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Group connections

Create a group connection to manage groups through Noyo.

In the group_data object for the create endpoint, use the Anthem group number as the carrier_group_id. The expected format is a 6-character string, e.g. “A12345”.

Group connection requests must contain either a TIN in the broker_tin field or an FEIN in the broker_federal_ein field (one of these identifiers must be present for the request to be successful). Anthem will validate the submitted identifier against their records; failed validations result in an error requesting an EIN or TIN.

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Sandbox testing

Use the following values as the carrier_group_id in order to simulate different group connection statuses.

Test group connections with these IDs will asynchronously update with the corresponding status within 10 seconds of submission.

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Carrier configurations

Group, plan, and member configurations are where Noyo shares and receives details that are unique to a carrier. Every other part of Noyo’s payloads are standardized, but the configurations hold the unique fields and classifications that change from connection to connection. As part of preparing to connect to a new carrier, you need to understand the contents of each configuration and be sure your system is able to send the required data for each member.

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Get the group configuration from Noyo

The group carrier configuration endpoint returns information about how the group is labeled and categorized within the carrier’s system. You can also see this data in the Command Center on a group’s detail page by clicking one of their carrier connections.

Some Anthem groups feature suffix IDs, which combine with plan IDs to uniquely identify a coverage option for Anthem. Suffix IDs are only present for groups which are maintained in a specific Anthem backend system; other groups will not have them at all. There is no set rule for which groups will use suffix IDs, although they are generally limited to larger groups.

When present for a group, suffix IDs appear in the group config section shown below. They are also present in account structure documents shared by Anthem to brokers and group administrators. The group configuration response shows the set of suffix IDs for a group, nested beneath the relevant Anthem group_number:

{
    "group_id": "de7e3009-836e-4a05-b91b-6efd21b21570",
    "carrier_id": "ff0b7d90-bc05-4ac6-bafc-edb512df67b7",
    "carrier_group_id": "T11410",
    "configuration": {
        "suffix_ids": {
            "T11410": ["T11411", "T11412", "T11413"]
        }
    }
}

Noyo requires that suffix IDs are included in all relevant requests, except when there’s only a single suffix ID available for the referenced plan and the COBRA plan - in those situations, Noyo is able to infer the right suffix ID.

Any other requests with invalid or missing suffix IDs will be rejected.

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Get the plan configuration from Noyo

The details in the plan configuration should be used to map each Noyo plan to the corresponding plan in your own system.

Individual plan configurations contain the suffix IDs that are compatible with each plan. Most plans have simple configurations and will be associated with only two suffix IDs, one for active coverage and one for COBRA coverage. Larger and more complex groups may have more suffix ID options per plan.

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Send the member configuration to Noyo

Each member snapshot sent to Noyo can contain a configuration section. Depending on each carrier’s requirements, you may need to use this section to include carrier-specific identifiers like classes, subdivisions, or bill groups. These go in the coverage block’s carrier_config section and ensure that members are enrolled in the correct coverages. Member snapshots missing a carrier_config section or with incorrect config data will result in a 422 error.

To send suffix IDs, include them in the carrier configuration of each request as shown:

{
    "suffix_id": "T11413"
}

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Validations

None

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Carrier-specific behaviors

• Anthem does not expose any data for members terminated before the current calendar year, so Noyo cannot confirm an exact termination date in these cases but can confirm that the termination happened successfully. We will apply the termination date submitted. For members terminated in the current calendar year, Noyo is able to confirm both the termination and its effective date.
• Following ACA guidelines, Anthem automatically terminates coverage for child dependents who are age 26 and not disabled. As Noyo identifies missing members during our regular syncs, any missing over-26 dependents will be highlighted as likely being terminated because of their age.
• Anthem is only able to accept U, M, or F through the API at this time. Noyo will send U for any nonbinary gender.
• Noyo is able to receive and store both a home and mailing address for employees, but Anthem will only receive and store a home address.
• Anthem requires members to change their email addresses directly in the member portal. This means that Noyo will accept API calls that change an email address but will not send that change to Anthem for processing.

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Coverage start and end dates

You must provide explicit coverage start dates for any requests that add or modify coverage, and explicit coverage end dates for any coverage termination requests.

The coverage_end_date is set at the individual employee level; for more details, please see the “Explicit Effective Dates” document attached here.

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Connection Basics

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Getting groups connected

For each group connecting to Noyo, the Broker of Record (BOR) will need to authorize Noyo as a vendor in the Producer Toolbox. This can happen as soon as the group is installed in Anthem’s system. Check out section 9 of this virtual training for a walkthrough of how to use the authorization tool; the process only takes a few minutes.

After authorization is complete, you can send a group connection request to Noyo containing Anthem’s carrier ID, the group’s name, and the Anthem group number as detailed in the Technical Spec.

Group connection requests must contain either a TIN in the broker_tin field or an FEIN in the broker_federal_ein field (one of these identifiers must be present for the request to be successful). Anthem will validate the submitted identifier against their records; failed validations result in an error requesting an EIN or TIN.

If at any point we encounter an issue connecting the group, Noyo will work with Anthem to resolve the issue. We may contact you if your input is needed.

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Groups are considered fully connected when:

• Noyo returns the connection status as “completed.”
• You’ve linked Noyo’s IDs for account structure information, plans, members, and coverages to your own, and established an account structure mapping process.
• You’ve deactivated previous forms of data exchange and are ready to send all enrollment changes through Noyo.

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Processing member changes

Each member request is broken into individual “transactions” by Noyo’s system. Our integrations with API-enabled Sync carriers generally result in 90% of member transactions arriving at the carrier within 10 minutes of being sent to Noyo, and 95% of transactions being confirmed by Noyo within 4 business days of original receipt.

We expect similar results for Anthem, but it’s important to note this is a new connection for Noyo as an early partner with Anthem. We will be monitoring closely and working with the Anthem team to ensure a high level of performance.

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Round-trip confirmation

As with all Sync carriers, Noyo is able to read data directly from Anthem’s system. Noyo monitors each member change with our round-trip confirmation feature, which triggers a check in Anthem’s system immediately after the change is sent to verify acceptance, and again on the change’s effective date to ensure that enrollments go through as expected.

Use the Tracking API to see the results of round-trip confirmation and get a granular view of how each change is being processed.

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Managed changes

In most cases, member changes will be confirmed within 4 business days. However, some transactions cannot be confirmed automatically after being submitted through our API; we call these “managed” transactions and they may have longer confirmation timelines.

Types of managed changes:

• SSN changes Changes to a member’s SSN are manually reviewed by the Anthem team.
• Current year changes after auto-renewal Current year coverage changes sent after a group’s auto-renewal are not accepted over API by Anthem (this cutoff typically occurs 45-60 days prior to the renewal date). Noyo automatically detects these changes and sends them on a daily file. Anthem’s team processes the changes and Noyo confirms them.

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Retroactive changes

Anthem does not accept retroactive changes for more than 60 days in the past. If a change is submitted for 60+ days in the past, Anthem will assign an effective date of 60 days before the date the change was submitted.

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Open enrollment

You can submit renewal decisions to Noyo after the group has selected plans for the new year. Noyo will check Anthem’s system daily until the new plans are available to ensure that they are installed correctly.

When the plans in Anthem’s system match the expectations you submitted, the renewal decision status will move to “ready” and you will be able to send elections for the new plan year. There are no blackout periods with Noyo, so you can send current year changes at any point during open enrollment.

Get group connection to view connection status.

Create a renewal decision to manage renewals through Noyo.

Get renewal decisions to view renewal status.