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["Field  Description ","Type  ","Length  ","Initial/Rereg ","Demo Change ","Notes  ","Error Processing/Error Code (Error Description)  "]
["Record Number","N",7,"R","R","Must be numeric","If RECNUM is not 7 digits in length, then assign UPLSTS = 1 and stop processing and report back error code 009 (RECORD NUMBER MUST BE POPULATED AND  A 7 DIGIT NUMBER) - FILE LEVEL ERROR"]
[null,null,null,null,null,"7 digit value that should start at 0000001 for first row, then  0000002 for second row, and so forth"]
[null,null,null,null,null,null,"If RECNUM does not increment by 1 from previous record, assign UPLSTS=1 stop processing and report back error code 011 (RECORD NUMBERS MUST INCREASE BY 1) - FILE LEVEL ERROR"]
[null,null,null,null,null,"All 7 digits must be populated, and each record should be incremented by 1. Two records cannot contain the same RECNUM value."]
[null,null,null,null,null,null,"If not numeric, then assign UPLSTS = 1 and stop processing and report back error code 010 (RECORD NUMBER MUST BE NUMERIC) - FILE LEVEL ERROR"]
["Carelon PARENT Code","A",4,"R","R","Carelon assigned 4 character code to identify the client. This field should always be CASB","If not populated, assign error code 007 (PARENT CODE MUST BE POPULATED) – FILE LEVEL ERROR"]
["Submitter ID","A",10,"R","R","Carelon assigned ID.\nDerived from Provider Connect account. Unique ID per LEA. Carelon will assist LEA in account creation. ","If not populated, assign error code 008 (SUBMITTER ID MUST BE POPULATED) – FILE LEVEL ERROR"]
["Registering Provider ID","A",15," R","R","Carelon assigned provider ID utilized to ensure the provider is in Carelons system. Derived from Provider Connect account. Unique ID per LEA. Carelon will assist LEA in account creation. ","Validate against PRVMAS incoming PROVNO = PRVMAS/PROVNO is not found assign error code 013 (ENROLLING PROVIDER ID IS MISSING OR NOT FOUND) "]
[]
[]
["Enrollment Indicator","A",1,"R","R","Valid Values:","If REGIND is invalid or not present on file, assign UPLSTS=1 and error code 014 (ENROLLMENT INDICATOR IS MISSING/INVALID)"]
[null,null,null,null,null,"I = Initial Enrollment: this option should be utilized when the member has not been previously enrolled in the Carelon system."]
[null,null,null,null,null,"R = Re-Enrollment: this option should be utilized when the member has been previously enrolled in the Carelon system and their coverage needs to be extended or terminated, update OHI information, etc."]
[null,null,null,null,null,"D = Demographic change: this option should be utilized when only a demographic change needs to be done."]
["Enrollment Start Date","N",8,"R","N","Required when 'Registration Indicator' is 'I' or 'R'","If REGIND = I or R and EFFDAT = blank, then assign UPLSTS=1 and error code 016 (ENROLLMENT START DATE IS MISSING)"]
[]
[null,null,null,null,null,"Do not populate when 'Registration Indicator' is 'D'","If REGIND = D and EFFDAT <> blank, then assign UPLSTS = 1 and error code 021 (ENROLLMENT START DATE MUST BE BLANK ON A DEMOGRAPHIC CHANGE)"]
[]
[null,null,null,null,null,"Must be valid numeric date in the format MMDDYYYY","If EFFDAT is not in the correct format assign UPLSTS=1 and error code 017 (ENROLLMENT START DATE MUST BE IN THE FORMAT MMDDYYYY)"]
[]
[null,null,null,null,null,"Can be backdated up to 365 days","Read forward to CWKMAS/SRCSYS=’ELG UPLOAD”, TBLNUM=’064’, PARENT= Incoming PARENT, SRCVAL and SRCVL2. If EFFDAT is more than X days prior to submission date, where X equal to CWKMAS/SRCVAL, assign UPLSTS=1 and error code 019 (ENROLLMENT START DATE EXCEEDS BACK DATING LIMIT. PLEASE USE MORE CURRENT DATE), or If EFFDAT is more than X days in the future to submission date, where X equal to CWKMAS/SRCVL2, assign UPLSTS=1 and error code 018 (ENROLLMENT START DATE EXCEEDS FUTURE DATE LIMIT. PLEASE USE MORE CURRENT DATE).  If SRCVAL = 99999, then do not apply a backdating limit.  If the EFFDAT < TRGTVL, then use the TRGTVL as EFFDAT.  If SRCVL2 = 99999, then there is no limit to the future dating."]
[]
[null,null,null,null,null,"Can be future effective dated up to 60 days.","If REGIND <> D and the member is over 26, then assign UPLSTS =1 and error code 023 (MEMBERS ARE NOT ELIGIBLE ONCE THEY TURN 26) **Note: The EFFDAT will be used when determining the members age. If the REGIND = D this edit will not be performed."]
[]
[null,null,null,null,null,"If 'Registration Indicator' is 'I' or 'R', cannot register members age 26 or over.  Only demographic updates are allowed on members age 26 or older."]
