Test Case Guide

The below examples correspond to the test cases OSCAR uses while on-boarding a new vendor to ICHRA

Test Case 1

  1. Vendor creates initial enrollment transaction
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 329.32 12345678 199999001402 Martha Jones CHECKING True PASSIVE test-policy-95495 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 95495 Martha Jones 1234567890 Martha.Jones@email.com 898079490 S FEMALE 1949-12-04 2131-1 False 18 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 ADDITION
  1. Vendor creates CHANGE transaction with ADD for spouse with new values for total premium
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 4371.15 12345678 199999001402 Martha Jones CHECKING False PASSIVE test-policy-95495 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 95495 Martha Jones 1234567890 Martha.Jones@email.com 898079490 S FEMALE 1949-12-04 2131-1 False 18 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 CHANGE 2025-03-01 ADDITIONAL_MAINTENANCE_REASON
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 4371.15 12345678 199999001402 Martha Jones CHECKING False PASSIVE test-policy-95495 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 40896 Edward Allen 1234567890 Edward.Allen@email.com 453822462 I FEMALE 2024-07-07 2131-1 False 19 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 ADDITION

Test Case 2

  1. Initial enrollment file with Subscriber and Dependent (Child) enrolling into Policy A.
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 548.33 12345678 199999001402 Robert Wallace CHECKING True PASSIVE test-policy-23194 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 23194 Robert Wallace 1234567890 Robert.Wallace@email.com 600917737 S FEMALE 1973-05-11 2131-1 False 18 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 ADDITION
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 548.33 12345678 199999001402 Robert Wallace CHECKING False PASSIVE test-policy-23194 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 96289 Jessica Calhoun 1234567890 Jessica.Calhoun@email.com 911112239 I FEMALE 2023-02-02 2131-1 False 19 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 ADDITION
  1. Change transaction with cancellation for child with new values for total premium.
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 43007.16 12345678 199999001402 Robert Wallace CHECKING False PASSIVE test-policy-23194 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 23194 Robert Wallace 1234567890 Robert.Wallace@email.com 600917737 S FEMALE 1973-05-11 2131-1 False 18 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 CHANGE 2025-03-01 ADDITIONAL_MAINTENANCE_REASON
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 43007.16 PASSIVE test-policy-23194 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 96289 Jessica Calhoun 1234567890 Jessica.Calhoun@email.com 911112239 I FEMALE 2023-02-02 2131-1 False 19 True 2025-03-01 2025-04-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 CANCELLATION 2025-03-01
  1. Change transaction to add child to Policy A with the original coverage start date with new values for total premium.
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 44664.25 12345678 199999001402 Robert Wallace CHECKING False PASSIVE test-policy-23194 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 23194 Robert Wallace 1234567890 Robert.Wallace@email.com 600917737 S FEMALE 1973-05-11 2131-1 False 18 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 CHANGE 2025-03-01 ADDITIONAL_MAINTENANCE_REASON
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 44664.25 12345678 199999001402 Robert Wallace CHECKING False PASSIVE test-policy-23194 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 96289 Jessica Calhoun 1234567890 Jessica.Calhoun@email.com 911112239 I FEMALE 2023-02-02 2131-1 False 19 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 ADDITION
  1. Change transaction to cancel the entire existing policy (Policy A).
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 44664.25 PASSIVE test-policy-23194 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 23194 Robert Wallace 1234567890 Robert.Wallace@email.com 600917737 S FEMALE 1973-05-11 2131-1 False 18 True 2025-03-01 2025-04-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 CANCELLATION 2025-03-01
  1. Reinstatement transaction for the entire existing policy (Policy A).
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 44664.25 12345678 199999001402 Robert Wallace CHECKING True PASSIVE test-policy-23194 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 23194 Robert Wallace 1234567890 Robert.Wallace@email.com 600917737 S FEMALE 1973-05-11 2131-1 False 18 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 REINSTATEMENT
  1. Soft termination for the entire existing policy (Policy A).
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 44664.25 PASSIVE test-policy-23194 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 23194 Robert Wallace 1234567890 Robert.Wallace@email.com 600917737 S FEMALE 1973-05-11 2131-1 False 18 True 2025-03-01 2025-04-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 TERMINATION

