@vbasoftware/vbapi-vbasoftware-typescript-axios 1.20230117.1 → 1.20230130.2
This diff represents the content of publicly available package versions that have been released to one of the supported registries. The information contained in this diff is provided for informational purposes only and reflects changes between package versions as they appear in their respective public registries.
- package/.openapi-generator/FILES +11 -0
- package/api/day-intervals-api.ts +716 -0
- package/api/group-volumes-api.ts +97 -0
- package/api/report-series-api.ts +17 -8
- package/api/waiting-period-types-api.ts +155 -0
- package/api.ts +2 -0
- package/models/auth-adjustment.ts +6 -0
- package/models/auth-diag-codes.ts +24 -0
- package/models/benefit-config.ts +43 -0
- package/models/criteria-detail.ts +10 -10
- package/models/criteria.ts +2 -2
- package/models/day-interval-list-vbaresponse.ts +45 -0
- package/models/day-interval-vbaresponse.ts +45 -0
- package/models/day-interval.ts +144 -0
- package/models/division-config.ts +43 -0
- package/models/group-volume-nested-list-vbaresponse.ts +45 -0
- package/models/group-volume-nested.ts +43 -0
- package/models/groups.ts +30 -0
- package/models/idcard-request.ts +30 -0
- package/models/index.ts +9 -0
- package/models/mem-enrollment-plan.ts +54 -0
- package/models/mem-enrollment-rider.ts +54 -0
- package/models/member-address.ts +36 -0
- package/models/member-beneficiary.ts +36 -0
- package/models/plan-benefit-rate.ts +30 -0
- package/models/plan-benefits.ts +295 -67
- package/models/plan-config.ts +43 -0
- package/models/plan-type.ts +42 -0
- package/models/plans.ts +256 -106
- package/models/sub-enrollment-plan.ts +60 -0
- package/models/sub-enrollment-rider.ts +56 -2
- package/models/subscribers.ts +36 -0
- package/models/users.ts +31 -1
- package/models/volume.ts +42 -0
- package/package.json +1 -1
package/models/plans.ts
CHANGED
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@@ -21,571 +21,721 @@
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*/
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export interface Plans {
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/**
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*
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* Unique identifier assigned to the Plan.
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* @type {string}
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* @memberof Plans
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*/
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'plan_ID': string;
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/**
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*
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* Total In-Network and Out of Network annual maximum the plan will pay out for the Familiy.
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* @type {number}
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* @memberof Plans
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*/
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'annual_Max'?: number | null;
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/**
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*
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* In-Network annual maximum that the plan will pay out for the Familiy.
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* @type {number}
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* @memberof Plans
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*/
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'annual_Max_Net'?: number | null;
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/**
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*
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* Out of Network annual maximum that the plan will pay out for the Familiy.
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* @type {number}
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* @memberof Plans
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*/
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'annual_Max_OON'?: number | null;
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/**
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*
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* Indicates if this plan allows auto-creation of Flex claims based on Group level configuration for flex auto-creation.
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* @type {boolean}
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* @memberof Plans
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*/
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'auto_Create_Flex': boolean;
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/**
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*
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* Used for custom reporting and information.
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* @type {string}
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* @memberof Plans
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*/
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'cobrA_Plan_Type_Desc'?: string | null;
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/**
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*
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* Indicates the maximum amount that can be held in COB savings.
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* @type {number}
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* @memberof Plans
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*/
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'coB_Savings_Max'?: number | null;
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/**
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*
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* Indicates the type of COB to be used with the selected plan.
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* @type {string}
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* @memberof Plans
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*/
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'coB_Type'?: string | null;
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/**
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*
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* No longer in use. All captiation logic and processing now resides in the capitation tables.
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* @type {boolean}
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* @memberof Plans
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*/
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'capitated': boolean;
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/**
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*
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* Default cash value when Policy & Forfeiture is used in enrollment.
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* @type {number}
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* @memberof Plans
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*/
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'cash_Value_Default'?: number | null;
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/**
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*
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* Indicates whether In-Network Coinsurance amounts apply toward the satisfaction of Out of Network amounts.
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* @type {boolean}
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* @memberof Plans
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*/
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'coIns_In_To_Out': boolean;
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/**
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*
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* In Network Co-Insurance amount for the Family.
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* @type {number}
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* @memberof Plans
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*/
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'coIns_Max_Mem'?: number | null;
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/**
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*
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* Total Co-Insurance amount for the Member.
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* @type {number}
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* @memberof Plans
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*/
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'coIns_Max_Net_Mem'?: number | null;
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/**
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*
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* Out of Network Co-Insurance amount for the Family.
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* @type {number}
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* @memberof Plans
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*/
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'coIns_Max_Net_Sub'?: number | null;
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/**
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*
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* Out of Network Co-Insurance amount for the Member.
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* @type {number}
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* @memberof Plans
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*/
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'coIns_Max_OON_Mem'?: number | null;
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/**
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*
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* In Network Co-Insurance amount for the Member.
