData>
<accountData>
<accountType>Standard</accountType>
<customerClass>HC</customerClass>
<billCycle>BK01</billCycle>
<billLeadDays>10</billLeadDays>
<division>HC</division>
<currency>USD</currency>
<setUpDate>2019-01-01</setUpDate>
<acctUsageFlg>USAG</acctUsageFlg>
<comments></comments>
<deferAutoPayDt></deferAutoPayDt>
<collectionClass></collectionClass>
<billRouteType>POSTAL</billRouteType>
<billAddressSource>PER</billAddressSource>
<accessGroup></accessGroup>
<skipAutoMaintenanceSw></skipAutoMaintenanceSw>
<identifiers>
<idType>ACCT_NM</idType>
<idValue>Standard Account</idValue>
<isPrimary>true</isPrimary>
</identifiers>
<address>
<addressEffDate>2019-01-01</addressEffDate>
<addressType></addressType>
<address1><</address1>
<address2></address2>
<address3></address3>
<address4></address4>
<city></city>
<state></state>
<zip></zip>
<country></country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
</address>
<autoPayDetails>
<priority></priority>
<startDate></startDate>
<endDate></endDate>
<percentage></percentage>
<autoPayMethod></autoPayMethod>
<autoPayRouteType></autoPayRouteType>
<autoPaySourceCode></autoPaySourceCode>
<accountNumber></accountNumber>
<expiryMonth></expiryMonth>
<expiryYear></expiryYear>
<name></name>
<maxWithdrawalAmount></maxWithdrawalAmount>
<comments></comments>
</autoPayDetails>
<accountPerson>
<idType></idType>
<idValue></idValue>
<accountRelationshipType>
</accountRelationshipType>
<isFinanciallyResponsible>
</isFinanciallyResponsible>
<personAddressOverride>
<address1></address1>
<address2></address2>
<address3></address3>
<address4></address4>
<city></city>
<postal></postal>
<state></state>
<country></country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
</personAddressOverride>
<accountPersonRouting>
<billRouteType></billRouteType>
<shouldReceiveCopyOfBill>
</shouldReceiveCopyOfBill>
<billFormat></billFormat>
<numberOfBillCopies></numberOfBillCopies>
<receivesNotification></receivesNotification>
<billAddressSource></billAddressSource>
</accountPersonRouting>
</accountPerson>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</accountData>
<accountData>
<accountType>Retention</accountType>
<customerClass>HC</customerClass>
<billCycle>BK02</billCycle>
<billLeadDays>10</billLeadDays>
<division>HC</division>
<currency>USD</currency>
<setUpDate>2019-01-01</setUpDate>
<acctUsageFlg>USAG</acctUsageFlg>
<comments></comments>
<deferAutoPayDt></deferAutoPayDt>
<collectionClass></collectionClass>
<billRouteType>POSTAL</billRouteType>
<billAddressSource>ACOV</billAddressSource>
<identifiers>
<idType>ACCT_NM</idType>
<idValue>Retention Account</idValue>
<isPrimary>true</isPrimary>
</identifiers>
<address>
<addressEffDate>2019-01-01</addressEffDate>
<addressType>OVRD</addressType>
<address1>Venus Park</address1>
<address2>Venus Street</address2>
<address3>Lake Side</address3>
<address4></address4>
<city>Los Angeles</city>
<state>CA</state>
<zip>90020</zip>
<country>USA</country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
</address>
<autoPayDetails>
<priority></priority>
<startDate></startDate>
<endDate></endDate>
<percentage></percentage>
<autoPayMethod></autoPayMethod>
<autoPayRouteType></autoPayRouteType>
<autoPaySourceCode></autoPaySourceCode>
<accountNumber></accountNumber>
<expiryMonth></expiryMonth>
<expiryYear></expiryYear>
<name></name>
<maxWithdrawalAmount></maxWithdrawalAmount>
<comments></comments>
</autoPayDetails>
<accountPerson>
<idType></idType>
<idValue></idValue>
<accountRelationshipType>
</accountRelationshipType>
