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Back  RFI # 1896: 834 Member Level Date

Formal vs. Informal Help Informal Formal

Submitter

Joyce Petrucci

Description

Is the Loop 2000, DTP - Member Level Date required when the Loop 2000, INS03 - Maintenance Type code = 021.

Note on DTP - Member Level Date: Situational Rule: Required when enrolling a member or when the sponsor is informed of a change to any applicable date listed in DTP01. Only those dates that apply to the particular insurance contract need to be sent. If not required by this implementation guide, do not send.

Could be implied, but does not appear to be explicit. Should this situation produce an error?

Response

The key to the situational rule for the Loop 2000 DTP - Member Level Dates is "Required when enrolling a member or when the sponsor is informed of a change to any applicable date listed in DTP01."

INS03=021 means - "Addition", with an IG note that states "Use this code to add a subscriber or dependent." Therefore, when INS03=021, a member is being added, and that triggers the situational rule 'for the Loop 2000, DTP' .
Submission 1/30/2014
Status Date 3/14/2014
Status F - Final
Primary References
Document 005010X220
Section2 Transa
Page59
Set ID834
Table2
Loop2000
Segment IDDTP