PlanSource API

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Coverage Fields

Coverage

Listed below are the data fields that can be accessed for Coverage data using PlanSource's API. Each field is described as being "optional". That is because developers are not required to fill out every data field in order to make the API call. Although that is the case, PlanSource does require certain data fields to be entered in order to POST/PUT/GET Coverage data. What is required can be changed manually within the PlanSource Benefits Admin site by utilizing the Data Field Security configuration.

NOTE: Some of these fields are list validated fields. To learn what that means, visit the Guide on List Validated Fields.

Coverage Fields
Data Types
Field Descriptions

coverages

array

Coverages

dependents

array

Dependents

valid_count

number

Valid Count

failed_count

number

Failed Count

failed_rows

array

Failed Rows

plan_year

string

Plan Year. Used as a parameter in endpoint URL

recalculate

boolean

Recalculate. Used as a parameter in endpoint URL

validate_volume

boolean

Validate Volume. Used as a parameter in endpoint URL

recalculate_volume

boolean

Recalculate Volume. Used as a parameter in endpoint URL

set_original_effective_date

date

Set Original Effective Date. Used as a parameter in endpoint URL

set_change_effective_date

date

Set Change Effective Date. Used as a parameter in endpoint URL

id

integer

Unique ID assigned to Subscriber

org_benefit_id

integer

Benefit ID

org_benefit_name

string

Benefit Name

benefit_lookup_code

string

Benefit Lookup Code

coverage_level_id

integer

Coverage Level ID

coverage_level_name

string

Coverage Level Name

termination_reason_id

integer

Termination Reason ID

termination_reasons

array

Termination Reasons

plan_year_starts_on

string

Plan Year Start On

plan_year_ends_on

string

Plan Year Ends On

coverage_type_name

string

Coverage Type Name

benefit_class

string

Benefit Class

beneficiary_required

string

Beneficiary Required

beneficiary_optional_admin

boolean

Beneficiary Optional Admin

original_effective_date

string

Original Effective Date

change_effective_date

string

Change Effective Date

payment_change_effective_date

string

Payment Change Effective Date

termination_date

string

Termination Date

organization_id

integer

Organization ID

pcp_code1

string

PCP Code for Dependent

pcpcode1

string

PCP Code 1

pcpcode2

string

PCP Code 2

org_carrier_id

integer

Carrier ID

org_plan_id

integer

Plan ID

org_plan_name

string

Plan Name

subscriber_id

integer

Subscriber ID

first_name

string

First Name

last_name

string

Last Name

subscriber_premium

number

Subscriber Premium

org_premium

number

Org Premium

volume

number

Volume

org_fsa_amount

number

Org FSA Amount

subscriber_fsa_amount

number

Subscriber FSA Amount

increments

number

Increments

billing_premium

number

Billing Premium

billing_fee

number

Billing Fee

billing_fee2

number

Billing Fee 2

pcp_name1

string

PCP Name 1

had_prior_coverage

string

Has prior coverage

pcp_existing_patient1

string

PCP existing patient

imputed_income

number

Imputed Income

req_volume

number

Requested Volume

req_increments

number

Requested Increments

req_subscriber_premium

number

Requested Subscriber Premium

req_org_premium

number

Requested Org Premium

req_billing_premium

number

Requested Billing Premium

req_billing_fee

number

Requested Billing Fee

req_billing_fee2

number

Requested Billing Fee 2

gi_volume

number

GI Volume

gi_increments

number

GI Increments

waiting_for_eoi

string

Waiting for EOI

req_imputed_income

number

Requested Imputed Income

dp_sub_imputed_income

number

DP Subscriber Imputed Income

dp_org_imputed_income

number

DP Org Imputed Income

req_dp_sub_imputed_income

number

Requested DP Subscriber Imputed Income

req_dp_org_imputed_income

number

Requested DP Org Imputed Income

election_effective_date

string

Election Effective Date

udef_1

string

User Defined Field 1

subscriber_election_amount

number

Subscriber Election Amount

subscriber_pretax_premium

number

Subscriber Pretax Premium

subscriber_posttax_premium

number

Subscriber Posttax Premium

carrier_effective_date

string

Carrier Effective Date

demographic_effective_date

string

Demographic Effective Date

signature_date

string

Signature Date

req_org_plan_id

integer

Requested Org Plan ID

req_org_plan_name

string

Requested Org Plan Name

req_coverage_level_id

integer

Requested Coverage Level ID

req_coverage_level_name

string

Requested Coverage Level Name

req_dependent_ids

array

Requested Dependent IDS

req_subscriber_election_amount

number

Requested Subscriber Election Amount

req_subscriber_fsa_amount

number

Requested Subscriber FSA Amount

req_org_fsa_amount

number

Requested Org FSA Amount

gi_org_plan_id

integer

GI Org Plan ID

gi_coverage_level_id

integer

GI Coverage Level ID

gi_dependent_ids

array

GI Dependent IDS

gi_subscriber_election_amount

number

GI Subscriber Election Amount

esigned_at

string

E-signed At

esigned_by

string

E-signed By

waive_plan_policyholder

string

Waive Plan Policyholder

waive_plan_insurer

string

Waive Plan Insurer

waive_plan_insurer_phone

string

Waive Plan Insurer Phone

waive_plan_effective_date

string

Waive Plan Effective Date

waive_plan_termination_date

string

Waive Plan Termination Date

beneficiary_esign_at

string

Beneficiary E-sign At

beneficiary_esign_by

string

Beneficiary E-sign By

subscriber_ytd

number

Subscriber Year to Date

org_ytd

number

Org Year to Date

subscriber_ytd_effective_date

string

Subscriber Year to Date Effective Date

org_ytd_effective_date

string

Org Year to Date Effective Date

deny_pend_permanently_amount

number

Deny Pend Permanently Amount

waiting_for_doc_requests

string

Waiting for Doc Requests

hsa_contribution_end_date

string

HSA Contribution End Date

req_hsa_contribution_end_date

string

Requested HSA Contribution End Date

bookkeeping_values

object

Bookkeeping Values

plan_structure

object

Plan Structure

name

string

Name

lookup_code

string

Lookup Code

coverage_id

integer

Coverage ID

policy

string

Policy

pretax

string

Pretax

coverage_line_id

integer

Coverage Line ID

start_date

string

Start Date. Used as a parameter in endpoint URL

end_date

string

End Date. Used as a parameter in endpoint URL

dependent_coverage_id

integer

Dependent Coverage ID

dependent_id

integer

Unique ID for Dependent

page

string

Page Number. Used as a parameter in endpoint URL

per_page

string

Per Page. Used as a parameter in endpoint URL

Include_test

string

Include Test Employees. Used as a parameter in endpoint URL

Coverage Fields


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