[]
[null,null,null,null,null,"Members are ineligible once they turn the age of 26 years old based on the Enrollment Start Date, only demographic changes (registration indicator of a 'D') are allowed"]
["Enrollment Termination Date","N",8,"O","N","Must be valid numeric date in the format MMDDYYYY","If populated and EXPDAT is not in the correct format assign UPLSTS=1 and error code 020 (ENROLLMENT TERMINATION DATE MUST BE IN THE FORMAT MMDDYYYY)"]
[]
[null,null,null,null,null,"If left blank, the members enrollment will systematically expire at the end of the current plan year (12/31/XX) based on the registration effective date which will result in coverage from 1 day to 365 days.  I.e.: Member enrollment date is 6/1/24, then 12/31/24 would systematically be assigned as the enrollment termination date.  An exception to this would be if the member is turning 26 prior to the end of the year.  In this instance the member will systematically be terminated the day prior to turning 26.","If REGIND = D and EXPDAT <> blank, then assign UPLSTS = 1 and error code 022 (ENROLLMENT TERMINATION DATE MUST BE BLANK ON A DEMOGRAPHIC CHANGE)"]
[]
[null,null,null,null,null,"Must be entered when the 'registration indicator' is an 'I' or 'R' and the member should be terminated prior to the calculated end date (end of year or 26th birthday).  **Note: if a previously enrolled member needs to be terminated prior to the previously assigned termination date, then this date must be entered with a registration indicator of an 'R' must be submitted.","If REGIND = I or R and EXPDAT <> Spaces and less than EFFDAT, then assign UPLSTS = 1 and error code 024 (ENROLLMENT TERMINATION DATE MUST BE GREATER THAN ENROLLMENT START DATE)"]
["Carelon Assigned Member ID ","A",15," C","R"]
[null,null,null,null,null,"Carelon Internally created 10 byte ID Number that will begin with a 'C'.  The assigned ID will be returned on the response file from the initial enrollment.","If registration indicator (REGIND) =R or D and this field is blank, assign UPLSTS=1 and error code 026 (MEMBERS ID NUMBER IS REQUIRED FOR RE-ENROLLMENT AND DEMOGRAPHIC CHANGES)"]
[]
[null,null,null,null,null,"Must be populated when enrollment indicator is 'R' or 'D'.","If MEMBNO contains special characters, then assign UPLSTS = 1 and error code 091 (MEMBER ID MUST NOT CONTAIN SPECIAL CHARACTERS)"]
[]
[null,null,null,null,null,"Must not contain special characters","If not 10 bytes, then assign UPLSTS = 1 and error code 093 (MEMBER ID MUST BE 10 BYTES)"]
["Student ID","A",15,"R","O","CALPADS Statewide Student Identifier (SSID)","If STUDID contains special characters, then assign UPLSTS = 1 and error code 101 (STUDENT ID MUST NOT CONTAIN SPECIAL CHARACTERS)"]
[]
[null,null,null,null,null,"Must not contain special characters"]
["Medicaid ID","A",15,"O","O","Must not contain special characters","If MCDIND contains special characters, then assign UPLSTS = 1 and error code 077 (MEDICAID ID MUST NOT CONTAIN SPECIAL CHARACTERS)"]
["Medicare ID","A",15,"O","O","Must not contain special characters","If MCRIND contains special characters, then assign UPLSTS = 1 and error code 079 (MEDICARE ID MUST NOT CONTAIN SPECIAL CHARACTERS)"]
["Social Security Number Unknown Indicator","A",1,"R","R","Required if Social Security Number is blank","If not valid value, assign UPLSTS=1 and error code 037 (SSN INDICATOR INVALID VALUE)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"U = Unknown: This option must be utilized when it's Unknown if the member has an SSN."]
[]
[null,null,null,null,null,"Y = No SSN: This option must be utilized when it's known that the member has no SSN."]
[]
[null,null,null,null,null,"Blank = SSN is known: This option must be utilized when the members SSN is known.  "]
["Social Security Number","N",9,"C","C","Must be valid and numeric. The following are considered invalid SSN numbers: 000000000, 111111111, 222222222, 333333333, 444444444, 555555555, 666666666, 777777777, 888888888, 999999999, 123456789, 987654321 or not numeric","If populated and equal to 000000000, 111111111, 222222222, 333333333, 444444444, 555555555, 666666666, 777777777, 888888888, 999999999, 123456789, 987654321 or numeric then assign UPLSTS = 1 and error code 035 (MEMBER SSN IS INVALID)"]
[]
[null,null,null,null,null,"Must not contain special characters","If MBRSSN = blank and SSNIND = blank, assign UPLSTS=1 and error code 034 (SSN OR SSN UNKNOWN INDICATOR MUST BE POPULATED)"]
[]
[null,null,null,null,null,"Required if 'Social Security Number Unknown Indicator' is blank","If MBRSSN <> blank and SSNIND <> blank, assign UPLSTS=1 and error code 036 (SSN OR SSN UNKNOWN INDICATOR BOTH POPULATED)"]
[]
[null,null,null,null,null,"Must be blank if 'Social Security Number Unknown Indicator' is populated with a 'Y' or 'U'","If MBRSSN <> 9 bytes, then assign UPLSTS = 1 and error code 113 (SOCIAL SECURITY NUMBER MUST BE 9 BYTES)"]
["Alien Registration ID","A",9,"O","O","Must not contain special characters","If AREGID contains special characters, then assign UPLSTS = 1 and error code 121 (ALIEN REGISTRATION ID MUST NOT CONTAIN SPECIAL CHARACTERS)"]
["VISA ID","A",8,"O","O","Must not contain special characters","If VISAID contains special characters, then assign UPLSTS = 1 and error code 122 (VISA ID MUST NOT CONTAIN SPECIAL CHARACTERS)"]
["Last Name","A",60," R","R","Student Last Name","If MBRLNM = blank, then assign UPLSTS=1 and error code 028 (LAST NAME IS MISSING)"]
["Birth Surname","A",60,"O","O"]
["First Name","A",35," R","R","Student First Name","If MBRFNM = blank, then assign UPLSTS=1 and error code 029 (FIRST NAME IS MISSING)"]
["Middle Initial","A",1,"O","O"]
["Name Suffix","A",3,"O","O"]