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* @type {number}
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* @memberof Plans
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*/
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'coIns_Max_OON_Sub'?: number | null;
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/**
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*
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* Total Co-Insurance amount for the Family.
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* @type {number}
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* @memberof Plans
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*/
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'coIns_Max_Sub'?: number | null;
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/**
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*
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* Indicates whether Out of Network CoInsurance amounts apply toward the satisfaction of the In-Network amounts.
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* @type {boolean}
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* @memberof Plans
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*/
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'coIns_Out_To_In': boolean;
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/**
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*
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* Claim UCR percentage provided by Context. Required for Context claim edits and repricing.
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* @type {number}
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* @memberof Plans
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*/
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'context4_ClmUcrPct'?: number | null;
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/**
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*
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* Out of network claim UCR percentage provided by context. Required for Context claim edits and repricing.
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* @type {number}
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* @memberof Plans
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*/
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'context4_ClmUcrPct_OON'?: number | null;
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/**
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*
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* Fee Selector provided by Context. Required for Context claim edits and repricing.
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* @type {string}
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* @memberof Plans
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*/
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'context4_FeeSelector'?: string | null;
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/**
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*
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* Out of network fee selector provided by context. Required for Context claim edits and repricing.
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* @type {string}
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* @memberof Plans
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*/
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'context4_FeeSelector_OON'?: string | null;
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/**
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*
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* Medicare percentage provided by Context. Required for Context claim edits and repricing.
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* @type {number}
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* @memberof Plans
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*/
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'context4_MedicarePct'?: number | null;
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/**
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*
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* Out of network Medicare percentage provided by context. Required for Context claim edits and repricing.
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* @type {number}
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* @memberof Plans
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*/
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'context4_MedicarePct_OON'?: number | null;
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/**
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* Password provided by Context. Required for Context claim edits and repricing.
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* @type {string}
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* @memberof Plans
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*/
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'context4_Password'?: string | null;
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/**
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* Payor type provided by context. Required for Context claim edits and repricing.
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* @type {string}
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* @memberof Plans
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*/
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'context4_PayorType'?: string | null;
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/**
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*
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* Out of network Payor type provided by context. Required for Context claim edits and repricing.
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* @type {string}
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* @memberof Plans
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*/
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'context4_PayorType_OON'?: string | null;
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/**
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* Percentage of change provided by context. Required for Context claim edits and repricing.
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* @type {number}
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* @memberof Plans
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*/
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'context4_PctOfChg'?: number | null;
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/**
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* Out of network percentage of change provided by context. Required for Context claim edits and repricing.
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* @type {number}
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* @memberof Plans
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*/
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'context4_PctOfChg_OON'?: number | null;
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/**
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* When using Context4, the Plan Price is never allowed to exceed the Billed Price, it\'ll set it to the Billed Price.
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* @type {boolean}
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* @memberof Plans
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*/
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'context4_PlanPriceNotGreaterBilledFg': boolean;
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/**
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* User ID provided by Context. Required for Context claim edits and repricing.
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* @type {string}
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* @memberof Plans
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*/
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'context4_UserID'?: string | null;
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/**
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* URL provided by Context. Required for Context claim edits and repricing.
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* @type {string}
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* @memberof Plans
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*/
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'context4_WebURI'?: string | null;
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/**
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* URL delete provided by Context. Required for Context claim edits and repricing.
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* @type {string}
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* @memberof Plans
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*/
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'context4_WebURI_Delete'?: string | null;
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/**
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* Indicates the currency being used.
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* @type {string}
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* @memberof Plans
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*/
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'currency_ID'?: string | null;
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/**
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* Indicates whether In-Network Deductible amounts apply toward the satisfaction of Out of Network amounts.
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* @type {boolean}
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* @memberof Plans
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*/
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'ded_In_To_Out': boolean;
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/**
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* Indicates whether Out of Network Deductible amounts apply toward the satisfaction of In-Network amounts.
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* @type {boolean}
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* @memberof Plans
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*/
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'ded_Out_To_In': boolean;
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/**
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* A short description of the associated plan.
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* @type {string}
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* @memberof Plans
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*/
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'description'?: string | null;
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/**
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* Date when the record was added to the system.
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* @type {string}
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* @memberof Plans
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*/
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'entry_Date'?: string;
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/**
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* User that first added the record to the system.
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* @type {string}
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* @memberof Plans
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*/
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'entry_User'?: string | null;
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/**
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* Deault extended term value assigned in Policy & Forfeiture when used in enrollment.
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* @type {number}
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* @memberof Plans
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*/
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'extended_Term_Default'?: number | null;
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/**
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* Specifies that the number of Member level Coinsurance amounts should be used to satisfy the Family level Coinsurance amount.