Test Case 3

  1. Initial enrollment file where 3 subscribers enroll into a policy
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 45220.72 12345678 199999001402 Kimberly Richard CHECKING True PASSIVE test-policy-76673 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 76673 Kimberly Richard 1234567890 Kimberly.Richard@email.com 942904280 S FEMALE 1936-03-27 2131-1 False 18 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 ADDITION
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 45220.72 12345678 199999001402 Kimberly Richard CHECKING False PASSIVE test-policy-76673 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 62902 Amy Camacho 1234567890 Amy.Camacho@email.com 904653012 I FEMALE 2022-06-18 2131-1 False 19 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 ADDITION
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 45220.72 12345678 199999001402 Kimberly Richard CHECKING False PASSIVE test-policy-76673 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 24767 Christopher Reed 1234567890 Christopher.Reed@email.com 199248414 I FEMALE 2015-05-12 2131-1 False 19 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 ADDITION
  1. Change transaction to add child dependent with BIRTH QLE and new values for total premium.
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 80.18 12345678 199999001402 Kimberly Richard CHECKING False PASSIVE test-policy-76673 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 76673 Kimberly Richard 1234567890 Kimberly.Richard@email.com 942904280 S FEMALE 1936-03-27 2131-1 False 18 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 CHANGE 2025-03-01 ADDITIONAL_MAINTENANCE_REASON
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 80.18 12345678 199999001402 Kimberly Richard CHECKING False PASSIVE test-policy-76673 2025-03-20 10:04:00.000+00:00 BIRTH 2025-03-20 1234567789 44516 Annette Richard 1234567890 Annette.Richard@email.com 934821319 I FEMALE 2011-01-26 2131-1 False 19 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 ADDITION
  1. Change transaction to terminate the dependent from the existing policy (Policy A)
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 9500.67 12345678 199999001402 Kimberly Richard CHECKING False PASSIVE test-policy-76673 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 76673 Kimberly Richard 1234567890 Kimberly.Richard@email.com 942904280 S FEMALE 1936-03-27 2131-1 False 18 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 CHANGE 2025-03-01 ADDITIONAL_MAINTENANCE_REASON
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 9500.67 PASSIVE test-policy-76673 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 24767 Christopher Reed 1234567890 Christopher.Reed@email.com 199248414 I FEMALE 2015-05-12 2131-1 False 19 True 2025-03-01 2025-04-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 TERMINATION
  1. Reinstatement transaction to add dependent back to the existing policy (Policy A)
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 99999NE7654321-00 277.15 12345678 199999001402 Kimberly Richard CHECKING False PASSIVE test-policy-76673 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 76673 Kimberly Richard 1234567890 Kimberly.Richard@email.com 942904280 S FEMALE 1936-03-27 2131-1 False 18 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 CHANGE 2025-03-01 ADDITIONAL_MAINTENANCE_REASON
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 99999NE7654321-00 277.15 12345678 199999001402 Christopher Reed CHECKING True PASSIVE test-policy-76673 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 24767 Christopher Reed 1234567890 Christopher.Reed@email.com 199248414 I FEMALE 2015-05-12 2131-1 False 19 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 REINSTATEMENT
  1. Soft termination for the entire existing policy (Policy A).
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 277.15 PASSIVE test-policy-76673 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 76673 Kimberly Richard 1234567890 Kimberly.Richard@email.com 942904280 S FEMALE 1936-03-27 2131-1 False 18 True 2025-03-01 2025-04-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 TERMINATION

