Member Addition

Add a new subscriber to an existing group

In order to add a new subscriber to an existing group:

1. Create the Subscriber

2. Create the Qualifying Life Event

3. Check the Status

Create the Subscriber

The request details to add a new hire to the group starts with providing the demographic and employment information.

Adding a new hire with coverage elections can be done in two steps: (1) Create the Subscriber, (2) Add plan elections using a Qualifying Life Event

POST /subscribers

{
    "subscriber":
    {
        "external_identifier": "ABC-132A54",
        "location_id": "UUID",
        "first_name": "John",
        "last_name": "Smith",
        "social_security_number": "222222222",
        "gender": "male",
        "marital_status": "married",
        "birth_date": "1991-01-01",
        "class": {
            "employment_classification_id": "EMPLOYMENT_CLASSIFICATION_UUID",
            "effective_date": "2020-01-01"
        },
        "employment_details":
        {
            "start_date": "2020-01-01",
            "status": "full_time"
        },
        "residential_address": {...},
        ,
        "dependents": [
            {
                "external_identifier": "Dependent1",
                "first_name": "Joanna",
                "last_name": "Smith",
                "social_security_number": "333333333",
                "gender": "female",
                "subscriber_relationship": "spouse",
                "birth_date": "1992-02-03"
            }
        ]
    }
}

Create the Qualifying Life Event

Now that you've added the Subscriber to the Group, the next step is to include the plan elections. To add the plan elections made by the new hire, you will then create a Qualifying Life Event of type new_hire.

POST /subscribers/:id/qualifying_life_events

{
    "qualifying_life_event": {
        "type": "new_hire",
        "date": "2020-01-01",
        "eligibility_start_date": "2020-01-01",
        "coverage_period_id": "COVERAGE_PERIOD_UUID",
        "plan_elections": {
            "medical": {
                "plan_id": "PLAN_UUID",
                "type": "election",
                "coverages": [
                    {
                        "member_id": "SUBSCRIBER_UUID",
                        "status": "employer_sponsored",
                        "start_date": "2020-01-01"
                    },
                    {
                        "member_id": "DEPENDENT_UUID",
                        "status": "employer_sponsored",
                        "start_date": "2020-01-01"
                    }
                ]
            }
        }
    }
}

Check the Status

A request can be made via a GET /subscribers/:id to retrieve the status of the subscriber. Ideon will transmit the new subscriber to the carrier in the carriers proprietary format. The status of the subscriber will be pending until transmitted to the carrier. After transmission to the carrier, the subscriber's status will be submitted. After submission a subscriber can move to one of three states: pending, synced, or errors.

Synced

The status will be marked as synced when a carrier accepts the enrollment without errors or requests for additional documentation. A copy of the subscriber record that was sent to the carrier that received the synced status will be included in the response body.

GET /subscribers/:id

{
    "status": "synced",
    "status_datetime": "2019-01-25T23:20:50Z",
    "subscriber":
    {
        "external_identifier": "ABC-132A54",
        "id": "a37ecd06-5d97-46e4-9b4e-dcde6a03246f",
        ...
        "dependents": [
        {
            "external_identifier": "Dependent1",
            "id": "a37ecd06-5d97-46e4-9b4e-dcde6a03246f",
            "coverages": [
            {
                "external_identifier": "ABC-132A54",
                "id": "a37ecd06-5d97-46e4-9b4e-dcde6a03246f",
                ...
            }]
            ...
        }]
        "current_qualifying_events": [
        {
            "id": "a37ecd06-5d97-46e4-9b4e-dcde6a03246f",
            ...
        }]
    }
}

Errors

The status of the subscriber will be marked errors when a carrier provides errors to Ideon based on the processing of the subscriber's enrollment. Any errors that are present will be represented in an array and displayed alongside the pending subscriber record. Errors indicate action needs to be taken by the platform to update the subscriber record in order to enroll in coverage. Only a pending record exists for this subscriber because the individual has not yet been synced with the carrier.

GET /subscribers/:id

{
    "status": "errors",
    "status_datetime": "2019-01-25T23:20:50Z",
    "errors": [
    {
        "error_type": "invalid_request.parameter_required",
        "message": "The parameter is missing and is required",
        "parameter": "first_name"
    }],
    "subscriber":
    {
        "external_identifier": "ABC-132A54",
        "id": "a37ecd06-5d97-46e4-9b4e-dcde6a03246f",
        ...
        "dependents": [
        {
            "external_identifier": "Dependent1",
            "id": "a37ecd06-5d97-46e4-9b4e-dcde6a03246f",
            "coverages": [
            {
                "external_identifier": "ABC-132A54",
                "id": "a37ecd06-5d97-46e4-9b4e-dcde6a03246f",
                ...
            }]
            ...
        }]
        "current_qualifying_events": [
        {
            "id": "a37ecd06-5d97-46e4-9b4e-dcde6a03246f",
            ...
        }]
}