Coverage Periods

Create a Coverage Period for a Group

Now that you have loaded in a Group, the next step is to create a Coverage Period. A full coverage period mapping guide is provided here.

A Coverage Period is a term for a carrier - time period combination, it indicates for which period of time an employer had coverage with a carrier.

The relationship between Groups and Coverage Periods is one-to-many.

For a given employer, one group would be created, but a separate coverage period would be created for each carrier per coverage year.

In order to create a Coverage Period:

1. Formulate the Request

2. Send Request / Receive Response

Formulate the Request

A Group can have coverage with multiple carriers in a plan year, and could have multiple Coverage Periods as a result.

Coverage Periods create a separate record for plans and coverage information across a coverage renewal period. When an open enrollment period starts with an employer, we work with the carrier to appropriately stop sending coverage information for one coverage period and start sending it for the updated year. See Coverage Period Field Mapping for more details.

If coverages are "evergreen" and do not renew, our system can receive a coverage period with no end-date, or simply a new set of those coverages per year.

Our operational processes ensure that data is not overridden in the carrier system and that retroactive changes can still be made for the past plan year. Retroactive change processes vary per carrier.

Coverage Period Request Body:

POST /groups/:id/coverage_periods

{
  "coverage_period": {
    "external_identifier": "ABC-132A54",
    "coverage_start_date": "2020-05-13",
    "carrier_name": "kasier",
    "carrier_group_number": "123456"
  }
}

Coverage Periods allow us to handle a clean separation between plans and coverage information for Renewal periods.

Send Request / Receive Response

The request is sent to Ideon using a POST /groups/:id/coverage_periods endpoint.

Ideon will provide one of two responses to the requestor.

• The first option is that the request was received successfully and the coverage period was created on our system: 201 - Resource Created Successfully.

• The second option is that syntax and semantic errors exist: i.e. 422 - Unprocessable Entity. This includes the violation of carrier specific business rules.

Success

If the request passes validation, the requestor will be informed of the successful receipt and provided a copy of the coverage period. In the response body the requestor will find UUIDs associated with resources that are used to manage plans and subscriber plan elections: coverage_period.id.

Coverage Period Response Body:

{
  "coverage_period": {
    "id": "a37ecd06-5d97-46e4-9b4e-dcde6a03246f",
    "coverage_start_date": "2020-05-13",
    "open_enrollment_end_date": "2020-05-13",
    "open_enrollment_start_date": "2020-05-13"
  }
}