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* @type {boolean}
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* @memberof Plans
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*/
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'family_Level_Co_Ins': boolean;
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/**
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*
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* Number of Members that must satisfy the Member level deductible before the Family level amount is considered met.
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* @type {number}
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* @memberof Plans
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*/
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'family_Level_Co_Ins_Member'?: number | null;
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/**
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*
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* Specifies that the number of Member level deductible amounts should be used to satisfy the Family level deductible.
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* @type {boolean}
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* @memberof Plans
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*/
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'family_Level_Ded': boolean;
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/**
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* Number of Members that must satisfy the Member level deductible before the Family level amount is considered met.
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* @type {number}
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* @memberof Plans
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*/
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'family_Level_Ded_Member'?: number | null;
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/**
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* Specifies that the number of Member level Out of Pocket amounts should be used to satisfy the Family level Out of Pocket amount.
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* @type {boolean}
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* @memberof Plans
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*/
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'family_Level_OOP': boolean;
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/**
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*
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+
* Number of Members that must satisfy the Member level Out of Pocket before the Family level Out of Pocket is considered met.
|
|
295
295
|
* @type {number}
|
|
296
296
|
* @memberof Plans
|
|
297
297
|
*/
|
|
298
298
|
'family_Level_OOP_Member'?: number | null;
|
|
299
299
|
/**
|
|
300
|
-
*
|
|
300
|
+
* Information field used in reporting to identify this plan as Flex Advance Fund.
|
|
301
301
|
* @type {boolean}
|
|
302
302
|
* @memberof Plans
|
|
303
303
|
*/
|
|
304
304
|
'flex_Advance_Fund': boolean;
|
|
305
305
|
/**
|
|
306
|
-
*
|
|
306
|
+
* Indicates what type of Flex account to be associated with the plan.
|
|
307
307
|
* @type {string}
|
|
308
308
|
* @memberof Plans
|
|
309
309
|
*/
|
|
310
310
|
'flex_Type'?: string | null;
|
|
311
311
|
/**
|
|
312
|
-
*
|
|
312
|
+
* Default forfeiture status assigned when Policy & Forteiture is used in enrollment.
|
|
313
313
|
* @type {string}
|
|
314
314
|
* @memberof Plans
|
|
315
315
|
*/
|
|
316
316
|
'forfeiture_Status_Default'?: string | null;
|
|
317
317
|
/**
|
|
318
|
-
*
|
|
318
|
+
* Ex Code associated with the illness waiting period.
|
|
319
319
|
* @type {string}
|
|
320
320
|
* @memberof Plans
|
|
321
321
|
*/
|
|
322
322
|
'illness_Ex_Code'?: string | null;
|
|
323
323
|
/**
|
|
324
|
-
*
|
|
324
|
+
* Waiting Period after an illness for Disability plans to start coverage.
|
|
325
325
|
* @type {number}
|
|
326
326
|
* @memberof Plans
|
|
327
327
|
*/
|
|
328
328
|
'illness_Waiting_Period'?: number | null;
|
|
329
329
|
/**
|
|
330
|
-
*
|
|
330
|
+
* Indicates whether the Disability plan includes a waiting period.
|
|
331
331
|
* @type {boolean}
|
|
332
332
|
* @memberof Plans
|
|
333
333
|
*/
|
|
334
334
|
'include_Waiting_Period'?: boolean | null;
|
|
335
335
|
/**
|
|
336
|
-
*
|
|
336
|
+
* Ex Code associated with the injury waiting period.
|
|
337
337
|
* @type {string}
|
|
338
338
|
* @memberof Plans
|
|
339
339
|
*/
|
|
340
340
|
'injury_Ex_Code'?: string | null;
|
|
341
341
|
/**
|
|
342
|
-
*
|
|
342
|
+
* Waiting Period after an injury for Disability plans to start coverage.
