vericred_client 0.0.23 → 0.0.25
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- checksums.yaml +4 -4
- data/README.md +826 -28
- data/docs/ACAPlan.md +35 -35
- data/docs/ACAPlan2018.md +36 -36
- data/docs/ACAPlan2018SearchResponse.md +1 -1
- data/docs/ACAPlan2018SearchResult.md +39 -39
- data/docs/ACAPlanPre2018.md +35 -35
- data/docs/ACAPlanPre2018SearchResponse.md +1 -1
- data/docs/ACAPlanPre2018SearchResult.md +38 -38
- data/docs/Address.md +14 -0
- data/docs/AncillaryPlanIdentifier.md +9 -0
- data/docs/BasePlanSearchResponse.md +1 -1
- data/docs/CarrierGroupRequest.md +1 -1
- data/docs/CarrierRequest.md +2 -2
- data/docs/CarrierSubsidiary.md +2 -2
- data/docs/CarrierVerificationDentalPlansApi.md +63 -0
- data/docs/CarrierVerificationMedicalPlansApi.md +63 -0
- data/docs/CarrierVerificationVisionPlansApi.md +63 -0
- data/docs/County.md +1 -1
- data/docs/CountyBulk.md +1 -1
- data/docs/DentalPlan.md +7 -7
- data/docs/DentalPlanBenefits.md +22 -22
- data/docs/DentalPlanSearchRequest.md +1 -2
- data/docs/DentalPlanUpdate.md +5 -5
- data/docs/DentalPlansApi.md +118 -4
- data/docs/DependentCreate.md +12 -0
- data/docs/DependentCreateRequest.md +12 -0
- data/docs/DependentShow.md +12 -0
- data/docs/Drug.md +3 -3
- data/docs/DrugCoverage.md +3 -3
- data/docs/DrugCoverageResponse.md +2 -2
- data/docs/DrugPackage.md +1 -1
- data/docs/DrugSearchResponse.md +2 -2
- data/docs/EmbargoRequest.md +3 -2
- data/docs/FormularyResponse.md +1 -1
- data/docs/GroupCreate.md +14 -0
- data/docs/GroupCreateRequest.md +9 -0
- data/docs/GroupCreateResponse.md +9 -0
- data/docs/GroupShow.md +15 -0
- data/docs/GroupShowResponse.md +9 -0
- data/docs/GroupUpdate.md +14 -0
- data/docs/GroupUpdateRequest.md +9 -0
- data/docs/IssuerRequest.md +7 -7
- data/docs/LocationCreate.md +13 -0
- data/docs/LocationShow.md +14 -0
- data/docs/LocationUpdate.md +14 -0
- data/docs/MajorMedicalPlansApi.md +122 -0
- data/docs/MedicalPlanBenefits.md +35 -35
- data/docs/MedicalPlanUpdate.md +21 -20
- data/docs/MedicalPlansApi.md +0 -114
- data/docs/MedicareAdvantagePlan.md +25 -0
- data/docs/MedicareAdvantagePlanBenefits.md +148 -0
- data/docs/MedicareAdvantagePlanSearchRequest.md +12 -0
- data/docs/MedicareAdvantagePlanSearchResponse.md +9 -0
- data/docs/MedicareAdvantagePlanShowResponse.md +8 -0
- data/docs/MemberCreate.md +17 -0
- data/docs/MemberRateShow.md +13 -0
- data/docs/MemberRateShowRequest.md +10 -0
- data/docs/MemberRatesShowResponse.md +9 -0
- data/docs/MemberShow.md +18 -0
- data/docs/MembersCreateRequest.md +9 -0
- data/docs/MembersCreateResponse.md +8 -0
- data/docs/MembersShowResponse.md +8 -0
- data/docs/MetaPlanSearchResponse.md +1 -1
- data/docs/NetworkComparisonResponse.md +1 -1
- data/docs/NetworkDetails.md +1 -1
- data/docs/NetworkSize.md +1 -1
- data/docs/NetworksApi.md +17 -12
- data/docs/PlanCounty.md +1 -1
- data/docs/PlanCountyBulk.md +1 -1
- data/docs/PlanMedicare.md +1 -1
- data/docs/PlanMedicareBulk.md +2 -2
- data/docs/PlanPricingMedicare.md +3 -3
- data/docs/PlanSearchResponse.md +1 -1
- data/docs/PlansApi.md +0 -169
- data/docs/PlansBulkACA2018.md +8 -0
- data/docs/PlansBulkACAPre2018.md +8 -0
- data/docs/PlansBulkBase.md +7 -0
- data/docs/PlansBulkDental.md +7 -0
- data/docs/PlansBulkVision.md +7 -0
- data/docs/Provider.md +2 -2
- data/docs/ProviderDetails.md +5 -3
- data/docs/ProviderNetworkEventNotification.md +3 -3
- data/docs/ProviderNetworks.md +11 -0
- data/docs/ProviderShowResponse.md +1 -1
- data/docs/ProvidersApi.md +1 -56
- data/docs/QuoteCreate.md +15 -0
- data/docs/QuoteCreateRequest.md +8 -0
- data/docs/QuoteCreateResponse.md +8 -0
- data/docs/QuoteShow.md +17 -0
- data/docs/QuoteShowResponse.md +8 -0
- data/docs/QuotingApi.md +344 -0
- data/docs/RateRequest.md +24 -24
- data/docs/RateSearch.md +23 -18
- data/docs/RateShow.md +12 -0
- data/docs/RateShowRequest.md +10 -0
- data/docs/RatesShowResponse.md +9 -0
- data/docs/RequestPlanFind.md +2 -2
- data/docs/RequestPlanFindCarrierVerification.md +3 -3
- data/docs/RequestProviderNotificationSubscription.md +1 -1
- data/docs/RequestProvidersSearch.md +1 -1
- data/docs/RequestRatesSearch.md +1 -1
- data/docs/RxCuiIdentifier.md +1 -1
- data/docs/RxCuiIdentifierSearchResponse.md +1 -1
- data/docs/State.md +2 -2
- data/docs/SupplementalOptions.md +13 -0
- data/docs/V7Network.md +10 -0
- data/docs/V7NetworkComparisonResponse.md +9 -0
- data/docs/V7NetworkDetails.md +11 -0
- data/docs/V7NetworkDetailsResponse.md +8 -0
- data/docs/V7NetworkSearchResponse.md +9 -0
- data/docs/V7ProviderDetails.md +33 -0
- data/docs/V7ProviderNetworks.md +12 -0
- data/docs/VisionPlan.md +7 -7
- data/docs/VisionPlanBenefits.md +22 -15
- data/docs/VisionPlanSearchRequest.md +1 -2
- data/docs/VisionPlanUpdate.md +5 -5
- data/docs/VisionPlansApi.md +114 -0
- data/docs/ZipCountiesResponse.md +1 -1
- data/docs/ZipCountyBulk.md +1 -1
- data/lib/vericred_client/api/carrier_groups_api.rb +754 -15
- data/lib/vericred_client/api/carrier_verification_dental_plans_api.rb +1026 -0
- data/lib/vericred_client/api/carrier_verification_medical_plans_api.rb +1026 -0
- data/lib/vericred_client/api/carrier_verification_plans_api.rb +754 -15
- data/lib/vericred_client/api/carrier_verification_vision_plans_api.rb +1026 -0
- data/lib/vericred_client/api/carriers_api.rb +754 -15
- data/lib/vericred_client/api/dental_plans_api.rb +874 -18
- data/lib/vericred_client/api/drug_coverages_api.rb +754 -15
- data/lib/vericred_client/api/drug_packages_api.rb +754 -15
- data/lib/vericred_client/api/drugs_api.rb +754 -15
- data/lib/vericred_client/api/embargoes_api.rb +754 -15
- data/lib/vericred_client/api/formularies_api.rb +754 -15
- data/lib/vericred_client/api/issuers_api.rb +754 -15
- data/lib/vericred_client/api/major_medical_plans_api.rb +1086 -0
- data/lib/vericred_client/api/medical_plans_api.rb +754 -132
- data/lib/vericred_client/api/network_sizes_api.rb +754 -15
- data/lib/vericred_client/api/networks_api.rb +773 -27
- data/lib/vericred_client/api/plans_api.rb +754 -189
- data/lib/vericred_client/api/provider_notification_subscriptions_api.rb +754 -15
- data/lib/vericred_client/api/providers_api.rb +756 -74
- data/lib/vericred_client/api/quoting_api.rb +1316 -0
- data/lib/vericred_client/api/rates_api.rb +754 -15
- data/lib/vericred_client/api/vision_plans_api.rb +871 -15
- data/lib/vericred_client/api/zip_counties_api.rb +754 -15
- data/lib/vericred_client/api_client.rb +754 -15
- data/lib/vericred_client/api_error.rb +754 -15
- data/lib/vericred_client/configuration.rb +754 -15
- data/lib/vericred_client/models/aca_plan.rb +1165 -426
- data/lib/vericred_client/models/aca_plan2018.rb +1174 -435
- data/lib/vericred_client/models/aca_plan2018_search_response.rb +765 -26
- data/lib/vericred_client/models/aca_plan2018_search_result.rb +1203 -464
- data/lib/vericred_client/models/aca_plan2018_show_response.rb +754 -15
- data/lib/vericred_client/models/aca_plan_pre2018.rb +1165 -426
- data/lib/vericred_client/models/aca_plan_pre2018_search_response.rb +765 -26
- data/lib/vericred_client/models/aca_plan_pre2018_search_result.rb +1202 -463
- data/lib/vericred_client/models/aca_plan_pre2018_show_response.rb +754 -15
- data/lib/vericred_client/models/address.rb +1195 -0
- data/lib/vericred_client/models/ancillary_plan_identifier.rb +1145 -0
- data/lib/vericred_client/models/base.rb +754 -15
- data/lib/vericred_client/models/base_plan_search_response.rb +768 -29
- data/lib/vericred_client/models/carrier.rb +754 -15
- data/lib/vericred_client/models/carrier_group_request.rb +765 -26
- data/lib/vericred_client/models/carrier_request.rb +769 -30
- data/lib/vericred_client/models/carrier_subsidiary.rb +778 -39
- data/lib/vericred_client/models/county.rb +765 -26
- data/lib/vericred_client/models/county_bulk.rb +768 -29
- data/lib/vericred_client/models/dental_plan.rb +825 -86
- data/lib/vericred_client/models/dental_plan_benefits.rb +927 -188
- data/lib/vericred_client/models/dental_plan_search_applicant.rb +754 -15
- data/lib/vericred_client/models/dental_plan_search_request.rb +768 -39
- data/lib/vericred_client/models/dental_plan_search_response.rb +754 -15
- data/lib/vericred_client/models/dental_plan_show_response.rb +754 -15
- data/lib/vericred_client/models/dental_plan_update.rb +804 -65
- data/lib/vericred_client/models/dental_plan_update_request.rb +754 -15
- data/lib/vericred_client/models/dependent_create.rb +1175 -0
- data/lib/vericred_client/models/dependent_create_request.rb +1175 -0
- data/lib/vericred_client/models/dependent_show.rb +1175 -0
- data/lib/vericred_client/models/drug.rb +781 -42
- data/lib/vericred_client/models/drug_coverage.rb +781 -42
- data/lib/vericred_client/models/drug_coverage_response.rb +769 -30
- data/lib/vericred_client/models/drug_package.rb +765 -26
- data/lib/vericred_client/models/drug_search_response.rb +771 -32
- data/lib/vericred_client/models/embargo_request.rb +790 -39
- data/lib/vericred_client/models/formulary.rb +754 -15
- data/lib/vericred_client/models/formulary_drug_package_response.rb +754 -15
- data/lib/vericred_client/models/formulary_response.rb +768 -29
- data/lib/vericred_client/models/group_create.rb +1195 -0
- data/lib/vericred_client/models/group_create_request.rb +1147 -0
- data/lib/vericred_client/models/group_create_response.rb +1147 -0
- data/lib/vericred_client/models/group_show.rb +1205 -0
- data/lib/vericred_client/models/group_show_response.rb +1147 -0
- data/lib/vericred_client/models/group_update.rb +1195 -0
- data/lib/vericred_client/models/group_update_request.rb +1147 -0
- data/lib/vericred_client/models/issuer_request.rb +819 -80
- data/lib/vericred_client/models/location_create.rb +1185 -0
- data/lib/vericred_client/models/location_show.rb +1195 -0
- data/lib/vericred_client/models/location_update.rb +1195 -0
- data/lib/vericred_client/models/medical_plan_benefits.rb +1084 -345
- data/lib/vericred_client/models/medical_plan_update.rb +930 -181
- data/lib/vericred_client/models/medical_plan_update_request.rb +754 -15
- data/lib/vericred_client/models/medicare_advantage_plan.rb +1309 -0
- data/lib/vericred_client/models/medicare_advantage_plan_benefits.rb +2535 -0
- data/lib/vericred_client/models/medicare_advantage_plan_search_request.rb +1175 -0
- data/lib/vericred_client/models/medicare_advantage_plan_search_response.rb +1147 -0
- data/lib/vericred_client/models/medicare_advantage_plan_show_response.rb +1135 -0
- data/lib/vericred_client/models/member_create.rb +1227 -0
- data/lib/vericred_client/models/member_rate_show.rb +1185 -0
- data/lib/vericred_client/models/member_rate_show_request.rb +1155 -0
- data/lib/vericred_client/models/member_rates_show_response.rb +1147 -0
- data/lib/vericred_client/models/member_show.rb +1237 -0
- data/lib/vericred_client/models/members_create_request.rb +1147 -0
- data/lib/vericred_client/models/members_create_response.rb +1137 -0
- data/lib/vericred_client/models/members_show_response.rb +1137 -0
- data/lib/vericred_client/models/meta.rb +754 -15
- data/lib/vericred_client/models/meta_plan_search_response.rb +768 -29
- data/lib/vericred_client/models/network.rb +754 -15
- data/lib/vericred_client/models/network_comparison.rb +754 -15
- data/lib/vericred_client/models/network_comparison_request.rb +754 -15
- data/lib/vericred_client/models/network_comparison_response.rb +770 -31
- data/lib/vericred_client/models/network_details.rb +770 -31
- data/lib/vericred_client/models/network_details_response.rb +754 -15
- data/lib/vericred_client/models/network_search_response.rb +754 -15
- data/lib/vericred_client/models/network_size.rb +765 -26
- data/lib/vericred_client/models/notification_subscription.rb +754 -15
- data/lib/vericred_client/models/notification_subscription_response.rb +754 -15
- data/lib/vericred_client/models/plan.rb +754 -15
- data/lib/vericred_client/models/plan_county.rb +768 -29
- data/lib/vericred_client/models/plan_county_bulk.rb +768 -29
- data/lib/vericred_client/models/plan_deleted.rb +754 -15
- data/lib/vericred_client/models/plan_identifier.rb +754 -15
- data/lib/vericred_client/models/plan_medicare.rb +768 -29
- data/lib/vericred_client/models/plan_medicare_bulk.rb +775 -36
- data/lib/vericred_client/models/plan_pricing_medicare.rb +782 -43
- data/lib/vericred_client/models/plan_search_response.rb +765 -26
- data/lib/vericred_client/models/plan_show_response.rb +754 -15
- data/lib/vericred_client/models/plans_bulk_aca2018.rb +1135 -0
- data/lib/vericred_client/models/plans_bulk_aca_pre2018.rb +1135 -0
- data/lib/vericred_client/models/plans_bulk_base.rb +1125 -0
