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Plan.md

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MarketplaceApi.Plan

Properties

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]