Plans

Create Plan

Creates a new Plan

SecurityapiKeyAuth and bearerAuth

Request

header Parameters

vbasoftware-database

required

string

Target database

Request Body schema:
application/json
required

plan_ID required	string [ 1 .. 20 ] characters Unique identifier assigned to the Plan.
annual_Max	number or null <double> Total In-Network and Out of Network annual maximum the plan will pay out for the Familiy.
annual_Max_Net	number or null <double> In-Network annual maximum that the plan will pay out for the Familiy.
annual_Max_OON	number or null <double> Out of Network annual maximum that the plan will pay out for the Familiy.
auto_Create_Flex required	boolean Indicates if this plan allows auto-creation of Flex claims based on Group level configuration for flex auto-creation. Note: This field is marked as NOT NULL in the database and therefore required by the API.
cobrA_Plan_Type_Desc	string or null <= 20 characters Used for custom reporting and information.
coB_Savings_Max	number or null <double> Indicates the maximum amount that can be held in COB savings.
coB_Type	string or null <= 16 characters Indicates the type of COB to be used with the selected plan.
capitated required	boolean No longer in use. All captiation logic and processing now resides in the capitation tables. Note: This field is marked as NOT NULL in the database and therefore required by the API.
cash_Value_Default	integer or null <int32> Default cash value when Policy & Forfeiture is used in enrollment.
coIns_In_To_Out required	boolean Indicates whether In-Network Coinsurance amounts apply toward the satisfaction of Out of Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
coIns_Max_Mem	number or null <double> In Network Co-Insurance amount for the Family.
coIns_Max_Net_Mem	number or null <double> Total Co-Insurance amount for the Member.
coIns_Max_Net_Sub	number or null <double> Out of Network Co-Insurance amount for the Family.
coIns_Max_OON_Mem	number or null <double> Out of Network Co-Insurance amount for the Member.
coIns_Max_OON_Sub	number or null <double> In Network Co-Insurance amount for the Member.
coIns_Max_Sub	number or null <double> Total Co-Insurance amount for the Family.
coIns_Out_To_In required	boolean Indicates whether Out of Network CoInsurance amounts apply toward the satisfaction of the In-Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
coIns_Out_To_In_Limit required	boolean When active, this will let the system know to limit the amount of co-insurance that applies to IN from OON by the Max. Note: This field is marked as NOT NULL in the database and therefore required by the API.
coIns_Out_To_In_Limit_Max	number or null <double> The max with which the co-insurance is limited by when CoIns_Out To In Limit is selected.
context4_ClmUcrPct	integer or null <int32> Claim UCR percentage provided by Context. Required for Context claim edits and repricing.
context4_ClmUcrPct_OON	integer or null <int32> Out of network claim UCR percentage provided by context. Required for Context claim edits and repricing.
context4_FeeSelector	string or null <= 8 characters Fee Selector provided by Context. Required for Context claim edits and repricing.
context4_FeeSelector_OON	string or null <= 8 characters Out of network fee selector provided by context. Required for Context claim edits and repricing.
context4_MedicarePct	integer or null <int32> Medicare percentage provided by Context. Required for Context claim edits and repricing.
context4_MedicarePct_OON	integer or null <int32> Out of network Medicare percentage provided by context. Required for Context claim edits and repricing.
context4_Password	string or null <= 128 characters Password provided by Context. Required for Context claim edits and repricing.
context4_PayorType	string or null <= 8 characters Payor type provided by context. Required for Context claim edits and repricing.
context4_PayorType_OON	string or null <= 8 characters Out of network Payor type provided by context. Required for Context claim edits and repricing.
context4_PctOfChg	integer or null <int32> Percentage of change provided by context. Required for Context claim edits and repricing.
context4_PctOfChg_OON	integer or null <int32> Out of network percentage of change provided by context. Required for Context claim edits and repricing.
context4_PlanPriceNotGreaterBilledFg required	boolean When using Context4, the Plan Price is never allowed to exceed the Billed Price, it'll set it to the Billed Price. Note: This field is marked as NOT NULL in the database and therefore required by the API.
context4_UserID	string or null <= 128 characters User ID provided by Context. Required for Context claim edits and repricing.
context4_WebURI	string or null <= 256 characters URL provided by Context. Required for Context claim edits and repricing.
context4_WebURI_Delete	string or null <= 256 characters URL delete provided by Context. Required for Context claim edits and repricing.
currency_ID	string or null <= 16 characters Indicates the currency being used.
ded_In_To_Out required	boolean Indicates whether In-Network Deductible amounts apply toward the satisfaction of Out of Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ded_Out_To_In required	boolean Indicates whether Out of Network Deductible amounts apply toward the satisfaction of In-Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ded_Out_To_In_Limit required	boolean When active, this will let the system know to limit the amount of deductible that applies to IN from OON by the Max. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ded_Out_To_In_Limit_Max	number or null <double> The max with which the deducible is limited by when Ded_Out To In Limit is selected.
description	string or null <= 50 characters A short description of the associated plan.
entry_Date	string <date-time> Date when the record was added to the system.
entry_User	string or null <= 20 characters User that first added the record to the system.
extended_Term_Default	integer or null <int32> Deault extended term value assigned in Policy & Forfeiture when used in enrollment.
family_Level_Co_Ins required	boolean Specifies that the number of Member level Coinsurance amounts should be used to satisfy the Family level Coinsurance amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
family_Level_Co_Ins_Member	integer or null <int32> Number of Members that must satisfy the Member level deductible before the Family level amount is considered met.
family_Level_Ded required	boolean Specifies that the number of Member level deductible amounts should be used to satisfy the Family level deductible. Note: This field is marked as NOT NULL in the database and therefore required by the API.
family_Level_Ded_Member	integer or null <int32> Number of Members that must satisfy the Member level deductible before the Family level amount is considered met.
family_Level_OOP required	boolean Specifies that the number of Member level Out of Pocket amounts should be used to satisfy the Family level Out of Pocket amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
family_Level_OOP_Member	integer or null <int32> Number of Members that must satisfy the Member level Out of Pocket before the Family level Out of Pocket is considered met.
flex_Advance_Fund required	boolean Information field used in reporting to identify this plan as Flex Advance Fund. Note: This field is marked as NOT NULL in the database and therefore required by the API.
flex_Type	string or null <= 16 characters Indicates what type of Flex account to be associated with the plan.
forfeiture_Status_Default	string or null <= 32 characters Default forfeiture status assigned when Policy & Forteiture is used in enrollment.
illness_Ex_Code	string or null <= 8 characters Ex Code associated with the illness waiting period.
illness_Waiting_Period	integer or null <int32> Waiting Period after an illness for Disability plans to start coverage.
include_Waiting_Period	boolean or null Indicates whether the Disability plan includes a waiting period.
injury_Ex_Code	string or null <= 8 characters Ex Code associated with the injury waiting period.
injury_Waiting_Period	integer or null <int32> Waiting Period after an injury for Disability plans to start coverage.
ltC_Apply_Elimination_Period required	boolean Indicates if this Plan has Elimination Period rules. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ltC_Apply_Waiver_Of_Premium required	boolean Indicates if Waiver of Premium rules should apply for this plan. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ltC_Daily_Benefit	number or null <double> This is the daily benefit amount
ltC_Daily_Benefit_Range_From	number or null <double> The start of the selection range for members taking this plan and choosing their daily benefit.
ltC_Daily_Benefit_Range_Increment	number or null <double> The increment of each option in the range between the from and thru. If empty, the member can manually select a value between the from / thru range.
ltC_Daily_Benefit_Range_Thru	number or null <double> The end of the selection range for members taking this plan and choosing their daily benefit.
ltC_Daily_Benefit_Type	string or null <= 32 characters This is the type of daily benefit defined for this plan. The values are: A - a flat daily benefit enforced by the plan. B - member selected value utilizing the daily benefit range/increment settings.
ltC_Elimination_Period	integer or null <int32> This is the elimination period value based on Elimination_Period_Type.
ltC_Elimination_Period_Per_Claim required	boolean Indicates if the elimination period is per claim. By default the elimination period is per plan/policy. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ltC_Elimination_Period_Type	string or null <= 32 characters This is the type of Elimination Period rule to apply for this Plan. Values are: A - Calendar Days B - Service Days C - Special Service Days (one day equals a week of elimination period)
ltC_Lifetime_Max_Days_From	integer or null <int32> The selectable range of days the member can pick for calculations based on days.
ltC_Lifetime_Max_Days_Thru	integer or null <int32> The selectable range of days the member can pick for calculations based on days.
ltC_Lifetime_Max_From	number or null <double> The low end range for member lifetime max selection.
ltC_Lifetime_Max_Increment	number or null <double> The increment of options the user can select within the max range. Empty value here means it is a free from entry of max between the range.
ltC_Lifetime_Max_Joint_Policy required	boolean Indicates if plans of the same plan type, and both flagged as joint policy, can share a "Total" lifetime max between both plans as long as both plans have selected a shared benefit. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ltC_Lifetime_Max_Thru	number or null <double> The high end range for member lifetime max selection.
ltC_Lifetime_Max_Type	string or null <= 32 characters Lifetime Max calculation type and will dicatate the max rules applied. Valid values are: STANDARD - DBM x 365 days x Lifetime Max Years selected LMDAYS - DBM x Lifetime Max Days selected FLAT - Lifetime Max Amount selected and not based on calculation LMMONTHS - MBA x 12 Months x Lifetime Max Years selected
ltC_Lifetime_Max_Years_From	integer or null <int32> the selectable range of years the member can pick for calculations based on years.
ltC_Lifetime_Max_Years_Thru	integer or null <int32> The selectable range of years the member can pick for calculations based on years.
ltC_Monthly_Benefit	number or null <double> This is the monthly benefit amount
ltC_Monthly_Benefit_Range_From	number or null <double> The start of the selection range for members taking this plan and choosing their monthly benefit.
ltC_Monthly_Benefit_Range_Increment	number or null <double> The increment of each option in the range between the from and thru. If empty, the member can manually select a value between the from / thru range.
ltC_Monthly_Benefit_Range_Thru	number or null <double> The end of the selection range for members taking this plan and choosing their monthly benefit.
ltC_Monthly_Benefit_Type	string or null <= 32 characters This is the type of monthly benefit defined for this plan. The values are: A - a flat monthly benefit enforced by the plan. B - member selected value utilizing the monthly benefit range/increment settings.
ltC_Waiver_Of_Premium_Type	string or null <= 32 characters This is the type/rules for LTC waiver of premium. Current Values are: A - 1st day of following month B - day of eligibility approval C - joint waiver D - survivorship waiver
lifetime_Max	number or null <double> Total lifetime amount that the Plan will pay both In Network and Out of Network for the Familiy.
lifetime_Max_Net	number or null <double> Lifetime amount that the Plan will pay In Network for the Familiy.
lifetime_Max_OON	number or null <double> Lifetime amount that the Plan will pay Out of Network for the Familiy.
maturity_Age	integer or null <int32> Specifies the required age for maturity of policy inside enrollment.
maturity_Age_Type	string or null <= 8 characters Defines the age type for maturity based upon birth date or anniversary of enrollment.
max_Disability_Weeks	integer or null <int32> Maximum number of weeks the specified Plan will pay Disability.
max_Includes_Waiting_Period	boolean or null Indicates whether the waiting period is included in the Max Disability Weeks.
mem_Ded_Credit	number or null <double> Total deductible amount to be credited back to each Member during adjudication.
mem_Ded_Credit_OON	number or null <double> Out of Network deductible amount to be credited back to each Member during adjudication.
mem_Ded_Credit_PPO	number or null <double> In-Network deductible amount to be credited back to each Member during adjudication.
member_Annual_Max	number or null <double> Total In-Network and Out of Network annual maximum the plan will pay out per Member.
member_Annual_Max_Net	number or null <double> In-Network annual maximum that the plan will pay out per Member.
member_Annual_Max_OON	number or null <double> Out of Network annual maximum that the plan will pay out per Member.
member_Ded_OON	number or null <double> Deductible amount for the Member Out of Network.
member_Ded_PPO	number or null <double> Deductible amount for the Member In Network.
member_Deductible	number or null <double> Total deductible amount for the Member both In Network and Out of Network.
member_Lifetime_Max	number or null <double> Total In-Network and Out of Network lifetime maximum that the plan will pay out per Member.
member_Lifetime_Max_Net	number or null <double> In-Network lifetime maximum that the plan will pay out per Member.
member_Lifetime_Max_OON	number or null <double> Out of Network lifetime that the plan will pay out per Member.
ooP_Calc_Option	string or null <= 8 characters Formula used to calculate Out of Pocket amounts.
ooP_In_To_Out required	boolean Indicates whether In-Network Out of Pocket amounts apply toward the satisfaction of Out of Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ooP_Max_Mem	number or null <double> Total In-Network and Out of Network Out of Pocket maximum for the Member.
ooP_Max_Net_Mem	number or null <double> In-Network Out of Pocket maximum for the Member.
ooP_Max_Net_Sub	number or null <double> In-Network Out of Pocket maximum for the Family.
ooP_Max_OON_Mem	number or null <double> Out of Network Out of Pocket for the Member.
ooP_Max_OON_Sub	number or null <double> Out of Network Out of Pocket for the Family.
ooP_Max_Sub	number or null <double> Total In-Network and Out of Network Out of Pocket maximum for the Family.
ooP_Out_To_In required	boolean Indicates whether Out of Network Out of Pocket amounts apply toward the satisfaction of In-Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ooP_Out_To_In_Limit required	boolean When active, this will let the system know to limit the amount of out of pocket that applies to IN from OON by the Max. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ooP_Out_To_In_Limit_Max	number or null <double> The max with which the out of pocket is limited by when OOP_Out To In Limit is selected.
payment_Interval	integer or null <int32> Payment Interval or frequency for Disability plans.
payor_ID	string or null <= 20 characters No longer in use.
pend_Ex_Code	string or null <= 6 characters Identifies the Ex Code that will be applied based upon the Pend_Flag field.
pend_Flag	string or null <= 1 characters 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.
plan_Document_URL	string or null <= 512 characters Used for custom reporting and information.
plan_Type	string or null <= 6 characters Identifies the Type of Plan (medical, dental, etc.). Keep in mind that Accumulators are tied to 'Plan Type' not the plan itself.
policy_Forfeiture_Grace_Period	integer or null <int32> Length of the grace period.
policy_Forfeiture_Grace_Period_Type	string or null <= 1 characters Defines the type of grace period. Restricted to units of days.
policy_Status_Default	string or null <= 32 characters Default policy status assigned when Policy & Forteiture is used in enrollment.
preEx_Ex_Code	string or null <= 8 characters Identifies the Ex Code that will be applied to disability claims falling within the provided range.
preEx_From	integer or null <int32> No longer in use. Pre-Ex processing has been moved to a more detailed structure in PlanPrex tables.
preEx_Range	integer or null <int32> 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.
preEx_Thru	integer or null <int32> No longer in use. Pre-Ex processing has been moved to a more detailed structure in PlanPrex tables.
qpA_Method	string or null <= 1 characters Determines the QPA Method to be used for claims under this Plan
reduced_Paid_Up_Default	integer or null <int32> Deault paid up value when Policy & Forfeiture is used in enrollment.
remove_Member_Amount_Edit required	boolean No longer in use. Note: This field is marked as NOT NULL in the database and therefore required by the API.
situs_State	string or null <= 2 characters State where the Plan originates or applies
sub_Ded_Credit	number or null <double> Total deductible amount to be credited back to the Subscriber during adjudication.
sub_Ded_Credit_OON	number or null <double> Out of Network deductible amount to be credited back to the Subscriber during adjudication.
sub_Ded_Credit_PPO	number or null <double> In-Network deductible amount to be credited back to the Subscriber during adjudication.
subscriber_Ded_OON	number or null <double> Deductible amount for the Family Out of Network.
subscriber_Ded_PPO	number or null <double> Deductible amount for the Family In Network.
subscriber_Deductible	number or null <double> Total deductible amount for the Family both In Network and Out of Network.
survivor_Benefit	integer or null <int32> Survivor Benefit associated with Disability plans.
update_Date	string <date-time> Date when the record was last updated in the system.
update_User	string or null <= 20 characters User that last updated the record in the system.
use_COB_Savings required	boolean Indicates whether the COB should be used. Note: This field is marked as NOT NULL in the database and therefore required by the API.