<isFinanciallyResponsible>
</isFinanciallyResponsible>
<personAddressOverride>
<address1></address1>
<address2></address2>
<address3></address3>
<address4></address4>
<city></city>
<postal></postal>
<state></state>
<country></country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
</personAddressOverride>
<accountPersonRouting>
<billRouteType></billRouteType>
<shouldReceiveCopyOfBill>
</shouldReceiveCopyOfBill>
<billFormat></billFormat>
<numberOfBillCopies></numberOfBillCopies>
<receivesNotification></receivesNotification>
<billAddressSource></billAddressSource>
</accountPersonRouting>
</accountPerson>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</accountData>
<policyData>
<policyType>SELF-FUNDED</policyType>
<sourceSystem>SMALLPRIME</sourceSystem>
<policyNumber>AP234902</policyNumber>
<description>
Active COBRA Employee Health Insurance Policy
</description>
<advancedLevelFundingEligibility>
</advancedLevelFundingEligibility>
<startDate>2019-01-01</startDate>
<endDate>2019-12-31</endDate>
<runOutEndDate>2020-03-31</runOutEndDate>
<runOutAdminOption>NROA</runOutAdminOption>
<renewalDate></renewalDate>
<advanceDepositApplSW></advanceDepositApplSW>
<advanceDepositAmount></advanceDepositAmount>
<advanceDepositGraceDays></advanceDepositGraceDays>
<advanceDepositAccountIdentifierType>
</advanceDepositAccountIdentifierType>
<advanceDepositAccountIdentifierValue>
</advanceDepositAccountIdentifierValue>
<policyPersons>
<idType></idType>
<idValue></idValue>
<policyPerRole></policyPerRole>
<startDate></startDate>
<endDate></endDate>
</policyPersons>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</policyData>
<policyData>
<policyType>SELF-FUNDED</policyType>
<sourceSystem>SMALLPRIME</sourceSystem>
<policyNumber>AP234903</policyNumber>
<description>
Retiree COBRA Employee Health Insurance Policy
</description>
<startDate>2019-01-01</startDate>
<endDate>2019-12-31</endDate>
<runOutEndDate>2020-03-31</runOutEndDate>
<runOutAdminOption>PERC</runOutAdminOption>
<renewalDate></renewalDate>
<advanceDepositApplSW></advanceDepositApplSW>
<advanceDepositAmount></advanceDepositAmount>
<advanceDepositGraceDays></advanceDepositGraceDays>
<advanceDepositAccountIdentifierType>
</advanceDepositAccountIdentifierType>
<advanceDepositAccountIdentifierValue>
</advanceDepositAccountIdentifierValue>
<policyPersons>
<idType></idType>
<idValue></idValue>
<policyPerRole></policyPerRole>
<startDate></startDate>
<endDate></endDate>
</policyPersons>
<terminationInformation>
<terminateDate></terminateDate>
<terminationReason></terminationReason>
</terminationInformation>
<reinstateInformation>
<reinstatementDate></reinstatementDate>
<reinstateReason></reinstateReason>
</reinstateInformation>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
<planData>
<planNumber></planNumber>
<priceItemCode></priceItemCode>
<planName></planName>
<priceItemCode></priceItemCode>
<planName></planName>
<pricingRuleTypeList>
<pricingRuleType></pricingRuleType>
</pricingRuleTypeList>
<startDate></startDate>
<endDate></endDate>
<primaryPlanSw></primaryPlanSw>
<benefitTypeFlag></benefitTypeFlag>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
<policyPlanProrationRuleList>
<effectiveDate></effectiveDate>
<prorationEventType></prorationEventType>
<prorationType></prorationType>
<numberOfDays></numberOfDays>
<membershipType></membershipType>
</policyPlanProrationRuleList>
</planData>
</policyData>
</personData>
<personData>
<sequence>4</sequence>
<personType>BG</personType>
<personName>
<sequence>1</sequence>