- data/lib/vericred_client/models/plans_bulk_dental.rb +1125 -0
- data/lib/vericred_client/models/plans_bulk_vision.rb +1125 -0
- data/lib/vericred_client/models/provider.rb +780 -41
- data/lib/vericred_client/models/provider_details.rb +813 -50
- data/lib/vericred_client/models/provider_geocode.rb +754 -15
- data/lib/vericred_client/models/provider_network_event_notification.rb +790 -51
- data/lib/vericred_client/models/provider_networks.rb +1165 -0
- data/lib/vericred_client/models/provider_show_response.rb +755 -16
- data/lib/vericred_client/models/providers_geocode_response.rb +754 -15
- data/lib/vericred_client/models/providers_search_response.rb +754 -15
- data/lib/vericred_client/models/quote_create.rb +1207 -0
- data/lib/vericred_client/models/quote_create_request.rb +1135 -0
- data/lib/vericred_client/models/quote_create_response.rb +1135 -0
- data/lib/vericred_client/models/quote_show.rb +1227 -0
- data/lib/vericred_client/models/quote_show_response.rb +1135 -0
- data/lib/vericred_client/models/rate_request.rb +990 -251
- data/lib/vericred_client/models/rate_search.rb +978 -189
- data/lib/vericred_client/models/rate_show.rb +1175 -0
- data/lib/vericred_client/models/rate_show_request.rb +1155 -0
- data/lib/vericred_client/models/rates_show_response.rb +1147 -0
- data/lib/vericred_client/models/rating_area.rb +754 -15
- data/lib/vericred_client/models/request_plan_find.rb +777 -38
- data/lib/vericred_client/models/request_plan_find_applicant.rb +754 -15
- data/lib/vericred_client/models/request_plan_find_carrier_verification.rb +792 -53
- data/lib/vericred_client/models/request_plan_find_drug_package.rb +754 -15
- data/lib/vericred_client/models/request_plan_find_provider.rb +754 -15
- data/lib/vericred_client/models/request_provider_notification_subscription.rb +768 -29
- data/lib/vericred_client/models/request_providers_search.rb +767 -26
- data/lib/vericred_client/models/request_rates_search.rb +768 -29
- data/lib/vericred_client/models/response_rates_search.rb +754 -15
- data/lib/vericred_client/models/rx_cui_identifier.rb +765 -26
- data/lib/vericred_client/models/rx_cui_identifier_search_response.rb +768 -29
- data/lib/vericred_client/models/service_area.rb +754 -15
- data/lib/vericred_client/models/service_area_zip_county.rb +754 -15
- data/lib/vericred_client/models/state.rb +778 -39
- data/lib/vericred_client/models/state_network_size_request.rb +754 -15
- data/lib/vericred_client/models/state_network_size_response.rb +754 -15
- data/lib/vericred_client/models/supplemental_options.rb +1187 -0
- data/lib/vericred_client/models/v7_network.rb +1155 -0
- data/lib/vericred_client/models/v7_network_comparison_response.rb +1149 -0
- data/lib/vericred_client/models/v7_network_details.rb +1167 -0
- data/lib/vericred_client/models/v7_network_details_response.rb +1135 -0
- data/lib/vericred_client/models/v7_network_search_response.rb +1147 -0
- data/lib/vericred_client/models/v7_provider_details.rb +1395 -0
- data/lib/vericred_client/models/v7_provider_networks.rb +1175 -0
- data/lib/vericred_client/models/vision_plan.rb +825 -86
- data/lib/vericred_client/models/vision_plan_benefits.rb +937 -128
- data/lib/vericred_client/models/vision_plan_search_applicant.rb +754 -15
- data/lib/vericred_client/models/vision_plan_search_request.rb +768 -39
- data/lib/vericred_client/models/vision_plan_search_response.rb +754 -15
- data/lib/vericred_client/models/vision_plan_show_response.rb +754 -15
- data/lib/vericred_client/models/vision_plan_update.rb +804 -65
- data/lib/vericred_client/models/vision_plan_update_request.rb +754 -15
- data/lib/vericred_client/models/zip_code.rb +754 -15
- data/lib/vericred_client/models/zip_counties_response.rb +770 -31
- data/lib/vericred_client/models/zip_county.rb +754 -15
- data/lib/vericred_client/models/zip_county_bulk.rb +765 -26
- data/lib/vericred_client/models/zip_county_response.rb +754 -15
- data/lib/vericred_client/version.rb +755 -16
- data/lib/vericred_client.rb +809 -15
- data/spec/api/carrier_groups_api_spec.rb +754 -15
- data/spec/api/carrier_verification_dental_plans_api_spec.rb +993 -0
- data/spec/api/carrier_verification_medical_plans_api_spec.rb +993 -0
- data/spec/api/carrier_verification_plans_api_spec.rb +754 -15
- data/spec/api/carrier_verification_vision_plans_api_spec.rb +993 -0
- data/spec/api/carriers_api_spec.rb +754 -15
- data/spec/api/dental_plans_api_spec.rb +780 -16
- data/spec/api/drug_coverages_api_spec.rb +754 -15
- data/spec/api/drug_packages_api_spec.rb +754 -15
- data/spec/api/drugs_api_spec.rb +754 -15
- data/spec/api/embargoes_api_spec.rb +754 -15
- data/spec/api/formularies_api_spec.rb +754 -15
- data/spec/api/issuers_api_spec.rb +754 -15
- data/spec/api/major_medical_plans_api_spec.rb +1006 -0
- data/spec/api/medical_plans_api_spec.rb +754 -40
- data/spec/api/network_sizes_api_spec.rb +754 -15
- data/spec/api/networks_api_spec.rb +760 -18
- data/spec/api/plans_api_spec.rb +754 -52
- data/spec/api/provider_notification_subscriptions_api_spec.rb +754 -15
- data/spec/api/providers_api_spec.rb +755 -28
- data/spec/api/quoting_api_spec.rb +1055 -0
- data/spec/api/rates_api_spec.rb +754 -15
- data/spec/api/vision_plans_api_spec.rb +779 -15
- data/spec/api/zip_counties_api_spec.rb +754 -15
- data/spec/api_client_spec.rb +754 -15
- data/spec/configuration_spec.rb +754 -15
- data/spec/models/aca_plan2018_search_response_spec.rb +756 -17
- data/spec/models/aca_plan2018_search_result_spec.rb +839 -100
- data/spec/models/aca_plan2018_show_response_spec.rb +754 -15
- data/spec/models/aca_plan2018_spec.rb +843 -104
- data/spec/models/aca_plan_pre2018_search_response_spec.rb +756 -17
- data/spec/models/aca_plan_pre2018_search_result_spec.rb +839 -100
- data/spec/models/aca_plan_pre2018_show_response_spec.rb +754 -15
- data/spec/models/aca_plan_pre2018_spec.rb +837 -98
- data/spec/models/aca_plan_spec.rb +837 -98
- data/spec/models/address_spec.rb +1024 -0
- data/spec/models/ancillary_plan_identifier_spec.rb +994 -0
- data/spec/models/base_plan_search_response_spec.rb +756 -17
- data/spec/models/base_spec.rb +754 -15
- data/spec/models/carrier_group_request_spec.rb +756 -17
- data/spec/models/carrier_request_spec.rb +756 -17
- data/spec/models/carrier_spec.rb +754 -15
- data/spec/models/carrier_subsidiary_spec.rb +758 -19
- data/spec/models/county_bulk_spec.rb +757 -18
- data/spec/models/county_spec.rb +756 -17
- data/spec/models/dental_plan_benefits_spec.rb +782 -43
- data/spec/models/dental_plan_search_applicant_spec.rb +754 -15
- data/spec/models/dental_plan_search_request_spec.rb +758 -25
- data/spec/models/dental_plan_search_response_spec.rb +754 -15
- data/spec/models/dental_plan_show_response_spec.rb +754 -15
- data/spec/models/dental_plan_spec.rb +767 -28
- data/spec/models/dental_plan_update_request_spec.rb +754 -15
- data/spec/models/dental_plan_update_spec.rb +763 -24
- data/spec/models/dependent_create_request_spec.rb +1012 -0
- data/spec/models/dependent_create_spec.rb +1012 -0
- data/spec/models/dependent_show_spec.rb +1012 -0
- data/spec/models/drug_coverage_response_spec.rb +756 -17
- data/spec/models/drug_coverage_spec.rb +758 -19
- data/spec/models/drug_package_spec.rb +756 -17
- data/spec/models/drug_search_response_spec.rb +756 -17
- data/spec/models/drug_spec.rb +758 -19
- data/spec/models/embargo_request_spec.rb +766 -21
- data/spec/models/formulary_drug_package_response_spec.rb +754 -15
- data/spec/models/formulary_response_spec.rb +756 -17
- data/spec/models/formulary_spec.rb +754 -15
- data/spec/models/group_create_request_spec.rb +994 -0
- data/spec/models/group_create_response_spec.rb +994 -0
- data/spec/models/group_create_spec.rb +1024 -0
- data/spec/models/group_show_response_spec.rb +994 -0
- data/spec/models/group_show_spec.rb +1030 -0
- data/spec/models/group_update_request_spec.rb +994 -0
- data/spec/models/group_update_spec.rb +1024 -0
- data/spec/models/issuer_request_spec.rb +765 -26
- data/spec/models/location_create_spec.rb +1018 -0
- data/spec/models/location_show_spec.rb +1024 -0
- data/spec/models/location_update_spec.rb +1024 -0
- data/spec/models/medical_plan_benefits_spec.rb +801 -62
- data/spec/models/medical_plan_update_request_spec.rb +754 -15
- data/spec/models/medical_plan_update_spec.rb +792 -47
- data/spec/models/medicare_advantage_plan_benefits_spec.rb +1828 -0
- data/spec/models/medicare_advantage_plan_search_request_spec.rb +1012 -0
- data/spec/models/medicare_advantage_plan_search_response_spec.rb +994 -0
- data/spec/models/medicare_advantage_plan_show_response_spec.rb +988 -0
- data/spec/models/medicare_advantage_plan_spec.rb +1090 -0
- data/spec/models/member_create_spec.rb +1042 -0
- data/spec/models/member_rate_show_request_spec.rb +1000 -0
- data/spec/models/member_rate_show_spec.rb +1018 -0
- data/spec/models/member_rates_show_response_spec.rb +994 -0
- data/spec/models/member_show_spec.rb +1048 -0
- data/spec/models/members_create_request_spec.rb +994 -0
- data/spec/models/members_create_response_spec.rb +988 -0
- data/spec/models/members_show_response_spec.rb +988 -0
- data/spec/models/meta_plan_search_response_spec.rb +757 -18
- data/spec/models/meta_spec.rb +754 -15
- data/spec/models/network_comparison_request_spec.rb +754 -15
- data/spec/models/network_comparison_response_spec.rb +756 -17
- data/spec/models/network_comparison_spec.rb +754 -15
- data/spec/models/network_details_response_spec.rb +754 -15
- data/spec/models/network_details_spec.rb +757 -18
- data/spec/models/network_search_response_spec.rb +754 -15
- data/spec/models/network_size_spec.rb +756 -17
- data/spec/models/network_spec.rb +754 -15
- data/spec/models/notification_subscription_response_spec.rb +754 -15
- data/spec/models/notification_subscription_spec.rb +754 -15
- data/spec/models/plan_county_bulk_spec.rb +756 -17
- data/spec/models/plan_county_spec.rb +756 -17
- data/spec/models/plan_deleted_spec.rb +754 -15
- data/spec/models/plan_identifier_spec.rb +754 -15
- data/spec/models/plan_medicare_bulk_spec.rb +763 -24
- data/spec/models/plan_medicare_spec.rb +760 -21
- data/spec/models/plan_pricing_medicare_spec.rb +761 -22
- data/spec/models/plan_search_response_spec.rb +756 -17
- data/spec/models/plan_show_response_spec.rb +754 -15
- data/spec/models/plan_spec.rb +754 -15
- data/spec/models/plans_bulk_aca2018_spec.rb +988 -0
- data/spec/models/plans_bulk_aca_pre2018_spec.rb +988 -0
- data/spec/models/plans_bulk_base_spec.rb +982 -0
- data/spec/models/plans_bulk_dental_spec.rb +982 -0
- data/spec/models/plans_bulk_vision_spec.rb +982 -0
- data/spec/models/provider_details_spec.rb +779 -28
- data/spec/models/provider_geocode_spec.rb +754 -15
- data/spec/models/provider_network_event_notification_spec.rb +760 -21
- data/spec/models/provider_networks_spec.rb +1006 -0
- data/spec/models/provider_show_response_spec.rb +754 -15
- data/spec/models/provider_spec.rb +762 -23
- data/spec/models/providers_geocode_response_spec.rb +754 -15
- data/spec/models/providers_search_response_spec.rb +754 -15
- data/spec/models/quote_create_request_spec.rb +988 -0
- data/spec/models/quote_create_response_spec.rb +988 -0
- data/spec/models/quote_create_spec.rb +1030 -0
- data/spec/models/quote_show_response_spec.rb +988 -0
- data/spec/models/quote_show_spec.rb +1042 -0
- data/spec/models/rate_request_spec.rb +884 -145
- data/spec/models/rate_search_spec.rb +886 -117
- data/spec/models/rate_show_request_spec.rb +1000 -0
- data/spec/models/rate_show_spec.rb +1012 -0
- data/spec/models/rates_show_response_spec.rb +994 -0
- data/spec/models/rating_area_spec.rb +754 -15
- data/spec/models/request_plan_find_applicant_spec.rb +754 -15
- data/spec/models/request_plan_find_carrier_verification_spec.rb +761 -22
- data/spec/models/request_plan_find_drug_package_spec.rb +754 -15
- data/spec/models/request_plan_find_provider_spec.rb +754 -15
- data/spec/models/request_plan_find_spec.rb +759 -20
- data/spec/models/request_provider_notification_subscription_spec.rb +757 -18
- data/spec/models/request_providers_search_spec.rb +758 -19
- data/spec/models/request_rates_search_spec.rb +756 -17
- data/spec/models/response_rates_search_spec.rb +754 -15
- data/spec/models/rx_cui_identifier_search_response_spec.rb +756 -17
- data/spec/models/rx_cui_identifier_spec.rb +756 -17
- data/spec/models/service_area_spec.rb +754 -15
- data/spec/models/service_area_zip_county_spec.rb +754 -15
- data/spec/models/state_network_size_request_spec.rb +754 -15
- data/spec/models/state_network_size_response_spec.rb +754 -15
- data/spec/models/state_spec.rb +762 -23