|
|
343
343
|
* @type {number}
|
|
344
344
|
* @memberof Plans
|
|
345
345
|
*/
|
|
346
346
|
'injury_Waiting_Period'?: number | null;
|
|
347
|
+
/**
|
|
348
|
+
*
|
|
349
|
+
* @type {boolean}
|
|
350
|
+
* @memberof Plans
|
|
351
|
+
*/
|
|
352
|
+
'ltC_Apply_Elimination_Period': boolean;
|
|
353
|
+
/**
|
|
354
|
+
*
|
|
355
|
+
* @type {boolean}
|
|
356
|
+
* @memberof Plans
|
|
357
|
+
*/
|
|
358
|
+
'ltC_Apply_Waiver_Of_Premium': boolean;
|
|
347
359
|
/**
|
|
348
360
|
*
|
|
349
361
|
* @type {number}
|
|
350
362
|
* @memberof Plans
|
|
351
363
|
*/
|
|
352
|
-
'
|
|
364
|
+
'ltC_Daily_Benefit'?: number | null;
|
|
353
365
|
/**
|
|
354
366
|
*
|
|
355
367
|
* @type {number}
|
|
356
368
|
* @memberof Plans
|
|
357
369
|
*/
|
|
358
|
-
'
|
|
370
|
+
'ltC_Daily_Benefit_Range_From'?: number | null;
|
|
359
371
|
/**
|
|
360
372
|
*
|
|
361
373
|
* @type {number}
|
|
362
374
|
* @memberof Plans
|
|
363
375
|
*/
|
|
364
|
-
'
|
|
376
|
+
'ltC_Daily_Benefit_Range_Increment'?: number | null;
|
|
365
377
|
/**
|
|
366
378
|
*
|
|
367
379
|
* @type {number}
|
|
368
380
|
* @memberof Plans
|
|
369
381
|
*/
|
|
370
|
-
'
|
|
382
|
+
'ltC_Daily_Benefit_Range_Thru'?: number | null;
|
|
371
383
|
/**
|
|
372
384
|
*
|
|
373
385
|
* @type {string}
|
|
374
386
|
* @memberof Plans
|
|
375
387
|
*/
|
|
376
|
-
'
|
|
388
|
+
'ltC_Daily_Benefit_Type'?: string | null;
|
|
377
389
|
/**
|
|
378
390
|
*
|
|
379
391
|
* @type {number}
|
|
380
392
|
* @memberof Plans
|
|
381
393
|
*/
|
|
382
|
-
'
|
|
394
|
+
'ltC_Elimination_Period'?: number | null;
|
|
383
395
|
/**
|
|
384
396
|
*
|
|
385
397
|
* @type {boolean}
|
|
386
398
|
* @memberof Plans
|
|
387
399
|
*/
|
|
388
|
-
'
|
|
400
|
+
'ltC_Elimination_Period_Per_Claim': boolean;
|
|
401
|
+
/**
|
|
402
|
+
*
|
|
403
|
+
* @type {string}
|
|
404
|
+
* @memberof Plans
|
|
405
|
+
*/
|
|
406
|
+
'ltC_Elimination_Period_Type'?: string | null;
|
|
389
407
|
/**
|
|
390
408
|
*
|
|
391
409
|
* @type {number}
|
|
392
410
|
* @memberof Plans
|
|
393
411
|
*/
|
|
394
|
-
'
|
|
412
|
+
'ltC_Lifetime_Max_Days_From'?: number | null;
|
|
395
413
|
/**
|
|
396
414
|
*
|
|
397
415
|
* @type {number}
|
|
398
416
|
* @memberof Plans
|
|
399
417
|
*/
|
|
400
|
-
'
|
|
418
|
+
'ltC_Lifetime_Max_Days_Thru'?: number | null;
|
|
401
419
|
/**
|
|
402
420
|
*
|
|
403
421
|
* @type {number}
|
|
404
422
|
* @memberof Plans
|
|
405
423
|
*/
|
|
406
|
-
'
|
|
424
|
+
'ltC_Lifetime_Max_From'?: number | null;
|
|
407
425
|
/**
|
|
408
426
|
*
|
|
409
427
|
* @type {number}
|
|
410
428
|
* @memberof Plans
|
|
411
429
|
*/
|
|
412
|
-
'
|
|
430
|
+
'ltC_Lifetime_Max_Increment'?: number | null;
|
|
431
|
+
/**
|
|
432
|
+
*
|
|
433
|
+
* @type {boolean}
|
|
434
|
+
* @memberof Plans
|
|
435
|
+
*/
|
|
436
|
+
'ltC_Lifetime_Max_Joint_Policy': boolean;
|
|
413
437
|
/**
|
|
414
438
|
*
|
|
415
439
|
* @type {number}
|
|
416
440
|
* @memberof Plans
|
|
417
441
|
*/
|
|
418
|
-
'
|
|
442
|
+
'ltC_Lifetime_Max_Thru'?: number | null;
|
|
443
|
+
/**
|
|
444
|
+
*
|
|
445
|
+
* @type {string}
|
|
446
|
+
* @memberof Plans
|
|
447
|
+
*/
|
|
448
|
+
'ltC_Lifetime_Max_Type'?: string | null;
|
|
419
449
|
/**
|
|
420
450
|
*
|
|
421
451
|
* @type {number}
|
|
422
452
|
* @memberof Plans
|
|
423
453
|
*/
|
|
424
|
-
'
|
|
454
|
+
'ltC_Lifetime_Max_Years_From'?: number | null;
|
|
425
455
|
/**
|
|
426
456
|
*
|
|
427
457
|
* @type {number}
|
|
428
458
|
* @memberof Plans
|
|
429
459
|
*/
|
|
430
|
-
'
|
|
460
|
+
'ltC_Lifetime_Max_Years_Thru'?: number | null;