<entityName>US Energy RETIREE</entityName>
<nameType>PRIM</nameType>
</personName>
<identifiers>
<idType>EIN</idType>
<idValue>98-7654322</idValue>
<isPrimary>Y</isPrimary>
</identifiers>
<division>HC</division>
<birthDate>1985-01-01</birthDate>
<sinceDate>2019-01-01</sinceDate>
<accessGroup></accessGroup>
<collectionClass></collectionClass>
<postponeCreditReviewUntil></postponeCreditReviewUntil>
<lastCreditReviewDate></lastCreditReviewDate>
<dragDays></dragDays>
<advanceDepositAmount></advanceDepositAmount>
<advanceDepositGraceDays></advanceDepositGraceDays>
<advanceDepositLevel></advanceDepositLevel>
<address>
<addressEffDate>2019-01-01</addressEffDate>
<addressType>MAIN</addressType>
<mailingName>US Energy RETIREE</mailingName>
<address1>Neptune Park</address1>
<address2>Neptune Street</address2>
<address3>River Side</address3>
<address4></address4>
<city>San Jose</city>
<state>CA</state>
<zip>94088</zip>
<country>USA</country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
<addressStatus></addressStatus>
</address>
<email>usencpre@example.com</email>
<overrideMailingName1></overrideMailingName1>
<overrideMailingName2></overrideMailingName2>
<overrideMailingName3></overrideMailingName3>
<phones>
<phoneType>BUSN</phoneType>
<phoneValue>408-555-0165</phoneValue>
</phones>
<relatedPersons>
<idType>EIN</idType>
<idValue>98-7654329</idValue>
<personRelationshipType></personRelationshipType>
<startDate>2019-01-01</startDate>
<endDate>2019-12-31</endDate>
<financialRelationshipSw>
false
</financialRelationshipSw>
<parentOrChild>P</parentOrChild>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</relatedPersons>
<characteristics>
<characteristicsList>
<characteristicType>PER_CAT</characteristicType>
<characteristicValue>OTHER</characteristicValue>
<effectiveDate>2019-01-01</effectiveDate>
</characteristicsList>
</characteristics>
<billLevelParameters>
<sequence>30</sequence>
<sourceSystem>SMALLPRIME</sourceSystem>
<billLevelInfo1>RETIRED</billLevelInfo1>
<billLevelInfo2>CHARLOTTE</billLevelInfo2>
<effectiveDate>2019-01-01</effectiveDate>
</billLevelParameters>
<billLevelParameters>
<sequence>31</sequence>
<sourceSystem>SMALLPRIME</sourceSystem>
<billLevelInfo1>RETIRED</billLevelInfo1>
<billLevelInfo2>DETROIT</billLevelInfo2>
<effectiveDate>2019-01-01</effectiveDate>
</billLevelParameters>
<memberData>
<sequence>30</sequence>
<startDate></startDate>
<endDate></endDate>
<skipAutoMaintenanceSw></skipAutoMaintenanceSw>
<paidThroughDate></paidThroughDate>
<memberId></memberId>
<memberRelationship></memberRelationship>
<membershipPersonStatus></membershipPersonStatus>
<membershipPersonstatusReason>
</membershipPersonstatusReason>
<autoRenew></autoRenew>
<associatedMemberIdentifierType>
</associatedMemberIdentifierType>
<associatedMemberIdentifier>
</associatedMemberIdentifier>
<exchangeFlag></exchangeFlag>
<exchangeId></exchangeId>
<binderLiabilityAmount></binderLiabilityAmount>
<binderPayApplicability></binderPayApplicability>
<binderPayGraceDays></binderPayGraceDays>
<binderPayThreshold></binderPayThreshold>
<holdBilling></holdBilling>
<membershipRenewalDate></membershipRenewalDate>
<contractPeriod></contractPeriod>
<membershipIdentifier>
<membershipIdentifierType>
</membershipIdentifierType>
<membershipIdentifierValue>
</membershipIdentifierValue>
</membershipIdentifier>
<isMemberSw></isMemberSw>
<isFinanciallyResponsibleSw>
</isFinanciallyResponsibleSw>
<membershipType></membershipType>
<externalMedicareBeneficiaryId>
</externalMedicareBeneficiaryId>
<mainSubscriber>