- data/spec/models/supplemental_options_spec.rb +1018 -0
- data/spec/models/v7_network_comparison_response_spec.rb +994 -0
- data/spec/models/v7_network_details_response_spec.rb +988 -0
- data/spec/models/v7_network_details_spec.rb +1006 -0
- data/spec/models/v7_network_search_response_spec.rb +994 -0
- data/spec/models/v7_network_spec.rb +1000 -0
- data/spec/models/v7_provider_details_spec.rb +1138 -0
- data/spec/models/v7_provider_networks_spec.rb +1012 -0
- data/spec/models/vision_plan_benefits_spec.rb +813 -32
- data/spec/models/vision_plan_search_applicant_spec.rb +754 -15
- data/spec/models/vision_plan_search_request_spec.rb +758 -25
- data/spec/models/vision_plan_search_response_spec.rb +754 -15
- data/spec/models/vision_plan_show_response_spec.rb +754 -15
- data/spec/models/vision_plan_spec.rb +767 -28
- data/spec/models/vision_plan_update_request_spec.rb +754 -15
- data/spec/models/vision_plan_update_spec.rb +763 -24
- data/spec/models/zip_code_spec.rb +754 -15
- data/spec/models/zip_counties_response_spec.rb +756 -17
- data/spec/models/zip_county_bulk_spec.rb +757 -18
- data/spec/models/zip_county_response_spec.rb +754 -15
- data/spec/models/zip_county_spec.rb +754 -15
- data/spec/spec_helper.rb +754 -15
- data/vericred_client.gemspec +754 -15
- metadata +315 -95
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=begin
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#Vericred API
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#Vericred's API allows you to search for Health Plans that a specific doctor
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## Getting Started
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## Signing Up
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Visit our [Developer Portal](https://developers.vericred.com) to
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Once you have created an account, you can create one Application for
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you create the Application).
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Once you have created an account, you can create one Application for your
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Production environment and another for a Sandbox (select the appropriate Plan when you create the Application).
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## SDKs
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Vericred's API default to the latest version. However, if you need a specific
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The current version is `v4`. We also support `v2` and `v3`
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`curl -H 'Vericred-Api-Key: YOUR_KEY' -H 'Accept-Version:
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`curl -H 'Vericred-Api-Key: YOUR_KEY' -H 'Accept-Version: v3' "https://api.vericred.com/providers?search_term=Foo&zip_code=11215"`
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## Pagination
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## Sideloading
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When we return multiple levels of an object graph (e.g. `Provider`s and their
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`State`s and a `state_id` for each provider. This is
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payload size since many of the `Provider`s
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When we return multiple levels of an object graph (e.g. `Provider`s and their
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`State`s we typically the associated data. In this example, we would
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provide an Array of `State`s and a `state_id` for each provider. This is
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done primarily to reduce the payload size since many of the `Provider`s
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will share a `State`
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### Simplified Example
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```
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{
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`select` in the query string for a `GET` or the body for a `POST`.
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# Plan and Rate Data
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Vericred's Plan and Rate Data let you search and quote Major Medical and Ancillary Insurance Plans in a given area for a particular family in the Individual Market or a group of families in the Small Group Market. Vericred provides the relevant data via this API and via our Bulk Format (documented [below](#Bulk Plan and Rate Data))
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## Plans
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A Plan defines a set of Benefits available to its purchaser. For example, a Major Medical Plan would specify cost-share Benefits for services like a Primary Care Provider visit, a Specialist visit or an Emergency Room visit. A Dental Plan might specify Benefits for Periodontics and Fluroride Treatments. The Benefits for each Product type ([Major Medical](#header-major-medical), [Dental](#header-dental), and [Vision](#header-vision)) are documented below.
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### Benefits Format
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Benefits for Plans can be quite complex. With the goals of capturing and standardizing the complexity while retaining a human-readable format, we have developed a [Bakus-Naur Form](https://en.wikipedia.org/wiki/Backus%E2%80%93Naur_form)(BNF) context-free grammar, with which we present Benefits.
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* Network tiers
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* Compound or conditional cost-share
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### Major Medical
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Vericred's data covers all Major Medical Plans available in the Individual and Small Groups (2-50 or 2-100) Markets in the US. These Plans are governed by CMS and are ACA-compliant. We do not include certain Plans that fall outside of the ACA, for example, Faith-Based Plans or Short-Term Medical Plans
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We support the following Benefits Fields for Major Medical Plans. These represent the vast majority of fields available on a [Summary of Benefits and Coverage](https://www.healthcare.gov/health-care-law-protections/summary-of-benefits-and-coverage/)
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The following are the appropriate Benefit Fields for Major Medical:
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- ambulance
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- child\_eye\_exam
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- child\_eyewear
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- chiropractic\_services
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- diagnostic\_test
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- durable\_medical\_equipment
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- emergency\_room
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- family\_drug\_deductible
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- generic\_drugs
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- habilitation\_services
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- imaging\_center
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- imaging\_physician
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- individual\_drug\_moop
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- individual\_medical\_moop
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- inpatient\_birth
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- inpatient\_facility
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- inpatient\_mental\_health
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- inpatient\_physician
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- inpatient\_substance
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- lab\_test
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- non\_preferred\_brand\_drugs
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- outpatient\_ambulatory\_care\_center
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- outpatient\_facility
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- outpatient\_mental\_health
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- outpatient\_physician
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- outpatient\_substance
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- postnatal\_care
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- preferred\_brand\_drugs
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- prenatal\_care
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- preventative\_care
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- primary\_care\_physician
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- rehabilitation\_services
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- specialist
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- urgent\_care
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### Dental
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Dental benefits are less standardized than [Major Medical](#header-major-medical). Because of this, we have captured benefits for the most commonly specified services and procedures. If a Plan only specifies cost-share for "Major", "Minor", "Elective", etc, we determine the category for each of the benefits that we support and display the appropriate value for its category.
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To view the technical documentation, [click here](#dental-plans).
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The following are the supported Benefit Fields for Dental:
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- bridges
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- crowns
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- denture\_relines\_rebases
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- denture\_repair\_and\_adjustments
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- dentures
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- emergency\_treatment
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- endodontics
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- family\_annual\_max
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- family\_deductible
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- fluoride\_treatment
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- implants
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- individual\_annual\_max
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- individual\_deductible
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- inlays
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- onlays
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- oral\_exam
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- oral\_surgery
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- orthodontics\_adult
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- orthodontics\_child
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- periodontal\_maintenance
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- periodontics
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- prophylaxis\_cleaning
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- radiograph\_bitewings
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- radiograph\_other
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- restoration\_fillings
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- sealant
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- simple\_extraction
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- space\_maintainers
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### Vision
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Vision benefits are similar in structure to [Dental](#header-dental). Again, when benefits are broken out by category, we determine the appropriate category for each service or procedure and display the approprate value for its category.
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To view the technical documentation, [click here](#vision-plans).
