INS Insured Benefit

Batch

To provide benefit information on insured entities

Elements

Position	Element	Name		Type	Min/Max	Repeat

1	1073	Yes/No Condition or Response Code	Mandatory	ID	1/1	1
2	1069	Individual Relationship Code	Mandatory	ID	2/2	1
3	875	Maintenance Type Code	Opt	ID	3/3	1
4	1203	Maintenance Reason Code	Opt	ID	2/3	1
5	1216	Benefit Status Code	Opt	ID	1/1	1
C052Medicare Status CodeOpt 1
7	1219	Consolidated Omnibus Budget Reconciliation Act (COBRA) Qualifying Event Code	Opt	ID	1/2	1
8	584	Employment Status Code	Opt	ID	2/2	1
9	1220	Student Status Code	Opt	ID	1/1	1
10	1073	Yes/No Condition or Response Code	Opt	ID	1/1	1
11	1250	Date Time Period Format Qualifier	Rel	ID	2/3	1
12	1251	Date Time Period	Rel	Alphanumeric	1/35	1
13	1165	Confidentiality Code	Opt	ID	1/1	1
14	19	City Name	Opt	Alphanumeric	2/30	1
15	156	State or Province Code	Opt	ID	2/2	1
16	26	Country Code	Opt	ID	2/3	1
17	1470	Number	Opt	Number	1/9	1
18	1073	Yes/No Condition or Response Code	Opt	ID	1/1	1
19	1073	Yes/No Condition or Response Code	Opt	ID	1/1	1
20	1073	Yes/No Condition or Response Code	Opt	ID	1/1	1
21	1073	Yes/No Condition or Response Code	Opt	ID	1/1	1
22	1073	Yes/No Condition or Response Code	Opt	ID	1/1	1
23	1073	Yes/No Condition or Response Code	Opt	ID	1/1	1
24	1073	Yes/No Condition or Response Code	Opt	ID	1/1	1
25	1073	Yes/No Condition or Response Code	Opt	ID	1/1	1
26	1073	Yes/No Condition or Response Code	Opt	ID	1/1	1
27	1073	Yes/No Condition or Response Code	Opt	ID	1/1	1
28	1073	Yes/No Condition or Response Code	Opt	ID	1/1	1
29	1073	Yes/No Condition or Response Code	Opt	ID	1/1	1
30	1073	Yes/No Condition or Response Code	Opt	ID	1/1	1

ID1073

NameYes/No Condition or Response Code

LengthMin 1 / Max 1

Position1

RequirementMandatory

Codes