<idType></idType>
<idValue></idValue>
<membershipType></membershipType>
</mainSubscriber>
<policyNumber></policyNumber>
<sourceSystem></sourceSystem>
<planNumber></planNumber>
<healthPlanCode></healthPlanCode>
<characteristics>
<characteristicsList>
<characteristicType>
</characteristicType>
<characteristicValue>
</characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
<membershipRateGuarantee>
<membershipRateGuaranteeList>
<rateGuaranteeStartDate></rateGuaranteeStartDate>
<rateGuaranteeEndDate></rateGuaranteeEndDate>
<rateGuaranteeStatus></rateGuaranteeStatus>
</membershipRateGuaranteeList>
</membershipRateGuarantee>
<membershipPersonCharacteristic>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</membershipPersonCharacteristic>
<benefitData>
<benefitDataList>
<sequence></sequence>
<startDate></startDate>
<endDate></endDate>
<benefitStatus></benefitStatus>
<benefitSourceFlag></benefitSourceFlag>
<benefitTypeFlag></benefitTypeFlag>
<benefitSubTypeFlag></benefitSubTypeFlag>
<planBenefitPackageId></planBenefitPackageId>
<benefitAmount></benefitAmount>
<characteristics>
<characteristicsList>
<characteristicType>
</characteristicType>
<characteristicValue>
</characteristicValue>
<effectiveDate>
</effectiveDate>
</characteristicsList>
</characteristics>
</benefitDataList>
</benefitData>
<billableChargeData>
<sequence></sequence>
<accountIdType></accountIdType>
<accountIdValue></accountIdValue>
<chargeType></chargeType>
<startDate></startDate>
<endDate></endDate>
<priceItemCode></priceItemCode>
<description></description>
<recurringMethod></recurringMethod>
<billPeriod></billPeriod>
<frequency></frequency>
<billAfterDt></billAfterDt>
<billableChargeLines>
<descriptionOnBill></descriptionOnBill>
<currencyCode></currencyCode>
<chargeAmount></chargeAmount>
<showOnBillSw></showOnBillSw>
<appearInSummarySw></appearInSummarySw>
<distributionCode></distributionCode>
</billableChargeLines>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</billableChargeData>
</memberData>
<accountData>
<accountType>Standard</accountType>
<customerClass>HC</customerClass>
<billCycle>BK01</billCycle>
<billLeadDays>10</billLeadDays>
<division>HC</division>
<dragDays></dragDays>
<currency>USD</currency>
<setUpDate>2019-01-01</setUpDate>
<acctUsageFlg>USAG</acctUsageFlg>
<comments></comments>
<deferAutoPayDt></deferAutoPayDt>
<collectionClass></collectionClass>
<billRouteType>POSTAL</billRouteType>
<billAddressSource>PER</billAddressSource>
<accessGroup></accessGroup>
<skipAutoMaintenanceSw></skipAutoMaintenanceSw>
<identifiers>
<idType>ACCT_NM</idType>
<idValue>Standard Account</idValue>
<isPrimary>true</isPrimary>
</identifiers>
<address>
<addressEffDate>2019-01-01</addressEffDate>
<addressType></addressType>
<address1></address1>
<address2></address2>
<address3></address3>
<address4></address4>
<city></city>
<state></state>
<zip></zip>
<country></country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
<addressStatus></addressStatus>
</address>
<autoPayDetails>
<priority></priority>
<startDate></startDate>
<endDate></endDate>
<percentage></percentage>
<autoPayMethod></autoPayMethod>
<autoPayRouteType></autoPayRouteType>
<autoPaySourceCode></autoPaySourceCode>
<accountNumber></accountNumber>
<expiryMonth></expiryMonth>
<expiryYear></expiryYear>
<name></name>
<maxWithdrawalAmount></maxWithdrawalAmount>
<comments></comments>
</autoPayDetails>
<accountPerson>
<idType></idType>
<idValue></idValue>
<accountRelationshipType>
</accountRelationshipType>
<isFinanciallyResponsible>
</isFinanciallyResponsible>
