Date Report the month for which eligibility is Period Reporting reported in this submission in MM ME 5 Month 6/24/10 - Month - MM char[2] Month of Format. Leading zero is required for All 100% A0 Eligibility reporting January through September files. Insured Report the number that defines the or / Policy insured or policy. Do not report the ME 6 6/24/10 Text ID Group varchar[30] All 99% A2 Policy Number number that uniquely identifies the Number subscriber or member Lookup Benefit Coverage Report the code that defines the ME 7 11/8/12 - char[3] Coverage All 99% A1 Level Code dependent coverage Text Level Code Code Description CHD Children Only DEP Dependents Only ECH Employee and Children ELF Employee and Life Partner EMP Employee Only ESP Employee and Spouse FAM Family IND Individual SPC Spouse and Children SPO Spouse Only UNK Unknown Report the Subscriber's SSN here; used Subscriber's to create Unique Member ID; will not be Subscriber Social ME 8 ID Tax char[9] passed into analytic file. Do not use All 85% A0 SSN Security hyphen. If not available do not report Number any value here Report the Plan assigned contract number. Do not include values in this Plan element that will distinguish one Specific Contract ME 9 Text ID Contract varchar[30] member of the family from another. All 9% A2 Contract Number This should be the contract or certificate Number number for the subscriber and all of the dependents. Member Member's Report the unique number / identifier of ME 10 6/24/10 Text ID Sequence varchar[20] All 99% Suffix or Contract the member within the contract
ME 5 Month 6/24/10 Date Period - Month - MM char[2] Reporting Month of Eligibility Report the month for which eligibility is reported in this submission in MM Format. Leading zero is required for reporting January through September files. All 100% A0 ME 6 Insured or Policy Number 6/24/10 Text ID Group varchar[30] / Policy Number Report the number that defines the insured or policy. Do not report the number that uniquely identifies the subscriber or member All 99% A2 ME 7 Coverage Level Code 11/8/12 Lookup - Text char[3] Benefit Coverage Level Code Report the code that defines the dependent coverage All 99% A1 Code Description CHD Children Only DEP Dependents Only ECH Employee and Children ELF Employee and Life Partner EMP Employee Only ESP Employee and Spouse FAM Family IND Individual SPC Spouse and Children SPO Spouse Only UNK Unknown ME 8 Subscriber SSN ID Tax char[9] Subscriber's Social Security Number Report the Subscriber's SSN here; used to create Unique Member ID; will not be passed into analytic file. Do not use hyphen. If not available do not report any value here All 85% A0 ME 9 Plan Specific Contract Number Text ID Contract varchar[30] Contract Number Report the Plan assigned contract number. Do not include values in this element that will distinguish one member of the family from another. This should be the contract or certificate number for the subscriber and all of the dependents. All 9% A2 ME 10 Member Suffix or 6/24/10 Text ID Sequence varchar[20] Member's Contract Report the unique number / identifier of the member within the contract All 99%
v6-apcd-member-eligibility-file-submission-guide-Redline-.docx