Regular State Employees and Retirees, 1 plus local authorities Elderly Governmental Retirees (EGR) 2 and Retired Municipal Teachers (RMTs) Report the number of individuals covered under the policy/contract Family Size (ME009) of the subscriber. This is ME 72 Family Size 11/8/12 Integer Counter varchar[2] All 100% A2 Contracted required for Risk Assessment and Division of Insurance reporting. No alpha or special characters Fully Lookup Report the value that defines the Insured ME 73 Insured 11/8/12 Table - int[1] element. EXAMPLE: 1 = Yes, Member All 100% A0 identifier member Integer is fully insured. Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable Lookup Indicator - Report the value that defines the ME 74 Interpreter 11/8/12 Table - int[1] Interpreter element. EXAMPLE: 1 = Yes, Member All 100% A2 Integer Need requires an interpreter. Value Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable Report the unique ID that NewMMIS Required NewMMIS ID uses to identify a member. This ID must ME 75 6/24/10 Text char[12] when = 98% B ID MassHealth be on all lines of eligibility for Member ID 4 MassHealth and Medicaid MCOs Carrier Carrier Member Member Required Defined Table Rating Report the rating category of the ME 76 rating 6/24/10 char[5] when ME134 90% B - MCO Rating Category member here. category Table - = 4 Category Code Text
1 Regular State Employees and Retirees, plus local authorities 2 Elderly Governmental Retirees (EGR) and Retired Municipal Teachers (RMTs) ME 72 Family Size 11/8/12 Integer Counter varchar[2] Family Size Contracted Report the number of individuals covered under the policy/contract (ME009) of the subscriber. This is required for Risk Assessment and Division of Insurance reporting. No alpha or special characters All 100% A2 ME 73 Fully Insured member 11/8/12 Lookup Table - Integer int[1] Insured identifier Report the value that defines the element. EXAMPLE: 1 = Yes, Member is fully insured. All 100% A0 Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable ME 74 Interpreter 11/8/12 Lookup Table - Integer int[1] Indicator - Interpreter Need Report the value that defines the element. EXAMPLE: 1 = Yes, Member requires an interpreter. All 100% A2 Value Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable ME 75 NewMMIS ID 6/24/10 Text ID MassHealth char[12] Member ID Report the unique ID that NewMMIS uses to identify a member. This ID must be on all lines of eligibility for MassHealth and Medicaid MCOs Required when = 4 98% B ME 76 Member rating category 6/24/10 Carrier Table - Text Carrier Defined Table - MCO Rating Category char[5] Member Rating Category Code Report the rating category of the member here. Required when ME134 = 4 90% B
v6-apcd-member-eligibility-file-submission-guide-Redline-.docx