Responses

200

Success

401

Unauthorized

post/plans

Request samples

Payload
C#
JavaScript
curl
Java

{"plan_ID": "string",
"annual_Max": 0.1,
"annual_Max_Net": 0.1,
"annual_Max_OON": 0.1,
"auto_Create_Flex": true,
"cobrA_Plan_Type_Desc": "string",
"coB_Savings_Max": 0.1,
"coB_Type": "string",
"capitated": true,
"cash_Value_Default": 0,
"coIns_In_To_Out": true,
"coIns_Max_Mem": 0.1,
"coIns_Max_Net_Mem": 0.1,
"coIns_Max_Net_Sub": 0.1,
"coIns_Max_OON_Mem": 0.1,
"coIns_Max_OON_Sub": 0.1,
"coIns_Max_Sub": 0.1,
"coIns_Out_To_In": true,
"coIns_Out_To_In_Limit": true,
"coIns_Out_To_In_Limit_Max": 0.1,
"context4_ClmUcrPct": 0,
"context4_ClmUcrPct_OON": 0,
"context4_FeeSelector": "string",
"context4_FeeSelector_OON": "string",
"context4_MedicarePct": 0,
"context4_MedicarePct_OON": 0,
"context4_Password": "string",
"context4_PayorType": "string",
"context4_PayorType_OON": "string",
"context4_PctOfChg": 0,
"context4_PctOfChg_OON": 0,
"context4_PlanPriceNotGreaterBilledFg": true,
"context4_UserID": "string",
"context4_WebURI": "string",
"context4_WebURI_Delete": "string",
"currency_ID": "string",
"ded_In_To_Out": true,
"ded_Out_To_In": true,
"ded_Out_To_In_Limit": true,
"ded_Out_To_In_Limit_Max": 0.1,
"description": "string",
"entry_Date": "2019-08-24T14:15:22Z",
"entry_User": "string",
"extended_Term_Default": 0,
"family_Level_Co_Ins": true,
"family_Level_Co_Ins_Member": 0,
"family_Level_Ded": true,
"family_Level_Ded_Member": 0,
"family_Level_OOP": true,
"family_Level_OOP_Member": 0,
"flex_Advance_Fund": true,
"flex_Type": "string",
"forfeiture_Status_Default": "string",
"illness_Ex_Code": "string",
"illness_Waiting_Period": 0,
"include_Waiting_Period": true,
"injury_Ex_Code": "string",
"injury_Waiting_Period": 0,
"ltC_Apply_Elimination_Period": true,
"ltC_Apply_Waiver_Of_Premium": true,
"ltC_Daily_Benefit": 0.1,
"ltC_Daily_Benefit_Range_From": 0.1,
"ltC_Daily_Benefit_Range_Increment": 0.1,
"ltC_Daily_Benefit_Range_Thru": 0.1,
"ltC_Daily_Benefit_Type": "string",
"ltC_Elimination_Period": 0,
"ltC_Elimination_Period_Per_Claim": true,
"ltC_Elimination_Period_Type": "string",
"ltC_Lifetime_Max_Days_From": 0,
"ltC_Lifetime_Max_Days_Thru": 0,
"ltC_Lifetime_Max_From": 0.1,
"ltC_Lifetime_Max_Increment": 0.1,
"ltC_Lifetime_Max_Joint_Policy": true,
"ltC_Lifetime_Max_Thru": 0.1,
"ltC_Lifetime_Max_Type": "string",
"ltC_Lifetime_Max_Years_From": 0,
"ltC_Lifetime_Max_Years_Thru": 0,
"ltC_Monthly_Benefit": 0.1,
"ltC_Monthly_Benefit_Range_From": 0.1,
"ltC_Monthly_Benefit_Range_Increment": 0.1,
"ltC_Monthly_Benefit_Range_Thru": 0.1,
"ltC_Monthly_Benefit_Type": "string",
"ltC_Waiver_Of_Premium_Type": "string",
"lifetime_Max": 0.1,
"lifetime_Max_Net": 0.1,
"lifetime_Max_OON": 0.1,
"maturity_Age": 0,
"maturity_Age_Type": "string",
"max_Disability_Weeks": 0,
"max_Includes_Waiting_Period": true,
"mem_Ded_Credit": 0.1,
"mem_Ded_Credit_OON": 0.1,
"mem_Ded_Credit_PPO": 0.1,
"member_Annual_Max": 0.1,
"member_Annual_Max_Net": 0.1,
"member_Annual_Max_OON": 0.1,
"member_Ded_OON": 0.1,
"member_Ded_PPO": 0.1,
"member_Deductible": 0.1,
"member_Lifetime_Max": 0.1,
"member_Lifetime_Max_Net": 0.1,
"member_Lifetime_Max_OON": 0.1,
"ooP_Calc_Option": "string",
"ooP_In_To_Out": true,
"ooP_Max_Mem": 0.1,
"ooP_Max_Net_Mem": 0.1,
"ooP_Max_Net_Sub": 0.1,
"ooP_Max_OON_Mem": 0.1,
"ooP_Max_OON_Sub": 0.1,
"ooP_Max_Sub": 0.1,
"ooP_Out_To_In": true,
"ooP_Out_To_In_Limit": true,
"ooP_Out_To_In_Limit_Max": 0.1,
"payment_Interval": 0,
"payor_ID": "string",
"pend_Ex_Code": "string",
"pend_Flag": "s",
"plan_Document_URL": "string",
"plan_Type": "string",
"policy_Forfeiture_Grace_Period": 0,
"policy_Forfeiture_Grace_Period_Type": "s",
"policy_Status_Default": "string",
"preEx_Ex_Code": "string",
"preEx_From": 0,
"preEx_Range": 0,
"preEx_Thru": 0,
"qpA_Method": "s",
"reduced_Paid_Up_Default": 0,
"remove_Member_Amount_Edit": true,
"situs_State": "st",
"sub_Ded_Credit": 0.1,
"sub_Ded_Credit_OON": 0.1,
"sub_Ded_Credit_PPO": 0.1,
"subscriber_Ded_OON": 0.1,
"subscriber_Ded_PPO": 0.1,
"subscriber_Deductible": 0.1,
"survivor_Benefit": 0,
"update_Date": "2019-08-24T14:15:22Z",
"update_User": "string",
"use_COB_Savings": true
}