|
|
431
461
|
/**
|
|
432
462
|
*
|
|
433
463
|
* @type {number}
|
|
434
464
|
* @memberof Plans
|
|
435
465
|
*/
|
|
436
|
-
'
|
|
466
|
+
'ltC_Monthly_Benefit'?: number | null;
|
|
437
467
|
/**
|
|
438
468
|
*
|
|
439
469
|
* @type {number}
|
|
440
470
|
* @memberof Plans
|
|
441
471
|
*/
|
|
442
|
-
'
|
|
472
|
+
'ltC_Monthly_Benefit_Range_From'?: number | null;
|
|
443
473
|
/**
|
|
444
474
|
*
|
|
445
475
|
* @type {number}
|
|
446
476
|
* @memberof Plans
|
|
447
477
|
*/
|
|
448
|
-
'
|
|
478
|
+
'ltC_Monthly_Benefit_Range_Increment'?: number | null;
|
|
449
479
|
/**
|
|
450
480
|
*
|
|
451
481
|
* @type {number}
|
|
452
482
|
* @memberof Plans
|
|
453
483
|
*/
|
|
454
|
-
'
|
|
484
|
+
'ltC_Monthly_Benefit_Range_Thru'?: number | null;
|
|
485
|
+
/**
|
|
486
|
+
*
|
|
487
|
+
* @type {string}
|
|
488
|
+
* @memberof Plans
|
|
489
|
+
*/
|
|
490
|
+
'ltC_Monthly_Benefit_Type'?: string | null;
|
|
455
491
|
/**
|
|
456
492
|
*
|
|
493
|
+
* @type {string}
|
|
494
|
+
* @memberof Plans
|
|
495
|
+
*/
|
|
496
|
+
'ltC_Waiver_Of_Premium_Type'?: string | null;
|
|
497
|
+
/**
|
|
498
|
+
* Total lifetime amount that the Plan will pay both In Network and Out of Network for the Familiy.
|
|
499
|
+
* @type {number}
|
|
500
|
+
* @memberof Plans
|
|
501
|
+
*/
|
|
502
|
+
'lifetime_Max'?: number | null;
|
|
503
|
+
/**
|
|
504
|
+
* Lifetime amount that the Plan will pay In Network for the Familiy.
|
|
505
|
+
* @type {number}
|
|
506
|
+
* @memberof Plans
|
|
507
|
+
*/
|
|
508
|
+
'lifetime_Max_Net'?: number | null;
|
|
509
|
+
/**
|
|
510
|
+
* Lifetime amount that the Plan will pay Out of Network for the Familiy.
|
|
511
|
+
* @type {number}
|
|
512
|
+
* @memberof Plans
|
|
513
|
+
*/
|
|
514
|
+
'lifetime_Max_OON'?: number | null;
|
|
515
|
+
/**
|
|
516
|
+
* Specifies the required age for maturity of policy inside enrollment.
|
|
517
|
+
* @type {number}
|
|
518
|
+
* @memberof Plans
|
|
519
|
+
*/
|
|
520
|
+
'maturity_Age'?: number | null;
|
|
521
|
+
/**
|
|
522
|
+
* Defines the age type for maturity based upon birth date or anniversary of enrollment.
|
|
523
|
+
* @type {string}
|
|
524
|
+
* @memberof Plans
|
|
525
|
+
*/
|
|
526
|
+
'maturity_Age_Type'?: string | null;
|
|
527
|
+
/**
|
|
528
|
+
* Maximum number of weeks the specified Plan will pay Disability.
|
|
529
|
+
* @type {number}
|
|
530
|
+
* @memberof Plans
|
|
531
|
+
*/
|
|
532
|
+
'max_Disability_Weeks'?: number | null;
|
|
533
|
+
/**
|
|
534
|
+
* Indicates whether the waiting period is included in the Max Disability Weeks.
|
|
535
|
+
* @type {boolean}
|
|
536
|
+
* @memberof Plans
|
|
537
|
+
*/
|
|
538
|
+
'max_Includes_Waiting_Period'?: boolean | null;
|
|
539
|
+
/**
|
|
540
|
+
* Total deductible amount to be credited back to each Member during adjudication.
|
|
541
|
+
* @type {number}
|
|
542
|
+
* @memberof Plans
|
|
543
|
+
*/
|
|
544
|
+
'mem_Ded_Credit'?: number | null;
|
|
545
|
+
/**
|
|
546
|
+
* Out of Network deductible amount to be credited back to each Member during adjudication.
|
|
547
|
+
* @type {number}
|
|
548
|
+
* @memberof Plans
|
|
549
|
+
*/
|
|
550
|
+
'mem_Ded_Credit_OON'?: number | null;
|
|
551
|
+
/**
|
|
552
|
+
* In-Network deductible amount to be credited back to each Member during adjudication.
|
|
553
|
+
* @type {number}
|
|
554
|
+
* @memberof Plans
|
|
555
|
+
*/
|
|
556
|
+
'mem_Ded_Credit_PPO'?: number | null;
|
|
557
|
+
/**
|
|
558
|
+
* Total In-Network and Out of Network annual maximum the plan will pay out per Member.
