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Group Name

ME032, Massachusetts

Versions: December 1, 2010 - v2.1 • June 7, 2013 - v3.1• October 1, 2014 - v4.0Compare Versions


Name:Group Name
Data Element ID:ME032
Description:Group name
State:Massachusetts
Data Type:Text
Data Type Description:Name Group
Format:varchar[50]
Length:50
Column:32
Threshold:1
File:ME
Element Submission Guideline:Report the group name that the policy is attached to. Report IND for individual policies. Do not report any value here if the data is not available
Condition:All
Cat:A2
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File Specification for Multiple versionsMember Eligibility File Submission - June 7, 2013 - v3.1

Data Element ID Data Element Description Type Format Length
Multiple versionsHD001 Record Type Header Record Identifier Text char[2] 2
Multiple versionsHD002 Submitter Header Submitter / Carrier ID defined by CHIA Integer varchar[6] 6
Multiple versionsHD003 National Plan ID Header CMS National Plan Identification Number (PlanID) Integer int[10] 10
Multiple versionsHD004 Type of File Defines the file type and data expected. Text char[2] 2
Multiple versionsHD005 Period Beginning Date Header Period Start Date Date Period - Integer int[6] CCYYMM 6
Multiple versionsHD006 Period Ending Date Header Period Ending Date Date Period - Integer int[6] CCYYMM 6
Multiple versionsHD007 Record Count Header Record Count Integer varchar[10] 10
Multiple versionsHD008 Comments Header Carrier Comments Text varchar[80] 80
Multiple versionsHD009 APCD Version Number Submission Guide Version Decimal - Numeric char[3] 3
Multiple versionsME001 Submitter CHIA defined and maintained unique identifier Integer varchar[6] 6
Multiple versionsME002 National Plan ID CMS National Plan Identification Number (PlanID) Integer int[10] 10
Multiple versionsME003 Insurance Type Code/Product Type / Product Identification Code Text char[2] 2
Multiple versionsME004 Year Eligibility year reported in this submission. Date Period - Integer int[4] CCYY 4
Multiple versionsME005 Month Reporting Month of Eligibility Date Period - Numeric char[2] MM 2
Multiple versionsME006 Insured Group or Policy Number Group / Policy Number Text varchar[30] 30
Multiple versionsME007 Coverage Level Code Benefit Coverage Level Code Lookup Table - Text char[3] 3
Multiple versionsME008 Subscriber SSN Subscriber's Social Security Number Numeric char[9] 9
Multiple versionsME009 Plan Specific Contract Number Contract Number Text varchar[30] 30
Multiple versionsME010 Member Suffix or Sequence Number Member's Contract Sequence Number Text varchar[20] 20
Multiple versionsME011 Member SSN Member's Social Security Number Numeric char[9] 9
Multiple versionsME012 Individual Relationship Code Member to Subscriber Relationship Code Numeric varchar[2] 2
Multiple versionsME013 Member Gender Member's Gender Text char[1] 1
Multiple versionsME014 Member Date of Birth Member's date of birth Full Date - Integer int[8] CCYYMMDD 8
Multiple versionsME015 Member City Name City name of the Member Text varchar[30] 30
Multiple versionsME016 Member State State / Province of the Member External Code Source 2 - Text char[2] 2
Multiple versionsME017 Member ZIP Code Zip Code of the Member External Code Source 2 - Text varchar[9] 9
Multiple versionsME018 Medical Coverage Indicator - Medical Option Lookup Table - Integer int[1] 1
Multiple versionsME019 Prescription Drug Coverage Indicator - Pharmacy Option Lookup Table - Integer int[1] 1
Multiple versionsME020 Dental Coverage Indicator - Dental Option Lookup Table - Integer int[1] 1
Multiple versionsME021 Race 1 Member's self-disclosed Primary Race Lookup Table - Text varchar[6] 6