Test Case 4

  1. Initial enrollment for 2 members into a Policy A
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 49.63 12345678 199999001402 Deanna Smith CHECKING True PASSIVE test-policy-50070 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 50070 Deanna Smith 1234567890 Deanna.Smith@email.com 978005596 S FEMALE 1938-11-07 2131-1 False 18 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 ADDITION
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 49.63 12345678 199999001402 Deanna Smith CHECKING False PASSIVE test-policy-50070 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 78581 Rebecca Welch 1234567890 Rebecca.Welch@email.com 834852490 I FEMALE 2023-11-07 2131-1 False 19 True 2025-03-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 ADDITION
  1. Change transaction with subscriber address change.
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 49.63 12345678 199999001402 Deanna Smith CHECKING False PASSIVE test-policy-50070 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 50070 Deanna Smith 1234567890 Deanna.Smith@email.com 978005596 S FEMALE 1938-11-07 2131-1 False 18 True 2025-03-01 eng 15420 S 2nd St Bennington NE 68007 15420 S 2nd St Bennington NE 68007 CHANGE 2025-03-01 ADDITIONAL_MAINTENANCE_REASON
  1. Change transaction with subscriber dob change and new premium.
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 2003.42 12345678 199999001402 Deanna Smith CHECKING False PASSIVE test-policy-50070 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 50070 Deanna Smith 1234567890 Deanna.Smith@email.com 978005596 S FEMALE 1938-11-07 2131-1 False 18 True 2025-03-01 eng 15420 S 2nd St Bennington NE 68007 15420 S 2nd St Bennington NE 68007 CHANGE 2025-03-01 ADDITIONAL_MAINTENANCE_REASON
  1. Change transaction with policy change, new premium and QLE.
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 99999NE7654321-00 6004.21 12345678 199999001402 Deanna Smith CHECKING False PASSIVE test-policy-50070 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 50070 Deanna Smith 1234567890 Deanna.Smith@email.com 978005596 S FEMALE 1938-11-07 2131-1 False 18 True 2025-03-01 eng 15420 S 2nd St Bennington NE 68007 15420 S 2nd St Bennington NE 68007 CHANGE 2025-03-01 ADDITIONAL_MAINTENANCE_REASON
  1. Change transaction to remove one dependent and update new premium and QLE
broker.first_name broker.middle_name broker.last_name broker.prefix broker.suffix broker.phone_number broker.email broker.npn servicing_agent.first_name servicing_agent.middle_name servicing_agent.last_name servicing_agent.prefix servicing_agent.suffix servicing_agent.phone_number servicing_agent.email servicing_agent.npn plan.year plan.hios_id plan.monthly_premium payment.routing_number payment.account_number payment.payer_name payment.account_type payment.is_new_payment_instrument enrollment.renewal_type enrollment.external_policy_id enrollment.external_subscriber_id enrollment.cancel_overlapping_eligibility enrollment.date_signed enrollment.qualifying_event enrollment.qualifying_event_date enrollment.application_id employer.employer_name employer.employer_tin enrollee.external_member_id enrollee.issuer_member_id enrollee.first_name enrollee.middle_name enrollee.last_name enrollee.prefix enrollee.suffix enrollee.phone enrollee.email enrollee.ssn enrollee.marital_status enrollee.sex enrollee.date_of_birth enrollee.ethnicity enrollee.is_tobacco_user enrollee.relationship_to_policy_holder enrollee.is_requesting_coverage enrollee.coverage_start_date enrollee.coverage_end_date enrollee.language_preference enrollee.mailing_address.address_line_1 enrollee.mailing_address.address_line_2 enrollee.mailing_address.city enrollee.mailing_address.state enrollee.mailing_address.zipcode enrollee.residential_address.address_line_1 enrollee.residential_address.address_line_2 enrollee.residential_address.city enrollee.residential_address.state enrollee.residential_address.zipcode enrollee.change_type enrollee.change_effective_date enrollee.additional_maintenance_reason
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 77.14 12345678 199999001402 Deanna Smith CHECKING False PASSIVE test-policy-50070 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 50070 Deanna Smith 1234567890 Deanna.Smith@email.com 978005596 S FEMALE 1938-11-07 2131-1 False 18 True 2025-03-01 eng 15420 S 2nd St Bennington NE 68007 15420 S 2nd St Bennington NE 68007 CHANGE 2025-03-01 ADDITIONAL_MAINTENANCE_REASON
Broker M Brokerton 8555200188 broker@broker.com 20090977 Agent Bond Mr. 2025 12345NE1234567-00 77.14 PASSIVE test-policy-50070 2025-03-20 10:04:00.000+00:00 HRAS 2025-03-20 1234567789 The Man 23424586-435 78581 Rebecca Welch 1234567890 Rebecca.Welch@email.com 834852490 I FEMALE 2023-11-07 2131-1 False 19 True 2025-03-01 2025-04-01 eng 11401 N 156th St Bennington NE 68007 11401 N 156th St Bennington NE 68007 TERMINATION