|
|
559
|
+
* @type {number}
|
|
560
|
+
* @memberof Plans
|
|
561
|
+
*/
|
|
562
|
+
'member_Annual_Max'?: number | null;
|
|
563
|
+
/**
|
|
564
|
+
* In-Network annual maximum that the plan will pay out per Member.
|
|
565
|
+
* @type {number}
|
|
566
|
+
* @memberof Plans
|
|
567
|
+
*/
|
|
568
|
+
'member_Annual_Max_Net'?: number | null;
|
|
569
|
+
/**
|
|
570
|
+
* Out of Network annual maximum that the plan will pay out per Member.
|
|
571
|
+
* @type {number}
|
|
572
|
+
* @memberof Plans
|
|
573
|
+
*/
|
|
574
|
+
'member_Annual_Max_OON'?: number | null;
|
|
575
|
+
/**
|
|
576
|
+
* Deductible amount for the Member Out of Network.
|
|
577
|
+
* @type {number}
|
|
578
|
+
* @memberof Plans
|
|
579
|
+
*/
|
|
580
|
+
'member_Ded_OON'?: number | null;
|
|
581
|
+
/**
|
|
582
|
+
* Deductible amount for the Member In Network.
|
|
583
|
+
* @type {number}
|
|
584
|
+
* @memberof Plans
|
|
585
|
+
*/
|
|
586
|
+
'member_Ded_PPO'?: number | null;
|
|
587
|
+
/**
|
|
588
|
+
* Total deductible amount for the Member both In Network and Out of Network.
|
|
589
|
+
* @type {number}
|
|
590
|
+
* @memberof Plans
|
|
591
|
+
*/
|
|
592
|
+
'member_Deductible'?: number | null;
|
|
593
|
+
/**
|
|
594
|
+
* Total In-Network and Out of Network lifetime maximum that the plan will pay out per Member.
|
|
595
|
+
* @type {number}
|
|
596
|
+
* @memberof Plans
|
|
597
|
+
*/
|
|
598
|
+
'member_Lifetime_Max'?: number | null;
|
|
599
|
+
/**
|
|
600
|
+
* In-Network lifetime maximum that the plan will pay out per Member.
|
|
601
|
+
* @type {number}
|
|
602
|
+
* @memberof Plans
|
|
603
|
+
*/
|
|
604
|
+
'member_Lifetime_Max_Net'?: number | null;
|
|
605
|
+
/**
|
|
606
|
+
* Out of Network lifetime that the plan will pay out per Member.
|
|
457
607
|
* @type {number}
|
|
458
608
|
* @memberof Plans
|
|
459
609
|
*/
|
|
460
610
|
'member_Lifetime_Max_OON'?: number | null;
|
|
461
611
|
/**
|
|
462
|
-
*
|
|
612
|
+
* Formula used to calculate Out of Pocket amounts.
|
|
463
613
|
* @type {string}
|
|
464
614
|
* @memberof Plans
|
|
465
615
|
*/
|
|
466
616
|
'ooP_Calc_Option'?: string | null;
|
|
467
617
|
/**
|
|
468
|
-
*
|
|
618
|
+
* Indicates whether In-Network Out of Pocket amounts apply toward the satisfaction of Out of Network amounts.
|
|
469
619
|
* @type {boolean}
|
|
470
620
|
* @memberof Plans
|
|
471
621
|
*/
|
|
472
622
|
'ooP_In_To_Out': boolean;
|
|
473
623
|
/**
|
|
474
|
-
*
|
|
624
|
+
* Total In-Network and Out of Network Out of Pocket maximum for the Member.
|
|
475
625
|
* @type {number}
|
|
476
626
|
* @memberof Plans
|
|
477
627
|
*/
|
|
478
628
|
'ooP_Max_Mem'?: number | null;
|
|
479
629
|
/**
|
|
480
|
-
*
|
|
630
|
+
* In-Network Out of Pocket maximum for the Member.
|
|
481
631
|
* @type {number}
|
|
482
632
|
* @memberof Plans
|
|
483
633
|
*/
|
|
484
634
|
'ooP_Max_Net_Mem'?: number | null;
|
|
485
635
|
/**
|
|
486
|
-
*
|
|
636
|
+
* In-Network Out of Pocket maximum for the Family.
|
|
487
637
|
* @type {number}
|
|
488
638
|
* @memberof Plans
|
|
489
639
|
*/
|
|
490
640
|
'ooP_Max_Net_Sub'?: number | null;
|
|
491
641
|
/**
|
|
492
|
-
*
|
|
642
|
+
* Out of Network Out of Pocket for the Member.
|
|
493
643
|
* @type {number}
|
|
494
644
|
* @memberof Plans
|
|
495
645
|
*/
|
|
496
646
|
'ooP_Max_OON_Mem'?: number | null;
|
|
497
647
|
/**
|
|
498
|
-
*
|
|
648
|
+
* Out of Network Out of Pocket for the Family.
