The APCD reserves All Z 0 this field for future PV066 Filler Char 0 Filler use. Do not populate with any data. The APCD reserves All Z 0 this field for future PV067 Filler Char 0 Filler use. Do not populate with any data. The APCD reserves All Z 0 this field for future PV068 Filler Char 0 Filler use. Do not populate with any data. The APCD reserves All Z 0 this field for future PV069 Filler Char 0 Filler use. Do not populate with any data. The APCD reserves All Z 0 this field for future PV070 Filler Char 0 Filler use. Do not populate with any data. Member Eligibility File Report the value that All B 100 defines the element. Example: 1 = Yes, Purchased policy for this through Indicator MA Exchange – ME045 Int 1 eligibility was Massachusetts Purchase purchased through Exchange Flag MA Health Exchange. Required for Risk Assessment. The APCD reserves All Z 0 this field for future ME119 Filler Char 0 Filler use. Do not populate with any data. Report the Actuarial Required B 100 Value of this member when for the time period Submitter is Calculated Score for Risk indicated by identified as ME120 Actuarial Value 6 Adjustment Enrollment Start and a Risk End dates in 0.0000 Holder Format. Required for Submitter Risk Assessment. Required B 100 Report the Metal when Level benefits that the Submitter is Standardized plan level in member is associated ME121 Metal Level Int 1 identified as metal reference to in this line of a Risk eligibility. Required Holder for Risk Assessment. Submitter
PV066 Filler Char 0 Filler The APCD reserves this field for future use. Do not populate with any data. All Z 0 PV067 Filler Char 0 Filler The APCD reserves this field for future use. Do not populate with any data. All Z 0 PV068 Filler Char 0 Filler The APCD reserves this field for future use. Do not populate with any data. All Z 0 PV069 Filler Char 0 Filler The APCD reserves this field for future use. Do not populate with any data. All Z 0 PV070 Filler Char 0 Filler The APCD reserves this field for future use. Do not populate with any data. All Z 0 Member Eligibility File ME045 Purchased through Massachusetts Exchange Flag Int 1 Indicator – MA Exchange Purchase Report the value that defines the element. Example: 1 = Yes, policy for this eligibility was purchased through MA Health Exchange. Required for Risk Assessment. All B 100 ME119 Filler Char 0 Filler The APCD reserves this field for future use. Do not populate with any data. All Z 0 ME120 Actuarial Value 6 Calculated Score for Risk Adjustment Report the Actuarial Value of this member for the time period indicated by Enrollment Start and End dates in 0.0000 Format. Required for Risk Assessment. Required when Submitter is identified as a Risk Holder Submitter B 100 ME121 Metal Level Int 1 Standardized plan level in metal reference Report the Metal Level benefits that the member is associated to in this line of eligibility. Required for Risk Assessment. Required when Submitter is identified as a Risk Holder Submitter B 100
ab-13-02-payers-claims-data-submissions-114-5-cmr-21-00.docx