Multiple versionsME022 Race 2 Member's self-disclosed Secondary Race Lookup Table - Text varchar[6] 6
Multiple versionsME023 Other Race Member's Other Race Text varchar[15] 15
Multiple versionsME024 Hispanic Indicator Indicator - Hispanic Status Lookup Table - Integer int[1] 1
Multiple versionsME025 Ethnicity 1 Member's Primary Ethnicity Lookup Table - OR - External Code Source 17 - Text char[6] 6
Multiple versionsME026 Ethnicity 2 Member's Secondary Ethnicity Lookup Table - OR - External Code Source 17 - Text char[6] 6
Multiple versionsME027 Other Ethnicity Member's Other Ethnicity Text varchar[20] 20
Multiple versionsME028 Primary Insurance Indicator Indicator - Primary Insurance Coverage Lookup Table - Integer int[1] 1
Multiple versionsME029 Coverage Type Type of Coverage Code Lookup Table - Text char[3] 3
Multiple versionsME030 Market Category Code Market Category Code Lookup Table - Text varchar[4] 4
Multiple versionsME031 Special Coverage Not Provided Lookup Table - Text varchar[3] 3
Multiple versionsME032 Group Name Group name Text varchar[50] 50
Multiple versionsME033 Member language preference Member's self-disclosed verbal language preference External Code Source 7 - Integer int[3] 3
Multiple versionsME034 Member language preference -Other Member's Other Language Preference Text varchar[20] 20
Multiple versionsME035 Health Care Home (PCMH) Assigned Flag Health Care Home Assigned indicator Lookup Table - Integer int[1] 1
Multiple versionsME036 Health Care Home (PCMH) Number Health Care Home ID Text varchar[30] 30
Multiple versionsME037 Health Care Home (PCMH) Tax ID Number Health Care Home EIN Numeric char[9] 9
Multiple versionsME038 National Provider ID - Health Care Home (PCMH) National Provider Identification (NPI) of the Health Care Home Provider External Code Source 3 - Integer int[10] 10
Multiple versionsME039 Health Care Home Name (PCMH) Name of Health Care Home Text varchar[60] 60
Multiple versionsME040 Product ID Number Product Identification Text varchar[30] 30
Multiple versionsME041 Product Enrollment Start Date Member Enrollment Date Full Date - Integer int[8] CCYYMMDD 8
Multiple versionsME042 Product Enrollment End Date Enrollment Date Full Date - Integer int[8] CCYYMMDD 8
Multiple versionsME043 Member Street Address Street address of the Member Text varchar[50] 50
Multiple versionsME044 Member Street Address 2 Secondary Street Address of the Member Text varchar[50] 50
Multiple versionsME045 Purchased through Massachusetts Exchange Flag Indicator - MA Exchange Purchase Lookup Table - Integer int[1] 1
Multiple versionsME046 Member PCP ID Member's PCP ID Text varchar[30] 30
Multiple versionsME047 Member PCP Effective Date PCP Effective Date with Member Full Date - Integer int[8] CCYYMMDD 8
Multiple versionsME048 Member PCP Termination Date PCP Termination Date with Member Full Date - Integer int[8] CCYYMMDD 8
Multiple versionsME049 Member Deductible Annual maximum out of pocket Member Deductible across all benefit types Integer varchar[10] 10
Multiple versionsME050 Member Deductible Used Member deductible amount incurred Integer varchar[10] 10
Multiple versionsME051 Behavioral Health Benefit Flag Indicator - Behavioral Health Option Lookup Table - Integer int[1] 1
Multiple versionsME052 Laboratory Benefit Flag Indicator - Laboratory Option Lookup Table - Integer int[1] 1
Multiple versionsME053 Disease Management Enrollee Flag Chronic Illness Management indicator Lookup Table - Integer int[1] 1
Multiple versionsME054 Eligibility Determination Date Eligibility date Full Date - Integer int[8] CCYYMMDD 8
Multiple versionsME055 Business Type Code Business Type Lookup Table - Integer int[1] 1