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The following are the supported Benefit Fields for Vision:
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- eye\_exam
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- retinal\_imaging
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- frame
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- eyeglass\_lenses\_single\_vision
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- eyeglass\_lenses\_bifocal
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- eyeglass\_lenses\_trifocal
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- eyeglass\_lenses\_lenticular
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- uv\_coating
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- tint
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- standard\_antireflective\_coating
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- premium\_antireflective\_coating
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- standard\_polycarbonate\_lenses\_child
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- standard\_polycarbonate\_lenses\_adult
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- standard\_progressive\_lenses
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- premium\_progressive\_lenses
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- standard\_scratch\_resistance
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- polarized\_lenses
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- photochromatic\_lenses
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- standard\_contact\_lens\_fit\_and\_follow\_up
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- contact\_lenses\_conventional
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- contact\_lenses\_medically\_necessary
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- laser\_vision\_correction
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- additional\_pairs\_of\_eyeglasses
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## Rates
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Rates are returned from the API as a part of [Quoting](#header-quoting). We calculate Rates in one of two ways.
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### Sheet Rates
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When a Carrier supplies us with Sheet Rates, we display *exactly* the value provided to us. For example, in the Major Medical market, most Carriers provide a single rate for each combination of Applicant age and tobacco status in a given [Rating Area](#header-rating-areas). For example, in Austin, TX, a 21-year-old non-tobacco-user may be $312.41 per month while a 22-year-old tobacco-user may be $401.75 per month. Certain Vision and Dental Carriers supply Sheet Rates as well, though it is less common.
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### Rate Factors
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Certain [Major Medical](#header-major-medical) Carriers and most [Vision](#header-vision) and [Dental](#header-dental) Carriers supply Rate Factors. The attributes on which the factors are based are the same as [Sheet Rates](#header-sheet-rates) for the [Major Medical](#header-major-medical) market (due to restrictions on what factors may be used in ACA Plans, which limit the possible factors to age and tobacco status).
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In [Dental](#header-dental) and [Vision](#header-vision), the types of [Rate Factors](#header-rate-factors) are more varied. For example, SIC Code and Group size in the Group market and Gender in the Individual Market are commonly used [Rate Factors](#header-rate-factors)
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Other common [Rate Factors](#header-rate-factors) for [Dental](#header-dental) and [Vision](#header-vision) products are Geographic and "Trend" (enrollment date) Factors. In [Major Medical](#header-major-medical), these types of variance are handled by CMS-defined [Rating Areas](#header-rating-areas).
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|
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In order to calculate a Rate using [Rate Factors](#header-rate-factors), the following methodology is applied:
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|
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```
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B = Base Rate
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f = Rate Factor Function 1
|
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f' = Rate Factor Function 2
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|
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B * f(x) * f'(y) [* f''(z)] ... = n
|
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```
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|
360
|
+
## Rating Areas
|
361
|
+
For [Major Medical](#header-major-medical) products, [CMS](https://www.cms.gov/) defines [Rating Areas](https://www.cms.gov/cciio/programs-and-initiatives/health-insurance-market-reforms/state-gra.html). Under the ACA, *all* [Rate Factors](#header-rate-factors) in a Rating Area must be identical for a given time period. E.g. in Arizona, the rate for a 21-year-old non-tobacco user must be identical in all counties contained in Rating Area 1 (Mohave, Coconino, Apache, and Navajo), but *may* be different than the rate for a 21-year-old non-tobacco user in all counties Rating Area 2 (Yavapai county only) for a given year in the Individual Market and a given quartern in the Small Group market.
|
362
|
+
|
363
|
+
[Rating Areas](#header-rating-areas) are defined either by County, Zip Code or both, depending on the State. Because of this variance, all API endpoints that require a [Location](#header-specifying-the-location) require both `zip_code` and `fips_code` (a county code). [Bulk Data](#bulkplanandratedata) for [Rating Areas](#bulkratingareas) and [Service Areas](#bulkserviceareas) also specifies locations using both `zip_code` and `fips_code`.
|
364
|
+
|
365
|
+
*Rating Areas do not apply to products other than [Major Medical](#header-major-medical)*
|
366
|
+
|
367
|
+
## Service Areas
|
368
|
+
CMS mandates that [Major Medical](#header-major-medical) Rates be defined by [Rating Areas](#header-rating-areas), which themselves define a geography in which Plans are offered. Carriers often choose *not* to offer a Plan in and entire [Rating Area](#header-rating-areas) due to network coverage or other factors. Instead, the Carrier would define a [Service Area](#header-service-areas) that specifies where a given Plan is offered.
|
369
|
+
|
370
|
+
Each Plan is available in a single [Service Area](#header-service-areas) and each [Service Area](#header-service-areas) is defined by either County, Zip Code, or both, depending on the Carrier. Because of this variance, all API endpoints that require a [Location](#header-specifying-the-location) require both `zip_code` and `fips_code` (a county code). [Bulk Data](#bulkplanandratedata) for [Rating Areas](#bulkratingareas) and [Service Areas](#bulkserviceareas) also specifies locations using both `zip_code` and `fips_code`.
|
371
|
+
|
372
|
+
In [Dental](#header-dental) and [Vision](#header-vision) plans, we use a [Service Area](#header-service-areas) to define availability as well, although it typically mirrors a Geographic [Rate Factor](#header-rate-factors).
|
373
|
+
|
374
|
+
# Quoting
|
375
|
+
|
376
|
+
One of the primary use-cases for the Vericred API is to run Quotes to determine the Rate for a given family (in the Individual Market) or group (in the Small Group Market). We support quoting across [Major Medical](#header-major-medical), [Vision](#header-vision), and [Dental](#header-dental). In both cases, the process of generating a Quote is broken out into several steps:
|
377
|
+
|
378
|
+
1. Find all available [Plans](#header-plans) in the relevent [Service Areas](#header-service-areas) for the family or group.
|
379
|
+
1. Using [Business Rules](#header-business-rules) for each [Plan](#header-plans), determine if the family or group is eligible for that [Plan](#header-plans).
|
380
|
+
1. Using [Business Rules](#header-business-rules) for each [Plan](#header-plans), determine which members of the family or which members of each family in the group should be considered for Rating.
|
381
|
+
1. Using the [Sheet Rates](#header-sheet-rates) or [Rate Factors](#header-rate-factors) for each [Plan](#header-plans), determine the Rate the family, or for each family in the group.
|
382
|
+
1. If running a [Composite](#compositerates) quote, determine the portion of the total Rate that each family will pay.
|
383
|
+
|
384
|
+
## Individual Quotes
|
385
|
+
An Individual Quote is one for Plans that are available to a particular family, outside the context of their Employer. In the [Major Medical](#header-major-medical) market, many of these Plans are available on [Healthcare.gov](https://www.healthcare.gov) or the State-Based Exchange for non-Healthcare.gov states. The API supports both on-market and off-market Plans.
|
386
|
+
|
387
|
+
For details on Major Medical Quoting API calls see [below](#medicalplans-medicalplans-post)
|
388
|
+
|
389
|
+
### Specifying the Location
|
390
|
+
In order to determine which plans are [available](#header-service-areas) and the [rate](#header-rating-areas) for each Plan, you must specify a location. When creating a [Quote](#header-quoting) for the Individual Market, that information is contained in the `POST` body of the request:
|
391
|
+
```
|
392
|
+
POST /plans/medical/search
|
393
|
+
{
|
394
|
+
...
|
395
|
+
"zip_code": "11201",
|
396
|
+
"fips_code": "36047"
|
397
|
+
...
|
398
|
+
}
|
399
|
+
|
400
|
+
```
|
401
|
+
|
402
|
+
### Specifying Applicants
|
403
|
+
Applicants are the members of the family being quoted and are specified in the `POST` body of the request.
|
404
|
+
```
|
405
|
+
POST /plans/medical/search
|
406
|
+
{
|
407
|
+
...
|
408
|
+
"applicants": [
|
409
|
+
{
|
410
|
+
"age": 34,
|
411
|
+
"smoker": true,
|
412
|
+
"child": false
|
413
|
+
},
|
414
|
+
{
|
415
|
+
"age": 32,
|
416
|
+
"smoker": false,
|
417
|
+
"child": false
|
418
|
+
},
|
419
|
+
{
|
420
|
+
"age": 4,
|
421
|
+
"smoker": false,
|
422
|
+
"child": true
|
423
|
+
}
|
424
|
+
]
|
425
|
+
...
|
426
|
+
}
|
427
|
+
```
|
428
|
+
|
429
|
+
### Specifying Enrollment Date
|
430
|
+
The `enrollment_date` determines which [Plans](#header-plans) and [Rates](#header-rates) are returned. Specifying an `enrollment_date` in the past allows you to calculate historical data as far back as 2014.
|
431
|
+
|
432
|
+
### Plan Benefits
|
433
|
+
Plan Benefits are returned in the response for [Individual Quotes](#individualquotes)
|
434
|
+
```
|
435
|
+
POST /plans/medical/search
|
436
|
+
{
|
437
|
+
...
|
438
|
+
}
|
439
|
+
|
440
|
+
Response:
|
441
|
+
{
|
442
|
+
"plans": [
|
443
|
+
{
|
444
|
+
...
|
445
|
+
"individual_medical_deductible": "$5,000",
|
446
|
+
"family_medical_deductible": "$10,000"
|
447
|
+
...
|
448
|
+
}
|
449
|
+
|
450
|
+
]
|
451
|
+
}
|
452
|
+
|
453
|
+
```
|
454
|
+
|
455
|
+
### Premiums
|
456
|
+
The value for the family being quoted is returned in the `premium` field. If no [Applicants](#specifyingapplicants) are provided, the `premium` field will be `0`
|
457
|
+
|
458
|
+
### Major Medical Quotes
|
459
|
+
In order to [Quote](#header-quoting) [Major Medical](#header-major-medical) Plans, send a `POST` to `/plans/medical/search`. In addition, the `age`, `smoker` and `child` attributes of each Applicant must be present.
|
460
|
+
|
461
|
+
#### Subsidies
|
462
|
+
On-market ([Healthcare.gov](https://www.healthcare.gov) and State-Based Exchange) [Major Medical](#header-major-medical) Plans are eligible for government subsidies. The subsidy calculation is based on the percentage of the family's income that the IRS has designated as "affordable" for that family and the Second Lowest-Cost Silver Plan available to that family.
|
463
|
+
|
464
|
+
In order to calculate subsidies for a family the following parameters must be supplied:
|
465
|
+
```
|
466
|
+
POST /plans/medical/search
|
467
|
+
{
|
468
|
+
...
|
469
|
+
"household_size": 4,
|
470
|
+
"household_income": 40000
|
471
|
+
...
|
472
|
+
}
|
473
|
+
```
|
474
|
+
|
475
|
+
The amount that the family will pay after subsidy is returned in the `premium_subsidized` field for each plan.
|
476
|
+
|
477
|
+
##### Subsidy Calculation
|
478
|
+
Here is how subsidies are calculated. This is fully handled by the Vericred API, but the steps are enumerated below for clarity.
|
479
|
+
|
480
|
+
1. Determine the percentage of the [Federal Poverty Level](https://aspe.hhs.gov/poverty-guidelines) for the family based on the household size and income.
|
481
|
+
1. Reference the [CMS table](https://www.irs.gov/pub/irs-drop/rp-17-36.pdf) to determine the appropriate percentage of income for the family to spend on healthcare.
|
482
|
+
1. Multiply that value by the family's income. This is the total amount that the family can spend on healthcare for the year, after the subsidy.
|
483
|
+
1. Find the cost of the Second Least-Expensive Silver Plan available to the family, accounting for the percentage of premium that goes to [Essential Health Benefits](https://www.healthcare.gov/glossary/essential-health-benefits/)
|
484
|
+
1. Calculate the difference in price between the amount the family should spend on healthcare and the Second Least-Expensive Silver Plan's premium. This is the subsidy.
|
485
|
+
1. Apply the subsidy to all on-market Plans available to the family. The subsidized premium can never be below $0 (for example, a low-cost Bronze Plan may be less expensive than the subsidy)
|
486
|
+
|
487
|
+
#### Cost Sharing Reduction Plans
|
488
|
+
[Cost Sharing Reduction (CSR)](https://www.healthcare.gov/glossary/cost-sharing-reduction/) Plans are available to lower income families and offer enhanced benefits for certain Silver Plans at the same cost as the non-CSR Plans available to higher-income families.
|
489
|
+
|
490
|
+
If a family is eligible for CSR Plans, the Vericred API will return the relevant Plan in place of the non-CSR version.
|
491
|
+
|
492
|
+
In order to include CSR Plans where applicable, the following parameters must be supplied:
|
493
|
+
```
|
494
|
+
POST /plans/medical/search
|
495
|
+
{
|
496
|
+
...
