Inbound Enrollment File

File name: FROM_VENDOR_NAME.EMT.YYYYMMDDThhmmss.P.csv Max file size: 10000 rows Please include header as the first line

Field Name	DataType	Description	Format	Example	Length	Required
broker.first_name	String	Broker First Name		Carlos	50	N
broker.middle_name	String	Broker Middle Name		William	50	N
broker.last_name	String	Broker Last Name		Garcia	50	N
broker.prefix	String	Broker Prefix		Mr.	4	N
broker.suffix	String	Broker Suffix		Jr.	4	N
broker.phone_number	String	Broker’s phone number	Valid 10-digit Phone Number (No delimiters)	5109027836	15	N
broker.email	String	Broker’s email address	Valid Email Format	[email protected]	50	N
broker.npn	String	Broker’s National Producer Number - required for enrollee attribution for commissions payments	Valid 9-digit NPN	123530000	25	N
servicing_agent.first_name	String	Servicing Agent First Name		Carlos	50	N
servicing_agent.middle_name	String	Servicing Agent Middle Name		William	50	N
servicing_agent.last_name	String	Servicing Agent Last Name		Garcia	50	N
servicing_agent.prefix	String	Servicing Agent Prefix		Mr.	4	N
servicing_agent.suffix	String	Servicing Agent Suffix		Jr.	4	N
servicing_agent.phone_number	String	Servicing Agent’s phone number	Valid 10-digit Phone Number (No delimiters)	5109027836	15	N
servicing_agent.email	String	Servicing Agent’s email address	Valid Email Format	[email protected]	50	N
servicing_agent.npn	String	Servicing Agent’s National Producer Number - required for enrollee attribution & to unlock servicing capabilities	Valid 9-digit NPN	123530000	25	N
plan.year	String	Plan Year	Valid plan year	2025	4	Y
plan.hios_id	String	HIOS ID	14-digit HIOS ID code plus variant	50221NJ0040001-02	17	Y
plan.monthly_premium	String	Plan Monthly Premium	Valid decimal value	999.99	20	Y
payment.routing_number	Digit	Routing number		21000021		Y if other payment related fields are provided
payment.account_number	Digit	Account number				Y if other payment related fields are provided
payment.payer_name	String	The name of payer				Y if other payment related fields are provided
payment.account_type	Enum	The account type of ACH		CHECKING		Y if other payment related fields are provided
payment.is_new_payment_instrument	Boolean	True if this is new or updated payment instrument				Y if other payment related fields are provided
enrollment.renewal_type	Enum	Renewal Type	Valid enum value (RENEWAL)			Y if enrollment is a renewal, blank otherwise
enrollment.external_policy_id	String	Unique identifier for the policy (coming from the partner)				Y
enrollment.external_subscriber_id	String					N
enrollment.cancel_overlapping_eligibility	Boolean	Term or cancel existing eligibility if it overlaps and prefer new one	Valid Boolean String	FALSE		N
enrollment.date_signed	String	Time when broker or consumer submitted their enrollment	ISO Format	2011-11-04 00:05:23.283+00:00		Y
enrollment.qualifying_event	Enum	Enrollment Qualifying Event				Y if enrollee.change_type is not CANCELLATION or TERMINATION
enrollment.qualifying_event_date	String	Enrollment Qualifying Event Date	YYYY-MM-DD	1996-01-01		Y if qualifying_event provided
enrollment.application_id	String	The ID of the application				N
enrollment.responsible_party.first_name	String	Responsible Party First Name				Y if enrollment is child-only
enrollment.responsible_party.last_name	String	Responsible Party Last Name				Y if enrollment is child-only
enrollment.responsible_party.dob	String	Responsible Party Date of Birth	YYYY-MM-DD	1996-01-01		Y if enrollment is child-only
enrollment.responsible_party.sex	Enum	Responsible Party Sex	MALE/FEMALE	MALE		N
enrollment.responsible_party.ssn	String	Responsible Party Social Security Number	Valid 9-digit SSN	123456789		N
enrollment.responsible_party.marital_status	Enum	Responsible Party Marital Status	Valid enum value (See Marital Status Mapping)	M		N
enrollment.responsible_party.ethnicity	Enum	Responsible Party Ethnicity	Valid enum value (See Ethnicity Code Mapping)	2135-2		N