Multiple versionsME056 Last Activity Date Activity Date Full Date - Integer int[8] CCYYMMDD 8
Multiple versionsME057 Date of Death Member's Date of Death Full Date - Integer int[8] CCYYMMDD 8
Multiple versionsME058 Subscriber Street Address Street address of the Subscriber Text varchar[50] 50
Multiple versionsME059 Disability Indicator Flag Indicator - Disability Status Lookup Table - Integer int[1] 1
Multiple versionsME060 Employment Status Employment Status Code Lookup Table - Text char[1] 1
Multiple versionsME061 Student Status Indicator - Student Status Lookup Table - Integer int[1] 1
Multiple versionsME062 Marital Status Marital Status Code Lookup Table - Text char[1] 1
Multiple versionsME063 Benefit Status Benefit Status Code Lookup Table - Text char[1] 1
Multiple versionsME064 Employee Type Employee Type Code Lookup Table - Text char[1] 1
Multiple versionsME065 Date of Retirement Member's date of Retirement Full Date - Integer int[8] CCYYMMDD 8
Multiple versionsME066 COBRA Status COBRA usage indicator Lookup Table - Integer int[1] 1
Multiple versionsME067 Spouse Plan Type Spouse Plan Type Code Carrier Defined Table - Text char[2] 2
Multiple versionsME068 Spouse Plan Spouse Plan Medicare Code Carrier Defined Table - Text char[2] 2
Multiple versionsME069 Spouse Medical Coverage Spouse Medical Medicare Coverage Code Carrier Defined Table - Text char[2] 2
Multiple versionsME070 Spouse Medicare Indicator Spouse Medicare Selected Code Carrier Defined Table - Text char[2] 2
Multiple versionsME071 Pool Indicator Pool Indicator Code Lookup Table - Integer int[1] 1
Multiple versionsME072 Family Size Family Size Contracted Integer varchar[2] 2
Multiple versionsME073 Fully Insured member Fully Insured identifier Lookup Table - Integer int[1] 1
Multiple versionsME074 Interpreter Indicator - Interpreter Need Lookup Table - Integer int[1] 1
Multiple versionsME075 NewMMIS ID MassHealth-assigned Member ID Text char[12] 12
Multiple versionsME076 Member rating category Member Rating Category Code Carrier Defined Table - Text char[2] 2
Multiple versionsME077 Members SIC Code Member Standard NAIC or SIC Code External Code Source 6 - Numeric varchar[6] 6
Multiple versionsME078 Employer Zip Code Zip code of the Employer External Code Source 2 - Text char[5] 5
Multiple versionsME079 Recipient Identification Number (MassHealth only) MassHealth-assigned Member ID Text varchar[15] 15
Multiple versionsME080 Recipient Historical Number (MassHealth only) MassHealth-assigned Member ID Text varchar[15] 15
Multiple versionsME081 Medicare Code Medicare Plan Indicator Code Lookup Table - Integer int[1] 1
Multiple versionsME082 Employer Name Member's Employer Name Text varchar[60] 60
Multiple versionsME083 Employer EIN Member's Employer EIN Numeric char[9] 9
Multiple versionsME101 Subscriber Last Name Last name of Subscriber Text varchar[60] 60
Multiple versionsME102 Subscriber First Name First name of Subscriber Text varchar[25] 25
Multiple versionsME103 Subscriber Middle Initial Middle initial of Subscriber Text char[1] 1
Multiple versionsME104 Member Last Name Last name of Member Text varchar[60] 60
Multiple versionsME105 Member First Name First name of Member Text varchar[25] 25
Multiple versionsME106 Member Middle Initial Middle initial of Member Text char[1] 1
Multiple versionsME107 Carrier Specific Unique Member ID Member's Unique ID Text varchar[50] 50
Multiple versionsME108 Subscriber City Name City name of the Subscriber Text varchar[30] 30
Multiple versionsME109 Subscriber State or Province State of the Subscriber External Code Source 2 - Text char[2] 2
Multiple versionsME110 Subscriber ZIP Code Zip Code of the Subscriber External Code Source 2 - Text varchar[9] 9