|
497
|
+
"household_size": 4,
|
498
|
+
"household_income": 40000
|
499
|
+
...
|
500
|
+
}
|
501
|
+
```
|
502
|
+
|
503
|
+
#### The Children's Health Insurance Program (CHIP)
|
504
|
+
[The Children's Health Insurance Program (CHIP)](https://www.healthcare.gov/medicaid-chip/childrens-health-insurance-program/) provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid.
|
505
|
+
|
506
|
+
If a family is eligible for CHIP, the Vericred API will include the subsidy in the returned premiums. In order to include CHIP subsidies in premium calculations, the following parameters must be supplied:
|
507
|
+
```
|
508
|
+
POST /plans/medical/search
|
509
|
+
{
|
510
|
+
...
|
511
|
+
"applicants": [
|
512
|
+
{
|
513
|
+
"age": 34,
|
514
|
+
"smoker": true,
|
515
|
+
"child": false
|
516
|
+
},
|
517
|
+
{
|
518
|
+
"age": 32,
|
519
|
+
"smoker": false,
|
520
|
+
"child": false
|
521
|
+
},
|
522
|
+
{
|
523
|
+
"age": 4,
|
524
|
+
"smoker": false,
|
525
|
+
"child": true
|
526
|
+
},
|
527
|
+
{
|
528
|
+
"age": 4,
|
529
|
+
"smoker": false,
|
530
|
+
"child": true
|
531
|
+
}
|
532
|
+
],
|
533
|
+
"household_size": 4,
|
534
|
+
"household_income": 40000
|
535
|
+
...
|
536
|
+
}
|
537
|
+
```
|
538
|
+
|
539
|
+
CHIP eligibility is displayed within the meta-tag in the response as `eligible_for_chip_medicaid`:
|
540
|
+
```
|
541
|
+
{
|
542
|
+
"meta": {
|
543
|
+
"total": 150,
|
544
|
+
"eligible_for_chip_medicaid": true,
|
545
|
+
"premium_tax_credit": 500.20
|
546
|
+
},
|
547
|
+
"coverages": [],
|
548
|
+
"plans": [...]
|
549
|
+
}
|
550
|
+
```
|
551
|
+
|
552
|
+
If you do not want CHIP subsidies to be included in the premiums, simply do not include the `household_income` parameter in the request.
|
553
|
+
|
554
|
+
### Dental Quotes
|
555
|
+
Quoting [Dental](#header-dental) Plans for a family requires slightly different parameters for [Applicants](#specifyingapplicants), due to the method with which Plans are [rated](#header-rate-factors). The folloiwng example contains the require parameters:
|
556
|
+
```
|
557
|
+
POST /plans/dental/search
|
558
|
+
{
|
559
|
+
...
|
560
|
+
"applicants": [
|
561
|
+
{
|
562
|
+
"age": 34,
|
563
|
+
"gender": "M",
|
564
|
+
"child": false
|
565
|
+
},
|
566
|
+
{
|
567
|
+
"age": 32,
|
568
|
+
"gender": "F",
|
569
|
+
"child": false
|
570
|
+
},
|
571
|
+
{
|
572
|
+
"age": 4,
|
573
|
+
"gender": "M",
|
574
|
+
"child": true
|
575
|
+
}
|
576
|
+
]
|
577
|
+
...
|
578
|
+
}
|
579
|
+
```
|
580
|
+
|
581
|
+
Note that in contrast to [Major Medical Quotes](#majormedicalquotes), [Dental Quotes](#dentalquotes) require `gender`, but *do not* require `smoker`.
|
582
|
+
|
583
|
+
Also note that [Subsidies](#subsidies) and [Cost Sharing Reduction](#costsharingreductionplans) are *not* relevant for [Dental Quotes](#dentalquotes).
|
584
|
+
|
585
|
+
### Vision Quotes
|
586
|
+
|
587
|
+
Quoting [Vision](#header-vision) Plans for a family requires slightly different parameters for [Applicants](#specifyingapplicants), due to the method with which Plans are [rated](#header-rate-factors). The folloiwng example contains the require parameters:
|
588
|
+
```
|
589
|
+
POST /plans/vision/search
|
590
|
+
{
|
591
|
+
...
|
592
|
+
"applicants": [
|
593
|
+
{
|
594
|
+
"age": 34,
|
595
|
+
"gender": "M",
|
596
|
+
"child": false
|
597
|
+
},
|
598
|
+
{
|
599
|
+
"age": 32,
|
600
|
+
"gender": "F",
|
601
|
+
"child": false
|
602
|
+
},
|
603
|
+
{
|
604
|
+
"age": 4,
|
605
|
+
"gender": "M",
|
606
|
+
"child": true
|
607
|
+
}
|
608
|
+
]
|
609
|
+
...
|
610
|
+
}
|
611
|
+
```
|
612
|
+
|
613
|
+
Note that in contrast to [Major Medical Quotes](#majormedicalquotes), [Vision Quotes](#visionquotes) require `gender`, but *do not* require `smoker`.
|
614
|
+
|
615
|
+
Also note that [Subsidies](#subsidies) and [Cost Sharing Reduction](#costsharingreductionplans) are *not* relevant for [Vision Quotes](#visionquotes).
|
616
|
+
|
617
|
+
## Quotes for Groups
|
618
|
+
A Group Quote finds [Plans](#header-plans) and [Rates](#header-rates) for a group of employees for a small business. Different [Plans](#header-plans) are available to small groups than are available in [Individual Quoting](#individualquotes). In addition, [Business Rules](#header-business-rules) that apply across multiple families or based upon employer attributes such as [SIC](https://en.wikipedia.org/wiki/Standard_Industrial_Classification) code factor into rates and availability.
|
619
|
+
|
620
|
+
In addition, due to performance requirements and for enhanced auditing, [Group Quotes](#groupquotes) are persisted across requests. This means that a given [Quote](#groupquotes) can be retrieved after it has been created.
|
621
|
+
|
622
|
+
### Identifiers
|
623
|
+
In order to make it easier to cross-reference local copies of data with [Quotes](#header-creating-a-quote) and other data in the Vericred API, most entities allow for the specification of an `external_id` field. You can use this to store a primary or natural key from your system in order to easily match records returned from the API with records in your system.
|
624
|
+
|
625
|
+
### Specifying the Group
|
626
|
+
Creating a group is the first step in [Group Quoting](#groupquoting). The API requires that certain information such as `sic_code`, and `chamber_association` be provided and returns a the attributes and `id` for the newly created `Group`
|
627
|
+
|
628
|
+
Full documentation is available [below](#groupscreate)
|
629
|
+
|
630
|
+
### Specifying the Locations
|
631
|
+
When creating a `Group`, you must also specify one or more `Location`s. Of those `Location`s specified, one must be `primary`. That `Location` is used to calculate Plan eligibility using the relevant [Service Areas](#header-service-areas). Some Carriers use secondary `Location`s to determine eligibility as well, which is why those must be specified as well.
|
632
|
+
|
633
|
+
```
|
634
|
+
POST /groups
|
635
|
+
{
|
636
|
+
"group": {
|
637
|
+
...
|
638
|
+
},
|
639
|
+
"locations": [
|
640
|
+
{
|
641
|
+
...
|
642
|
+
"zip_code": "11201",
|
643
|
+
"fips_code": "36047",
|
644
|
+
"primary": true
|
645
|
+
...
|
646
|
+
}
|
647
|
+
]
|
648
|
+
}
|
649
|
+
```
|
650
|
+
|
651
|
+
### Specifying the Census
|
652
|
+
A Census is the collection of `Member`s contained in the `Group`. The attributes of each `Member` and his or her `Dependent`s determine the [Rate](#header-rates) for the `Group` as a whole. Certain attributes of the `Member` are important for calculating [Rates](#header-rates) and applying [Business Rules](#header-business-rules). For example, the `Member`'s home address and in which office he or she works are relevant for certain [Business Rules](#header-business-rules).
|
653
|
+
|
654
|
+
#### Dependent Relationships
|
655
|
+
The `Dependent`s for a given `Member` also factor into the [Rates](#header-rates) and application of [Business Rules](#header-business-rules). For example, certain [Plans](#header-plans) cover only `Dependent`s of particular types and/or only `Dependent`s of a particular type who live in the same household as the primary `Member`
|
656
|
+
|
657
|
+
Valid Dependent Relationships:
|
658
|
+
- `adopted_child`
|
659
|
+
- `child`
|
660
|
+
- `court_appointed_guardian`
|
661
|
+
- `dependent_of_dependent`
|
662
|
+
- `ex_spouse`
|
663
|
+
- `foster_child`
|
664
|
+
- `grand_child`
|
665
|
+
- `guardian`
|
666
|
+
- `life_partner`
|
667
|
+
- `other`
|
668
|
+
- `sibling`
|
669
|
+
- `sponsored_dependent`
|
670
|
+
- `spouse`
|
671
|
+
- `step_child`
|
672
|
+
- `ward`
|
673
|
+
|
674
|
+
```
|
675
|
+
POST
|
676
|
+
|
677
|
+
/groups/{id}/members
|
678
|
+
{
|
679
|
+
"members": [
|
680
|
+
...
|
681
|
+
{
|
682
|
+
"cobra": false,
|
683
|
+
"date_of_birth": "1980-01-01",
|
684
|
+
"fips_code": "36047"
|
685
|
+
"gender": "M",
|
686
|
+
"last_used_tobacco": "2017-01-01",
|
687
|
+
"location_id": :location_id
|
688
|
+
"retiree": false,
|
689
|
+
"zip_code": "11201",
|
690
|
+
"dependents": [
|
691
|
+
...
|
692
|
+
{
|
693
|
+
"relationship": "child",
|
694
|
+
"same_household": true
|
695
|
+
}
|
696
|
+
...
|
697
|
+
]
|
698
|
+
}
|
699
|
+
...
|
700
|
+
]
|
701
|
+
}
|
702
|
+
|
703
|
+
```
|
704
|
+
|
705
|
+
### Creating a Quote
|
706
|
+
Once the [Census](#header-specifying-the-census) has been created, we can generate a `Quote` for the `Group`.
|
707
|
+
|
708
|
+
#### Major Medical Quotes
|
709
|
+
To generate a [Major Medical](#header-major-medical) Quote, specify the `product_line` of `Quote` as `medical`
|
710
|
+
|
711
|
+
```
|
712
|
+
POST /groups/{id}/quotes
|
713
|
+
{
|
714
|
+
...
|
715
|
+
"product_line": "medical"
|
716
|
+
...
|
717
|
+
}
|
718
|
+
```
|
719
|
+
|
720
|
+
#### Dental Quotes
|
721
|
+
To generate a [Dental](#header-dental) Quote, specify the `product_line` of `Quote` as `dental`
|
722
|
+
|
723
|
+
```
|
724
|
+
POST /groups/{id}/quotes
|
725
|
+
{
|
726
|
+
...
|
727
|
+
"product_line": "dental"
|
728
|
+
...
|
729
|
+
}
|
730
|
+
```
|
731
|
+
|
732
|
+
#### Vision Quotes
|
733
|
+
To generate a [Vision](#header-vision) Quote, specify the `product_line` of `Quote` as `vision`
|
734
|
+
|
735
|
+
```
|
736
|
+
POST /groups/{id}/quotes
|
737
|
+
{
|
738
|
+
...
|
739
|
+
"product_line": "vision"
|
740
|
+
...
|
741
|
+
}
|
742
|
+
```
|
743
|
+
|
744
|
+
### Retrieving Aggregate Rates
|
745
|
+
Once you have created a [Quote](#header-creating-a-quote), you can retrieve its aggregate [Rates](#header-rates). [Rates](#header-rates) are broken down by `Member` and `Dependent`, so that you can show the final cost in different scenarios where an employer might cover a different percentage of `Member` and `Dependent` costs.
|
746
|
+
|
747
|
+
```
|
748
|
+
GET /quotes/{id}/rates
|
749
|
+
|
750
|
+
Response
|
751
|
+
{
|
752
|
+
"rates": [
|
753
|
+
...
|
754
|
+
{
|
755
|
+
"plan_id": "12345NY6789012",
|
756
|
+
"total_premium": 2800.0,
|
757
|
+
"member_premium": 1000.0,
|
758
|
+
"dependent_premium": 1800.0,
|
759
|
+
"id": "123abc"
|
760
|
+
}
|
761
|
+
...