["Preferred First Name ","A",25,"O","O"]
["Pronouns","A",4,"O","O","Valid Values: ","If not valid value in RFCMAS, REFTYP = HEPP, REFVAL, assign UPLSTS=1 and error code 123 (MEMBER PRONOUNS IS INVALID)"]
[null,null,null,null,null,"HE - He/him/his"]
[null,null,null,null,null,"SHE - She/her/hers"]
[null,null,null,null,null,"THEY - They/them/theirs"]
[null,null,null,null,null,"DCAR - Declined to Answer"]
[null,null,null,null,null,"OTER - Other"]
["Pronouns Other","A",25,"C","C","Required if 'Pronouns' is 'OTER'","IF PROOTH <> blank and PRONOU <> OTER, assign UPLSTS = 1 and error code 124 (PRONOUNS OTHER POPULATED, PRONOUNS NOT EQUAL TO OTHER)"]
[]
[null,null,null,null,null,"Must not be populated if 'Pronouns' is not 'OTER'","IF PROOTH = blank and PRONOU = OTER, assign UPLSTS = 1 and error code 125 (PRONOUNS OTHER NOT POPULATED, PRONOUNS EQUAL TO OTHER)"]
["Birth Date","N",8," R","R","Must be valid numeric date in the format MMDDYYYY"]
[null,null,null,null,null,null,"If MBRDOB = blank or invalid, then assign UPLSTS=1 and error code 030 (DATE OF BIRTH IS MISSING OR INVALID)"]
[null,null,null,null,null,"Cannot be greater than enrollment start date"]
[null,null,null,null,null,null,"If MBRDOB is populated and not in the format MMDDYYYY assign error code 032 (DATE OF BIRTH MUST BE IN THE FORMAT MMDDYYYY)"]
[null,null,null,null,null,"Student cannot be older than 25"]
[null,null,null,null,null,null,"If MBRDOB is greater than the enrollment start date (EFFDAT) assign error code 031 (DATE OF BIRTH CANNOT BE GREATER THAN ENROLLMENT START DATE)"]
["Unknown Address","A",1,"C","C","Cannot be Y if 'Member is Homeless' is also 'Y'.","If UNKADR = Y and MBRAD1 or MBRAD2 <> blank, assign UPLSTS = 1 and error code 044 (UNKNOWN ADDRESS MARKED AS Y AND STREET ADDRESS FIELDS ARE POPULATED)"]
[]
[null,null,null,null,null,"Must be valid if populated","If UNKADR = Y and NOADR = Y, assign UPLSTS = 1 and error code 045 (UNKNOWN ADDRESS AND NO ADDRESS CANNOT BOTH BE SELECTED)"]
[]
[null,null,null,null,null,"Valid Values:","If not valid value, assign UPLSTS=1 and error code 046 (UNKNOWN ADDRESS INDICATOR IS INVALID)"]
[null,null,null,null,null,"Y – Yes"]
[null,null,null,null,null,"Blank = Member address is known, or Member is Homeless is 'Y'"]
["Member is Homeless","A",1,"C","C","Cannot be Y if 'Unknown Address' is also 'Y'.","If NOADRR = Y and MBRAD1 or MBRAD2 <> blank, assign UPLSTS = 1 and error code 047 (NO ADDRESS MARKED AS Y, AND STREET ADDRESS FIELDS ARE POPULATED)"]
[]
[null,null,null,null,null,"Must be valid if populated","If populated and not valid value assign UPLSTS=1 and error code 048 (NO ADDRESS INDICATOR IS INVALID)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"Y – Yes"]
[null,null,null,null,null,"Blank = Member address is known 'Unknown Address' is 'Y'."]
["Street Address Line 1","A",55," C","C","If both 'Unknown Address' and 'Member is Homeless' are blank, then this must be populated.","If UNKADR and NOADRR = blank and MBRAD1 = blank, then assign UPLSTS = 1 and error code 049 (MEMBER ADDRESS LINE 1 MISSING)"]
[]
[null,null,null,null,null,"If 'Unknown Address' or 'Member is Homeless' is Y, then this should be left blank."]
["Street Address Line 2","A",55,"O","O","If 'Unknown Address' or 'Member is Homeless' is Y, then this should be left blank.","IF MBRAD2 <> blanks and MBRAD1 = blanks, then assign UPLSTS = 1 and error code 126 (MEMBER ADDRESS LINE 1 MUST BE POPULATED IF ENTERING ADDRESS LINE 2)"]
[]
[null,null,null,null,null,"Must populated Address Line 1 is populating Address Line 2"]
["City","A",30,"C","C","Must be a valid City","If UNKADR and NOADRR = blank and MBRCTY = blank, then assign UPLSTS = 1 and error code 050 (MEMBER CITY IS MISSING)"]
[]
[null,null,null,null,null,"If both 'Unknown Address' and 'Member is Homeless' are blank, then this must be populated.","If MBRCTY <> blank, then compare MBRCTY1:28 to ZIPMAS/CITYCD and if not found, then assign UPLSTS = 1 and error code 127 (MEMBER CITY IS INVALID)"]
[]
[null,null,null,null,null,"If either 'Unknown Address' or 'Member is Homeless' then this can be left blank if not known"]
["State","A",2,"C","C","Must be a valid State","If UNKADR and NOADRR = blank and MBRSTA = blank, then assign UPLSTS = 1 and error code 051 (MEMBER STATE IS MISSING)"]
[]
[null,null,null,null,null,"If both 'Unknown Address' and 'Member is Homeless' are blank, then this must be populated.","If populated and not valid in ZIPMAS/STACOD, assign UPLSTS = 1 and error code 128 (MEMBER STATE IS INVALID)"]
[]
[null,null,null,null,null,"If either 'Unknown Address' or 'Member is Homeless' then this can be left blank if not known"]
["Zip Code","A",5," C"," C","Must be a valid Zip Code","If UNKADR and NOADRR = blank, and MBRZIP = blank, then assign UPLSTS = 1 and error code 053 (MEMBER ZIP CODE IS MISSING) "]
[]
[null,null,null,null,null,"If both 'Unknown Address' and 'Member is Homeless' are blank, then this must be populated.","If MBRZIP <> blank, and not valid in ZIPMAS/ZIPCOD, then assign UPLSTS = 1 and error code 129 (MEMBER ZIP CODE IS INVALID)"]
[]
[null,null,null,null,null,"If either 'Unknown Address' or 'Member is Homeless' then this can be left blank if not known","If MBRZIP <> blank and valid, then compare MBRCTY1:28, MBRSTA, and MBRZIP to ZIPMAS, and if not a valid combination, assign UPLSTS = 1, and error code 052 (MEMBER CITY, STATE, AND ZIP CODE IS NOT A VALID USPS COMBINATION)."]
[]
[null,null,null,null,null,"Must be a valid combination of City, State, and ZIP when all 3 are populated"]
["Zip Code Extension","A",4,"O","O","Must be numeric","If populated and not numeric or invalid, assign UPLSTS = 1 and error code 130 (MEMBERS ZIP CODE EXTENSION IS NOT NUMERIC)."]
