CSV Testing Guide

As part of Oscar's integration process, we require partners to complete a series of test enrollment transactions. The below examples correspond to the test cases OSCAR uses while setting up a new CSV enrollment integration.

Download all test cases here

Test Case 1: Add spouse to existing policy

1.1 Vendor creates initial enrollment transaction

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	329.32	12345678	199999001402	Martha Jones	CHECKING	True	PASSIVE	test-policy-95495			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	95495		Martha		Jones		1234567890	[email protected]	898079490	S	FEMALE	1949-12-04	2131-1	False	18	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	ADDITION

Download test case 1.1

1.2 Vendor creates CHANGE transaction with ADD for spouse with new values for total premium

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	4371.15	12345678	199999001402	Martha Jones	CHECKING	False	PASSIVE	test-policy-95495			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	95495		Martha		Jones		1234567890	[email protected]	898079490	S	FEMALE	1949-12-04	2131-1	False	18	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	CHANGE	2025-03-01	ADDITIONAL_MAINTENANCE_REASON
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	4371.15	12345678	199999001402	Martha Jones	CHECKING	False	PASSIVE	test-policy-95495			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789		40896			Edward		Allen		1234567890	[email protected]	453822462	I	FEMALE	2024-07-07	2131-1	False	19	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	ADDITION

Download test case 1.2

Test Case 2

2.1 Initial enrollment file with Subscriber and Dependent (Child) enrolling into Policy A

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	548.33	12345678	199999001402	Robert Wallace	CHECKING	True	PASSIVE	test-policy-23194			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	23194		Robert		Wallace			1234567890	[email protected]	600917737	S	FEMALE	1973-05-11	2131-1	False	18	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	ADDITION
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	548.33	12345678	199999001402	Robert Wallace	CHECKING	False	PASSIVE	test-policy-23194			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789			96289		Jessica		Calhoun			1234567890	[email protected]	911112239	I	FEMALE	2023-02-02	2131-1	False	19	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	ADDITION

Download test case 2.1

2.2 Change transaction with cancellation for child with new values for total premium

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	43007.16	12345678	199999001402	Robert Wallace	CHECKING	False	PASSIVE	test-policy-23194			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	23194		Robert		Wallace			1234567890	[email protected]	600917737	S	FEMALE	1973-05-11	2131-1	False	18	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	CHANGE	2025-03-01	ADDITIONAL_MAINTENANCE_REASON
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	43007.16						PASSIVE	test-policy-23194			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789			96289		Jessica		Calhoun			1234567890	[email protected]	911112239	I	FEMALE	2023-02-02	2131-1	False	19	True	2025-03-01	2025-04-01	eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	CANCELLATION	2025-03-01

Download test case 2.2

2.3 Change transaction to add child to Policy A with the original coverage start date with new values for total premium

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	44664.25	12345678	199999001402	Robert Wallace	CHECKING	False	PASSIVE	test-policy-23194			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	23194		Robert		Wallace			1234567890	[email protected]	600917737	S	FEMALE	1973-05-11	2131-1	False	18	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	CHANGE	2025-03-01	ADDITIONAL_MAINTENANCE_REASON
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	44664.25	12345678	199999001402	Robert Wallace	CHECKING	False	PASSIVE	test-policy-23194			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789			96289		Jessica		Calhoun			1234567890	[email protected]	911112239	I	FEMALE	2023-02-02	2131-1	False	19	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	ADDITION

Download test case 2.3

2.4 Change transaction to cancel the entire existing policy (Policy A)

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	44664.25						PASSIVE	test-policy-23194			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789			23194		Robert		Wallace			1234567890	[email protected]	600917737	S	FEMALE	1973-05-11	2131-1	False	18	True	2025-03-01	2025-04-01	eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	CANCELLATION	2025-03-01

Download test case 2.4

2.5 Reinstatement transaction for the entire existing policy (Policy A)

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	44664.25	12345678	199999001402	Robert Wallace	CHECKING	True	PASSIVE	test-policy-23194			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	23194		Robert		Wallace			1234567890	[email protected]	600917737	S	FEMALE	1973-05-11	2131-1	False	18	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	REINSTATEMENT

Download test case 2.5

2.6 Soft termination for the entire existing policy (Policy A)

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	44664.25						PASSIVE	test-policy-23194			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	23194		Robert		Wallace			1234567890	[email protected]	600917737	S	FEMALE	1973-05-11	2131-1	False	18	True	2025-03-01	2025-04-01	eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	TERMINATION