<personAddressOverride>
<address1></address1>
<address2></address2>
<address3></address3>
<address4></address4>
<city></city>
<zip></zip>
<state></state>
<country></country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
<zip></zip>
<addressStatus></addressStatus>
</personAddressOverride>
<accountPersonRouting>
<billRouteType></billRouteType>
<shouldReceiveCopyOfBill>
</shouldReceiveCopyOfBill>
<billFormat></billFormat>
<numberOfBillCopies></numberOfBillCopies>
<receivesNotification></receivesNotification>
<billAddressSource></billAddressSource>
</accountPersonRouting>
</accountPerson>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</accountData>
<accountData>
<accountType>Retention</accountType>
<customerClass>HC</customerClass>
<billCycle>BK02</billCycle>
<billLeadDays>10</billLeadDays>
<division>HC</division>
<dragDays></dragDays>
<currency>USD</currency>
<setUpDate>2019-01-01</setUpDate>
<acctUsageFlg>USAG</acctUsageFlg>
<comments></comments>
<deferAutoPayDt></deferAutoPayDt>
<collectionClass></collectionClass>
<billRouteType>POSTAL</billRouteType>
<billAddressSource>ACOV</billAddressSource>
<accessGroup></accessGroup>
<skipAutoMaintenanceSw></skipAutoMaintenanceSw>
<identifiers>
<idType>ACCT_NM</idType>
<idValue>Retention Account</idValue>
<isPrimary>true</isPrimary>
</identifiers>
<address>
<addressEffDate>2019-01-01</addressEffDate>
<addressType>OVRD</addressType>
<address1>Saturn Park</address1>
<address2>Saturn Street</address2>
<address3>River Side</address3>
<address4></address4>
<city>San Franciso</city>
<state>CA</state>
<zip>94122</zip>
<country>USA</country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
<addressStatus></addressStatus>
</address>
<autoPayDetails>
<priority></priority>
<startDate></startDate>
<endDate></endDate>
<percentage></percentage>
<autoPayMethod></autoPayMethod>
<autoPayRouteType></autoPayRouteType>
<autoPaySourceCode></autoPaySourceCode>
<accountNumber></accountNumber>
<expiryMonth></expiryMonth>
<expiryYear></expiryYear>
<name></name>
<maxWithdrawalAmount></maxWithdrawalAmount>
<comments></comments>
</autoPayDetails>
<accountPerson>
<idType></idType>
<idValue></idValue>
<accountRelationshipType>
</accountRelationshipType>
<isFinanciallyResponsible>
</isFinanciallyResponsible>
<personAddressOverride>
<address1></address1>
<address2></address2>
<address3></address3>
<address4></address4>
<city></city>
<zip></zip>
<state></state>
<country></country>
<houseType></houseType>
<streetNumber1></streetNumber1>
<streetNumber2></streetNumber2>
<inCityLimit></inCityLimit>
<taxVendorGeographicalCode>
</taxVendorGeographicalCode>
<county></county>
<addressStatus></addressStatus>
</personAddressOverride>
<accountPersonRouting>
<billRouteType></billRouteType>
<shouldReceiveCopyOfBill>
</shouldReceiveCopyOfBill>
<billFormat></billFormat>
<numberOfBillCopies></numberOfBillCopies>
<receivesNotification></receivesNotification>
<billAddressSource></billAddressSource>
</accountPersonRouting>
</accountPerson>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</accountData>
<policyData>
<policyType>SELF-FUNDED</policyType>
<sourceSystem>SMALLPRIME</sourceSystem>
<policyNumber>AP234905</policyNumber>
<description>
Retiree Employee Health Insurance Policy
</description>
<startDate>2019-01-01</startDate>
<endDate>2019-12-31</endDate>
<runOutEndDate>2020-03-31</runOutEndDate>
<runOutAdminOption>PERC</runOutAdminOption>
<renewalDate></renewalDate>
<advanceDepositApplSW></advanceDepositApplSW>
<advanceDepositAmount></advanceDepositAmount>