[]
[null,null,null,null,null,"Must be 4 bytes","If ZIPEXT <> blanks and <> 4 bytes, assign UPLSTS = 1 and error code 131 (MEMBERS ZIP CODE EXTENSION MUST BE 4 BYTES WHEN POPULATED)"]
["Member's County","A",3,"C","C","Must be a valid value when populated","If MBRCNT <> blanks and not valid in RFCMAS.REFTYP = CNTY with PARENT = CASB, then assign UPLSTS = 1 and error code 054 (MEMBER COUNTY IS INVALID)"]
[]
[null,null,null,null,null,"If both 'Unknown Address' and 'Member is Homeless' are blank, then this must be populated.","If UNKADR and NOADRR = blank, and MBRCNT = blank, then assign UPLSTS = 1 and error code 063 (MEMBER COUNTY IS MISSING) "]
[]
[null,null,null,null,null,"If either 'Unknown Address' or 'Member is Homeless' then this can be left blank if not known"," "]
[]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"County Code      County"]
[null,null,null,null,null,"1              Alameda "]
[null,null,null,null,null,"7              Butte "]
[null,null,null,null,null,"13              Contra Costa "]
[null,null,null,null,null,"17              El Dorado "]
[null,null,null,null,null,"19              Fresno "]
[null,null,null,null,null,"23              Humboldt "]
[null,null,null,null,null,"25              Imperial "]
[null,null,null,null,null,"37              Los Angeles "]
[null,null,null,null,null,"39              Madera "]
[null,null,null,null,null,"57              Nevada "]
[null,null,null,null,null,"59              Orange "]
[null,null,null,null,null,"61              Placer "]
[null,null,null,null,null,"65              Riverside "]
[null,null,null,null,null,"67              Sacramento "]
[null,null,null,null,null,"71              San Bernardino "]
[null,null,null,null,null,"73              San Diego "]
[null,null,null,null,null,"77              San Joaquin "]
[null,null,null,null,null,"79              San Luis Obispo "]
[null,null,null,null,null,"85              Santa Clara "]
[null,null,null,null,null,"83              Santa Barbara "]
[null,null,null,null,null,"87              Santa Cruz "]
["Individual Email Address","A",100,"O","O","Must be a valid format.  Valid format = address@ISP.nnn” (where the “address” can be any combination of letters and characters, the @ must be present and the value must contain a valid email extension (e.g., .net, .com, .org)","If MEMEML <> blanks and not in valid format, then assign error UPLSTS = 1 and error code 062 (MEMBERS EMAIL MUST BE IN A VALID FORMAT)"]
["No Phone","A",1,"C","C","Valid Values:","If populated and not valid value, assign UPLSTS=1 and error code 059 (NO PHONE INVALID VALUE)"]
[null,null,null,null,null,"Y – Yes: This option should be utilized if the member does not have a home phone or cellphone."]
[null,null,null,null,null,"Blank: This option should be utilized if the member has a home phone and/or cellphone.","If NOPHONE = spaces and MBRPH1 and SECPH1 = spaces, then assign UPLSTS = 1 and error code 058 (EITHER HOME PHONE, CELL PHONE OR NO PHONE MUST BE POPULATED)"]
[]
[null,null,null,null,null,null,"If NOPHON = Y and MBRPH1, 2, 3 or SECPH1, 2, 3 is not blank assign UPLSTS=1 and error code 060 (NO PHONE MARKED AS YES, PHONE NUMBER IS POPULATED)"]
["Home Phone Area Code","N",3,"C","C","Must be 3 bytes and numeric when populated","If not numeric, then assign UPLSTS = 1 and error code 055 (MEMBERS HOME PHONE NUMBER MUST BE NUMERIC)"]
[]
[null,null,null,null,null,"If 'No Phone' is populated with a 'Y', then leave blank.","If MBRPH1 is populated and MBRPH2 or MBRPH3 is blank, or if MBRPH1 <> 3 bytes, assign UPLSTS=1 and error code 056 ( MEMBERS HOME PHONE IS INCOMPLETE)"]
[]
[null,null,null,null,null,"Must have all 3 home phone elements populated"]
["Home Phone Exchange Number","N",3,"C","C","Must be 3 bytes and numeric when populated","If not numeric, then assign UPLSTS = 1 and error code 055 ( MEMBERS HOME PHONE NUMBER MUST BE NUMERIC)"]
[]
[null,null,null,null,null,"If 'No Phone' is populated with a 'Y', then leave blank.","If MBRPH2 is populated and MBRPH1 or MBRPH3 is blank, or if MBRPH2 <> 3 bytes, assign UPLSTS=1 and error code 056 ( MEMBERS HOME PHONE IS INCOMPLETE)"]
[]
[null,null,null,null,null,"Must have all 3 home phone elements populated"]
["Home Phone Suffix","N",4,"C","C","Must be 4 bytes and numeric when populated","If not numeric, then assign UPLSTS = 1 and error code 055 ( MEMBERS HOME PHONE NUMBER MUST BE NUMERIC)"]
[]
[null,null,null,null,null,"If 'No Phone' is populated with a 'Y', then leave blank.","If MBRPH3 is populated and MBRPH1 or MBRPH2 is blank or MBRPH3 <> 4 bytes, assign UPLSTS=1 and error code 056 ( MEMBERS HOME PHONE IS INCOMPLETE)"]
[]
[null,null,null,null,null,"Must have all 3 home phone elements populated"]
["Cell Phone Area Code","N",3,"C","C","Must be 3 bytes and numeric when populated","If not numeric, then assign UPLSTS = 1 and error code 057 ( MEMBERS CELLULAR PHONE NUMBER MUST BE NUMERIC)"]
[]
[null,null,null,null,null,"If 'No Phone' is populated with a 'Y', then leave blank","If SECPH1 is populated and SECPH2 or SECPH3 is blank, or if SECPH1 <> 3 bytes, assign UPLSTS=1 and error code 061 ( MEMBERS CELLULAR PHONE NUMBER IS INCOMPLETE) "]
[]
[null,null,null,null,null,"Must have all 3 cell phone elements populated"]
["Cell Phone Exchange Number","N",3,"C","C","Must be 3 bytes and numeric when populated","If not numeric, then assign UPLSTS = 1 and error code 057 ( MEMBERS CELLULAR PHONE NUMBER MUST BE NUMERIC)"]