Download test case 2.6

Test Case 3

3.1 Initial enrollment file where 3 subscribers enroll into a policy

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	45220.72	12345678	199999001402	Kimberly Richard	CHECKING	True	PASSIVE	test-policy-76673			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	76673		Kimberly		Richard			1234567890	[email protected]	942904280	S	FEMALE	1936-03-27	2131-1	False	18	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	ADDITION
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	45220.72	12345678	199999001402	Kimberly Richard	CHECKING	False	PASSIVE	test-policy-76673			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789			62902		Amy		Camacho			1234567890	[email protected]	904653012	I	FEMALE	2022-06-18	2131-1	False	19	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	ADDITION
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	45220.72	12345678	199999001402	Kimberly Richard	CHECKING	False	PASSIVE	test-policy-76673			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789			24767		Christopher		Reed			1234567890	[email protected]	199248414	I	FEMALE	2015-05-12	2131-1	False	19	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	ADDITION

Download test case 3.1

3.2 Change transaction to add child dependent with BIRTH QLE and new values for total premium

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	80.18	12345678	199999001402	Kimberly Richard	CHECKING	False	PASSIVE	test-policy-76673			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	76673		Kimberly		Richard			1234567890	[email protected]	942904280	S	FEMALE	1936-03-27	2131-1	False	18	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	CHANGE	2025-03-01	ADDITIONAL_MAINTENANCE_REASON
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	80.18	12345678	199999001402	Kimberly Richard	CHECKING	False	PASSIVE	test-policy-76673			2025-03-20 10:04:00.000+00:00	BIRTH	2025-03-20	1234567789			44516		Annette		Richard			1234567890	[email protected]	934821319	I	FEMALE	2011-01-26	2131-1	False	19	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	ADDITION

Download test case 3.2

3.3 Change transaction to terminate the dependent from the existing policy (Policy A)

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	9500.67	12345678	199999001402	Kimberly Richard	CHECKING	False	PASSIVE	test-policy-76673			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	76673		Kimberly		Richard			1234567890	[email protected]	942904280	S	FEMALE	1936-03-27	2131-1	False	18	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	CHANGE	2025-03-01	ADDITIONAL_MAINTENANCE_REASON
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	9500.67						PASSIVE	test-policy-76673			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	24767		Christopher		Reed			1234567890	[email protected]	199248414	I	FEMALE	2015-05-12	2131-1	False	19	True	2025-03-01	2025-04-01	eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	TERMINATION

Download test case 3.3

3.4 Reinstatement transaction to add dependent back to the existing policy (Policy A)

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	99999NE7654321-00	277.15	12345678	199999001402	Kimberly Richard	CHECKING	False	PASSIVE	test-policy-76673			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	76673		Kimberly		Richard			1234567890	[email protected]	942904280	S	FEMALE	1936-03-27	2131-1	False	18	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	CHANGE	2025-03-01	ADDITIONAL_MAINTENANCE_REASON
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	99999NE7654321-00	277.15	12345678	199999001402	Christopher Reed	CHECKING	True	PASSIVE	test-policy-76673			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	24767		Christopher		Reed			1234567890	[email protected]	199248414	I	FEMALE	2015-05-12	2131-1	False	19	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	REINSTATEMENT

Download test case 3.4

3.5 Soft termination for the entire existing policy (Policy A).

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	277.15						PASSIVE	test-policy-76673			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	76673		Kimberly		Richard			1234567890	[email protected]	942904280	S	FEMALE	1936-03-27	2131-1	False	18	True	2025-03-01	2025-04-01	eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	TERMINATION

Download test case 3.5

Test Case 4

4.1 Initial enrollment for 2 members into a Policy A

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	49.63	12345678	199999001402	Deanna Smith	CHECKING	True	PASSIVE	test-policy-50070			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	50070		Deanna		Smith			1234567890	[email protected]	978005596	S	FEMALE	1938-11-07	2131-1	False	18	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	ADDITION
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	49.63	12345678	199999001402	Deanna Smith	CHECKING	False	PASSIVE	test-policy-50070			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789			78581		Rebecca		Welch			1234567890	[email protected]	834852490	I	FEMALE	2023-11-07	2131-1	False	19	True	2025-03-01		eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	ADDITION

