Premera BlueCross

API: Snapshot COBRA: Supported Geographies: All Group Size: Confirm with carrier Lines: dental, medical, vision Name: Premera Network: Send New Group Connection Time: 6-8 weeks Noyo ID: c09b0a82-309d-44bf-9430-856c3c6027cd

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Group connections

Create a group connection request to manage groups through Noyo. In the group_data object for the create endpoint, use the Premera group ID (also called the master agreement number) for the carrier_group_id.

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Sandbox testing

Use the following special Premera carrier_group_ids to simulate different group connection statuses. Test group connections with these IDs will asynchronously update with the corresponding status within 10 seconds of submission.

Only the first three characters are evaluated to figure out the target status (e.g. 989 means noyo_review). Since group connections should be unique by a carrier ID and carrier group ID combination, you may use the final characters to iterate and test this interaction further.

989*****: noyo_review

767*****: waiting_on_carrier

545*****: action_required

323*****: unable_to_connect

212*****: move_to_carrier_authorization

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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.

Premera groups will be configured with a master_agreement_number string, which is the primary group identifier, along with a list of one or more groups (8-digit numeric code) to categorize employees enrolling in coverage.

{
    "group_id": "da8d32cc-ce9d-4cf3-9360-733ee0023f1f",
    "carrier_id": "6ecb26f1-da0f-40b3-9e9a-3272aa17d70e",
    "configuration": {
        "master_agreement_number": "123456789",
        "subgroups": [
            {
                "subgroup_identifier": "0001",
                "subgroup_name": "AcmeCo subgroup 1"
            }
        ],
        "benefit_classes": [
            {
                "benefit_class_identifier": "A001",
                "benefit_class_name": "AcmeCo class 1"
            }
        ]
    }
}

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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. Importantly, each plan configuration has details about which populations are connected to an individual plan. Groups with multiple populations may link a plan with one or more of them.

Some Premera plans are only available for employees in certain groups. Premera plans will include a plan_configuration ****block with subgroup_identifiers and benefit_class_identifiers fields containing lists of string identifiers. The identifiers will match the subgroups and benefit classes in the carrier configuration respectively, and describe which subgroups and benefit classes are eligible to enroll in the plan.

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Member snapshot carrier configuration

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.

Snapshots with Premera coverage may include an optional subgroup_identifier and benefit_class_identifier that matches the corresponding values in the group carrier configuration.

For Premera, there may often be only one of each respective identifier allowed for a plan. If the caller omits any values, Noyo will attempt to resolve the correct identifier in cases where only one option is available for the member’s enrollment.

{
    "subgroup_identifier": "0001",
    "benefit_class_identifier": "A001"
}

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Carrier-specific requirements

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Validations

Noyo will validate the following based on the member carrier configuration:

• The subgroup and benefit class specified is valid for the group
• The provided subgroup and benefit class identifiers are valid for the plans specified in the relevant coverages
• Requests to add or modify coverage contain plans that are available to the subgroup and benefit class fields specified