[]
[null,null,null,null,null,"If 'No Phone' is populated with a 'Y', then leave blank.","If SECPH2 is populated and SECPH1 or SECPH3 is blank or SECPH2 <> 3 bytes, assign UPLSTS=1 and error code 061 ( MEMBERS CELLULAR PHONE NUMBER IS INCOMPLETE)"]
[]
[null,null,null,null,null,"Must have all 3 cell phone elements populated"]
["Cell Phone Suffix","N",4,"C","C","Must be 4 bytes and numeric when populated","If not numeric, then assign UPLSTS = 1 and error code 057 ( MEMBERS CELLULAR PHONE NUMBER MUST BE NUMERIC)"]
[]
[null,null,null,null,null,"If 'No Phone' is populated with a 'Y', then leave blank","If SECPH3 is populated and SECPH1 or SECPH2 is blank or SECPH3 <> 4 bytes, assign UPLSTS=1 and error code 061 ( MEMBERS CELLULAR PHONE NUMBER IS INCOMPLETE)"]
[]
[null,null,null,null,null,"Must have all 3 cell phone elements populated"]
["Verbal Preference ","A",1,"R","R",null,"If not populated or not valid in RFCMAS.REFTYP = VP, assign UPLSTS=1 and error code 132 (MEMBERS VERBAL PREFERENCE MISSING OR INVALID)"]
[null,null,null,null,null,"Must be a valid value when populated"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"E - Electronic"]
[null,null,null,null,null,"V - Verbal"]
[null,null,null,null,null,"T - Text "]
["Interpreter Services Needed ","A",1,"R","R","The type of interpreter services required by the member.","If ISNIND = blanks or not valid in RFCMAS.REFTYP = INTS, assign UPLSTS=1 and error code 133 (MEMBER INTERPRETER SERVICES IS BLANK OR INVALID)"]
[]
[null,null,null,null,null,"Must be a valid value when populated."]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"0 - Services Not Needed"]
[null,null,null,null,null,"1 - American Sign Language"]
[null,null,null,null,null,"2 - Foreign Language"]
[null,null,null,null,null,"9 - Unknown "]
["Speaking Language ","A",4,"O","O","Must be a valid value when populated.","If populated and invalid per RFCMAS.REFTYP = HESL, then assign error UPLSTS = 1 and error code 134 (SPEAKING LANGUAGE SPECIFICATION INVALID)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"ARBC - Arabic                "]
[null,null,null,null,null,"ARMN - Armenian              "]
[null,null,null,null,null,"ASLG - American Sign Language"]
[null,null,null,null,null,"BNGL - Bengali               "]
[null,null,null,null,null,"BSLG -  British Sign Language"]
[null,null,null,null,null,"CHNE - Chinese (Mandarin)    "]
[null,null,null,null,null,"CTNS - Cantonese             "]
[null,null,null,null,null,"DCAR - Declined to Answer    "]
[null,null,null,null,null,"ENGL - English               "]
[null,null,null,null,null,"FRCH - French                "]
[null,null,null,null,null,"FRSI - Farsi                 "]
[null,null,null,null,null,"GREK - Greek                 "]
[null,null,null,null,null,"GRMN - German                "]
[null,null,null,null,null,"HNCE - Creole                "]
[null,null,null,null,null,"ITLN - Italian               "]
[null,null,null,null,null,"JPNS - Japanese    "]
[null,null,null,null,null,"KRAN - Korean     "]
[null,null,null,null,null,"OTER - Other      "]
[null,null,null,null,null,"PTGS - Portuguese"]
[null,null,null,null,null,"RMNA - Romanian   "]
[null,null,null,null,null,"RSAN - Russian    "]
[null,null,null,null,null,"SPNH - Spanish    "]
[null,null,null,null,null,"SWAH - Swahili    "]
[null,null,null,null,null,"TGLG - Tagalog    "]
[null,null,null,null,null,"THAI - Thai       "]
[null,null,null,null,null,"UKR - Ukrainian  "]
[null,null,null,null,null,"VTNS - Vietnamese           "]
["Speaking Language Other","A",25,"C","C","Required if 'Speaking Language' is 'OTER'","If populated and LNGCOD <> OTER, assign UPLSTS = 1 and error code 135 (SPEAKING LANGUAGE OTHER POPULATED, SPEAKING LANGUAGE NOT EQUAL TO OTHER)"]
[]
[null,null,null,null,null,"Must not be populated if 'Speaking Language' is not 'OTER'","If not populated and LNGCOD = OTER, assign UPLSTS = 1 and error code 136 (SPEAKING LANGUAGE OTHER NOT POPULATED, SPEAKING LANGUAGE EQUAL TO OTHER)"]
["Written Language ","A",4,"O","O","Must be a valid value when populated.","If populated and invalid per RFCMAS.REFTYP = HEWL, then assign error UPLSTS = 1 and error code 137 (WRITTEN LANGUAGE SPECIFICATION INVALID)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"ARBC - Arabic            "]
[null,null,null,null,null,"ARMN - Armenian          "]
[null,null,null,null,null,"BNGL - Bengali           "]
[null,null,null,null,null,"BRAL - Braille           "]
[null,null,null,null,null,"CHNE - Chinese (Mandarin)"]
[null,null,null,null,null,"CTNS - Cantonese         "]
[null,null,null,null,null,"DCAR - Declined to Answer"]
[null,null,null,null,null,"ENGL -  English           "]
[null,null,null,null,null,"FRCH - French            "]
[null,null,null,null,null,"FRSI - Farsi             "]
[null,null,null,null,null,"GREK - Greek             "]
[null,null,null,null,null,"GRMN - German            "]
[null,null,null,null,null,"HNCE - Creole            "]
[null,null,null,null,null,"ITLN - Italian           "]
[null,null,null,null,null,"JPNS - Japanese          "]
[null,null,null,null,null,"KRAN - Korean            "]
[null,null,null,null,null,"LFOA - Large font or alt format"]
[null,null,null,null,null,"OTER - Other                   "]
[null,null,null,null,null,"PTGS - Portuguese              "]
[null,null,null,null,null,"RMNA - Romanian                "]
[null,null,null,null,null,"RSAN - Russian                 "]