Response samples

{"data": {"plan_ID": "string",
"annual_Max": 0.1,
"annual_Max_Net": 0.1,
"annual_Max_OON": 0.1,
"auto_Create_Flex": true,
"cobrA_Plan_Type_Desc": "string",
"coB_Savings_Max": 0.1,
"coB_Type": "string",
"capitated": true,
"cash_Value_Default": 0,
"coIns_In_To_Out": true,
"coIns_Max_Mem": 0.1,
"coIns_Max_Net_Mem": 0.1,
"coIns_Max_Net_Sub": 0.1,
"coIns_Max_OON_Mem": 0.1,
"coIns_Max_OON_Sub": 0.1,
"coIns_Max_Sub": 0.1,
"coIns_Out_To_In": true,
"coIns_Out_To_In_Limit": true,
"coIns_Out_To_In_Limit_Max": 0.1,
"context4_ClmUcrPct": 0,
"context4_ClmUcrPct_OON": 0,
"context4_FeeSelector": "string",
"context4_FeeSelector_OON": "string",
"context4_MedicarePct": 0,
"context4_MedicarePct_OON": 0,
"context4_Password": "string",
"context4_PayorType": "string",
"context4_PayorType_OON": "string",
"context4_PctOfChg": 0,
"context4_PctOfChg_OON": 0,
"context4_PlanPriceNotGreaterBilledFg": true,
"context4_UserID": "string",
"context4_WebURI": "string",
"context4_WebURI_Delete": "string",
"currency_ID": "string",
"ded_In_To_Out": true,
"ded_Out_To_In": true,
"ded_Out_To_In_Limit": true,
"ded_Out_To_In_Limit_Max": 0.1,
"description": "string",
"entry_Date": "2019-08-24T14:15:22Z",
"entry_User": "string",
"extended_Term_Default": 0,
"family_Level_Co_Ins": true,
"family_Level_Co_Ins_Member": 0,
"family_Level_Ded": true,
"family_Level_Ded_Member": 0,
"family_Level_OOP": true,
"family_Level_OOP_Member": 0,
"flex_Advance_Fund": true,
"flex_Type": "string",
"forfeiture_Status_Default": "string",
"illness_Ex_Code": "string",
"illness_Waiting_Period": 0,
"include_Waiting_Period": true,
"injury_Ex_Code": "string",
"injury_Waiting_Period": 0,
"ltC_Apply_Elimination_Period": true,
"ltC_Apply_Waiver_Of_Premium": true,
"ltC_Daily_Benefit": 0.1,
"ltC_Daily_Benefit_Range_From": 0.1,
"ltC_Daily_Benefit_Range_Increment": 0.1,
"ltC_Daily_Benefit_Range_Thru": 0.1,
"ltC_Daily_Benefit_Type": "string",
"ltC_Elimination_Period": 0,
"ltC_Elimination_Period_Per_Claim": true,
"ltC_Elimination_Period_Type": "string",
"ltC_Lifetime_Max_Days_From": 0,
"ltC_Lifetime_Max_Days_Thru": 0,
"ltC_Lifetime_Max_From": 0.1,
"ltC_Lifetime_Max_Increment": 0.1,
"ltC_Lifetime_Max_Joint_Policy": true,
"ltC_Lifetime_Max_Thru": 0.1,
"ltC_Lifetime_Max_Type": "string",
"ltC_Lifetime_Max_Years_From": 0,
"ltC_Lifetime_Max_Years_Thru": 0,
"ltC_Monthly_Benefit": 0.1,
"ltC_Monthly_Benefit_Range_From": 0.1,
"ltC_Monthly_Benefit_Range_Increment": 0.1,
"ltC_Monthly_Benefit_Range_Thru": 0.1,
"ltC_Monthly_Benefit_Type": "string",
"ltC_Waiver_Of_Premium_Type": "string",
"lifetime_Max": 0.1,
"lifetime_Max_Net": 0.1,
"lifetime_Max_OON": 0.1,
"maturity_Age": 0,
"maturity_Age_Type": "string",
"max_Disability_Weeks": 0,
"max_Includes_Waiting_Period": true,
"mem_Ded_Credit": 0.1,
"mem_Ded_Credit_OON": 0.1,
"mem_Ded_Credit_PPO": 0.1,
"member_Annual_Max": 0.1,
"member_Annual_Max_Net": 0.1,
"member_Annual_Max_OON": 0.1,
"member_Ded_OON": 0.1,
"member_Ded_PPO": 0.1,
"member_Deductible": 0.1,
"member_Lifetime_Max": 0.1,
"member_Lifetime_Max_Net": 0.1,
"member_Lifetime_Max_OON": 0.1,
"ooP_Calc_Option": "string",
"ooP_In_To_Out": true,
"ooP_Max_Mem": 0.1,
"ooP_Max_Net_Mem": 0.1,
"ooP_Max_Net_Sub": 0.1,
"ooP_Max_OON_Mem": 0.1,
"ooP_Max_OON_Sub": 0.1,
"ooP_Max_Sub": 0.1,
"ooP_Out_To_In": true,
"ooP_Out_To_In_Limit": true,
"ooP_Out_To_In_Limit_Max": 0.1,
"payment_Interval": 0,
"payor_ID": "string",
"pend_Ex_Code": "string",
"pend_Flag": "s",
"plan_Document_URL": "string",
"plan_Type": "string",
"policy_Forfeiture_Grace_Period": 0,
"policy_Forfeiture_Grace_Period_Type": "s",
"policy_Status_Default": "string",
"preEx_Ex_Code": "string",
"preEx_From": 0,
"preEx_Range": 0,
"preEx_Thru": 0,
"qpA_Method": "s",
"reduced_Paid_Up_Default": 0,
"remove_Member_Amount_Edit": true,
"situs_State": "st",
"sub_Ded_Credit": 0.1,
"sub_Ded_Credit_OON": 0.1,
"sub_Ded_Credit_PPO": 0.1,
"subscriber_Ded_OON": 0.1,
"subscriber_Ded_PPO": 0.1,
"subscriber_Deductible": 0.1,
"survivor_Benefit": 0,
"update_Date": "2019-08-24T14:15:22Z",
"update_User": "string",
"use_COB_Savings": true
},
"error": {"detail": "string",
"instance": "string",
"status": 0,
"title": "string",
"type": "string"
},
"debug": {"activityID": "string"
}
}

List Plans

Lists all Plans with option to filter by Plan Type.

SecurityapiKeyAuth and bearerAuth

Request

query Parameters

planType

string

Plan Type

header Parameters

vbasoftware-database

required

string

Target database

Responses

200

Success

401

Unauthorized

get/plans

Request samples

C#
JavaScript
curl
Java

Response samples

No sample

Copy Plan Advanced API

Copies an existing plan. This copy can be to a completely new Plan ID, or to overwrite an existing Plan ID.

SecurityapiKeyAuth and bearerAuth

Request

header Parameters

vbasoftware-database

required

string

Target database

Request Body schema:
application/json
required

benefits	boolean
cascade	boolean
capitation	boolean
restrictions	boolean
preEx	boolean
addedAccum	boolean
maximums	boolean
pbmCoPay	boolean
placeDetails	boolean
placeAuth	boolean
placeCoPay	boolean
placeCoIns	boolean
exCodeDetails	boolean
exCodeProcedure	boolean
exCodeDiagnosis	boolean
exCodePlace	boolean
context4Details	boolean
context4Pricing	boolean
authPenalty	boolean
benefitLevel	boolean
benefitRates	boolean
idCodes	boolean
exCodeModifiers	boolean
originalPlanID	string or null
newPlanID	string or null
newPlanDescription	string or null
newPlanType	string or null
copyMode	integer <int32>

Responses

200

Success

401

Unauthorized

post/plans-copy

Request samples

Payload
C#
JavaScript
curl
Java

{"benefits": true,
"cascade": true,
"capitation": true,
"restrictions": true,
"preEx": true,
"addedAccum": true,
"maximums": true,
"pbmCoPay": true,
"placeDetails": true,
"placeAuth": true,
"placeCoPay": true,
"placeCoIns": true,
"exCodeDetails": true,
"exCodeProcedure": true,
"exCodeDiagnosis": true,
"exCodePlace": true,
"context4Details": true,
"context4Pricing": true,
"authPenalty": true,
"benefitLevel": true,
"benefitRates": true,
"idCodes": true,
"exCodeModifiers": true,
"originalPlanID": "string",
"newPlanID": "string",
"newPlanDescription": "string",
"newPlanType": "string",
"copyMode": 0
}