enrollment.responsible_party.phone	String	Responsible Party Phone	Valid 10-digit Phone Number (No delimiters)	5109027836		N
enrollment.responsible_party.email	String	Responsible Party Email	Valid Email Format	[email protected]		N
enrollment.responsible_party.address_line_1	String	Responsible Party Address Line 1				Y if enrollment is child-only
enrollment.responsible_party.address_line_2	String	Responsible Party Address Line 2				N
enrollment.responsible_party.city	String	Responsible Party City				Y if enrollment is child-only
enrollment.responsible_party.state	String	Responsible Party State				Y if enrollment is child-only
enrollment.responsible_party.zipcode	String	Responsible Party Zipcode				Y if enrollment is child-only
employer.employer_name	String	The name of employer				N
employer.employer_tin	String	The tax number of employer				N
enrollee.external_member_id	String	Member ID defined by vendor				Y
enrollee.issuer_member_id	String	Member ID defined by issuer				Y if enrollee.change_type is CHANGE
enrollee.first_name	String	Enrollee First Name				Y
enrollee.middle_name	String	Enrollee Middle Name				N
enrollee.last_name	String	Enrollee Last Name				Y
enrollee.prefix	String	Enrollee Prefix				N
enrollee.suffix	String	Enrollee Suffix				N
enrollee.phone	String	Enrollee Phone Number	Valid 10-digit Phone Number (No delimiters)	5109027836		N
enrollee.email	String	Enrollee Email	Valid Email Format	[email protected]		N
enrollee.ssn	String	Enrollee Social Security Number	Valid 9-digit SSN	123456789		N
enrollee.marital_status	Enum	Enrollee Marital Status	Valid enum value (See Marital Status Mapping)	M		N
enrollee.sex	Enum	Enrollee Sex	Valid enum value (MALE/FEMALE)	FEMALE		Y
enrollee.date_of_birth	String	Enrollee Date of Birth	YYYY-MM-DD	1996-01-01		Y
enrollee.ethnicity	Enum	Enrollee Ethnicity	Valid enum value (See Ethnicity Code Mapping)	2135-2		N
enrollee.is_tobacco_user	Boolean	Specifies if enrollee is a tobacco user	Valid Boolean String	TRUE		Y
enrollee.relationship_to_policy_holder	Enum	Enrollee’s relationship to policy holder (See Relationship Code Mapping)	Valid enum value	15		Y
enrollee.is_requesting_coverage	Boolean	Specifies if enrollee is requesting coverage	Valid Boolean String	TRUE		Y
enrollee.coverage_start_date	String	Coverage Start Date for enrollee	YYYY-MM-DD	1996-01-01		Y
enrollee.coverage_end_date	String	Coverage End Date for enrollee	YYYY-MM-DD	1996-01-01		Only include/required when change type is CANCELLATION or TERMINATION
enrollee.language_preference	Enum	Enrollee Language Preference	Valid enum value (See Language Code mapping)	spa		N
enrollee.mailing_address.address_line_1	String	Enrollee Mailing Address Line 1				N
enrollee.mailing_address.address_line_2	String	Enrollee Mailing Address Line 2				N
enrollee.mailing_address.city	String	Enrollee Mailing Address City				N
enrollee.mailing_address.state	String	Enrollee Mailing Address State				N
enrollee.mailing_address.zipcode	String	Enrollee Mailing Address Zipcode				N
enrollee.residential_address.address_line_1	String	Enrollee Residential Address Line 1				Y
enrollee.residential_address.address_line_2	String	Enrollee Residential Address Line 2				N
enrollee.residential_address.city	String	Enrollee Residential Address City				Y
enrollee.residential_address.state	String	Enrollee Residential Address State				Y
enrollee.residential_address.zipcode	String	Enrollee Residential Address Zipcode				Y
enrollee.change_type	Enum	Type of modification made to the enrollee’s policy status		CHANGE, ADDITION, CANCELLATION, TERMINATION, REINSTATEMENT		Y
enrollee.change_effective_date	String	Date at which change should take effect	YYYY-MM-DD			Y if enrollee.change_type is CHANGE
enrollee.additional_maintenance_reason	String	Additional maintenance reason code for the policy status change.		e.g. LEAVE_PLATFORM		Y if enrollee.change_type is CHANGE
enrollee.organ_donor_opt_in	Boolean	NYS Donate Life Registry (NYDLR) Opt-In Collection	Valid True boolean string or empty	TRUE, empty		Y if state is NY