[null,null,null,null,null,"SPNH - Spanish                 "]
[null,null,null,null,null,"SWAH - Swahili                 "]
[null,null,null,null,null,"TGLG - Tagalog                 "]
[null,null,null,null,null,"THAI - Thai                    "]
[null,null,null,null,null,"UKR - Ukrainian               "]
[null,null,null,null,null,"VTNS - Vietnamese               "]
["Written Language Other","A",25,"C","C","Required if 'Written Language' is 'OTER'","If populated and LNGWRI <> OTER, assign UPLSTS = 1 and error code 138 (WRITTEN LANGUAGE OTHER POPULATED, WRITTEN LANGUAGE NOT EQUAL TO OTHER)"]
[]
[null,null,null,null,null,"Must not be populated if 'Written Language' is not 'OTER'","If not populated and LNGWRI = OTER, assign UPLSTS = 1 and error code 139 (WRITTEN LANGUAGE OTHER NOT POPULATED, WRITTEN LANGUAGE EQUAL TO OTHER)"]
["Gender At Birth","A",1,"R","R","Must be a valid value","If not populated, assign UPLSTS=1 and the error code 038 (MEMBER GENDER IS MISSING)"]
[]
[null,null,null,null,null,"Valid Values:","If populated and <> to M, F, or U, assign UPLSTS=1 and the error code 140 (MEMBER GENDER IS INVALID)"]
[null,null,null,null,null,"M - Male"]
[null,null,null,null,null,"F - Female"]
[null,null,null,null,null,"U - Unknown"]
["Gender Identity","A",4,"O","O","Must be a valid value when populated.","If GNDIDY <> blanks and not valid in RFCMAS.REFTYP = HEGI, assign UPLSTS=1 and error code 141 (MEMBER GENDER IDENTITY IS INVALID)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"MALE - Male"]
[null,null,null,null,null,"FMLE - Female"]
[null,null,null,null,null,"TGMN - Transgender Male/Transgender Man"]
[null,null,null,null,null,"TGWN - Transgender Female/Transgender Woman"]
[null,null,null,null,null,"GDQR - GenderQueer (neither exclusively male nor female)"]
[null,null,null,null,null,"NBNY - Non-Binary"]
[null,null,null,null,null,"UKWN - Unknown"]
[null,null,null,null,null,"DCAR - Declined to Answer"]
[null,null,null,null,null,"OTER - Other"]
["Gender Identity Other","A",25,"C","C","Populate only if' 'Gender Identity' is 'Other'","If GNDOTH <> blank and GNDIDY <> OTER, assign UPLSTS = 1 and error code 142 (GENDER IDENTITY OTHER POPULATED, GENDER IDENTITY NOT EQUAL TO OTHER)"]
[]
[null,null,null,null,null,null,"If GNDOTH = blank and GNDIDY = OTER, assign UPLSTS = 1 and error code 143 (GENDER IDENTITY OTHER NOT POPULATED, GENDER IDENTITY EQUAL TO OTHER)"]
["Race Code 1","A",4,"O","O","Must be a valid value when populated","If RACCD1 <> blanks and not valid per RFCMAS.REFTYP= ‘HEPR', value assign UPLSTS=1 and error code 040 (RACE CODE 1 IS INVALID)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"WHTE - Caucasian/White"]
[null,null,null,null,null,"ACAN - Black/African American"]
[null,null,null,null,null,"ANAN - Asian/Asian-American"]
[null,null,null,null,null,"ANIN - American Indian or Alaska Native"]
[null,null,null,null,null,"LTNO - Latino(a)"]
[null,null,null,null,null,"NTHN - Native Hawaiian or Other Pacific Islander"]
[null,null,null,null,null,"BMRL - Bi or Multi-racial"]
[null,null,null,null,null,"OTER - Other"]
[null,null,null,null,null,"DCAR - Declined to Answer"]
["Race Code 2","A",4,"O","O","Must be a valid value when populated","If RACCD2 <> blanks and not valid per RFCMAS.REFTYP= ‘HEPR', value assign UPLSTS=1 and error code 146 (RACE CODE 2 IS INVALID)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"WHTE - Caucasian/White"]
[null,null,null,null,null,"ACAN - Black/African American"]
[null,null,null,null,null,"ANAN - Asian/Asian-American"]
[null,null,null,null,null,"ANIN - American Indian or Alaska Native"]
[null,null,null,null,null,"LTNO - Latino(a)"]
[null,null,null,null,null,"NTHN - Native Hawaiian or Other Pacific Islander"]
[null,null,null,null,null,"BMRL - Bi or Multi-racial"]
[null,null,null,null,null,"OTER - Other"]
[null,null,null,null,null,"DCAR - Declined to Answer"]
["Race Code 3","A",4,"O","O",null,"If RACCD3 <> blanks and not valid per RFCMAS.REFTYP= ‘HEPR', value assign UPLSTS=1 and error code 149 (RACE CODE 3 IS INVALID)"]
[null,null,null,null,null,"Must be a valid value when populated"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"WHTE - Caucasian/White"]
[null,null,null,null,null,"ACAN - Black/African American"]
[null,null,null,null,null,"ANAN - Asian/Asian-American"]
[null,null,null,null,null,"ANIN - American Indian or Alaska Native"]
[null,null,null,null,null,"LTNO - Latino(a)"]
[null,null,null,null,null,"NTHN - Native Hawaiian or Other Pacific Islander"]
[null,null,null,null,null,"BMRL - Bi or Multi-racial"]
[null,null,null,null,null,"OTER - Other"]
[null,null,null,null,null,"DCAR - Declined to Answer"]
["Race Code Other","A",25,"C","C","Populate only if' 'Race Code 1,2 or 3' is 'Oter'","If RACOTH <> blank and RACCD1 , RACCD2 or RACCD3 <> OTER, assign UPLSTS=1 and error code 150 (RACE CODE  OTHER IS POPULATED, RACE CODE NOT EQUAL TO OTHER)"]
[]
[null,null,null,null,null,null,"If RACOTH = blank and RACCD1, RACCD2 or RACCD3 = OTER, assign UPLSTS=1 and error code 151 (RACE CODE  OTHER NOT POPULATED, RACE CODE IS EQUAL TO OTHER)"]
["Hispanic\\Latino Origin","A",4,"O","O","Must be a valid value when populated","If populated and not valid per RFCMAS.REFTYP= ‘HEPE', value assign UPLSTS=1 and error code 041 (ETHNICITY IS INVALID)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"DCAR - Declined to Answer"]
[null,null,null,null,null,"HSPC - Hispanic          "]