Download test case 4.1

4.2 Change transaction with subscriber address change.

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	49.63	12345678	199999001402	Deanna Smith	CHECKING	False	PASSIVE	test-policy-50070			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	50070		Deanna		Smith			1234567890	[email protected]	978005596	S	FEMALE	1938-11-07	2131-1	False	18	True	2025-03-01		eng	15420 S 2nd St		Bennington	NE	68007	15420 S 2nd St		Bennington	NE	68007	CHANGE	2025-03-01	ADDITIONAL_MAINTENANCE_REASON

Download test case 4.2

4.3 Change transaction with subscriber dob change and new premium.

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	2003.42	12345678	199999001402	Deanna Smith	CHECKING	False	PASSIVE	test-policy-50070			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	50070		Deanna		Smith			1234567890	[email protected]	978005596	S	FEMALE	1938-11-07	2131-1	False	18	True	2025-03-01		eng	15420 S 2nd St		Bennington	NE	68007	15420 S 2nd St		Bennington	NE	68007	CHANGE	2025-03-01	ADDITIONAL_MAINTENANCE_REASON

Download test case 4.3

4.4 Change transaction with policy change, new premium and QLE.

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	99999NE7654321-00	6004.21	12345678	199999001402	Deanna Smith	CHECKING	False	PASSIVE	test-policy-50070			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	50070		Deanna		Smith			1234567890	[email protected]	978005596	S	FEMALE	1938-11-07	2131-1	False	18	True	2025-03-01		eng	15420 S 2nd St		Bennington	NE	68007	15420 S 2nd St		Bennington	NE	68007	CHANGE	2025-03-01	ADDITIONAL_MAINTENANCE_REASON

Download test case 4.4

4.5 Change transaction to remove one dependent and update new premium and QLE

broker.first_name	broker.middle_name	broker.last_name	broker.prefix	broker.suffix	broker.phone_number	broker.email	broker.npn	servicing_agent.first_name	servicing_agent.middle_name	servicing_agent.last_name	servicing_agent.prefix	servicing_agent.suffix	servicing_agent.phone_number	servicing_agent.email	servicing_agent.npn	plan.year	plan.hios_id	plan.monthly_premium	payment.routing_number	payment.account_number	payment.payer_name	payment.account_type	payment.is_new_payment_instrument	enrollment.renewal_type	enrollment.external_policy_id	enrollment.external_subscriber_id	enrollment.cancel_overlapping_eligibility	enrollment.date_signed	enrollment.qualifying_event	enrollment.qualifying_event_date	enrollment.application_id	employer.employer_name	employer.employer_tin	enrollee.external_member_id	enrollee.issuer_member_id	enrollee.first_name	enrollee.middle_name	enrollee.last_name	enrollee.prefix	enrollee.suffix	enrollee.phone	enrollee.email	enrollee.ssn	enrollee.marital_status	enrollee.sex	enrollee.date_of_birth	enrollee.ethnicity	enrollee.is_tobacco_user	enrollee.relationship_to_policy_holder	enrollee.is_requesting_coverage	enrollee.coverage_start_date	enrollee.coverage_end_date	enrollee.language_preference	enrollee.mailing_address.address_line_1	enrollee.mailing_address.address_line_2	enrollee.mailing_address.city	enrollee.mailing_address.state	enrollee.mailing_address.zipcode	enrollee.residential_address.address_line_1	enrollee.residential_address.address_line_2	enrollee.residential_address.city	enrollee.residential_address.state	enrollee.residential_address.zipcode	enrollee.change_type	enrollee.change_effective_date	enrollee.additional_maintenance_reason
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	77.14	12345678	199999001402	Deanna Smith	CHECKING	False	PASSIVE	test-policy-50070			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	50070		Deanna		Smith			1234567890	[email protected]	978005596	S	FEMALE	1938-11-07	2131-1	False	18	True	2025-03-01		eng	15420 S 2nd St		Bennington	NE	68007	15420 S 2nd St		Bennington	NE	68007	CHANGE	2025-03-01	ADDITIONAL_MAINTENANCE_REASON
Broker	M	Brokerton			8555200188	[email protected]	20090977	Agent		Bond	Mr.					2025	12345NE1234567-00	77.14						PASSIVE	test-policy-50070			2025-03-20 10:04:00.000+00:00	HRAS	2025-03-20	1234567789	The Man	23424586-435	78581		Rebecca		Welch			1234567890	[email protected]	834852490	I	FEMALE	2023-11-07	2131-1	False	19	True	2025-03-01	2025-04-01	eng	11401 N 156th St		Bennington	NE	68007	11401 N 156th St		Bennington	NE	68007	TERMINATION

Download test case 4.5

Updated 10 days ago

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