Multiple versionsME111 Medical Deductible Maximum out of pocket amount of applied member's deductible Integer varchar[10] 10
Multiple versionsME112 Pharmacy Deductible Maximum out of pocket amount of member's deductible applied to pharmacy Integer varchar[10] 10
Multiple versionsME113 Medical and Pharmacy Deductible Maximum out of pocket amount of member's deductible applied to services Integer varchar[10] 10
Multiple versionsME114 Behavioral Health Deductible Maximum out of pocket amount of member's deductible applied to behavioral health Integer varchar[10] 10
Multiple versionsME115 Dental Deductible Maximum out of pocket amount of member's deductible applied to dental services Integer varchar[10] 10
Multiple versionsME116 Vision Deductible Maximum out of pocket amount of member's deductible applied to vision services Integer varchar[10] 10
Multiple versionsME117 Carrier Specific Unique Subscriber ID Subscriber's Unique ID Text varchar[50] 50
Multiple versionsME118 Vision Benefit Indicator - Vision Option Lookup Table - Integer int[1] 1
Multiple versionsME119 Filler Filler Filler char[0] 0
Multiple versionsME120 Actuarial Value The actuarial value of the risk adjustment covered plan the member is enrolled in Decimal - Numeric varchar[6] 6
Multiple versionsME121 Metal Level Standardized plan level in metal reference Lookup Table - Integer int[1] 1
Multiple versionsME122 Coinsurance Maximum % Maximum coinsurance percentage contract of the member Lookup Table - Integer int[1] 1
Multiple versionsME123 Monthly Premium Expected Monthly Premium Integer varchar[10] 10
Multiple versionsME124 Attributed PCP Provider ID PV002 for PCP attributed to the patient for prior year. Text varchar[30] 30
Multiple versionsME125 TME OrgID - Physician Group of the Member's PCP TME Provider OrgID Integer varchar[6] 6
Multiple versionsME126 Risk Adjustment Covered Plan (RACP) Member Enrolled in RACP Indicator Lookup table - Integer Int(1) 1
Multiple versionsME127 Billable Member Billable Member Indicator Lookup table - Integer Int(1) 1
Multiple versionsME128 Benefit Plan Contract ID Identifier for the benefit plan the member is enrolled in as of 15th of the month Text varchar [30] 30
Multiple versionsME129 Member Benefit Plan Contract Enrollment Start Date Date the member is enrolled in the benefit plan Date Int(8) CCYYMMDD 8
Multiple versionsME130 Member Benefit Plan Contract Enrollment End Date Date the member's enrollment ends with the benefit plan Date Int(8) CCYYMMDD 8
Multiple versionsME131 TME Global Budget/Payment Indicator TME Global Budget/Payment Indicator Integer Int[1] 1
Multiple versionsME132 Total Monthly Premium Employer + Subscriber's total contribution to monthly premium Integer varchar[10] 10
Multiple versionsME133 GIC ID GIC Member ID Text varchar[9] 9
Multiple versionsME134 APCD ID Code Member Enrollment Type Lookup Table - Integer int[1] 1
Multiple versionsME899 Record Type File Type Identifier Text char[2] 2
Multiple versionsTR001 Record Type Trailer Record Identifier Text char[2] 2
Multiple versionsTR002 Submitter Trailer Submitter / Carrier ID defined by CHIA Integer varchar[6] 6
Multiple versionsTR003 National Plan ID CMS National Plan Identification Number (PlanID) Integer int[10] 10
Multiple versionsTR004 Type of File Validates the file type defined in HD004. Text char[2] 2
Multiple versionsTR005 Period Beginning Date Trailer Period Start Date Date Period - Integer int[6] CCYYMM 6
Multiple versionsTR006 Period Ending Date Trailer Period Ending Date Date Period - Integer int[6] CCYYMM 6
Multiple versionsTR007 Date Processed Trailer Processed Date Full Date - Integer int[8] CCYYMMDD 8

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