[null,null,null,null,null,"NHSP - Non-Hispanic      "]
["Marital Status","A",1,"O","O","Valid Values: ","If populated and not valid per RFCMAS.REFTYP= 'MS'', value assign UPLSTS=1 and error code 042 (MARITAL STATUS IS INVALID)"]
[null,null,null,null,null,"D - Divorced       "]
[null,null,null,null,null,"M - Married         "]
[null,null,null,null,null,"N - Data not provided"]
[null,null,null,null,null,"W - Widowed"]
[null,null,null,null,null,"1 - Never Married    "]
[null,null,null,null,null,"4 - Cohabitating     "]
[null,null,null,null,null,"5 - Separated                                                                             "]
["Sexual Orientation Status","A",4,"O","O","Must be a valid value when populated","If SEXORI <> blank and not valid per RFCMAS.REFTYP= ‘HESS, assign UPLSTS=1 and error code 152 (SEXUAL ORIENTATION IS INVALID)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"LGHS - Lesbian or gay or homosexual"]
[null,null,null,null,null,"STHS - Straight or heterosexual"]
[null,null,null,null,null,"BSEX - Bisexual"]
[null,null,null,null,null,"SMEL - Something else, please describe"]
[null,null,null,null,null,"DNKW - Don’t know"]
[null,null,null,null,null,"DNTD - Choose not to disclose"]
["Sexual Orientation Status \"Something else, please describe\"","A",25,"C","C","Populate only if' Sexual Orientation Status' is 'SMEL'","If SEXOTH <> blank and SEXORI <> SMEL, assign UPLSTS = 1 and error code 153 (SEXUAL ORIENTATION OTHER POPULATED, SEXUAL ORIENTATION NOT EQUAL TO OTHER)"]
[]
[null,null,null,null,null,null,"If SEXOTH = blank and SEXORI = SMEL, assign UPLSTS = 1 and error code 154 (SEXUAL ORIENTATION OTHER NOT POPULATED, SEXUAL ORIENTATION EQUAL TO OTHER)"]
["Housing Status",null,4,"O","O","Must be a valid value when populated","If HOUSTA <> blanks and not valid per RFCMAS.REFTYP = HEHS, assign UPLSTS=1 and error code 155 (HOUSING STATUS IS BLANK OR INVALID)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"HMLS - Homeless"]
[null,null,null,null,null,"IMRH - Imminent Risk of Losing Housing"]
[null,null,null,null,null,"DVSH - DV Shelter"]
[null,null,null,null,null,"HLSH - Homeless Shelter"]
[null,null,null,null,null,"SBHS - Stable Housing"]
[null,null,null,null,null,"ASLV - Assisted Living"]
[null,null,null,null,null,"ARHL - At risk of Homelessness"]
[null,null,null,null,null,"CDNK - Unknown"]
[null,null,null,null,null,"CLRF - Refused to answer"]
[null,null,null,null,null,"FSCR - Foster Care"]
["Disability Status 1",null,4,"O","O","Must be a valid value when populated","If DSBST1 <> blanks and not valid per RFCMAS.REFTYP = HEDS, assign UPLSTS=1 and error code 156 (DISABILITY STATUS 1 IS INVALID)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"VSIP - Vision Impairment"]
[null,null,null,null,null,"DHHR - Deaf or Hard of Hearing"]
[null,null,null,null,null,"MHCD - Mental Health Conditions"]
[null,null,null,null,null,"ITLD - Intellectual Disability"]
[null,null,null,null,null,"ADBI - Acquired Brain Injury"]
[null,null,null,null,null,"AMST - Autism Spectrum Disorder"]
[null,null,null,null,null,"Physical Disability"]
[null,null,null,null,null,"ASAD - Assistance with ADLs required"]
[null,null,null,null,null,"INCO - Inability to communicate independently"]
[null,null,null,null,null,"OTER - Other"]
[null,null,null,null,null,"DCAR - Declined to Answer"]
["Disability Status 2",null,4,"O","O","Must be a valid value when populated","If DSBST2 <> blanks and not valid per RFCMAS.REFTYP = HEDS, assign UPLSTS=1 and error code 159 (DISABILITY STATUS 2 IS INVALID)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"VSIP - Vision Impairment"]
[null,null,null,null,null,"DHHR - Deaf or Hard of Hearing"]
[null,null,null,null,null,"MHCD - Mental Health Conditions"]
[null,null,null,null,null,"ITLD - Intellectual Disability"]
[null,null,null,null,null,"ADBI - Acquired Brain Injury"]
[null,null,null,null,null,"AMST - Autism Spectrum Disorder"]
[null,null,null,null,null,"Physical Disability"]
[null,null,null,null,null,"ASAD - Assistance with ADLs required"]
[null,null,null,null,null,"INCO - Inability to communicate independently"]
[null,null,null,null,null,"OTER - Other"]
[null,null,null,null,null,"DCAR - Declined to Answer"]
["Disability Status 3",null,4,"O","O","Must be a valid value when populated","If DSBST3 <> blanks and not valid per RFCMAS.REFTYP = HEDS, assign UPLSTS=1 and error code 162 (DISABILITY STATUS 3 IS INVALID)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"VSIP - Vision Impairment"]
[null,null,null,null,null,"DHHR - Deaf or Hard of Hearing"]
[null,null,null,null,null,"MHCD - Mental Health Conditions"]
[null,null,null,null,null,"ITLD - Intellectual Disability"]
[null,null,null,null,null,"ADBI - Acquired Brain Injury"]
[null,null,null,null,null,"AMST - Autism Spectrum Disorder"]
[null,null,null,null,null,"Physical Disability"]
[null,null,null,null,null,"ASAD - Assistance with ADLs required"]
[null,null,null,null,null,"INCO - Inability to communicate independently"]
[null,null,null,null,null,"OTER - Other"]
[null,null,null,null,null,"DCAR - Declined to Answer"]
["Disability Status Other ",null,25,"C","C","Populate only if' Disability Status 1,2 or 3' is 'Other'","If DSBOTH <> blank and DSBST1, DSBST2 or DSBST3 <> Oter, assign UPLSTS = 1 and error code 163 (DISABILITY STATUS OTHER POPULATED, DISABILITY STATUS NOT EQUAL TO OTHER)"]
[]