Response samples

{"data": {"plan_ID": "string",
"annual_Max": 0.1,
"annual_Max_Net": 0.1,
"annual_Max_OON": 0.1,
"auto_Create_Flex": true,
"cobrA_Plan_Type_Desc": "string",
"coB_Savings_Max": 0.1,
"coB_Type": "string",
"capitated": true,
"cash_Value_Default": 0,
"coIns_In_To_Out": true,
"coIns_Max_Mem": 0.1,
"coIns_Max_Net_Mem": 0.1,
"coIns_Max_Net_Sub": 0.1,
"coIns_Max_OON_Mem": 0.1,
"coIns_Max_OON_Sub": 0.1,
"coIns_Max_Sub": 0.1,
"coIns_Out_To_In": true,
"coIns_Out_To_In_Limit": true,
"coIns_Out_To_In_Limit_Max": 0.1,
"context4_ClmUcrPct": 0,
"context4_ClmUcrPct_OON": 0,
"context4_FeeSelector": "string",
"context4_FeeSelector_OON": "string",
"context4_MedicarePct": 0,
"context4_MedicarePct_OON": 0,
"context4_Password": "string",
"context4_PayorType": "string",
"context4_PayorType_OON": "string",
"context4_PctOfChg": 0,
"context4_PctOfChg_OON": 0,
"context4_PlanPriceNotGreaterBilledFg": true,
"context4_UserID": "string",
"context4_WebURI": "string",
"context4_WebURI_Delete": "string",
"currency_ID": "string",
"ded_In_To_Out": true,
"ded_Out_To_In": true,
"ded_Out_To_In_Limit": true,
"ded_Out_To_In_Limit_Max": 0.1,
"description": "string",
"entry_Date": "2019-08-24T14:15:22Z",
"entry_User": "string",
"extended_Term_Default": 0,
"family_Level_Co_Ins": true,
"family_Level_Co_Ins_Member": 0,
"family_Level_Ded": true,
"family_Level_Ded_Member": 0,
"family_Level_OOP": true,
"family_Level_OOP_Member": 0,
"flex_Advance_Fund": true,
"flex_Type": "string",
"forfeiture_Status_Default": "string",
"illness_Ex_Code": "string",
"illness_Waiting_Period": 0,
"include_Waiting_Period": true,
"injury_Ex_Code": "string",
"injury_Waiting_Period": 0,
"ltC_Apply_Elimination_Period": true,
"ltC_Apply_Waiver_Of_Premium": true,
"ltC_Daily_Benefit": 0.1,
"ltC_Daily_Benefit_Range_From": 0.1,
"ltC_Daily_Benefit_Range_Increment": 0.1,
"ltC_Daily_Benefit_Range_Thru": 0.1,
"ltC_Daily_Benefit_Type": "string",
"ltC_Elimination_Period": 0,
"ltC_Elimination_Period_Per_Claim": true,
"ltC_Elimination_Period_Type": "string",
"ltC_Lifetime_Max_Days_From": 0,
"ltC_Lifetime_Max_Days_Thru": 0,
"ltC_Lifetime_Max_From": 0.1,
"ltC_Lifetime_Max_Increment": 0.1,
"ltC_Lifetime_Max_Joint_Policy": true,
"ltC_Lifetime_Max_Thru": 0.1,
"ltC_Lifetime_Max_Type": "string",
"ltC_Lifetime_Max_Years_From": 0,
"ltC_Lifetime_Max_Years_Thru": 0,
"ltC_Monthly_Benefit": 0.1,
"ltC_Monthly_Benefit_Range_From": 0.1,
"ltC_Monthly_Benefit_Range_Increment": 0.1,
"ltC_Monthly_Benefit_Range_Thru": 0.1,
"ltC_Monthly_Benefit_Type": "string",
"ltC_Waiver_Of_Premium_Type": "string",
"lifetime_Max": 0.1,
"lifetime_Max_Net": 0.1,
"lifetime_Max_OON": 0.1,
"maturity_Age": 0,
"maturity_Age_Type": "string",
"max_Disability_Weeks": 0,
"max_Includes_Waiting_Period": true,
"mem_Ded_Credit": 0.1,
"mem_Ded_Credit_OON": 0.1,
"mem_Ded_Credit_PPO": 0.1,
"member_Annual_Max": 0.1,
"member_Annual_Max_Net": 0.1,
"member_Annual_Max_OON": 0.1,
"member_Ded_OON": 0.1,
"member_Ded_PPO": 0.1,
"member_Deductible": 0.1,
"member_Lifetime_Max": 0.1,
"member_Lifetime_Max_Net": 0.1,
"member_Lifetime_Max_OON": 0.1,
"ooP_Calc_Option": "string",
"ooP_In_To_Out": true,
"ooP_Max_Mem": 0.1,
"ooP_Max_Net_Mem": 0.1,
"ooP_Max_Net_Sub": 0.1,
"ooP_Max_OON_Mem": 0.1,
"ooP_Max_OON_Sub": 0.1,
"ooP_Max_Sub": 0.1,
"ooP_Out_To_In": true,
"ooP_Out_To_In_Limit": true,
"ooP_Out_To_In_Limit_Max": 0.1,
"payment_Interval": 0,
"payor_ID": "string",
"pend_Ex_Code": "string",
"pend_Flag": "s",
"plan_Document_URL": "string",
"plan_Type": "string",
"policy_Forfeiture_Grace_Period": 0,
"policy_Forfeiture_Grace_Period_Type": "s",
"policy_Status_Default": "string",
"preEx_Ex_Code": "string",
"preEx_From": 0,
"preEx_Range": 0,
"preEx_Thru": 0,
"qpA_Method": "s",
"reduced_Paid_Up_Default": 0,
"remove_Member_Amount_Edit": true,
"situs_State": "st",
"sub_Ded_Credit": 0.1,
"sub_Ded_Credit_OON": 0.1,
"sub_Ded_Credit_PPO": 0.1,
"subscriber_Ded_OON": 0.1,
"subscriber_Ded_PPO": 0.1,
"subscriber_Deductible": 0.1,
"survivor_Benefit": 0,
"update_Date": "2019-08-24T14:15:22Z",
"update_User": "string",
"use_COB_Savings": true
},
"error": {"detail": "string",
"instance": "string",
"status": 0,
"title": "string",
"type": "string"
},
"debug": {"activityID": "string"
}
}

Get Plan

Gets a specific Plan

SecurityapiKeyAuth and bearerAuth

Request

path Parameters

planID

required

string

Plan ID

header Parameters

vbasoftware-database

required

string

Target database

Responses

200

Success

401

Unauthorized

get/plans/{planID}

Request samples

C#
JavaScript
curl
Java

Response samples

No sample

Update Plans

Updates a specific Plans.