<advanceDepositGraceDays></advanceDepositGraceDays>
<advanceDepositAccountIdentifierType>
</advanceDepositAccountIdentifierType>
<advanceDepositAccountIdentifierValue>
</advanceDepositAccountIdentifierValue>
<policyPersons>
<idType></idType>
<idValue></idValue>
<policyPerRole></policyPerRole>
<startDate></startDate>
<endDate></endDate>
</policyPersons>
<terminationInformation>
<terminateDate></terminateDate>
<terminationReason></terminationReason>
</terminationInformation>
<reinstateInformation>
<reinstatementDate></reinstatementDate>
<reinstateReason></reinstateReason>
</reinstateInformation>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
<planData>
<planNumber></planNumber>
<priceItemCode></priceItemCode>
<planName></planName>
<priceItemCode></priceItemCode>
<planName></planName>
<pricingRuleTypeList>
<pricingRuleType></pricingRuleType>
</pricingRuleTypeList>
<startDate></startDate>
<endDate></endDate>
<primaryPlanSw></primaryPlanSw>
<benefitTypeFlag></benefitTypeFlag>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
<policyPlanProrationRuleList>
<effectiveDate></effectiveDate>
<prorationEventType></prorationEventType>
<prorationType></prorationType>
<numberOfDays></numberOfDays>
<membershipType></membershipType>
</policyPlanProrationRuleList>
</planData>
</policyData>
</personData>
<pricingRuleData>
<sequence></sequence>
<entityIdentifiers>
<entityIdentifiersList>
<entityIdentifierType></entityIdentifierType>
<entityIdentifierValue></entityIdentifierValue>
<entityIdentifiersList>
</entityIdentifiers>
<status></status>
<startDate></startDate>
<endDate></endDate>
<pricingRuleType></pricingRuleType>
<rateOption></rateOption>
<pricingType></pricingType>
<modifierApplicability></modifierApplicability>
<modifierMethod></modifierMethod>
<baseRate>
<sequence></sequence>
<baseFee></baseFee>
<lowerAgeLimit></lowerAgeLimit>
<upperAgeLimit></upperAgeLimit>
<pricingParameter>
<sequence></sequence>
<parameterCode></parameterCode>
<parameterValue></parameterValue>
</pricingParameter>
<modifierInformation>
<sequence></sequence>
<parameterCode></parameterCode>
<parameterValue></parameterValue>
<rate></rate>
</modifierInformation>
</baseRate>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</pricingRuleData>
<statementConstructsData>
<personStatementConstructs>
<personIdentifier></personIdentifier>
<personIdentifierType></personIdentifierType>
<statementConstructIdentifier>
</statementConstructIdentifier>
<statementAddressSource></statementAddressSource>
<statementCycle></statementCycle>
<statementRouteType></statementRouteType>
<effectiveStatus></effectiveStatus>
<addressId></addressId>
<numberOfCopies></numberOfCopies>
<statementFormat></statementFormat>
<description></description>
<statementConstructDetails>
<serviceAgreement></serviceAgreement>
<accountNumber></accountNumber>
<accountNumberTypeCd></accountNumberTypeCd>
<division></division>
<statementPrintDescription>
</statementPrintDescription>
<printOrder></printOrder>
<startDate></startDate>
<endDate></endDate>
</statementConstructDetails>
</personStatementConstructs>
</statementConstructsData>
<characteristics>
<characteristicsList>
<characteristicType></characteristicType>
<characteristicValue></characteristicValue>
<effectiveDate></effectiveDate>
</characteristicsList>
</characteristics>
</customerStructureData>
</customerStructureMessage>
</schema>Note: We have given the above sample to illustrate how the tags should
be nested while sending an inbound message 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.