Lookup Required Employee Employee Report the code that defines the ME 64 11/8/12 Table - char[1] when ME063 100% C Type Type Code subscribers employment. Text = A Code Description H Hourly Q Seasonal S Salaried T Temporary U Unknown Full Century Year Member's Required Date of Report the date of the subscriber's ME 65 11/8/12 Date - Month Day - int[8] date of when ME060 98% B Retirement retirement in CCYYMMDD Format. Integer CCYYMMDD Retirement = R Lookup COBRA Report the that defines the element. COBRA ME 66 11/8/12 Table - int[1] usage EXAMPLE: 1 = Yes, Member is covered All 98% A2 Status Integer indicator using COBRA benefit. Code Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable Carrier Carrier Report the code that defines the plan Required Spouse Defined Table Spouse Plan type of the spouse of the employee when ME062 ME 67 11/8/12 char[2] 1% C Plan Type - GIC Plan Type Code when Medicare coverage is selected = M and Table - Type and separate from GIC. ME134 = 3 Text Carrier Report the code that defines the plan Required Carrier Spouse Plan Spouse type of the spouse of the employee when ME062 ME 68 11/8/12 Defined Table char[2] Medicare 1% C Plan when Medicare coverage is selected = M and Table - - GIC Plan Code and separate from GIC. ME134 = 3 Text Carrier Spouse Report the code that defines the Required Spouse Carrier Medical medical coverage of the spouse of the when ME062 ME 69 Medical 11/8/12 Defined Table char[2] Medicare 1% C employee when Medicare coverage is = M and Coverage Table - - GIC Medical Coverage selected and separate from GIC. ME134 = 3 Text Code
ME 64 Employee Type 11/8/12 Lookup Table - Text char[1] Employee Type Code Report the code that defines the subscribers employment. Required when ME063 = A 100% C Code Description H Hourly Q Seasonal S Salaried T Temporary U Unknown ME 65 Date of Retirement 11/8/12 Full Date - Integer Century Year Month Day - CCYYMMDD int[8] Member's date of Retirement Report the date of the subscriber's retirement in CCYYMMDD Format. Required when ME060 = R 98% B ME 66 COBRA Status 11/8/12 Lookup Table - Integer int[1] COBRA usage indicator Report the that defines the element. EXAMPLE: 1 = Yes, Member is covered using COBRA benefit. All 98% A2 Code Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable ME 67 Spouse Plan Type 11/8/12 Carrier Table - Text Carrier Defined Table - GIC Plan Type char[2] Spouse Plan Type Code Report the code that defines the plan type of the spouse of the employee when Medicare coverage is selected and separate from GIC. Required when ME062 = M and ME134 = 3 1% C ME 68 Spouse Plan 11/8/12 Carrier Table - Text Carrier Defined Table - GIC Plan char[2] Spouse Plan Medicare Code Report the code that defines the plan type of the spouse of the employee when Medicare coverage is selected and separate from GIC. Required when ME062 = M and ME134 = 3 1% C ME 69 Spouse Medical Coverage 11/8/12 Carrier Table - Text Carrier Defined Table - GIC Medical char[2] Spouse Medical Medicare Coverage Code Report the code that defines the medical coverage of the spouse of the employee when Medicare coverage is selected and separate from GIC. Required when ME062 = M and ME134 = 3 1% C
v6-apcd-member-eligibility-file-submission-guide-FINAL.docx