SecurityapiKeyAuth and bearerAuth

Request

path Parameters

planID

required

string

Plan ID

header Parameters

vbasoftware-database

required

string

Target database

Request Body schema:
application/json
required

plan_ID required	string [ 1 .. 20 ] characters Unique identifier assigned to the Plan.
annual_Max	number or null <double> Total In-Network and Out of Network annual maximum the plan will pay out for the Familiy.
annual_Max_Net	number or null <double> In-Network annual maximum that the plan will pay out for the Familiy.
annual_Max_OON	number or null <double> Out of Network annual maximum that the plan will pay out for the Familiy.
auto_Create_Flex required	boolean Indicates if this plan allows auto-creation of Flex claims based on Group level configuration for flex auto-creation. Note: This field is marked as NOT NULL in the database and therefore required by the API.
cobrA_Plan_Type_Desc	string or null <= 20 characters Used for custom reporting and information.
coB_Savings_Max	number or null <double> Indicates the maximum amount that can be held in COB savings.
coB_Type	string or null <= 16 characters Indicates the type of COB to be used with the selected plan.
capitated required	boolean No longer in use. All captiation logic and processing now resides in the capitation tables. Note: This field is marked as NOT NULL in the database and therefore required by the API.
cash_Value_Default	integer or null <int32> Default cash value when Policy & Forfeiture is used in enrollment.
coIns_In_To_Out required	boolean Indicates whether In-Network Coinsurance amounts apply toward the satisfaction of Out of Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
coIns_Max_Mem	number or null <double> In Network Co-Insurance amount for the Family.
coIns_Max_Net_Mem	number or null <double> Total Co-Insurance amount for the Member.
coIns_Max_Net_Sub	number or null <double> Out of Network Co-Insurance amount for the Family.
coIns_Max_OON_Mem	number or null <double> Out of Network Co-Insurance amount for the Member.
coIns_Max_OON_Sub	number or null <double> In Network Co-Insurance amount for the Member.
coIns_Max_Sub	number or null <double> Total Co-Insurance amount for the Family.
coIns_Out_To_In required	boolean Indicates whether Out of Network CoInsurance amounts apply toward the satisfaction of the In-Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
coIns_Out_To_In_Limit required	boolean When active, this will let the system know to limit the amount of co-insurance that applies to IN from OON by the Max. Note: This field is marked as NOT NULL in the database and therefore required by the API.
coIns_Out_To_In_Limit_Max	number or null <double> The max with which the co-insurance is limited by when CoIns_Out To In Limit is selected.
context4_ClmUcrPct	integer or null <int32> Claim UCR percentage provided by Context. Required for Context claim edits and repricing.
context4_ClmUcrPct_OON	integer or null <int32> Out of network claim UCR percentage provided by context. Required for Context claim edits and repricing.
context4_FeeSelector	string or null <= 8 characters Fee Selector provided by Context. Required for Context claim edits and repricing.
context4_FeeSelector_OON	string or null <= 8 characters Out of network fee selector provided by context. Required for Context claim edits and repricing.
context4_MedicarePct	integer or null <int32> Medicare percentage provided by Context. Required for Context claim edits and repricing.
context4_MedicarePct_OON	integer or null <int32> Out of network Medicare percentage provided by context. Required for Context claim edits and repricing.
context4_Password	string or null <= 128 characters Password provided by Context. Required for Context claim edits and repricing.
context4_PayorType	string or null <= 8 characters Payor type provided by context. Required for Context claim edits and repricing.
context4_PayorType_OON	string or null <= 8 characters Out of network Payor type provided by context. Required for Context claim edits and repricing.
context4_PctOfChg	integer or null <int32> Percentage of change provided by context. Required for Context claim edits and repricing.
context4_PctOfChg_OON	integer or null <int32> Out of network percentage of change provided by context. Required for Context claim edits and repricing.
context4_PlanPriceNotGreaterBilledFg required	boolean When using Context4, the Plan Price is never allowed to exceed the Billed Price, it'll set it to the Billed Price. Note: This field is marked as NOT NULL in the database and therefore required by the API.
context4_UserID	string or null <= 128 characters User ID provided by Context. Required for Context claim edits and repricing.
context4_WebURI	string or null <= 256 characters URL provided by Context. Required for Context claim edits and repricing.
context4_WebURI_Delete	string or null <= 256 characters URL delete provided by Context. Required for Context claim edits and repricing.
currency_ID	string or null <= 16 characters Indicates the currency being used.
ded_In_To_Out required	boolean Indicates whether In-Network Deductible amounts apply toward the satisfaction of Out of Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ded_Out_To_In required	boolean Indicates whether Out of Network Deductible amounts apply toward the satisfaction of In-Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ded_Out_To_In_Limit required	boolean When active, this will let the system know to limit the amount of deductible that applies to IN from OON by the Max. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ded_Out_To_In_Limit_Max	number or null <double> The max with which the deducible is limited by when Ded_Out To In Limit is selected.
description	string or null <= 50 characters A short description of the associated plan.
entry_Date	string <date-time> Date when the record was added to the system.
entry_User	string or null <= 20 characters User that first added the record to the system.
extended_Term_Default	integer or null <int32> Deault extended term value assigned in Policy & Forfeiture when used in enrollment.
family_Level_Co_Ins required	boolean Specifies that the number of Member level Coinsurance amounts should be used to satisfy the Family level Coinsurance amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
family_Level_Co_Ins_Member	integer or null <int32> Number of Members that must satisfy the Member level deductible before the Family level amount is considered met.
family_Level_Ded required	boolean Specifies that the number of Member level deductible amounts should be used to satisfy the Family level deductible. Note: This field is marked as NOT NULL in the database and therefore required by the API.
family_Level_Ded_Member	integer or null <int32> Number of Members that must satisfy the Member level deductible before the Family level amount is considered met.
family_Level_OOP required	boolean Specifies that the number of Member level Out of Pocket amounts should be used to satisfy the Family level Out of Pocket amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
family_Level_OOP_Member	integer or null <int32> Number of Members that must satisfy the Member level Out of Pocket before the Family level Out of Pocket is considered met.
flex_Advance_Fund required	boolean Information field used in reporting to identify this plan as Flex Advance Fund. Note: This field is marked as NOT NULL in the database and therefore required by the API.
flex_Type	string or null <= 16 characters Indicates what type of Flex account to be associated with the plan.
forfeiture_Status_Default	string or null <= 32 characters Default forfeiture status assigned when Policy & Forteiture is used in enrollment.
illness_Ex_Code	string or null <= 8 characters Ex Code associated with the illness waiting period.
illness_Waiting_Period	integer or null <int32> Waiting Period after an illness for Disability plans to start coverage.
include_Waiting_Period	boolean or null Indicates whether the Disability plan includes a waiting period.
injury_Ex_Code	string or null <= 8 characters Ex Code associated with the injury waiting period.
injury_Waiting_Period	integer or null <int32> Waiting Period after an injury for Disability plans to start coverage.
ltC_Apply_Elimination_Period required	boolean Indicates if this Plan has Elimination Period rules. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ltC_Apply_Waiver_Of_Premium required	boolean Indicates if Waiver of Premium rules should apply for this plan. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ltC_Daily_Benefit	number or null <double> This is the daily benefit amount
ltC_Daily_Benefit_Range_From	number or null <double> The start of the selection range for members taking this plan and choosing their daily benefit.
ltC_Daily_Benefit_Range_Increment	number or null <double> The increment of each option in the range between the from and thru. If empty, the member can manually select a value between the from / thru range.
ltC_Daily_Benefit_Range_Thru	number or null <double> The end of the selection range for members taking this plan and choosing their daily benefit.
ltC_Daily_Benefit_Type	string or null <= 32 characters This is the type of daily benefit defined for this plan. The values are: A - a flat daily benefit enforced by the plan. B - member selected value utilizing the daily benefit range/increment settings.
ltC_Elimination_Period	integer or null <int32> This is the elimination period value based on Elimination_Period_Type.
ltC_Elimination_Period_Per_Claim required	boolean Indicates if the elimination period is per claim. By default the elimination period is per plan/policy. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ltC_Elimination_Period_Type	string or null <= 32 characters This is the type of Elimination Period rule to apply for this Plan. Values are: A - Calendar Days B - Service Days C - Special Service Days (one day equals a week of elimination period)
ltC_Lifetime_Max_Days_From	integer or null <int32> The selectable range of days the member can pick for calculations based on days.
ltC_Lifetime_Max_Days_Thru	integer or null <int32> The selectable range of days the member can pick for calculations based on days.
ltC_Lifetime_Max_From	number or null <double> The low end range for member lifetime max selection.
ltC_Lifetime_Max_Increment	number or null <double> The increment of options the user can select within the max range. Empty value here means it is a free from entry of max between the range.
ltC_Lifetime_Max_Joint_Policy required	boolean Indicates if plans of the same plan type, and both flagged as joint policy, can share a "Total" lifetime max between both plans as long as both plans have selected a shared benefit. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ltC_Lifetime_Max_Thru	number or null <double> The high end range for member lifetime max selection.
ltC_Lifetime_Max_Type	string or null <= 32 characters Lifetime Max calculation type and will dicatate the max rules applied. Valid values are: STANDARD - DBM x 365 days x Lifetime Max Years selected LMDAYS - DBM x Lifetime Max Days selected FLAT - Lifetime Max Amount selected and not based on calculation LMMONTHS - MBA x 12 Months x Lifetime Max Years selected
ltC_Lifetime_Max_Years_From	integer or null <int32> the selectable range of years the member can pick for calculations based on years.
ltC_Lifetime_Max_Years_Thru	integer or null <int32> The selectable range of years the member can pick for calculations based on years.
ltC_Monthly_Benefit	number or null <double> This is the monthly benefit amount
ltC_Monthly_Benefit_Range_From	number or null <double> The start of the selection range for members taking this plan and choosing their monthly benefit.
ltC_Monthly_Benefit_Range_Increment	number or null <double> The increment of each option in the range between the from and thru. If empty, the member can manually select a value between the from / thru range.
ltC_Monthly_Benefit_Range_Thru	number or null <double> The end of the selection range for members taking this plan and choosing their monthly benefit.
ltC_Monthly_Benefit_Type	string or null <= 32 characters This is the type of monthly benefit defined for this plan. The values are: A - a flat monthly benefit enforced by the plan. B - member selected value utilizing the monthly benefit range/increment settings.
ltC_Waiver_Of_Premium_Type	string or null <= 32 characters This is the type/rules for LTC waiver of premium. Current Values are: A - 1st day of following month B - day of eligibility approval C - joint waiver D - survivorship waiver
lifetime_Max	number or null <double> Total lifetime amount that the Plan will pay both In Network and Out of Network for the Familiy.
lifetime_Max_Net	number or null <double> Lifetime amount that the Plan will pay In Network for the Familiy.
lifetime_Max_OON	number or null <double> Lifetime amount that the Plan will pay Out of Network for the Familiy.
maturity_Age	integer or null <int32> Specifies the required age for maturity of policy inside enrollment.
maturity_Age_Type	string or null <= 8 characters Defines the age type for maturity based upon birth date or anniversary of enrollment.
max_Disability_Weeks	integer or null <int32> Maximum number of weeks the specified Plan will pay Disability.
max_Includes_Waiting_Period	boolean or null Indicates whether the waiting period is included in the Max Disability Weeks.
mem_Ded_Credit	number or null <double> Total deductible amount to be credited back to each Member during adjudication.
mem_Ded_Credit_OON	number or null <double> Out of Network deductible amount to be credited back to each Member during adjudication.
mem_Ded_Credit_PPO	number or null <double> In-Network deductible amount to be credited back to each Member during adjudication.
member_Annual_Max	number or null <double> Total In-Network and Out of Network annual maximum the plan will pay out per Member.
member_Annual_Max_Net	number or null <double> In-Network annual maximum that the plan will pay out per Member.
member_Annual_Max_OON	number or null <double> Out of Network annual maximum that the plan will pay out per Member.
member_Ded_OON	number or null <double> Deductible amount for the Member Out of Network.
member_Ded_PPO	number or null <double> Deductible amount for the Member In Network.
member_Deductible	number or null <double> Total deductible amount for the Member both In Network and Out of Network.
member_Lifetime_Max	number or null <double> Total In-Network and Out of Network lifetime maximum that the plan will pay out per Member.
member_Lifetime_Max_Net	number or null <double> In-Network lifetime maximum that the plan will pay out per Member.
member_Lifetime_Max_OON	number or null <double> Out of Network lifetime that the plan will pay out per Member.
ooP_Calc_Option	string or null <= 8 characters Formula used to calculate Out of Pocket amounts.
ooP_In_To_Out required	boolean Indicates whether In-Network Out of Pocket amounts apply toward the satisfaction of Out of Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ooP_Max_Mem	number or null <double> Total In-Network and Out of Network Out of Pocket maximum for the Member.
ooP_Max_Net_Mem	number or null <double> In-Network Out of Pocket maximum for the Member.
ooP_Max_Net_Sub	number or null <double> In-Network Out of Pocket maximum for the Family.
ooP_Max_OON_Mem	number or null <double> Out of Network Out of Pocket for the Member.
ooP_Max_OON_Sub	number or null <double> Out of Network Out of Pocket for the Family.
ooP_Max_Sub	number or null <double> Total In-Network and Out of Network Out of Pocket maximum for the Family.
ooP_Out_To_In required	boolean Indicates whether Out of Network Out of Pocket amounts apply toward the satisfaction of In-Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ooP_Out_To_In_Limit required	boolean When active, this will let the system know to limit the amount of out of pocket that applies to IN from OON by the Max. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ooP_Out_To_In_Limit_Max	number or null <double> The max with which the out of pocket is limited by when OOP_Out To In Limit is selected.
payment_Interval	integer or null <int32> Payment Interval or frequency for Disability plans.
payor_ID	string or null <= 20 characters No longer in use.
pend_Ex_Code	string or null <= 6 characters Identifies the Ex Code that will be applied based upon the Pend_Flag field.
pend_Flag	string or null <= 1 characters 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.
plan_Document_URL	string or null <= 512 characters Used for custom reporting and information.
plan_Type	string or null <= 6 characters Identifies the Type of Plan (medical, dental, etc.). Keep in mind that Accumulators are tied to 'Plan Type' not the plan itself.
policy_Forfeiture_Grace_Period	integer or null <int32> Length of the grace period.
policy_Forfeiture_Grace_Period_Type	string or null <= 1 characters Defines the type of grace period. Restricted to units of days.
policy_Status_Default	string or null <= 32 characters Default policy status assigned when Policy & Forteiture is used in enrollment.
preEx_Ex_Code	string or null <= 8 characters Identifies the Ex Code that will be applied to disability claims falling within the provided range.
preEx_From	integer or null <int32> No longer in use. Pre-Ex processing has been moved to a more detailed structure in PlanPrex tables.
preEx_Range	integer or null <int32> 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.
preEx_Thru	integer or null <int32> No longer in use. Pre-Ex processing has been moved to a more detailed structure in PlanPrex tables.
qpA_Method	string or null <= 1 characters Determines the QPA Method to be used for claims under this Plan
reduced_Paid_Up_Default	integer or null <int32> Deault paid up value when Policy & Forfeiture is used in enrollment.
remove_Member_Amount_Edit required	boolean No longer in use. Note: This field is marked as NOT NULL in the database and therefore required by the API.
situs_State	string or null <= 2 characters State where the Plan originates or applies
sub_Ded_Credit	number or null <double> Total deductible amount to be credited back to the Subscriber during adjudication.
sub_Ded_Credit_OON	number or null <double> Out of Network deductible amount to be credited back to the Subscriber during adjudication.
sub_Ded_Credit_PPO	number or null <double> In-Network deductible amount to be credited back to the Subscriber during adjudication.
subscriber_Ded_OON	number or null <double> Deductible amount for the Family Out of Network.
subscriber_Ded_PPO	number or null <double> Deductible amount for the Family In Network.
subscriber_Deductible	number or null <double> Total deductible amount for the Family both In Network and Out of Network.
survivor_Benefit	integer or null <int32> Survivor Benefit associated with Disability plans.
update_Date	string <date-time> Date when the record was last updated in the system.
update_User	string or null <= 20 characters User that last updated the record in the system.
use_COB_Savings required	boolean Indicates whether the COB should be used. Note: This field is marked as NOT NULL in the database and therefore required by the API.

