reported as 15000; 150.70 is reported as 15070 Report the identifier the carrier / Carrier ID Link to submitter uses internally to uniquely Specific MC141, Subscriber's identify the subscriber. Used to create ME Unique 11/8/12 Text varchar[50] All 100% A0 117 PC108, Unique ID Unique Member ID and link across Subscriber DC057 carrier's / submitter's files for reporting ID and aggregation Lookup Report the value that defines the Vision Indicator - ME 11/8/12 Table - int[1] element. EXAMPLE: 1 = Yes, Vision is All 100% A0 Benefit Vision Option Integer a covered benefit. Value Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable The APCD reserves this field for future ME Filler 4/5/13 Filler Filler char[0] Filler All 0% Z use. Do not populate with any data. Calculate the Federal AV Calculator The actuarial for the risk adjustment covered plan the value of the member is enrolled in. Report the risk Required Actuarial - Percent as Actuarial Value of this member as of the ME varchar[6] adjustment when ME126 100% A0 Value 0.0000 15th of the month. Format to be used is covered plan = 1 or 3 0.0000. For example, an AV of the member 88.27689% should be reported as is enrolled in 0.8828. Report the Level benefits that the Standardized Lookup member is associated to in this line of Required plan in ME Level Table - int[1] eligibility. Required for Risk when ME126 100% A0 metal Integer Assessment. = 1 or 3 reference 1 = Bronze Level EXAMPLE: Value Description
reported as 15000; 150.70 is reported as 15070 ME Carrier Specific Unique Subscriber ID 11/8/12 Text ID Link to MC141, PC108, DC057 varchar[50] Subscriber's Unique ID Report the identifier the carrier / submitter uses internally to uniquely identify the subscriber. Used to create Unique Member ID and link across carrier's / submitter's files for reporting and aggregation All 100% A0 ME Vision Benefit 11/8/12 Lookup Table - Integer int[1] Indicator - Vision Option Report the value that defines the element. EXAMPLE: 1 = Yes, Vision is a covered benefit. All 100% A0 Value Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable ME Filler 4/5/13 Filler Filler char[0] Filler The APCD reserves this field for future use. Do not populate with any data. All 0% Z ME Actuarial Value - Percent as 0.0000 varchar[6] The actuarial value of the risk adjustment covered plan the member is enrolled in Calculate the Federal AV Calculator for the risk adjustment covered plan the member is enrolled in. Report the Actuarial Value of this member as of the 15th of the month. Format to be used is 0.0000. For example, an AV of 88.27689% should be reported as 0.8828. Required when ME126 = 1 or 3 100% A0 ME Level Lookup Table - Integer int[1] Standardized plan in metal reference Report the Level benefits that the member is associated to in this line of eligibility. Required for Risk Assessment. EXAMPLE: 1 = Bronze Level Required when ME126 = 1 or 3 100% A0 Value Description 117
v6-apcd-member-eligibility-file-submission-guide-Redline-.docx