Address_Line1 of this person record, if it doesn’t 15 170 229 Mailing Address1 60 A/N Y exist then use the Member Address_Line1. Address Type = ‘R’ Address_Line2 of this person record, if it doesn’t 16 230 259 Mailing Address2 30 A/N Y exist then use the Member Address_Line2. Address Type = ‘R’ City of this person record, if it doesn’t exist then use 17 260 309 Mailing City 50 A/N Y the Member City Address Type = ‘R’ State of this person record, if it doesn’t exist then use 18 310 311 Mailing State 2 A/N Y the Member State Address Type = ‘R’ Zip of this person record, if it doesn’t exist then use the Member Zip A/N Address Type = ‘R’ 19 312 321 Mailing Zip 10 Y *See *Zip code will be right Description justified and padded with leading spaces. (Home) of this person record, if it doesn’t exist then use the Member 20 322 331 Phone 10 A/N N phone Address Type = ‘R’ If not supplied: Null or ‘0000000000’ 21 332 332 Alt Ins Indicator 1 A/N N Not Used 22 333 342 Alt Ins Code 10 A/N N Not Used 23 343 360 Alt Ins ID 18 A/N N Not Used 24 361 371 Filler 11 For Future Additions Member or dependents status code. For example, 25 372 381 Status 10 A/N N Active, Medicare, Cobra etc. Selected benefit level, elected by the member. Examples Healthchoice Hi 26 382 391 Plan 10 A/N N option, Healthchoice Low option etc. Enrollment_type_id 27 392 399 Plan Eff Date 8 N N Not used
15 170 229 Mailing Address1 60 A/N Y Address_Line1 of this person record, if it doesn’t exist then use the Member Address_Line1. Address Type = ‘R’ 16 230 259 Mailing Address2 30 A/N Y Address_Line2 of this person record, if it doesn’t exist then use the Member Address_Line2. Address Type = ‘R’ 17 260 309 Mailing City 50 A/N Y City of this person record, if it doesn’t exist then use the Member City Address Type = ‘R’ 18 310 311 Mailing State 2 A/N Y State of this person record, if it doesn’t exist then use the Member State Address Type = ‘R’ 19 312 321 Mailing Zip 10 A/N *See Description Y Zip of this person record, if it doesn’t exist then use the Member Zip Address Type = ‘R’ *Zip code will be right justified and padded with leading spaces. 20 322 331 Phone 10 A/N N (Home) of this person record, if it doesn’t exist then use the Member phone Address Type = ‘R’ If not supplied: Null or ‘0000000000’ 21 332 332 Alt Ins Indicator 1 A/N N Not Used 22 333 342 Alt Ins Code 10 A/N N Not Used 23 343 360 Alt Ins ID 18 A/N N Not Used 24 361 371 Filler 11 For Future Additions 25 372 381 Status 10 A/N N Member or dependents status code. For example, Active, Medicare, Cobra etc. 26 382 391 Plan 10 A/N N Selected benefit level, elected by the member. Examples Healthchoice Hi option, Healthchoice Low option etc. Enrollment_type_id 27 392 399 Plan Eff Date 8 N N Not used
Solicitation0900000303Attachment4.docx