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When a member snapshot omits an existing active coverage but includes a different active coverage for the same line, Noyo can automatically detect that a plan switch occurred. This is called inferred plan switching. Instead of rejecting the snapshot, Noyo handles the old coverage automatically.

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When does inferred plan switching apply?

Inferred plan switching applies when all of the following are true:
  1. An active coverage exists in Noyo for a member
  2. That coverage is not included in the incoming snapshot
  3. The snapshot does include a different active coverage for the same line of coverage and member

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How Noyo matches coverages

For Noyo to infer a plan switch, the new coverage in the snapshot must match the existing coverage on:
  • Individual: Same member (employee or specific dependent)
  • Line of coverage: Same line (e.g., both medical, both dental)
  • Overlapping effective dates: The coverage periods must share at least one day in common. Since active coverages typically use 9999-12-31 as the effective_end_date, this condition is met in most plan switch scenarios. However, if there is a gap between the old coverage’s end date and the new coverage’s start date (e.g., old ends 2024-06-30 and new starts 2025-01-01), Noyo will not treat it as a plan switch.
The new and old coverages do not need to be from the same carrier.

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Plan type matching

For medical, dental, and vision, any plan type can switch to any other (e.g., HMO to PPO). For all other lines of coverage — life, add, std, ltd, accident, critical_illness, cancer, health_fund, hospital_indemnity, pharmacy, wellness — plan types must match. For example, basic life cannot switch to voluntary life.
If multiple possible matches are found for a single omitted coverage, Noyo will not infer a plan switch and the coverage will be treated as missing. Ensure that only one active coverage per line of coverage per member is included in the snapshot.

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How the old coverage is handled

The action Noyo takes on the old coverage depends on the timing of the new coverage relative to the old.

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Terminated when the new coverage starts later

If the new coverage starts after the old coverage’s start date, the old coverage is terminated with an effective_end_date set to one day before the new coverage’s effective_start_date. Example: An employee is switching dental plans during open enrollment.
  • Old dental plan: effective_start_date of 2024-01-01
  • New dental plan: effective_start_date of 2025-01-01
  • Result: Old dental plan is terminated with an effective_end_date of 2024-12-31

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Waived/canceled when the new coverage starts at the same time or earlier

If the new coverage starts on or before the old coverage’s start date, the old coverage is waived/canceled as if it never took effect. Example: A member’s upcoming dental coverage is being replaced before it starts.
  • Old dental plan: effective_start_date of 2025-01-01
  • New dental plan: effective_start_date of 2025-01-01
  • Result: Old dental plan is waived/canceled

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Snapshot warnings

When Noyo infers a plan switch, the snapshot response will include an InferredPlanSwitchWarning indicating which coverage was terminated or waived/canceled and the resulting end date. You can use these warnings to confirm that the inferred behavior matches your expectations.

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Open enrollment example

An employee is currently enrolled in Dental Plan A (started 2024-01-01) and you want to switch them to Dental Plan B for the new plan year. With inferred plan switching, you only need to send the new plan: 
{
    "snapshot_mode": "current_open",
    "employee": {},
    "dependents": [],
    "coverages": [
        {
            "carrier_id": "2d370e0e-fd73-45e0-8828-796d2cacaeef",
            "line_of_coverage": "dental",
            "plan_id": "40fdcb25-0fb3-43db-8dda-28180692854d",
            "enrolled_members": [
                {
                    "individual_id": "52b8ff36-388a-4faf-bc42-df446f13b89a",
                    "individual_type": "employee",
                    "effective_start_date": "2025-01-01",
                    "effective_end_date": "9999-12-31",
                    "event_id": "2001",
                    "latest_change_effective_date": "2024-11-15"
                }
            ]
        }
    ],
    "events": [
        {
            "id": "2001",
            "date": "2025-01-01",
            "type": "coverage",
            "reason": "open_enrollment"
        }
    ]
}
Noyo will automatically terminate the member’s enrollment in Dental Plan A with an effective_end_date of 2024-12-31 and process the new enrollment in Dental Plan B.

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Inferred vs. explicit plan switching

You can always explicitly switch plans by including both the old coverage (with a termination end date) and the new coverage in the same snapshot. Inferred plan switching provides an alternative when your system does not track or send the old coverage.
AspectExplicit plan switchInferred plan switch
Old coverage in snapshot?Yes, with an effective_end_dateNo
New coverage in snapshot?YesYes
Control over termination date?Full controlAutomatically set to one day before new start date
If you include the old coverage with an explicit termination date, Noyo will use your specified date and inferred plan switching will not apply.

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Relationship to omitted coverage handling

Inferred plan switching and omitted coverage handling both address active coverages missing from a snapshot, but they serve different purposes:
  • Inferred plan switching handles cases where a replacement coverage is present
  • Omitted coverage handling handles cases where no replacement is present
Inferred plan switching is always evaluated first. If a match is found, the coverage is handled as a plan switch. Any remaining missing coverages are then subject to your omitted_coverage_handling policy (reject, continue, or terminate).

Switch plans (explicit)

Code example

Omitted coverage handling

Read more

Effective end dates

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Waiving/canceling coverage

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