Name | Type | Description | Notes |
---|---|---|---|
id | String | 14-character HIOS plan ID | [optional] |
name | String | Name of the insurance plan | [optional] |
benefits | [Benefit] | [optional] | |
deductibles | [Deductible] | [optional] | |
diseaseMgmtPrograms | [DiseaseMgmtProgramsEnum] | [optional] | |
hasNationalNetwork | Boolean | if plan has a national network of providers | [optional] |
qualityRating | QualityRating | [optional] | |
insuranceMarket | InsuranceMarketEnum | [optional] | |
issuer | Issuer | [optional] | |
market | MarketEnum | [optional] | |
maxAgeChild | Number | the maximum age a person is considered a child on their parents' plan | [optional] |
metalLevel | MetalLevelEnum | [optional] | |
moops | [MOOP] | [optional] | |
premium | Number | monthly premium in US dollars, unsubsidized (i.e., no APTC applied) | [optional] |
premiumWCredit | Number | monthly premium in US dollars, with APTC applied | [optional] |
ehbPremium | Number | monthly premium in US dollars, for essential health benefits portion of total premium | [optional] |
pediatricEhbPremium | Number | monthly pediatric portion of the ehb premium in US dollars | [optional] |
aptcEligiblePremium | Number | the portion of the premium that is eligible for APTC | [optional] |
guaranteedRate | Boolean | true if the premiums are guaranteed (versus estimated) | [optional] |
simpleChoice | Boolean | true if the plan is a Simple Choice plan | [optional] |
productDivision | ProductDivisionEnum | [optional] | |
specialistReferralRequired | Boolean | [optional] | |
state | String | 2-letter USPS state abbreviation | [optional] |
type | PlanTypeEnum | [optional] | |
benefitsUrl | String | [optional] | |
brochureUrl | String | [optional] | |
formularyUrl | String | [optional] | |
networkUrl | String | [optional] | |
hsaEligible | Boolean | Is this plan eligible as an HSA? | [optional] |
oopc | Number | out-of-pocket cost; calculated when age, gender and utilization_level are present, otherwise -1 | [optional] |
suppressionState | SuppressionStatus | [optional] | |
tobaccoLookback | Number | [optional] | |
certification | CertificationStatus | [optional] | |
networkAdequacy | PlanNetworkAdequacy | [optional] | |
sbcs | PlanSbcs | [optional] | |
rx3moMailOrder | Boolean | 3-month in-network mail order pharmacy benefit | [optional] |
isIneligible | Boolean | If the given enrollment group/household is ineligible for the plan by business rules, it will be flagged true | [optional] |
coversNonhydeAbortion | Boolean | [optional] | |
serviceAreaId | String | 6-character id representing the geographic area the plan accepts members from. The first two characters are the state's abbreviation. | [optional] |