|
|
499
649
|
* @type {number}
|
|
500
650
|
* @memberof Plans
|
|
501
651
|
*/
|
|
502
652
|
'ooP_Max_OON_Sub'?: number | null;
|
|
503
653
|
/**
|
|
504
|
-
*
|
|
654
|
+
* Total In-Network and Out of Network Out of Pocket maximum for the Family.
|
|
505
655
|
* @type {number}
|
|
506
656
|
* @memberof Plans
|
|
507
657
|
*/
|
|
508
658
|
'ooP_Max_Sub'?: number | null;
|
|
509
659
|
/**
|
|
510
|
-
*
|
|
660
|
+
* Indicates whether Out of Network Out of Pocket amounts apply toward the satisfaction of In-Network amounts.
|
|
511
661
|
* @type {boolean}
|
|
512
662
|
* @memberof Plans
|
|
513
663
|
*/
|
|
514
664
|
'ooP_Out_To_In': boolean;
|
|
515
665
|
/**
|
|
516
|
-
*
|
|
666
|
+
* Payment Interval or frequency for Disability plans.
|
|
517
667
|
* @type {number}
|
|
518
668
|
* @memberof Plans
|
|
519
669
|
*/
|
|
520
670
|
'payment_Interval'?: number | null;
|
|
521
671
|
/**
|
|
522
|
-
*
|
|
672
|
+
* No longer in use.
|
|
523
673
|
* @type {string}
|
|
524
674
|
* @memberof Plans
|
|
525
675
|
*/
|
|
526
676
|
'payor_ID'?: string | null;
|
|
527
677
|
/**
|
|
528
|
-
*
|
|
678
|
+
* Identifies the Ex Code that will be applied based upon the Pend_Flag field.
|
|
529
679
|
* @type {string}
|
|
530
680
|
* @memberof Plans
|
|
531
681
|
*/
|
|
532
682
|
'pend_Ex_Code'?: string | null;
|
|
533
683
|
/**
|
|
534
|
-
*
|
|
684
|
+
* Specifies if an Ex Code will be assigned, which will apply to all claims adjudicated for this plan. The Ex Code can be an informational, denial, or pend code. All ExCodes impact adjudication.
|
|
535
685
|
* @type {string}
|
|
536
686
|
* @memberof Plans
|
|
537
687
|
*/
|
|
538
688
|
'pend_Flag'?: string | null;
|
|
539
689
|
/**
|
|
540
|
-
*
|
|
690
|
+
* Used for custom reporting and information.
|
|
541
691
|
* @type {string}
|
|
542
692
|
* @memberof Plans
|
|
543
693
|
*/
|
|
544
694
|
'plan_Document_URL'?: string | null;
|
|
545
695
|
/**
|
|
546
|
-
*
|
|
696
|
+
* Identifies the Type of Plan (medical, dental, etc.). Keep in mind that Accumulators are tied to \'Plan Type\' not the plan itself.
|
|
547
697
|
* @type {string}
|
|
548
698
|
* @memberof Plans
|
|
549
699
|
*/
|
|
550
700
|
'plan_Type'?: string | null;
|
|
551
701
|
/**
|
|
552
|
-
*
|
|
702
|
+
* Length of the grace period.
|
|
553
703
|
* @type {number}
|
|
554
704
|
* @memberof Plans
|
|
555
705
|
*/
|
|
556
706
|
'policy_Forfeiture_Grace_Period'?: number | null;
|
|
557
707
|
/**
|
|
558
|
-
*
|
|
708
|
+
* Defines the type of grace period. Restricted to units of days.
|
|
559
709
|
* @type {string}
|
|
560
710
|
* @memberof Plans
|
|
561
711
|
*/
|
|
562
712
|
'policy_Forfeiture_Grace_Period_Type'?: string | null;
|
|
563
713
|
/**
|
|
564
|
-
*
|
|
714
|
+
* Default policy status assigned when Policy & Forteiture is used in enrollment.
|
|
565
715
|
* @type {string}
|
|
566
716
|
* @memberof Plans
|
|
567
717
|
*/
|
|
568
718
|
'policy_Status_Default'?: string | null;
|
|
569
719
|
/**
|
|
570
|
-
*
|
|
720
|
+
* Identifies the Ex Code that will be applied to disability claims falling within the provided range.
|
|
571
721
|
* @type {string}
|
|
572
722
|
* @memberof Plans
|
|
573
723
|
*/
|
|
574
724
|
'preEx_Ex_Code'?: string | null;
|
|
575
725
|
/**
|
|
576
|
-
*
|
|
726
|
+
* No longer in use. Pre-Ex processing has been moved to a more detailed structure in PlanPrex tables.
