Open Enrollment (OE)

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The Member Request workflow is now deprecated in favor of Member Snapshot

Open Enrollment

The open enrollment member request is used to make changes to existing employees, dependents and coverages during the open enrollment period.
Create Open Enrollment Request

The coverages array contains one entry for each carrier with which you would like to make changes to coverage. The carrier_id along with the schema of the carrier_config object will be provided by the Noyo team. You can reference the group carrier configuration resource to get additional carrier-specific data. The lines_of_coverage object allows the following keys:

KeyDescription
accidentAccident
addAccidental Death & Dismemberment
cancerCancer
critical_illnessCritical Illness
dentalDental
hospital_indemnityHospital Indemnity
lifeLife
ltdLong Term Disability
medicalMedical
stdShort Term Disability
visionVision

Signature Date

Within each entry in the coverages array you can optionally specify a signature_date. The signature_date is the date when the employee or employer signed for the change to be made. If a signature_date is not provided we will communicate the date the member request was received by the Noyo system as the signature_date to the carrier.

signature_datestringISO-8601 date string for signature date

Coverage Actions

Within each object inside of lines_of_coverage you may provide three different actions: adding_coverage, removing_coverage, and modifying_coverage. More information about each of these is below.

Adding Coverage

The adding_coverage action is used to add new coverage for a member with a carrier. You must provide an adding_coverage entry for each employee or dependent that is enrolling in coverage with the carrier along with the plan_id. The plan_id can be retrieved by selecting a valid plan from the group plans list.

Adding medical, dental, vision, accident, cancer or hospital_indemnity coverage

Medical, dental, vision, accident, cancer and hospital indemnity coverage do not require any information beyond the member information and the selected plan.

id*uuidUnique identifier of the employee or dependent in Noyo
member_type*stringType of member adding coverage. One of: dependent, employee
plan_iduuidUnique identifier of the group plan in Noyo

Adding life, add, std, ltd and critical_illness coverage

Life, AD&D, STD, LTD and critical illness coverage also optionally accept volume parameter in dollars (e.g. $50,000 should be sent as 50000).

id*uuidUnique identifier of the employee or dependent in Noyo
member_type*stringType of member adding coverage. One of: dependent, employee
plan_iduuidUnique identifier of the group plan in Noyo
volumeˢintegerElected volume for the type of coverage being selected
prior_coverageobject
  • carrier_name*: Name of insurance carrier providing prior coverage
  • last_coverage_date*: ISO-8601 date string of the last day of coverage with the prior insurance carrier

Removing Coverage

The removing_coverage action is used to remove coverage from a member with a carrier. The structure of the removing_coverage action is below:

id*uuidUnique identifier of the employee or dependent in Noyo
member_type*stringType of member removing coverage. One of: dependent, employee
plan_iduuidUnique identifier of the group plan in Noyo
reason*stringReason the member is removing or canceling coverage. One of: medi-cal, medicaid, no-coverage, other-cobra, other-employee-group, other-ind-off-exchange, other-ind-on-exchange, other-medicare, other-parent-group, other-spouse-group, retiree-coverage, tricare-coverage, va-coverage, voluntary-withdrawal

Modifying Coverage

The modifying_coverage action is used to make changes to an existing coverage for a member / plan combination, given that the member already has coverage on that plan with the carrier. For example, you can use the modifying_coverage action to change the volume of coverage for a member's existing life or disability plan, or provide a new carrier_config to remain on the same plan but move the member into a new subgroup or benefit class.

Modifying medical, dental, vision, accident, cancer or hospital_indemnity coverage

Medical, dental, vision, accident, cancer and hospital indemnity coverage do not require any information beyond the member information and the selected plan.

id*uuidUnique identifier of the employee or dependent in Noyo
member_type*stringType of member modifying coverage. One of: dependent, employee
plan_iduuidUnique identifier of the group plan in Noyo

Modifying life, add, std, ltd and critical_illness coverage

Life, AD&D, STD, LTD and critical illness coverage also optionally accept volume parameter in dollars (e.g. $50,000 should be sent as 50000).

id*uuidUnique identifier of the employee or dependent in Noyo
member_type*stringType of member modifying coverage. One of: dependent, employee
plan_iduuidUnique identifier of the group plan in Noyo
volumeˢintegerElected volume for the type of coverage being selected

Open Enrollment Transactions

One or more open enrollment transactions will created based on the requested changes in the coverages array. For some carriers, there may be a single transaction including all of the requested changes, while other carriers may require separate transactions for each action type (i.e. one transaction per action per carrier).

Open Enrollment Member Transaction completed Result

Upon the successful completion of the transaction, the status of the member transaction will be updated and the result of the member transaction will be in the same format as the member request result.


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