Responses

200

Success

401

Unauthorized

put/plans/{planID}

Request samples

Payload
C#
JavaScript
curl
Java

{"plan_ID": "string",
"annual_Max": 0.1,
"annual_Max_Net": 0.1,
"annual_Max_OON": 0.1,
"auto_Create_Flex": true,
"cobrA_Plan_Type_Desc": "string",
"coB_Savings_Max": 0.1,
"coB_Type": "string",
"capitated": true,
"cash_Value_Default": 0,
"coIns_In_To_Out": true,
"coIns_Max_Mem": 0.1,
"coIns_Max_Net_Mem": 0.1,
"coIns_Max_Net_Sub": 0.1,
"coIns_Max_OON_Mem": 0.1,
"coIns_Max_OON_Sub": 0.1,
"coIns_Max_Sub": 0.1,
"coIns_Out_To_In": true,
"coIns_Out_To_In_Limit": true,
"coIns_Out_To_In_Limit_Max": 0.1,
"context4_ClmUcrPct": 0,
"context4_ClmUcrPct_OON": 0,
"context4_FeeSelector": "string",
"context4_FeeSelector_OON": "string",
"context4_MedicarePct": 0,
"context4_MedicarePct_OON": 0,
"context4_Password": "string",
"context4_PayorType": "string",
"context4_PayorType_OON": "string",
"context4_PctOfChg": 0,
"context4_PctOfChg_OON": 0,
"context4_PlanPriceNotGreaterBilledFg": true,
"context4_UserID": "string",
"context4_WebURI": "string",
"context4_WebURI_Delete": "string",
"currency_ID": "string",
"ded_In_To_Out": true,
"ded_Out_To_In": true,
"ded_Out_To_In_Limit": true,
"ded_Out_To_In_Limit_Max": 0.1,
"description": "string",
"entry_Date": "2019-08-24T14:15:22Z",
"entry_User": "string",
"extended_Term_Default": 0,
"family_Level_Co_Ins": true,
"family_Level_Co_Ins_Member": 0,
"family_Level_Ded": true,
"family_Level_Ded_Member": 0,
"family_Level_OOP": true,
"family_Level_OOP_Member": 0,
"flex_Advance_Fund": true,
"flex_Type": "string",
"forfeiture_Status_Default": "string",
"illness_Ex_Code": "string",
"illness_Waiting_Period": 0,
"include_Waiting_Period": true,
"injury_Ex_Code": "string",
"injury_Waiting_Period": 0,
"ltC_Apply_Elimination_Period": true,
"ltC_Apply_Waiver_Of_Premium": true,
"ltC_Daily_Benefit": 0.1,
"ltC_Daily_Benefit_Range_From": 0.1,
"ltC_Daily_Benefit_Range_Increment": 0.1,
"ltC_Daily_Benefit_Range_Thru": 0.1,
"ltC_Daily_Benefit_Type": "string",
"ltC_Elimination_Period": 0,
"ltC_Elimination_Period_Per_Claim": true,
"ltC_Elimination_Period_Type": "string",
"ltC_Lifetime_Max_Days_From": 0,
"ltC_Lifetime_Max_Days_Thru": 0,
"ltC_Lifetime_Max_From": 0.1,
"ltC_Lifetime_Max_Increment": 0.1,
"ltC_Lifetime_Max_Joint_Policy": true,
"ltC_Lifetime_Max_Thru": 0.1,
"ltC_Lifetime_Max_Type": "string",
"ltC_Lifetime_Max_Years_From": 0,
"ltC_Lifetime_Max_Years_Thru": 0,
"ltC_Monthly_Benefit": 0.1,
"ltC_Monthly_Benefit_Range_From": 0.1,
"ltC_Monthly_Benefit_Range_Increment": 0.1,
"ltC_Monthly_Benefit_Range_Thru": 0.1,
"ltC_Monthly_Benefit_Type": "string",
"ltC_Waiver_Of_Premium_Type": "string",
"lifetime_Max": 0.1,
"lifetime_Max_Net": 0.1,
"lifetime_Max_OON": 0.1,
"maturity_Age": 0,
"maturity_Age_Type": "string",
"max_Disability_Weeks": 0,
"max_Includes_Waiting_Period": true,
"mem_Ded_Credit": 0.1,
"mem_Ded_Credit_OON": 0.1,
"mem_Ded_Credit_PPO": 0.1,
"member_Annual_Max": 0.1,
"member_Annual_Max_Net": 0.1,
"member_Annual_Max_OON": 0.1,
"member_Ded_OON": 0.1,
"member_Ded_PPO": 0.1,
"member_Deductible": 0.1,
"member_Lifetime_Max": 0.1,
"member_Lifetime_Max_Net": 0.1,
"member_Lifetime_Max_OON": 0.1,
"ooP_Calc_Option": "string",
"ooP_In_To_Out": true,
"ooP_Max_Mem": 0.1,
"ooP_Max_Net_Mem": 0.1,
"ooP_Max_Net_Sub": 0.1,
"ooP_Max_OON_Mem": 0.1,
"ooP_Max_OON_Sub": 0.1,
"ooP_Max_Sub": 0.1,
"ooP_Out_To_In": true,
"ooP_Out_To_In_Limit": true,
"ooP_Out_To_In_Limit_Max": 0.1,
"payment_Interval": 0,
"payor_ID": "string",
"pend_Ex_Code": "string",
"pend_Flag": "s",
"plan_Document_URL": "string",
"plan_Type": "string",
"policy_Forfeiture_Grace_Period": 0,
"policy_Forfeiture_Grace_Period_Type": "s",
"policy_Status_Default": "string",
"preEx_Ex_Code": "string",
"preEx_From": 0,
"preEx_Range": 0,
"preEx_Thru": 0,
"qpA_Method": "s",
"reduced_Paid_Up_Default": 0,
"remove_Member_Amount_Edit": true,
"situs_State": "st",
"sub_Ded_Credit": 0.1,
"sub_Ded_Credit_OON": 0.1,
"sub_Ded_Credit_PPO": 0.1,
"subscriber_Ded_OON": 0.1,
"subscriber_Ded_PPO": 0.1,
"subscriber_Deductible": 0.1,
"survivor_Benefit": 0,
"update_Date": "2019-08-24T14:15:22Z",
"update_User": "string",
"use_COB_Savings": true
}

Response samples

{"data": {"plan_ID": "string",
"annual_Max": 0.1,
"annual_Max_Net": 0.1,
"annual_Max_OON": 0.1,
"auto_Create_Flex": true,
"cobrA_Plan_Type_Desc": "string",
"coB_Savings_Max": 0.1,
"coB_Type": "string",
"capitated": true,
"cash_Value_Default": 0,
"coIns_In_To_Out": true,
"coIns_Max_Mem": 0.1,
"coIns_Max_Net_Mem": 0.1,
"coIns_Max_Net_Sub": 0.1,
"coIns_Max_OON_Mem": 0.1,
"coIns_Max_OON_Sub": 0.1,
"coIns_Max_Sub": 0.1,
"coIns_Out_To_In": true,
"coIns_Out_To_In_Limit": true,
"coIns_Out_To_In_Limit_Max": 0.1,
"context4_ClmUcrPct": 0,
"context4_ClmUcrPct_OON": 0,
"context4_FeeSelector": "string",
"context4_FeeSelector_OON": "string",
"context4_MedicarePct": 0,
"context4_MedicarePct_OON": 0,
"context4_Password": "string",
"context4_PayorType": "string",
"context4_PayorType_OON": "string",
"context4_PctOfChg": 0,
"context4_PctOfChg_OON": 0,
"context4_PlanPriceNotGreaterBilledFg": true,
"context4_UserID": "string",
"context4_WebURI": "string",
"context4_WebURI_Delete": "string",
"currency_ID": "string",
"ded_In_To_Out": true,
"ded_Out_To_In": true,
"ded_Out_To_In_Limit": true,
"ded_Out_To_In_Limit_Max": 0.1,
"description": "string",
"entry_Date": "2019-08-24T14:15:22Z",
"entry_User": "string",
"extended_Term_Default": 0,
"family_Level_Co_Ins": true,
"family_Level_Co_Ins_Member": 0,
"family_Level_Ded": true,
"family_Level_Ded_Member": 0,
"family_Level_OOP": true,
"family_Level_OOP_Member": 0,
"flex_Advance_Fund": true,
"flex_Type": "string",
"forfeiture_Status_Default": "string",
"illness_Ex_Code": "string",
"illness_Waiting_Period": 0,
"include_Waiting_Period": true,
"injury_Ex_Code": "string",
"injury_Waiting_Period": 0,
"ltC_Apply_Elimination_Period": true,
"ltC_Apply_Waiver_Of_Premium": true,
"ltC_Daily_Benefit": 0.1,
"ltC_Daily_Benefit_Range_From": 0.1,
"ltC_Daily_Benefit_Range_Increment": 0.1,
"ltC_Daily_Benefit_Range_Thru": 0.1,
"ltC_Daily_Benefit_Type": "string",
"ltC_Elimination_Period": 0,
"ltC_Elimination_Period_Per_Claim": true,
"ltC_Elimination_Period_Type": "string",
"ltC_Lifetime_Max_Days_From": 0,
"ltC_Lifetime_Max_Days_Thru": 0,
"ltC_Lifetime_Max_From": 0.1,
"ltC_Lifetime_Max_Increment": 0.1,
"ltC_Lifetime_Max_Joint_Policy": true,
"ltC_Lifetime_Max_Thru": 0.1,
"ltC_Lifetime_Max_Type": "string",
"ltC_Lifetime_Max_Years_From": 0,
"ltC_Lifetime_Max_Years_Thru": 0,
"ltC_Monthly_Benefit": 0.1,
"ltC_Monthly_Benefit_Range_From": 0.1,
"ltC_Monthly_Benefit_Range_Increment": 0.1,
"ltC_Monthly_Benefit_Range_Thru": 0.1,
"ltC_Monthly_Benefit_Type": "string",
"ltC_Waiver_Of_Premium_Type": "string",
"lifetime_Max": 0.1,
"lifetime_Max_Net": 0.1,
"lifetime_Max_OON": 0.1,
"maturity_Age": 0,
"maturity_Age_Type": "string",
"max_Disability_Weeks": 0,
"max_Includes_Waiting_Period": true,
"mem_Ded_Credit": 0.1,
"mem_Ded_Credit_OON": 0.1,
"mem_Ded_Credit_PPO": 0.1,
"member_Annual_Max": 0.1,
"member_Annual_Max_Net": 0.1,
"member_Annual_Max_OON": 0.1,
"member_Ded_OON": 0.1,
"member_Ded_PPO": 0.1,
"member_Deductible": 0.1,
"member_Lifetime_Max": 0.1,
"member_Lifetime_Max_Net": 0.1,
"member_Lifetime_Max_OON": 0.1,
"ooP_Calc_Option": "string",
"ooP_In_To_Out": true,
"ooP_Max_Mem": 0.1,
"ooP_Max_Net_Mem": 0.1,
"ooP_Max_Net_Sub": 0.1,
"ooP_Max_OON_Mem": 0.1,
"ooP_Max_OON_Sub": 0.1,
"ooP_Max_Sub": 0.1,
"ooP_Out_To_In": true,
"ooP_Out_To_In_Limit": true,
"ooP_Out_To_In_Limit_Max": 0.1,
"payment_Interval": 0,
"payor_ID": "string",
"pend_Ex_Code": "string",
"pend_Flag": "s",
"plan_Document_URL": "string",
"plan_Type": "string",
"policy_Forfeiture_Grace_Period": 0,
"policy_Forfeiture_Grace_Period_Type": "s",
"policy_Status_Default": "string",
"preEx_Ex_Code": "string",
"preEx_From": 0,
"preEx_Range": 0,
"preEx_Thru": 0,
"qpA_Method": "s",
"reduced_Paid_Up_Default": 0,
"remove_Member_Amount_Edit": true,
"situs_State": "st",
"sub_Ded_Credit": 0.1,
"sub_Ded_Credit_OON": 0.1,
"sub_Ded_Credit_PPO": 0.1,
"subscriber_Ded_OON": 0.1,
"subscriber_Ded_PPO": 0.1,
"subscriber_Deductible": 0.1,
"survivor_Benefit": 0,
"update_Date": "2019-08-24T14:15:22Z",
"update_User": "string",
"use_COB_Savings": true
},
"error": {"detail": "string",
"instance": "string",
"status": 0,
"title": "string",
"type": "string"
},
"debug": {"activityID": "string"
}
}

Delete Plans

Deletes an Plans

SecurityapiKeyAuth and bearerAuth

Request

path Parameters

planID

required

string

Plan ID

header Parameters

vbasoftware-database

required

string

Target database

Responses

204

Success

401

Unauthorized

delete/plans/{planID}

Request samples

C#
JavaScript
curl
Java

Create or Update Batch Plans

Create or Update multiple Plans at once. If the entity exists, it will be updated. If the entity does not exist, it will be created.

