Add a Census

Associate a census of employees and their dependents with a group

ICHRA Group Quoting is under development. Endpoint schemas and other components stated in this section are subject to change.

Members and their dependents can be added to a group through the "Create Members" endpoint (API docs). All members in a group will be quoted when an ICHRA Group Quote is created.

The maximum number of members allowed in a single PUT or POST request to the "Create Members" endpoint is being reviewed during development to optimize performance. When complete, this will be documented in this section as well as the technical API docs. If the number of members in a group is below this maximum batch size, a PUT or POST can be used. If the number of members exceeds it, then batched POST requests must be made to associate all members to the group for quoting. The working maximum batch size is 5,000 members.

Configuring Requests

When quoting a group for ICHRA, each member in the group's census will be quoted individually. The required fields for each member differ based on the optional calculations requested as part of the ICHRA quote. Notes on these requirements are broken out by section below.

Required and Used for Basic ICHRA Quotes

• Member Location zip_code and fips_code - the home location of the member, used to assess the available plans and premiums for the associated member and their dependents. This is also used for the optional ICHRA affordability calculation, if the rating_area_location is set to home.

• Date of Birth date_of_birth and dependents[].date_of_birth - premiums are evaluated using the age of the member and their dependents at the effective date of coverage.

• Last Used Tobacco last_used_tobacco and dependents[].last_used_tobacco - tobacco status is dependent on state and carrier, both in terms of the cutoff date to consider an individual a user as well as the potential impact on premiums. If an individual has never used tobacco, or the last use date is unknown, null can be passed. Smoker status is evaluated based on the ACA's 6-month lookback, using the effective date of coverage and the last_used_tobacco date.

• Dependent Relationship dependents[].relationship - valid dependent relationships are enumerated in the API docs. For ICHRA quotes, the dependent will be quoted as a child if the relationship is child, adopted_child, disabled_child, foster_child, or step_child. Otherwise, the dependent will be quoted as an adult.

Required for Optional Calculations on ICHRA Quotes

• Household Income household_income - the total household income for the member, similar to what they'd include on their tax return. Required for PTC subsidy, CSR eligibility, and ICHRA affordability calculations.

• Household Size household_size - the number of applicant(s) applying for coverage in the member's household; the member and their dependent(s). Required for PTC subsidy, CSR eligibility, and ICHRA affordability calculations.

• Safe Harbor Income safe_harbor_income - the annual income for the member utilizing ICHRA's safe harbor provisions. This value is required for the ICHRA affordability calculation and used specifically for the minimum employer contribution.

• Location ID location_id - the internal identifier for the location the member works at, as returned in the "Create a Group" endpoint. This value is used for ICHRA affordability calculations if the rating_area_location is set to work.

Required, but Unused for ICHRA Quotes

The following fields are unused for ICHRA Quotes and optional calculations. Assuming the group is not being used to quote other products or markets, hardcoded values can be safely passed.

• Cobra and Retiree cobra and retiree

• Gender gender and dependents[].gender

• Same Household dependents[].same_household

An example request with all required fields for an ICHRA group quote with optional calculations included, for reference:

PUT /groups/<group.id>/members

{
    "members": [
        {
            "zip_code": "10010",
            "fips_code": "36061",
            "date_of_birth": "1970-01-01",
            "gender": "F",
            "cobra": false,
            "last_used_tobacco": null,
            "retiree": false,
            "external_id": "003",
            "location_id": "<locations[].id>",
            "household_income": 100000,
            "household_size": 2,
            "safe_harbor_income": 50000,
            "dependents": [
                {
                    "date_of_birth": "1970-01-01",
                    "gender": "M",
                    "last_used_tobacco": null,
                    "relationship": "spouse",
                    "same_household": true
                }
            ]
        }
    ]
}