Member Change

Change the coverage of a subscriber

In order to change the coverage for an existing subscriber:

1. Create the Qualifying Life Event

2. Check the Status

Create the Qualifying Life Event

To change the plan elections made by a subscriber, you will then create a Qualifying Life Event. Examples of Qualifying Life Event types that could meet this criteria are: birth, marriage, divorce. For all allowable types, refer to the schema for a Qualifying Life Event.

POST /subscribers/:id/qualifying_life_events

{
    "qualifying_life_event": {
        "type": "marriage",
        "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": "SPOUSE_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_life_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_life_events": [
        {
            "id": "a37ecd06-5d97-46e4-9b4e-dcde6a03246f",
            ...
        }]
}