Health Plan Interface
Open Enrollment Potential
Transition Listing Layout
DATA
NAME |
TYPE |
SIZE |
REMARKS |
| PROCESS DATE |
X |
8 |
YEARMMDD |
| CHOICE INDICATOR |
X |
1 |
J=JOINING
L=LEAVING |
| NEW HEALTH PLAN ID |
X |
6 |
|
| NEW HEALTH PLAN NAME |
X |
26 |
|
| NEW COUNTY OF SERVICE |
X |
2 |
|
| NEW RATE CODE |
X |
4 |
|
| PREVIOUS HEALTH PLAN ID |
X |
6 |
|
| PREVIOUS HEALTH PL. NAME |
X |
26 |
|
| PREVIOUS COUNTY OF SERV. |
X |
2 |
|
| PREVIOUS RATE CODE |
X |
4 |
|
| RECIPIENT AHCCCS ID |
X |
9 |
|
| RECIPIENT LAST NAME |
X |
20 |
|
| RECIPIENT FIRST NAME |
X |
10 |
|
| RECIPIENT MIDDLE INITIAL |
X |
1 |
|
| RCP. STREET ADDRESS LINE1 |
X |
25 |
|
| RCP. STREET ADDRESS LINE2 |
X |
25 |
|
| CITY |
X |
20 |
|
| STATE |
X |
2 |
|
| ZIP CODE |
X |
5 |
|
| DATE OF BIRTH |
X |
8 |
|
| NEW RECORD INDICATOR |
X |
1 |
N=NEW |
| FILLER |
X |
25 |
|
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