Create Eligibility

Create a new eligibility record with associated dependents, coverages, and accumulators.

The eligibility data is specified in the body of the request. The data is a JSON object conforming to the DI file specification for eligibility, coverages, and accumulators accordingly.  All field names must be lowercase.

If there is an existing data match for the new eligibility record, the record is not created. When the call is accepted it returns an operations URL that the requesting client uses to track the status of the request.

Sample Request Format

POST [base URL]/eligibility

{
    "memberid": "",
    "groupnumber": "",
    "groupname": "",
    "seqnumber": "",
    "salary": "",
    "coverages":
    [
        {
            "covtypename": "",
            "covtypedesc": "",
            "coveffdate": "",
            "covtermdate": "",
            "covvolume": ""
        }
    ],
    "accumulators": 
    [
        {
            "accum_name": "",
            "accum_desc": "",
            "coveragetype": "",
            "specifictype": "",
            "currentamount": "",
            "maximumamount": "",

            "innetwork": "",

            "individualaccum": "",

            "daterange": ""
        }
    ],
    dependents:
    [
        {

            "depmemberid": "",
            "groupnumber": "",
            "groupname": "",
            "seqnumber": "",
            "salary": "",
            "coverages":
            [
                {
                    "covtypename": "",
                    "covtypedesc": "",
                    "coveffdate": "",
                    "covtermdate": "",
                    "covvolume": ""
                }
            ],
            "accumulators": 
            [
                {
                    "accum_name": "",
                    "accum_desc": "",
                    "coveragetype": "",
                    "specifictype": "",
                    "currentamount": "",
                    "maximumamount": "",
                    "innetwork": "",
                    "individualaccum": "",
                    "daterange": ""                }
            ]
        }
    ]
}

Sample Response Format

HTTP/1.1 202 Accepted
Operation-Location: [base URL]/operation/[operationId]
 

Update Eligibility

Update an eligibility record with associated dependents, coverages, and accumulators.  

This is a sparse update; only fields being changed need to be included.  

The lookup keys for the eligiblity record to update are included in the query parameters, memberid and groupnumber.

Any child records being updated (coverages, accumulators, dependents, etc) must include a "record_action" field with the action being taken on them (n - new, m - modify, d - delete).

Child records must also include the appropriate neccesary keys.

Sample Request Format
Required key fields are highlighted.
PATCH [base URL]/eligibility?memberid=[memberid]&groupnumber=[groupnumber]

{
    "groupname": "",
    "seqnumber": "",
    "salary": "",
    "coverages":
    [
        {
            "record_action: "n",
            "covtypename": "",
            "covtypedesc": "",
            "coveffdate": "",
            "covtermdate": "",
            "covvolume": ""
        }
    ],
    dependents:
    [
        {
            "record_action": "m",
                      "depmemberid": "",
            "groupnumber": "",
            "groupname": "",
            "seqnumber": "",
            "salary": "",
            "accumulators": 
            [
                {
                    "record_action": "d",
                    "accum_name": "",
                    "accum_desc": "",
                    "coveragetype": "",
                    "specifictype": "",
                    "currentamount": "",
                    "maximumamount": "",
                    "innetwork": "",
                    "individualaccum": "",
                    "daterange": ""                }
            ]
        }
    ]
}


Sample Response Format

HTTP/1.1 202 Accepted
Operation-Location: [base URL]/operation/[operationId]

Delete Eligibility
Delete an eligibility record and all associated child records (coverages, accumulators, dependents, etc).
The lookup keys for the eligiblity record to update are included in the query parameters, memberid and groupnumber.
Sample Request Format

DELETE [base URL]/eligibility?memberid=[memberid]&groupnumber=[groupnumber]

Sample Response Format

HTTP/1.1 202 Accepted
Operation-Location: [base URL]/operation/[operationId]