SecurityapiKeyAuth and bearerAuth

Request

header Parameters

vbasoftware-database

required

string

Target database

Request Body schema:
application/json
required

Array

plan_ID required	string [ 1 .. 20 ] characters Unique identifier assigned to the Plan.
annual_Max	number or null <double> Total In-Network and Out of Network annual maximum the plan will pay out for the Familiy.
annual_Max_Net	number or null <double> In-Network annual maximum that the plan will pay out for the Familiy.
annual_Max_OON	number or null <double> Out of Network annual maximum that the plan will pay out for the Familiy.
auto_Create_Flex required	boolean Indicates if this plan allows auto-creation of Flex claims based on Group level configuration for flex auto-creation. Note: This field is marked as NOT NULL in the database and therefore required by the API.
cobrA_Plan_Type_Desc	string or null <= 20 characters Used for custom reporting and information.
coB_Savings_Max	number or null <double> Indicates the maximum amount that can be held in COB savings.
coB_Type	string or null <= 16 characters Indicates the type of COB to be used with the selected plan.
capitated required	boolean No longer in use. All captiation logic and processing now resides in the capitation tables. Note: This field is marked as NOT NULL in the database and therefore required by the API.
cash_Value_Default	integer or null <int32> Default cash value when Policy & Forfeiture is used in enrollment.
coIns_In_To_Out required	boolean Indicates whether In-Network Coinsurance amounts apply toward the satisfaction of Out of Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
coIns_Max_Mem	number or null <double> In Network Co-Insurance amount for the Family.
coIns_Max_Net_Mem	number or null <double> Total Co-Insurance amount for the Member.
coIns_Max_Net_Sub	number or null <double> Out of Network Co-Insurance amount for the Family.
coIns_Max_OON_Mem	number or null <double> Out of Network Co-Insurance amount for the Member.
coIns_Max_OON_Sub	number or null <double> In Network Co-Insurance amount for the Member.
coIns_Max_Sub	number or null <double> Total Co-Insurance amount for the Family.
coIns_Out_To_In required	boolean Indicates whether Out of Network CoInsurance amounts apply toward the satisfaction of the In-Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
coIns_Out_To_In_Limit required	boolean When active, this will let the system know to limit the amount of co-insurance that applies to IN from OON by the Max. Note: This field is marked as NOT NULL in the database and therefore required by the API.
coIns_Out_To_In_Limit_Max	number or null <double> The max with which the co-insurance is limited by when CoIns_Out To In Limit is selected.
context4_ClmUcrPct	integer or null <int32> Claim UCR percentage provided by Context. Required for Context claim edits and repricing.
context4_ClmUcrPct_OON	integer or null <int32> Out of network claim UCR percentage provided by context. Required for Context claim edits and repricing.
context4_FeeSelector	string or null <= 8 characters Fee Selector provided by Context. Required for Context claim edits and repricing.
context4_FeeSelector_OON	string or null <= 8 characters Out of network fee selector provided by context. Required for Context claim edits and repricing.
context4_MedicarePct	integer or null <int32> Medicare percentage provided by Context. Required for Context claim edits and repricing.
context4_MedicarePct_OON	integer or null <int32> Out of network Medicare percentage provided by context. Required for Context claim edits and repricing.
context4_Password	string or null <= 128 characters Password provided by Context. Required for Context claim edits and repricing.
context4_PayorType	string or null <= 8 characters Payor type provided by context. Required for Context claim edits and repricing.
context4_PayorType_OON	string or null <= 8 characters Out of network Payor type provided by context. Required for Context claim edits and repricing.
context4_PctOfChg	integer or null <int32> Percentage of change provided by context. Required for Context claim edits and repricing.
context4_PctOfChg_OON	integer or null <int32> Out of network percentage of change provided by context. Required for Context claim edits and repricing.
context4_PlanPriceNotGreaterBilledFg required	boolean When using Context4, the Plan Price is never allowed to exceed the Billed Price, it'll set it to the Billed Price. Note: This field is marked as NOT NULL in the database and therefore required by the API.
context4_UserID	string or null <= 128 characters User ID provided by Context. Required for Context claim edits and repricing.
context4_WebURI	string or null <= 256 characters URL provided by Context. Required for Context claim edits and repricing.
context4_WebURI_Delete	string or null <= 256 characters URL delete provided by Context. Required for Context claim edits and repricing.
currency_ID	string or null <= 16 characters Indicates the currency being used.
ded_In_To_Out required	boolean Indicates whether In-Network Deductible amounts apply toward the satisfaction of Out of Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ded_Out_To_In required	boolean Indicates whether Out of Network Deductible amounts apply toward the satisfaction of In-Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ded_Out_To_In_Limit required	boolean When active, this will let the system know to limit the amount of deductible that applies to IN from OON by the Max. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ded_Out_To_In_Limit_Max	number or null <double> The max with which the deducible is limited by when Ded_Out To In Limit is selected.
description	string or null <= 50 characters A short description of the associated plan.
entry_Date	string <date-time> Date when the record was added to the system.
entry_User	string or null <= 20 characters User that first added the record to the system.
extended_Term_Default	integer or null <int32> Deault extended term value assigned in Policy & Forfeiture when used in enrollment.
family_Level_Co_Ins required	boolean Specifies that the number of Member level Coinsurance amounts should be used to satisfy the Family level Coinsurance amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
family_Level_Co_Ins_Member	integer or null <int32> Number of Members that must satisfy the Member level deductible before the Family level amount is considered met.
family_Level_Ded required	boolean Specifies that the number of Member level deductible amounts should be used to satisfy the Family level deductible. Note: This field is marked as NOT NULL in the database and therefore required by the API.
family_Level_Ded_Member	integer or null <int32> Number of Members that must satisfy the Member level deductible before the Family level amount is considered met.
family_Level_OOP required	boolean Specifies that the number of Member level Out of Pocket amounts should be used to satisfy the Family level Out of Pocket amount. Note: This field is marked as NOT NULL in the database and therefore required by the API.
family_Level_OOP_Member	integer or null <int32> Number of Members that must satisfy the Member level Out of Pocket before the Family level Out of Pocket is considered met.
flex_Advance_Fund required	boolean Information field used in reporting to identify this plan as Flex Advance Fund. Note: This field is marked as NOT NULL in the database and therefore required by the API.
flex_Type	string or null <= 16 characters Indicates what type of Flex account to be associated with the plan.
forfeiture_Status_Default	string or null <= 32 characters Default forfeiture status assigned when Policy & Forteiture is used in enrollment.
illness_Ex_Code	string or null <= 8 characters Ex Code associated with the illness waiting period.
illness_Waiting_Period	integer or null <int32> Waiting Period after an illness for Disability plans to start coverage.
include_Waiting_Period	boolean or null Indicates whether the Disability plan includes a waiting period.
injury_Ex_Code	string or null <= 8 characters Ex Code associated with the injury waiting period.
injury_Waiting_Period	integer or null <int32> Waiting Period after an injury for Disability plans to start coverage.
ltC_Apply_Elimination_Period required	boolean Indicates if this Plan has Elimination Period rules. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ltC_Apply_Waiver_Of_Premium required	boolean Indicates if Waiver of Premium rules should apply for this plan. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ltC_Daily_Benefit	number or null <double> This is the daily benefit amount
ltC_Daily_Benefit_Range_From	number or null <double> The start of the selection range for members taking this plan and choosing their daily benefit.
ltC_Daily_Benefit_Range_Increment	number or null <double> The increment of each option in the range between the from and thru. If empty, the member can manually select a value between the from / thru range.
ltC_Daily_Benefit_Range_Thru	number or null <double> The end of the selection range for members taking this plan and choosing their daily benefit.
ltC_Daily_Benefit_Type	string or null <= 32 characters This is the type of daily benefit defined for this plan. The values are: A - a flat daily benefit enforced by the plan. B - member selected value utilizing the daily benefit range/increment settings.
ltC_Elimination_Period	integer or null <int32> This is the elimination period value based on Elimination_Period_Type.
ltC_Elimination_Period_Per_Claim required	boolean Indicates if the elimination period is per claim. By default the elimination period is per plan/policy. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ltC_Elimination_Period_Type	string or null <= 32 characters This is the type of Elimination Period rule to apply for this Plan. Values are: A - Calendar Days B - Service Days C - Special Service Days (one day equals a week of elimination period)
ltC_Lifetime_Max_Days_From	integer or null <int32> The selectable range of days the member can pick for calculations based on days.
ltC_Lifetime_Max_Days_Thru	integer or null <int32> The selectable range of days the member can pick for calculations based on days.
ltC_Lifetime_Max_From	number or null <double> The low end range for member lifetime max selection.
ltC_Lifetime_Max_Increment	number or null <double> The increment of options the user can select within the max range. Empty value here means it is a free from entry of max between the range.
ltC_Lifetime_Max_Joint_Policy required	boolean Indicates if plans of the same plan type, and both flagged as joint policy, can share a "Total" lifetime max between both plans as long as both plans have selected a shared benefit. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ltC_Lifetime_Max_Thru	number or null <double> The high end range for member lifetime max selection.
ltC_Lifetime_Max_Type	string or null <= 32 characters Lifetime Max calculation type and will dicatate the max rules applied. Valid values are: STANDARD - DBM x 365 days x Lifetime Max Years selected LMDAYS - DBM x Lifetime Max Days selected FLAT - Lifetime Max Amount selected and not based on calculation LMMONTHS - MBA x 12 Months x Lifetime Max Years selected
ltC_Lifetime_Max_Years_From	integer or null <int32> the selectable range of years the member can pick for calculations based on years.
ltC_Lifetime_Max_Years_Thru	integer or null <int32> The selectable range of years the member can pick for calculations based on years.
ltC_Monthly_Benefit	number or null <double> This is the monthly benefit amount
ltC_Monthly_Benefit_Range_From	number or null <double> The start of the selection range for members taking this plan and choosing their monthly benefit.
ltC_Monthly_Benefit_Range_Increment	number or null <double> The increment of each option in the range between the from and thru. If empty, the member can manually select a value between the from / thru range.
ltC_Monthly_Benefit_Range_Thru	number or null <double> The end of the selection range for members taking this plan and choosing their monthly benefit.
ltC_Monthly_Benefit_Type	string or null <= 32 characters This is the type of monthly benefit defined for this plan. The values are: A - a flat monthly benefit enforced by the plan. B - member selected value utilizing the monthly benefit range/increment settings.
ltC_Waiver_Of_Premium_Type	string or null <= 32 characters This is the type/rules for LTC waiver of premium. Current Values are: A - 1st day of following month B - day of eligibility approval C - joint waiver D - survivorship waiver
lifetime_Max	number or null <double> Total lifetime amount that the Plan will pay both In Network and Out of Network for the Familiy.
lifetime_Max_Net	number or null <double> Lifetime amount that the Plan will pay In Network for the Familiy.
lifetime_Max_OON	number or null <double> Lifetime amount that the Plan will pay Out of Network for the Familiy.
maturity_Age	integer or null <int32> Specifies the required age for maturity of policy inside enrollment.
maturity_Age_Type	string or null <= 8 characters Defines the age type for maturity based upon birth date or anniversary of enrollment.
max_Disability_Weeks	integer or null <int32> Maximum number of weeks the specified Plan will pay Disability.
max_Includes_Waiting_Period	boolean or null Indicates whether the waiting period is included in the Max Disability Weeks.
mem_Ded_Credit	number or null <double> Total deductible amount to be credited back to each Member during adjudication.
mem_Ded_Credit_OON	number or null <double> Out of Network deductible amount to be credited back to each Member during adjudication.
mem_Ded_Credit_PPO	number or null <double> In-Network deductible amount to be credited back to each Member during adjudication.
member_Annual_Max	number or null <double> Total In-Network and Out of Network annual maximum the plan will pay out per Member.
member_Annual_Max_Net	number or null <double> In-Network annual maximum that the plan will pay out per Member.
member_Annual_Max_OON	number or null <double> Out of Network annual maximum that the plan will pay out per Member.
member_Ded_OON	number or null <double> Deductible amount for the Member Out of Network.
member_Ded_PPO	number or null <double> Deductible amount for the Member In Network.
member_Deductible	number or null <double> Total deductible amount for the Member both In Network and Out of Network.
member_Lifetime_Max	number or null <double> Total In-Network and Out of Network lifetime maximum that the plan will pay out per Member.
member_Lifetime_Max_Net	number or null <double> In-Network lifetime maximum that the plan will pay out per Member.
member_Lifetime_Max_OON	number or null <double> Out of Network lifetime that the plan will pay out per Member.
ooP_Calc_Option	string or null <= 8 characters Formula used to calculate Out of Pocket amounts.
ooP_In_To_Out required	boolean Indicates whether In-Network Out of Pocket amounts apply toward the satisfaction of Out of Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ooP_Max_Mem	number or null <double> Total In-Network and Out of Network Out of Pocket maximum for the Member.
ooP_Max_Net_Mem	number or null <double> In-Network Out of Pocket maximum for the Member.
ooP_Max_Net_Sub	number or null <double> In-Network Out of Pocket maximum for the Family.
ooP_Max_OON_Mem	number or null <double> Out of Network Out of Pocket for the Member.
ooP_Max_OON_Sub	number or null <double> Out of Network Out of Pocket for the Family.
ooP_Max_Sub	number or null <double> Total In-Network and Out of Network Out of Pocket maximum for the Family.
ooP_Out_To_In required	boolean Indicates whether Out of Network Out of Pocket amounts apply toward the satisfaction of In-Network amounts. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ooP_Out_To_In_Limit required	boolean When active, this will let the system know to limit the amount of out of pocket that applies to IN from OON by the Max. Note: This field is marked as NOT NULL in the database and therefore required by the API.
ooP_Out_To_In_Limit_Max	number or null <double> The max with which the out of pocket is limited by when OOP_Out To In Limit is selected.
payment_Interval	integer or null <int32> Payment Interval or frequency for Disability plans.
payor_ID	string or null <= 20 characters No longer in use.
pend_Ex_Code	string or null <= 6 characters Identifies the Ex Code that will be applied based upon the Pend_Flag field.
pend_Flag	string or null <= 1 characters 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.
plan_Document_URL	string or null <= 512 characters Used for custom reporting and information.
plan_Type	string or null <= 6 characters Identifies the Type of Plan (medical, dental, etc.). Keep in mind that Accumulators are tied to 'Plan Type' not the plan itself.
policy_Forfeiture_Grace_Period	integer or null <int32> Length of the grace period.
policy_Forfeiture_Grace_Period_Type	string or null <= 1 characters Defines the type of grace period. Restricted to units of days.
policy_Status_Default	string or null <= 32 characters Default policy status assigned when Policy & Forteiture is used in enrollment.
preEx_Ex_Code	string or null <= 8 characters Identifies the Ex Code that will be applied to disability claims falling within the provided range.
preEx_From	integer or null <int32> No longer in use. Pre-Ex processing has been moved to a more detailed structure in PlanPrex tables.
preEx_Range	integer or null <int32> 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.
preEx_Thru	integer or null <int32> No longer in use. Pre-Ex processing has been moved to a more detailed structure in PlanPrex tables.
qpA_Method	string or null <= 1 characters Determines the QPA Method to be used for claims under this Plan
reduced_Paid_Up_Default	integer or null <int32> Deault paid up value when Policy & Forfeiture is used in enrollment.
remove_Member_Amount_Edit required	boolean No longer in use. Note: This field is marked as NOT NULL in the database and therefore required by the API.
situs_State	string or null <= 2 characters State where the Plan originates or applies
sub_Ded_Credit	number or null <double> Total deductible amount to be credited back to the Subscriber during adjudication.
sub_Ded_Credit_OON	number or null <double> Out of Network deductible amount to be credited back to the Subscriber during adjudication.
sub_Ded_Credit_PPO	number or null <double> In-Network deductible amount to be credited back to the Subscriber during adjudication.
subscriber_Ded_OON	number or null <double> Deductible amount for the Family Out of Network.
subscriber_Ded_PPO	number or null <double> Deductible amount for the Family In Network.
subscriber_Deductible	number or null <double> Total deductible amount for the Family both In Network and Out of Network.
survivor_Benefit	integer or null <int32> Survivor Benefit associated with Disability plans.
update_Date	string <date-time> Date when the record was last updated in the system.
update_User	string or null <= 20 characters User that last updated the record in the system.
use_COB_Savings required	boolean Indicates whether the COB should be used. Note: This field is marked as NOT NULL in the database and therefore required by the API.