|
762
|
+
]
|
763
|
+
}
|
764
|
+
```
|
765
|
+
|
766
|
+
|
767
|
+
#### Loading Plan Data
|
768
|
+
Aggregate [Rates](#header-rates) responses *do not* include [Plan](#header-plans) details in order to keep the payload small. [Plan](#header-plans) data can be retrieved in one of two ways:
|
769
|
+
|
770
|
+
Loading the [Plan](#header-plans) from the API:
|
771
|
+
```
|
772
|
+
GET /plans/{id}
|
773
|
+
|
774
|
+
Response:
|
775
|
+
{
|
776
|
+
"plans": [
|
777
|
+
...
|
778
|
+
{
|
779
|
+
...
|
780
|
+
"individual_medical_deductible": "$5,000",
|
781
|
+
"family_medical_deductible": "$10,000",
|
782
|
+
...
|
783
|
+
}
|
784
|
+
...
|
785
|
+
|
786
|
+
]
|
787
|
+
}
|
788
|
+
```
|
789
|
+
Pulling in [Bulk Plan Data](#bulkplans) and matching up [Plans](#header-plans) by their `id`.
|
790
|
+
|
791
|
+
### Retrieving Member-Level Rates
|
792
|
+
In order to retrieve the exact [Rate](#header-rates) for each `Member` and their `Dependents` for given [Plan](#header-plans), you can load Member-Level `Rates`.
|
793
|
+
|
794
|
+
```
|
795
|
+
GET /rates/{id}/member_rates
|
796
|
+
|
797
|
+
Response
|
798
|
+
{
|
799
|
+
"member_rates": [
|
800
|
+
...
|
801
|
+
{
|
802
|
+
"id": "123abc",
|
803
|
+
"member_id": "234def",
|
804
|
+
"member_external_id": "externally-supplied-id",
|
805
|
+
"member_premium": 500.0,
|
806
|
+
"dependent_premium": 600.0,
|
807
|
+
"total_premium": 1100.0,
|
808
|
+
}
|
809
|
+
...
|
810
|
+
]
|
811
|
+
}
|
812
|
+
|
813
|
+
```
|
814
|
+
|
815
|
+
Note that *all* `MemberRate`s are for one particular [Plan](#header-plans) - the one referenced by the parent [Rate](#header-rates).
|
816
|
+
|
817
|
+
### Business Rules
|
818
|
+
Vericred works with our Carrier partners to acquire and apply Business Rules that can affect either [Plan](#header-plans) availability or the way in which `Member`s and `Dependent`s are rated. For example, one Carrier's Business Rules might specify that `Member`s and `Dependent`s who have used tobacco in the past 4 months are considered "tobacco-users", while another's may specify that period to be 1 year.
|
819
|
+
|
820
|
+
These rules are applied transparently during the [Quoting](#header-quoting) process and *do not* require any additional action or input on your part.
|
821
|
+
|
822
|
+
For a full accounting of Business Rules and a list of Carriers whose Business Rules are applied, please contact support@vericred.com
|
823
|
+
|
824
|
+
### Composite Rates
|
825
|
+
Composite Rates are commonly used in [Major Medical](#header-major-medical), [Dental](#header-dental), and [Vision](#header-vision) [Plans](#header-plans) to simplify operations by charging each family the weighted average of the `Group`'s total premium. The most common methodology is as follows:
|
826
|
+
|
827
|
+
1. Calculate the [Rates](#header-rates) for the entire `Group` using [Sheet Rates](#header-sheet-rates) or [Rate Factors](#header-rate-factors) as appropriate
|
828
|
+
1. Categorize each Family within the Group. The categorization differs depending on whether the Composite Rate is 2, 3, or 4-tier
|
829
|
+
1. Multiply the number of Families in each category by the constant for that category. These constants are provided to Vericred by the Carrier. This determines the total number of "Rating Units"
|
830
|
+
1. Divide the total premium calculated in Step 1 by the total number of Rating Units to get the price per Rating Unit
|
831
|
+
1. The [Rate](#header-rates) each Family pays is the constant for that Family's category multiplied by the price per Rating Unit.
|
832
|
+
|
833
|
+
You can request that a [Quote](#header-quoting) be calculated using Composite Rates when creating it:
|
834
|
+
```
|
835
|
+
POST /quotes
|
836
|
+
{
|
837
|
+
...
|
838
|
+
"rating_method": "4_tier_composite"
|
839
|
+
...
|
840
|
+
}
|
841
|
+
```
|
842
|
+
If no Composite Rates methodology is available, the Vericred API will return standard age-banded Rates.
|
843
|
+
|
844
|
+
# Network and Provider Data
|
845
|
+
|
846
|
+
A `Provider` is an individual or organization in the medical profession. For example, an individual doctor is a `Provider` as are certain clinics and hospitals.
|
847
|
+
|
848
|
+
`Provider`s are related to `Network`s. A `Network` is a collection of `Provider`s that are under a particular contract with a given `Carrier`. A given `Carrier` will often have multiple `Network`s. For example, there may be a large national `Network` as well as several smaller regional `Network`s.
|
849
|
+
|
850
|
+
Each `Plan` has a `Network`. A consumer who visits a `Provider` typically incurs fewer costs when visiting a `Provider` in the `Network` covered by his or her `Plan`. The `premium` for a `Plan` is often proportional to the size of its `Network`
|
851
|
+
|
852
|
+
## Finding Providers
|
853
|
+
In order to determine if a particular `Plan` covers a given `Provider`, you must first identify the `Provider`. To do so, use the [Provider Search API endpoint](#providers-providers-post) and specify some search criteria:
|
854
|
+
|
855
|
+
```
|
856
|
+
POST /providers/search
|
857
|
+
{
|
858
|
+
"search_term": "foo",
|
859
|
+
"zip_code": "11201"
|
860
|
+
}
|
861
|
+
```
|
862
|
+
|
863
|
+
The API will return an ordered list of `Provider`s who match the query along with their names, addresses, and other demographic data. The `id` field returned refers to the `Provider`'s [NPI number](https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand/). This is the key that is used to identify the `Provider` across different API endpoints.
|
864
|
+
|
865
|
+
## Finding Networks
|
866
|
+
|
867
|
+
A `Network` is a collection of `Provider`s that are under a particular contract with a given `Carrier`. A given `Carrier` will often have multiple `Network`s. For example, there may be a large national `Network` as well as several smaller regional `Network`s.
|
868
|
+
|
869
|
+
The API supports searching for `Networks` by Carrier, market and state. For more details view the [endpoint documentation](#networks-networks-get)
|
870
|
+
|
871
|
+
## Matching Providers to Networks
|
872
|
+
In order to determine if a `Provider` is covered by a user's `Plan`, you will need to map the `Provider` to a `Network`. There are several methods to do this using the API
|
873
|
+
|
874
|
+
### Using Plan Search
|
875
|
+
You can specify one or more `npi` values in the [`plan` search](#majormedicalplans-majormedicalplans-post). To do so, include a list of `providers` in the request
|
876
|
+
```
|
877
|
+
POST /plans/medical/search
|
878
|
+
{
|
879
|
+
...
|
880
|
+
"providers": [
|
881
|
+
{ "npi": 1234567890 },
|
882
|
+
{ "npi": 2345678901 }
|
883
|
+
]
|
884
|
+
...
|
885
|
+
}
|
886
|
+
|
887
|
+
The response will then return a list of `in_network_ids` and `out_of_network_ids` for each `Plan`
|
888
|
+
|
889
|
+
```
|
890
|
+
{
|
891
|
+
"plans": [
|
892
|
+
...
|
893
|
+
{
|
894
|
+
...
|
895
|
+
"id": "12345NY1234567",
|
896
|
+
"in_network_ids": [1234567890],
|
897
|
+
"out_of_network_ids": [1234567890]
|
898
|
+
...
|
899
|
+
},
|
900
|
+
{
|
901
|
+
...
|
902
|
+
"id": "12345NY2345678",
|
903
|
+
"in_network_ids": [1234567890, 1234567890],
|
904
|
+
"out_of_network_ids": []
|
905
|
+
...
|
906
|
+
}
|
907
|
+
...
|
908
|
+
]
|
909
|
+
}
|
910
|
+
|
911
|
+
Simply reference the `Provider` in question by its `id` for each `Plan` to see if that `Provider` is in-network for the `Plan`.
|
912
|
+
|
913
|
+
### Matching by Plan ID
|
914
|
+
Given a `Provider`'s `id`, you can retrieve all of his or her `hios_ids`
|
915
|
+
|
916
|
+
For more details see the [endpoint documentation](#providers-providers-get)
|
917
|
+
|
918
|
+
```
|
919
|
+
GET /providers/1234567890
|
920
|
+
{
|
921
|
+
"provider": {
|
922
|
+
...
|
923
|
+
"hios_ids": [
|
924
|
+
...
|
925
|
+
"12345NY1234567"
|
926
|
+
...
|
927
|
+
]
|
928
|
+
...
|
929
|
+
}
|
930
|
+
}
|
931
|
+
```
|
932
|
+
|
933
|
+
The returned `hios_ids` can be used to cross-reference a `Plan`
|
934
|
+
|
935
|
+
### Matching by Network
|
936
|
+
Once you have an ID returned from the [`Network` search endpoint](#networks-networks-get), you can cross-reference it with the `network_ids` returned from both the [`Provider` search](#providers-providers-post) and [`Provider` details](#providers-providers-get) endpoints.
|
937
|
+
|
938
|
+
This is useful for large group data or when you are not dealing with `Plan`s directly, but rather at the `Network` level.
|
939
|
+
|
201
940
|
|
202
941
|
OpenAPI spec version: 1.0.0
|
203
942
|
|
@@ -222,17 +961,8 @@ require 'date'
|
|
222
961
|
module VericredClient
|
223
962
|
|
224
963
|
class MedicalPlanUpdate
|
225
|
-
#
|
226
|
-
attr_accessor :
|
227
|
-
|
228
|
-
# The issuer vericred id
|
229
|
-
attr_accessor :issuer_vericred_id
|
230
|
-
|
231
|
-
# The medical plan audience
|
232
|
-
attr_accessor :audience
|
233
|
-
|
234
|
-
# Category of the plan (e.g. EPO, HMO, PPO, POS, Indemnity, PACE, Medicare-Medicaid, HMO w/POS, Cost, FFS, MSA)
|
235
|
-
attr_accessor :plan_type
|
964
|
+
# Indicates whether this plan is being actively marketed by the carrier.
|
965
|
+
attr_accessor :actively_marketed
|
236
966
|
|
237
967
|
# Percentage of total average costs for covered benefits that a plan will cover.
|
238
968
|
attr_accessor :actuarial_value
|
@@ -240,29 +970,44 @@ module VericredClient
|
|
240
970
|
# True if the plan allows dependents up to age 29
|
241
971
|
attr_accessor :age29_rider
|
242
972
|
|
243
|
-
#
|
244
|
-
attr_accessor :
|
973
|
+
# The medical plan audience
|
974
|
+
attr_accessor :audience
|
975
|
+
|
976
|
+
# Medical Plan Benefits
|
977
|
+
attr_accessor :benefits
|
245
978
|
|
246
979
|
# Link to the summary of benefits and coverage (SBC) document.
|
247
980
|
attr_accessor :benefits_summary_url
|
248
981
|
|
982
|
+
# Link to a location to purchase the plan.
|
983
|
+
attr_accessor :buy_link
|
984
|
+
|
249
985
|
# Standard cost share for most benefits
|
250
986
|
attr_accessor :coinsurance
|
251
987
|
|
988
|
+
# allowed ages on the plan, possible values: allows adult-only, allows child-only, allows adult and child-only, child29, requires adult
|
989
|
+
attr_accessor :covered_ages
|
990
|
+
|
252
991
|
# True if plan does not cover domestic partners
|
253
992
|
attr_accessor :dp_rider
|
254
993
|
|
255
|
-
# True if plan is in a fixed family tier state
|
256
|
-
attr_accessor :family_tier
|
257
|
-
|
258
994
|
# Link to the summary of drug benefits for the plan
|
259
995
|
attr_accessor :drug_formulary_url
|
260
996
|
|
997
|
+
# Is the individual deductible for each covered person, embedded in the family deductible
|
998
|
+
attr_accessor :embedded_deductible
|
999
|
+
|
261
1000
|
# Percentage of essential plan benefits
|
262
1001
|
attr_accessor :essential_health_benefits_percentage
|
263
1002
|
|
264
|
-
#
|
265
|
-
attr_accessor :
|
1003
|
+
# Medical Plan External Identifier
|
1004
|
+
attr_accessor :external_id
|
1005
|
+
|
1006
|
+
# Medical Plan External Identifiers
|
1007
|
+
attr_accessor :external_ids
|
1008
|
+
|
1009
|
+
# True if plan is in a fixed family tier state
|
1010
|
+
attr_accessor :family_tier
|
266
1011
|
|
267
1012
|
# True if plan does not cover family planning
|
268
1013
|
attr_accessor :fp_rider
|
@@ -273,140 +1018,139 @@ module VericredClient
|
|
273
1018
|
# Is the plan HSA eligible?
|
274
1019
|
attr_accessor :hsa_eligible
|
275
1020
|
|
1021
|
+
# The issuer vericred id
|
1022
|
+
attr_accessor :issuer_vericred_id
|
1023
|
+
|
1024
|
+
# Indicates whether the plan has meaningful descriptions for these benefits: individual_medical_deductible, family_medical_deductible, individual_medical_moop, family_medical_moop, primary_care_physician.