|
|
577
727
|
* @type {number}
|
|
578
728
|
* @memberof Plans
|
|
579
729
|
*/
|
|
580
730
|
'preEx_From'?: number | null;
|
|
581
731
|
/**
|
|
582
|
-
*
|
|
732
|
+
* Defines a range of days that is determined by comparing the start date of the plan and the disability date. If a disability claim falls within this defined range, the specified Ex Code will be applied to that claim.
|
|
583
733
|
* @type {number}
|
|
584
734
|
* @memberof Plans
|
|
585
735
|
*/
|
|
586
736
|
'preEx_Range'?: number | null;
|
|
587
737
|
/**
|
|
588
|
-
*
|
|
738
|
+
* No longer in use. Pre-Ex processing has been moved to a more detailed structure in PlanPrex tables.
|
|
589
739
|
* @type {number}
|
|
590
740
|
* @memberof Plans
|
|
591
741
|
*/
|
|
@@ -597,73 +747,73 @@ export interface Plans {
|
|
|
597
747
|
*/
|
|
598
748
|
'qpA_Method'?: string | null;
|
|
599
749
|
/**
|
|
600
|
-
*
|
|
750
|
+
* Deault paid up value when Policy & Forfeiture is used in enrollment.
|
|
601
751
|
* @type {number}
|
|
602
752
|
* @memberof Plans
|
|
603
753
|
*/
|
|
604
754
|
'reduced_Paid_Up_Default'?: number | null;
|
|
605
755
|
/**
|
|
606
|
-
*
|
|
756
|
+
* No longer in use.
|
|
607
757
|
* @type {boolean}
|
|
608
758
|
* @memberof Plans
|
|
609
759
|
*/
|
|
610
760
|
'remove_Member_Amount_Edit': boolean;
|
|
611
761
|
/**
|
|
612
|
-
*
|
|
762
|
+
* Total deductible amount to be credited back to the Subscriber during adjudication.
|
|
613
763
|
* @type {number}
|
|
614
764
|
* @memberof Plans
|
|
615
765
|
*/
|
|
616
766
|
'sub_Ded_Credit'?: number | null;
|
|
617
767
|
/**
|
|
618
|
-
*
|
|
768
|
+
* Out of Network deductible amount to be credited back to the Subscriber during adjudication.
|
|
619
769
|
* @type {number}
|
|
620
770
|
* @memberof Plans
|
|
621
771
|
*/
|
|
622
772
|
'sub_Ded_Credit_OON'?: number | null;
|
|
623
773
|
/**
|
|
624
|
-
*
|
|
774
|
+
* In-Network deductible amount to be credited back to the Subscriber during adjudication.
|
|
625
775
|
* @type {number}
|
|
626
776
|
* @memberof Plans
|
|
627
777
|
*/
|
|
628
778
|
'sub_Ded_Credit_PPO'?: number | null;
|
|
629
779
|
/**
|
|
630
|
-
*
|
|
780
|
+
* Deductible amount for the Family Out of Network.
|
|
631
781
|
* @type {number}
|
|
632
782
|
* @memberof Plans
|
|
633
783
|
*/
|
|
634
784
|
'subscriber_Ded_OON'?: number | null;
|
|
635
785
|
/**
|
|
636
|
-
*
|
|
786
|
+
* Deductible amount for the Family In Network.
|
|
637
787
|
* @type {number}
|
|
638
788
|
* @memberof Plans
|
|
639
789
|
*/
|
|
640
790
|
'subscriber_Ded_PPO'?: number | null;
|
|
641
791
|
/**
|
|
642
|
-
*
|
|
792
|
+
* Total deductible amount for the Family both In Network and Out of Network.
|
|
643
793
|
* @type {number}
|
|
644
794
|
* @memberof Plans
|
|
645
795
|
*/
|
|
646
796
|
'subscriber_Deductible'?: number | null;
|
|
647
797
|
/**
|
|
648
|
-
*
|
|
798
|
+
* Survivor Benefit associated with Disability plans.
|
|
649
799
|
* @type {number}
|
|
650
800
|
* @memberof Plans
|
|
651
801
|
*/
|
|
652
802
|
'survivor_Benefit'?: number | null;
|
|
653
803
|
/**
|
|
654
|
-
*
|
|
804
|
+
* Date when the record was last updated in the system.
|
|
655
805
|
* @type {string}
|
|
656
806
|
* @memberof Plans
|
|
657
807
|
*/
|
|
658
808
|
'update_Date'?: string;
|
|
659
809
|
/**
|
|
660
|
-
*
|
|
810
|
+
* User that last updated the record in the system.
|
|
661
811
|
* @type {string}
|
|
662
812
|
* @memberof Plans
|
|
663
813
|
*/
|
|
664
814
|
'update_User'?: string | null;
|
|
665
815
|
/**
|
|
666
|
-
*
|
|
816
|
+
* Indicates whether the COB should be used.
|
|
667
817
|
* @type {boolean}
|
|
668
818
|
* @memberof Plans
|
|
669
819
|
*/
|