Using temporal data in member snapshots
In member snapshots, you can set aneffective_start_date
and effective_end_date
for certain fields in the coverages
block, which updates an individual enrollment record:
enrolled_members
carrier_config
cobra_details
volume
Important concepts
effective_start_date
- The original date that a member started coverage on a plan. When members are terminated and rehired, they get new effective start dates. This can differ from some other industry definitions, which define a new start any time benefits change.effective_end_date
- The end date of coverage on a plan. Unless the coverage itself is ending, this should be set to datemax (9999-12-31
). Read more here.effective_date
- A query parameter for some endpoints that allow the user to specify the relative date for which to see the state of a record.latest_change_effective_date
- The effective date of the temporal data contained within the coverage block. See below for example usage.
Example scenarios
Mid-year benefit class change
If an employee has a QLE on June 1st that changes their benefit class from A to B for a coverage that’s active from January 1st, there are two ways to represent this in the member snapshot payload. Preferred method: one coverage block with alatest_change_effective_date
Add a latest_change_effective_date
to the enrolled member, and pass the new benefit class value in the carrier_config
section.
Example Request
effective_dates
Edit the effective dates for each enrolled member in the original coverage block to January 1st through June 1st and leave the original carrier_config
in place.
Then add a second coverage block with an effective date of June 2nd, with the new benefit class defined in the associated carrier_config
section.
This method is not recommended because specifying the previous state (benefit class A) can cause Noyo to attempt to fulfill that previous state at the carrier and thus run afoul of the carrier’s retro rules. For this example scenario, the user likely just wants to change the benefit class to B starting 6/1 and is not concerned with the earlier state.
Example Request
Open enrollment election
During open enrollment, employees may enroll in new coverages with future effective dates while still being enrolled in current-year coverage. To express this in a member snapshot, you should ensure that any coverages that are discontinuing have aneffective_end_date
set. Then add a new coverage block for each new enrollment and set the effective_start_date
to the day after the current coverage ends.
Note that this specific scenario is often considered a “plan switch.”
Request