|
1025
|
+
attr_accessor :key_benefits_complete
|
1026
|
+
|
276
1027
|
# Plan metal grouping (e.g. platinum, gold, silver, etc)
|
277
1028
|
attr_accessor :level
|
278
1029
|
|
279
1030
|
# Multiple of the standard Rx cost share for orders filled via mail order
|
280
1031
|
attr_accessor :mail_order_rx
|
281
1032
|
|
282
|
-
#
|
1033
|
+
# Market for plan
|
1034
|
+
attr_accessor :market
|
1035
|
+
|
1036
|
+
# The medical plan name
|
1037
|
+
attr_accessor :name
|
1038
|
+
|
1039
|
+
# Are deductibles and MOOPs reset on Dec-31 (\"calendar year\"), 365 day(s) after enrollment date (\"plan year\"), or are both options available (\"both\")?
|
283
1040
|
attr_accessor :plan_calendar
|
284
1041
|
|
285
1042
|
# Market in which the plan is offered (on_marketplace, shop, etc)
|
286
1043
|
attr_accessor :plan_market
|
287
1044
|
|
288
|
-
#
|
289
|
-
attr_accessor :
|
1045
|
+
# Category of the plan (e.g. EPO, HMO, PPO, POS, Indemnity, PACE, Medicare-Medicaid, HMO w/POS, Cost, FFS, MSA)
|
1046
|
+
attr_accessor :plan_type
|
290
1047
|
|
291
|
-
#
|
292
|
-
attr_accessor :
|
293
|
-
|
294
|
-
# Link to a location to purchase the plan.
|
295
|
-
attr_accessor :buy_link
|
296
|
-
|
297
|
-
# Does the plan cover full-time, year-round, nursing facilities?
|
298
|
-
attr_accessor :skilled_nursing_facility_365
|
299
|
-
|
300
|
-
# allowed ages on the plan, possible values: allows adult-only, allows child-only, allows adult and child-only, child29, requires adult
|
301
|
-
attr_accessor :covered_ages
|
302
|
-
|
303
|
-
# Plan year
|
304
|
-
attr_accessor :year
|
305
|
-
|
306
|
-
# State code
|
307
|
-
attr_accessor :state_code
|
1048
|
+
# Plan private exchange
|
1049
|
+
attr_accessor :private_exchange
|
308
1050
|
|
309
|
-
#
|
310
|
-
attr_accessor :
|
1051
|
+
# TRUE if plan data is Privileged
|
1052
|
+
attr_accessor :privileged_data
|
311
1053
|
|
312
1054
|
# Name of the SBC
|
313
1055
|
attr_accessor :sbc_name
|
314
1056
|
|
315
|
-
#
|
316
|
-
attr_accessor :
|
1057
|
+
# The external identifier for the plan service area
|
1058
|
+
attr_accessor :service_area_external_key
|
317
1059
|
|
318
|
-
#
|
319
|
-
attr_accessor :
|
1060
|
+
# Does the plan cover full-time, year-round, nursing facilities?
|
1061
|
+
attr_accessor :skilled_nursing_facility_365
|
320
1062
|
|
321
|
-
#
|
322
|
-
attr_accessor :
|
1063
|
+
# Source of the plan benefit data
|
1064
|
+
attr_accessor :source
|
323
1065
|
|
324
|
-
#
|
325
|
-
attr_accessor :
|
1066
|
+
# State code
|
1067
|
+
attr_accessor :state_code
|
326
1068
|
|
327
|
-
#
|
328
|
-
attr_accessor :
|
1069
|
+
# Plan year
|
1070
|
+
attr_accessor :year
|
329
1071
|
|
330
1072
|
|
331
1073
|
# Attribute mapping from ruby-style variable name to JSON key.
|
332
1074
|
def self.attribute_map
|
333
1075
|
{
|
334
|
-
:'
|
335
|
-
:'issuer_vericred_id' => :'issuer_vericred_id',
|
336
|
-
:'audience' => :'audience',
|
337
|
-
:'plan_type' => :'plan_type',
|
1076
|
+
:'actively_marketed' => :'actively_marketed',
|
338
1077
|
:'actuarial_value' => :'actuarial_value',
|
339
1078
|
:'age29_rider' => :'age29_rider',
|
340
|
-
:'
|
1079
|
+
:'audience' => :'audience',
|
1080
|
+
:'benefits' => :'benefits',
|
341
1081
|
:'benefits_summary_url' => :'benefits_summary_url',
|
1082
|
+
:'buy_link' => :'buy_link',
|
342
1083
|
:'coinsurance' => :'coinsurance',
|
1084
|
+
:'covered_ages' => :'covered_ages',
|
343
1085
|
:'dp_rider' => :'dp_rider',
|
344
|
-
:'family_tier' => :'family_tier',
|
345
1086
|
:'drug_formulary_url' => :'drug_formulary_url',
|
346
|
-
:'essential_health_benefits_percentage' => :'essential_health_benefits_percentage',
|
347
1087
|
:'embedded_deductible' => :'embedded_deductible',
|
1088
|
+
:'essential_health_benefits_percentage' => :'essential_health_benefits_percentage',
|
1089
|
+
:'external_id' => :'external_id',
|
1090
|
+
:'external_ids' => :'external_ids',
|
1091
|
+
:'family_tier' => :'family_tier',
|
348
1092
|
:'fp_rider' => :'fp_rider',
|
349
1093
|
:'gated' => :'gated',
|
350
1094
|
:'hsa_eligible' => :'hsa_eligible',
|
1095
|
+
:'issuer_vericred_id' => :'issuer_vericred_id',
|
1096
|
+
:'key_benefits_complete' => :'key_benefits_complete',
|
351
1097
|
:'level' => :'level',
|
352
1098
|
:'mail_order_rx' => :'mail_order_rx',
|
1099
|
+
:'market' => :'market',
|
1100
|
+
:'name' => :'name',
|
353
1101
|
:'plan_calendar' => :'plan_calendar',
|
354
1102
|
:'plan_market' => :'plan_market',
|
355
|
-
:'
|
356
|
-
:'
|
357
|
-
:'
|
1103
|
+
:'plan_type' => :'plan_type',
|
1104
|
+
:'private_exchange' => :'private_exchange',
|
1105
|
+
:'privileged_data' => :'privileged_data',
|
1106
|
+
:'sbc_name' => :'sbc_name',
|
1107
|
+
:'service_area_external_key' => :'service_area_external_key',
|
358
1108
|
:'skilled_nursing_facility_365' => :'skilled_nursing_facility_365',
|
359
|
-
:'covered_ages' => :'covered_ages',
|
360
|
-
:'year' => :'year',
|
361
|
-
:'state_code' => :'state_code',
|
362
1109
|
:'source' => :'source',
|
363
|
-
:'
|
364
|
-
:'
|
365
|
-
:'private_exchange' => :'private_exchange',
|
366
|
-
:'external_ids' => :'external_ids',
|
367
|
-
:'external_id' => :'external_id',
|
368
|
-
:'benefits' => :'benefits'
|
1110
|
+
:'state_code' => :'state_code',
|
1111
|
+
:'year' => :'year'
|
369
1112
|
}
|
370
1113
|
end
|
371
1114
|
|
372
1115
|
# Attribute type mapping.
|
373
1116
|
def self.swagger_types
|
374
1117
|
{
|
375
|
-
:'
|
376
|
-
:'issuer_vericred_id' => :'String',
|
377
|
-
:'audience' => :'String',
|
378
|
-
:'plan_type' => :'String',
|
1118
|
+
:'actively_marketed' => :'String',
|
379
1119
|
:'actuarial_value' => :'Float',
|
380
1120
|
:'age29_rider' => :'BOOLEAN',
|
381
|
-
:'
|
1121
|
+
:'audience' => :'String',
|
1122
|
+
:'benefits' => :'MedicalPlanBenefits',
|
382
1123
|
:'benefits_summary_url' => :'String',
|
1124
|
+
:'buy_link' => :'String',
|
383
1125
|
:'coinsurance' => :'Float',
|
1126
|
+
:'covered_ages' => :'String',
|
384
1127
|
:'dp_rider' => :'BOOLEAN',
|
385
|
-
:'family_tier' => :'BOOLEAN',
|
386
1128
|
:'drug_formulary_url' => :'String',
|
387
|
-
:'essential_health_benefits_percentage' => :'Float',
|
388
1129
|
:'embedded_deductible' => :'String',
|
1130
|
+
:'essential_health_benefits_percentage' => :'Float',
|
1131
|
+
:'external_id' => :'String',
|
1132
|
+
:'external_ids' => :'Array<PlanIdentifier>',
|
1133
|
+
:'family_tier' => :'BOOLEAN',
|
389
1134
|
:'fp_rider' => :'BOOLEAN',
|
390
1135
|
:'gated' => :'BOOLEAN',
|
391
1136
|
:'hsa_eligible' => :'BOOLEAN',
|
1137
|
+
:'issuer_vericred_id' => :'String',
|
1138
|
+
:'key_benefits_complete' => :'BOOLEAN',
|
392
1139
|
:'level' => :'String',
|
393
1140
|
:'mail_order_rx' => :'Float',
|
1141
|
+
:'market' => :'String',
|
1142
|
+
:'name' => :'String',
|
394
1143
|
:'plan_calendar' => :'String',
|
395
1144
|
:'plan_market' => :'String',
|
396
|
-
:'
|
397
|
-
:'
|
398
|
-
:'
|
1145
|
+
:'plan_type' => :'String',
|
1146
|
+
:'private_exchange' => :'String',
|
1147
|
+
:'privileged_data' => :'BOOLEAN',
|
1148
|
+
:'sbc_name' => :'String',
|
1149
|
+
:'service_area_external_key' => :'String',
|
399
1150
|
:'skilled_nursing_facility_365' => :'String',
|
400
|
-
:'covered_ages' => :'String',
|
401
|
-
:'year' => :'Integer',
|
402
|
-
:'state_code' => :'String',
|
403
1151
|
:'source' => :'String',
|
404
|
-
:'
|
405
|
-
:'
|
406
|
-
:'private_exchange' => :'String',
|
407
|
-
:'external_ids' => :'Array<PlanIdentifier>',
|
408
|
-
:'external_id' => :'String',
|
409
|
-
:'benefits' => :'MedicalPlanBenefits'
|
1152
|
+
:'state_code' => :'String',
|
1153
|
+
:'year' => :'Integer'
|
410
1154
|
}
|
411
1155
|
end
|
412
1156
|
|
@@ -418,20 +1162,8 @@ module VericredClient
|
|
418
1162
|
# convert string to symbol for hash key
|
419
1163
|
attributes = attributes.each_with_object({}){|(k,v), h| h[k.to_sym] = v}
|
420
1164
|
|
421
|
-
if attributes.has_key?(:'
|
422
|
-
self.
|
423
|
-
end
|
424
|
-
|
425
|
-
if attributes.has_key?(:'issuer_vericred_id')
|
426
|
-
self.issuer_vericred_id = attributes[:'issuer_vericred_id']
|
427
|
-
end
|
428
|
-
|
429
|
-
if attributes.has_key?(:'audience')
|
430
|
-
self.audience = attributes[:'audience']
|
431
|
-
end
|
432
|
-
|
433
|
-
if attributes.has_key?(:'plan_type')
|
434
|
-
self.plan_type = attributes[:'plan_type']
|
1165
|
+
if attributes.has_key?(:'actively_marketed')
|
1166
|
+
self.actively_marketed = attributes[:'actively_marketed']
|
435
1167
|
end
|
436
1168
|
|
437
1169
|
if attributes.has_key?(:'actuarial_value')
|
@@ -442,36 +1174,58 @@ module VericredClient
|
|
442
1174
|
self.age29_rider = attributes[:'age29_rider']
|
443
1175
|
end
|
444
1176
|
|
445
|
-
if attributes.has_key?(:'
|
446
|
-
self.