Responses

207

Success

401

Unauthorized

put/plans-batch

Request samples

Payload
C#
JavaScript
curl
Java

[{"plan_ID": "string",
"annual_Max": 0.1,
"annual_Max_Net": 0.1,
"annual_Max_OON": 0.1,
"auto_Create_Flex": true,
"cobrA_Plan_Type_Desc": "string",
"coB_Savings_Max": 0.1,
"coB_Type": "string",
"capitated": true,
"cash_Value_Default": 0,
"coIns_In_To_Out": true,
"coIns_Max_Mem": 0.1,
"coIns_Max_Net_Mem": 0.1,
"coIns_Max_Net_Sub": 0.1,
"coIns_Max_OON_Mem": 0.1,
"coIns_Max_OON_Sub": 0.1,
"coIns_Max_Sub": 0.1,
"coIns_Out_To_In": true,
"coIns_Out_To_In_Limit": true,
"coIns_Out_To_In_Limit_Max": 0.1,
"context4_ClmUcrPct": 0,
"context4_ClmUcrPct_OON": 0,
"context4_FeeSelector": "string",
"context4_FeeSelector_OON": "string",
"context4_MedicarePct": 0,
"context4_MedicarePct_OON": 0,
"context4_Password": "string",
"context4_PayorType": "string",
"context4_PayorType_OON": "string",
"context4_PctOfChg": 0,
"context4_PctOfChg_OON": 0,
"context4_PlanPriceNotGreaterBilledFg": true,
"context4_UserID": "string",
"context4_WebURI": "string",
"context4_WebURI_Delete": "string",
"currency_ID": "string",
"ded_In_To_Out": true,
"ded_Out_To_In": true,
"ded_Out_To_In_Limit": true,
"ded_Out_To_In_Limit_Max": 0.1,
"description": "string",
"entry_Date": "2019-08-24T14:15:22Z",
"entry_User": "string",
"extended_Term_Default": 0,
"family_Level_Co_Ins": true,
"family_Level_Co_Ins_Member": 0,
"family_Level_Ded": true,
"family_Level_Ded_Member": 0,
"family_Level_OOP": true,
"family_Level_OOP_Member": 0,
"flex_Advance_Fund": true,
"flex_Type": "string",
"forfeiture_Status_Default": "string",
"illness_Ex_Code": "string",
"illness_Waiting_Period": 0,
"include_Waiting_Period": true,
"injury_Ex_Code": "string",
"injury_Waiting_Period": 0,
"ltC_Apply_Elimination_Period": true,
"ltC_Apply_Waiver_Of_Premium": true,
"ltC_Daily_Benefit": 0.1,
"ltC_Daily_Benefit_Range_From": 0.1,
"ltC_Daily_Benefit_Range_Increment": 0.1,
"ltC_Daily_Benefit_Range_Thru": 0.1,
"ltC_Daily_Benefit_Type": "string",
"ltC_Elimination_Period": 0,
"ltC_Elimination_Period_Per_Claim": true,
"ltC_Elimination_Period_Type": "string",
"ltC_Lifetime_Max_Days_From": 0,
"ltC_Lifetime_Max_Days_Thru": 0,
"ltC_Lifetime_Max_From": 0.1,
"ltC_Lifetime_Max_Increment": 0.1,
"ltC_Lifetime_Max_Joint_Policy": true,
"ltC_Lifetime_Max_Thru": 0.1,
"ltC_Lifetime_Max_Type": "string",
"ltC_Lifetime_Max_Years_From": 0,
"ltC_Lifetime_Max_Years_Thru": 0,
"ltC_Monthly_Benefit": 0.1,
"ltC_Monthly_Benefit_Range_From": 0.1,
"ltC_Monthly_Benefit_Range_Increment": 0.1,
"ltC_Monthly_Benefit_Range_Thru": 0.1,
"ltC_Monthly_Benefit_Type": "string",
"ltC_Waiver_Of_Premium_Type": "string",
"lifetime_Max": 0.1,
"lifetime_Max_Net": 0.1,
"lifetime_Max_OON": 0.1,
"maturity_Age": 0,
"maturity_Age_Type": "string",
"max_Disability_Weeks": 0,
"max_Includes_Waiting_Period": true,
"mem_Ded_Credit": 0.1,
"mem_Ded_Credit_OON": 0.1,
"mem_Ded_Credit_PPO": 0.1,
"member_Annual_Max": 0.1,
"member_Annual_Max_Net": 0.1,
"member_Annual_Max_OON": 0.1,
"member_Ded_OON": 0.1,
"member_Ded_PPO": 0.1,
"member_Deductible": 0.1,
"member_Lifetime_Max": 0.1,
"member_Lifetime_Max_Net": 0.1,
"member_Lifetime_Max_OON": 0.1,
"ooP_Calc_Option": "string",
"ooP_In_To_Out": true,
"ooP_Max_Mem": 0.1,
"ooP_Max_Net_Mem": 0.1,
"ooP_Max_Net_Sub": 0.1,
"ooP_Max_OON_Mem": 0.1,
"ooP_Max_OON_Sub": 0.1,
"ooP_Max_Sub": 0.1,
"ooP_Out_To_In": true,
"ooP_Out_To_In_Limit": true,
"ooP_Out_To_In_Limit_Max": 0.1,
"payment_Interval": 0,
"payor_ID": "string",
"pend_Ex_Code": "string",
"pend_Flag": "s",
"plan_Document_URL": "string",
"plan_Type": "string",
"policy_Forfeiture_Grace_Period": 0,
"policy_Forfeiture_Grace_Period_Type": "s",
"policy_Status_Default": "string",
"preEx_Ex_Code": "string",
"preEx_From": 0,
"preEx_Range": 0,
"preEx_Thru": 0,
"qpA_Method": "s",
"reduced_Paid_Up_Default": 0,
"remove_Member_Amount_Edit": true,
"situs_State": "st",
"sub_Ded_Credit": 0.1,
"sub_Ded_Credit_OON": 0.1,
"sub_Ded_Credit_PPO": 0.1,
"subscriber_Ded_OON": 0.1,
"subscriber_Ded_PPO": 0.1,
"subscriber_Deductible": 0.1,
"survivor_Benefit": 0,
"update_Date": "2019-08-24T14:15:22Z",
"update_User": "string",
"use_COB_Savings": true
}
]

Response samples

{"data": [{"id": [{"key": "string",
"value": "string"
}
],
"status": 0,
"body": "string"
}
],
"error": {"detail": "string",
"instance": "string",
"status": 0,
"title": "string",
"type": "string"
},
"debug": {"activityID": "string"
}
}

Plans

Create Plan

header Parameters

Request Body schema: application/jsontext/jsonapplication/*+jsonapplication/jsonrequired

List Plans

query Parameters

header Parameters

Copy Plan Advanced API

header Parameters

Request Body schema: application/jsontext/jsonapplication/*+jsonapplication/jsonrequired

Get Plan

path Parameters

header Parameters

Update Plans

path Parameters

header Parameters

Request Body schema: application/jsontext/jsonapplication/*+jsonapplication/jsonrequired

Delete Plans

path Parameters

header Parameters

Create or Update Batch Plans

header Parameters

Request Body schema: application/jsontext/jsonapplication/*+jsonapplication/jsonrequired

Request Body schema:
application/json
required

Request Body schema:
application/json
required

Request Body schema:
application/json
required

Request Body schema:
application/json
required