|
1177
|
+
if attributes.has_key?(:'audience')
|
1178
|
+
self.audience = attributes[:'audience']
|
1179
|
+
end
|
1180
|
+
|
1181
|
+
if attributes.has_key?(:'benefits')
|
1182
|
+
self.benefits = attributes[:'benefits']
|
447
1183
|
end
|
448
1184
|
|
449
1185
|
if attributes.has_key?(:'benefits_summary_url')
|
450
1186
|
self.benefits_summary_url = attributes[:'benefits_summary_url']
|
451
1187
|
end
|
452
1188
|
|
1189
|
+
if attributes.has_key?(:'buy_link')
|
1190
|
+
self.buy_link = attributes[:'buy_link']
|
1191
|
+
end
|
1192
|
+
|
453
1193
|
if attributes.has_key?(:'coinsurance')
|
454
1194
|
self.coinsurance = attributes[:'coinsurance']
|
455
1195
|
end
|
456
1196
|
|
457
|
-
if attributes.has_key?(:'
|
458
|
-
self.
|
1197
|
+
if attributes.has_key?(:'covered_ages')
|
1198
|
+
self.covered_ages = attributes[:'covered_ages']
|
459
1199
|
end
|
460
1200
|
|
461
|
-
if attributes.has_key?(:'
|
462
|
-
self.
|
1201
|
+
if attributes.has_key?(:'dp_rider')
|
1202
|
+
self.dp_rider = attributes[:'dp_rider']
|
463
1203
|
end
|
464
1204
|
|
465
1205
|
if attributes.has_key?(:'drug_formulary_url')
|
466
1206
|
self.drug_formulary_url = attributes[:'drug_formulary_url']
|
467
1207
|
end
|
468
1208
|
|
1209
|
+
if attributes.has_key?(:'embedded_deductible')
|
1210
|
+
self.embedded_deductible = attributes[:'embedded_deductible']
|
1211
|
+
end
|
1212
|
+
|
469
1213
|
if attributes.has_key?(:'essential_health_benefits_percentage')
|
470
1214
|
self.essential_health_benefits_percentage = attributes[:'essential_health_benefits_percentage']
|
471
1215
|
end
|
472
1216
|
|
473
|
-
if attributes.has_key?(:'
|
474
|
-
self.
|
1217
|
+
if attributes.has_key?(:'external_id')
|
1218
|
+
self.external_id = attributes[:'external_id']
|
1219
|
+
end
|
1220
|
+
|
1221
|
+
if attributes.has_key?(:'external_ids')
|
1222
|
+
if (value = attributes[:'external_ids']).is_a?(Array)
|
1223
|
+
self.external_ids = value
|
1224
|
+
end
|
1225
|
+
end
|
1226
|
+
|
1227
|
+
if attributes.has_key?(:'family_tier')
|
1228
|
+
self.family_tier = attributes[:'family_tier']
|
475
1229
|
end
|
476
1230
|
|
477
1231
|
if attributes.has_key?(:'fp_rider')
|
@@ -486,78 +1240,72 @@ module VericredClient
|
|
486
1240
|
self.hsa_eligible = attributes[:'hsa_eligible']
|
487
1241
|
end
|
488
1242
|
|
489
|
-
if attributes.has_key?(:'
|
490
|
-
self.
|
1243
|
+
if attributes.has_key?(:'issuer_vericred_id')
|
1244
|
+
self.issuer_vericred_id = attributes[:'issuer_vericred_id']
|
491
1245
|
end
|
492
1246
|
|
493
|
-
if attributes.has_key?(:'
|
494
|
-
self.
|
1247
|
+
if attributes.has_key?(:'key_benefits_complete')
|
1248
|
+
self.key_benefits_complete = attributes[:'key_benefits_complete']
|
495
1249
|
end
|
496
1250
|
|
497
|
-
if attributes.has_key?(:'
|
498
|
-
self.
|
1251
|
+
if attributes.has_key?(:'level')
|
1252
|
+
self.level = attributes[:'level']
|
499
1253
|
end
|
500
1254
|
|
501
|
-
if attributes.has_key?(:'
|
502
|
-
self.
|
1255
|
+
if attributes.has_key?(:'mail_order_rx')
|
1256
|
+
self.mail_order_rx = attributes[:'mail_order_rx']
|
503
1257
|
end
|
504
1258
|
|
505
1259
|
if attributes.has_key?(:'market')
|
506
1260
|
self.market = attributes[:'market']
|
507
1261
|
end
|
508
1262
|
|
509
|
-
if attributes.has_key?(:'
|
510
|
-
self.
|
511
|
-
end
|
512
|
-
|
513
|
-
if attributes.has_key?(:'buy_link')
|
514
|
-
self.buy_link = attributes[:'buy_link']
|
1263
|
+
if attributes.has_key?(:'name')
|
1264
|
+
self.name = attributes[:'name']
|
515
1265
|
end
|
516
1266
|
|
517
|
-
if attributes.has_key?(:'
|
518
|
-
self.
|
1267
|
+
if attributes.has_key?(:'plan_calendar')
|
1268
|
+
self.plan_calendar = attributes[:'plan_calendar']
|
519
1269
|
end
|
520
1270
|
|
521
|
-
if attributes.has_key?(:'
|
522
|
-
self.
|
1271
|
+
if attributes.has_key?(:'plan_market')
|
1272
|
+
self.plan_market = attributes[:'plan_market']
|
523
1273
|
end
|
524
1274
|
|
525
|
-
if attributes.has_key?(:'
|
526
|
-
self.
|
1275
|
+
if attributes.has_key?(:'plan_type')
|
1276
|
+
self.plan_type = attributes[:'plan_type']
|
527
1277
|
end
|
528
1278
|
|
529
|
-
if attributes.has_key?(:'
|
530
|
-
self.
|
1279
|
+
if attributes.has_key?(:'private_exchange')
|
1280
|
+
self.private_exchange = attributes[:'private_exchange']
|
531
1281
|
end
|
532
1282
|
|
533
|
-
if attributes.has_key?(:'
|
534
|
-
self.
|
1283
|
+
if attributes.has_key?(:'privileged_data')
|
1284
|
+
self.privileged_data = attributes[:'privileged_data']
|
535
1285
|
end
|
536
1286
|
|
537
1287
|
if attributes.has_key?(:'sbc_name')
|
538
1288
|
self.sbc_name = attributes[:'sbc_name']
|
539
1289
|
end
|
540
1290
|
|
541
|
-
if attributes.has_key?(:'
|
542
|
-
self.
|
1291
|
+
if attributes.has_key?(:'service_area_external_key')
|
1292
|
+
self.service_area_external_key = attributes[:'service_area_external_key']
|
543
1293
|
end
|
544
1294
|
|
545
|
-
if attributes.has_key?(:'
|
546
|
-
self.
|
1295
|
+
if attributes.has_key?(:'skilled_nursing_facility_365')
|
1296
|
+
self.skilled_nursing_facility_365 = attributes[:'skilled_nursing_facility_365']
|
547
1297
|
end
|
548
1298
|
|
549
|
-
if attributes.has_key?(:'
|
550
|
-
|
551
|
-
self.external_ids = value
|
552
|
-
end
|
1299
|
+
if attributes.has_key?(:'source')
|
1300
|
+
self.source = attributes[:'source']
|
553
1301
|
end
|
554
1302
|
|
555
|
-
if attributes.has_key?(:'
|
556
|
-
self.
|
1303
|
+
if attributes.has_key?(:'state_code')
|
1304
|
+
self.state_code = attributes[:'state_code']
|
557
1305
|
end
|
558
1306
|
|
559
|
-
if attributes.has_key?(:'
|
560
|
-
self.
|
1307
|
+
if attributes.has_key?(:'year')
|
1308
|
+
self.year = attributes[:'year']
|
561
1309
|
end
|
562
1310
|
|
563
1311
|
end
|
@@ -580,41 +1328,42 @@ module VericredClient
|
|
580
1328
|
def ==(o)
|
581
1329
|
return true if self.equal?(o)
|
582
1330
|
self.class == o.class &&
|
583
|
-
|
584
|
-
issuer_vericred_id == o.issuer_vericred_id &&
|
585
|
-
audience == o.audience &&
|
586
|
-
plan_type == o.plan_type &&
|
1331
|
+
actively_marketed == o.actively_marketed &&
|
587
1332
|
actuarial_value == o.actuarial_value &&
|
588
1333
|
age29_rider == o.age29_rider &&
|
589
|
-
|
1334
|
+
audience == o.audience &&
|
1335
|
+
benefits == o.benefits &&
|
590
1336
|
benefits_summary_url == o.benefits_summary_url &&
|
1337
|
+
buy_link == o.buy_link &&
|
591
1338
|
coinsurance == o.coinsurance &&
|
1339
|
+
covered_ages == o.covered_ages &&
|
592
1340
|
dp_rider == o.dp_rider &&
|
593
|
-
family_tier == o.family_tier &&
|
594
1341
|
drug_formulary_url == o.drug_formulary_url &&
|
595
|
-
essential_health_benefits_percentage == o.essential_health_benefits_percentage &&
|
596
1342
|
embedded_deductible == o.embedded_deductible &&
|
1343
|
+
essential_health_benefits_percentage == o.essential_health_benefits_percentage &&
|
1344
|
+
external_id == o.external_id &&
|
1345
|
+
external_ids == o.external_ids &&
|
1346
|
+
family_tier == o.family_tier &&
|
597
1347
|
fp_rider == o.fp_rider &&
|
598
1348
|
gated == o.gated &&
|
599
1349
|
hsa_eligible == o.hsa_eligible &&
|
1350
|
+
issuer_vericred_id == o.issuer_vericred_id &&
|
1351
|
+
key_benefits_complete == o.key_benefits_complete &&
|
600
1352
|
level == o.level &&
|
601
1353
|
mail_order_rx == o.mail_order_rx &&
|
1354
|
+
market == o.market &&
|
1355
|
+
name == o.name &&
|
602
1356
|
plan_calendar == o.plan_calendar &&
|
603
1357
|
plan_market == o.plan_market &&
|
604
|
-
|
605
|
-
|
606
|
-
|
1358
|
+
plan_type == o.plan_type &&
|
1359
|
+
private_exchange == o.private_exchange &&
|
1360
|
+
privileged_data == o.privileged_data &&
|
1361
|
+
sbc_name == o.sbc_name &&
|
1362
|
+
service_area_external_key == o.service_area_external_key &&
|
607
1363
|
skilled_nursing_facility_365 == o.skilled_nursing_facility_365 &&
|
608
|
-
covered_ages == o.covered_ages &&
|
609
|
-
year == o.year &&
|
610
|
-
state_code == o.state_code &&
|
611
1364
|
source == o.source &&
|
612
|
-
|
613
|
-
|
614
|
-
private_exchange == o.private_exchange &&
|
615
|
-
external_ids == o.external_ids &&
|
616
|
-
external_id == o.external_id &&
|
617
|
-
benefits == o.benefits
|
1365
|
+
state_code == o.state_code &&
|
1366
|
+
year == o.year
|
618
1367
|
end
|
619
1368
|
|
620
1369
|
# @see the `==` method
|
@@ -626,7 +1375,7 @@ module VericredClient
|
|
626
1375
|
# Calculates hash code according to all attributes.
|
627
1376
|
# @return [Fixnum] Hash code
|
628
1377
|
def hash
|
629
|
-
[
|
1378
|
+
[actively_marketed, actuarial_value, age29_rider, audience, benefits, benefits_summary_url, buy_link, coinsurance, covered_ages, dp_rider, drug_formulary_url, embedded_deductible, essential_health_benefits_percentage, external_id, external_ids, family_tier, fp_rider, gated, hsa_eligible, issuer_vericred_id, key_benefits_complete, level, mail_order_rx, market, name, plan_calendar, plan_market, plan_type, private_exchange, privileged_data, sbc_name, service_area_external_key, skilled_nursing_facility_365, source, state_code, year].hash
|
630
1379
|
end
|
631
1380
|
|
632
1381
|
# Builds the object from hash
|