[null,null,null,null,null,null,"If DSBOTH = blank and DSBST1, DSBST2 or DSBST3 = Oter, assign UPLSTS = 1 and error code 164 (DISABILITY STATUS  OTHER NOT POPULATED, DISABILITY STATUS EQUAL TO OTHER)"]
["Filler Field 1","A",1,"N","N"]
[]
[]
[]
[]
[]
[]
[]
["Filler Field 2","A",1,"N","N"]
[]
[]
[]
[]
[]
[]
[]
["Filler Field 3","A",1,"N","N"]
[]
[]
[]
[]
[]
[]
[]
["Filler Field 4","A",1,"N","N"]
[]
[]
[]
[]
[]
[]
[]
["Insurance Carrier Code 1","A",3,"R","N","When registration indicator is I (Initial Registration) or R (Re-registration), must contain members primary insurance Information","If REGIND = I or R and not populated, then assign UPLSTS = 1 and error code 170 (INSURANCE CARRIER CODE 1 NOT POPULATED)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 408 (INSURANCE CARRIER CODE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,null," "]
[null,null,null,null,null,"Must be a valid 3-digit code"]
[]
[null,null,null,null,null,"Valid Values:","If REGIND = I or R and not valid per RFCMAS.REFTYP = INSR with PARENT = CASB, then assign error code 329 (INSURANCE CARRIER CODE 1 INVALID)"]
[null,null,null,null,null,"AU2  Aetna"]
[null,null,null,null,null,"AU5  Americas Health Plan","If REGIND = I or R and INSCOD2, INSCOD3, INSCOD4, or INSCOD5 <> spaces and INSCOD1 = spaces, assign UPLSTS = 1 and error code 328 (INSURANCE 1 FIELDS MUST BE POPULATED BEFORE INSURANCE 2 - 5)"]
[null,null,null,null,null,"AL0  Anthem Blue Cross"]
[null,null,null,null,null,"AU4  Alameda Alliance for Health"]
[null,null,null,null,null,"BSC  Blue Shield of California Promise Health plan"]
[null,null,null,null,null,"CU2  CalOptima"]
[null,null,null,null,null,"CU3  CalViva Health"]
[null,null,null,null,null,"C73  CenCal Health"]
[null,null,null,null,null,"CU4  Central CA Alliance for Health"]
[null,null,null,null,null,"CU6  Cigna HealthCare"]
[null,null,null,null,null,"CU7  Community Care Health Plan"]
[null,null,null,null,null,"CU8  Community Health Group"]
[null,null,null,null,null,"PIV  Community Health Plan of Imperial Valley"]
[null,null,null,null,null,"CN6  Contra Costa Health Plan"]
[null,null,null,null,null,"EVN  Evernorth Behavioral Health of California"]
[null,null,null,null,null,"GCH  Gold Coast Health Plan"]
[null,null,null,null,null,"HU0  Health Plan of San Joaquin"]
[null,null,null,null,null,"HSN  Health Plan of San Mateo"]
[null,null,null,null,null,"HU1  Health Net"]
[null,null,null,null,null,"HU2  Heritage Provider Network"]
[null,null,null,null,null,"IEH  Inland Empire Health Plan"]
[null,null,null,null,null,"KAS  Kaiser Permanente - South"]
[null,null,null,null,null,"KPN  Kaiser Permanente - North"]
[null,null,null,null,null,"KRN  Kern Health Systems"]
[null,null,null,null,null,"LA2  LA Care Health Plan"]
[null,null,null,null,null,"CAF  Medi-Cal Fee for Service"]
[null,null,null,null,null,"MU4  MemorialCare Select Health Plan"]
[null,null,null,null,null,"MU5  Molina HealthCare"]
[null,null,null,null,null,"NPN  Nippon"]
[null,null,null,null,null,"OPM  US Behavioral Health Plan/Optum"]
[null,null,null,null,null,"PH9  Partnership Healthplan of CA"]
[null,null,null,null,null,"SH7  San Francisco Health Plan"]
[null,null,null,null,null,"SU3  Santa Clara Family Health Plan"]
[null,null,null,null,null,"SU4  Scripps Health Plan Services"]
[null,null,null,null,null,"SU5  Sharp Health Plan"]
[null,null,null,null,null,"SU2  Sutter Health Plan"]
[null,null,null,null,null,"UH0  UnitedHealthcare (UHC)"]
[null,null,null,null,null,"WED  Western Health Advantage"]
[null,null,null,null,null,"AX1  Aspire Health Plan"]
[null,null,null,null,null,"C75  Chinese Community Health Plan (CCHP)"]
[null,null,null,null,null,"VHP  Valley Health Plan"]
[null,null,null,null,null,"VCP  Ventura County Health Plan"]
[]
["Filler Field 5","A",50,"N","N"]
[]
[]
["Insurance Policy Member ID 1","A",30,"R","N","When registration indicator is I (Initial Registration) or R (Re-registration), must contain members primary insurance Information","If  REGIND = I or R and not populated, then assign UPLSTS = 1 and error code 171 (INSURANCE POLICY MEMBER NUMBER 1 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 409 (INSURANCE POLICY MEMBER NUMBER MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
["Insurance Subscriber First Name 1",null,35,"R","N","When registration indicator is I (Initial Registration) or R (Re-registration), must contain members primary insurance Information","If  REGIND = I or R and not populated, then assign UPLSTS = 1 and error code 172 (INSURANCE SUBSCRIBER FIRST NAME 1 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 410 (INSURANCE SUBSCRIBER FIRST NAME MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
["Insurance Subscriber Last Name 1",null,60,"R","N","When registration indicator is I (Initial Registration) or R (Re-registration), must contain members primary insurance Information","If  REGIND = I or R and not populated, then assign UPLSTS = 1 and error code 173 (INSURANCE SUBSCRIBER LAST NAME 1 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 411 (INSURANCE SUBSCRIBER LAST NAME MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
["Insurance Primacy Indicator 1","A",1,"R","N","When registration indicator is I (Initial Registration) or R (Re-registration), must contain members primary insurance Information","If  REGIND = I or R and not populated, then assign UPLSTS = 1 and error code 174 (INSURANCE PRIMACY INDICATOR 1 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 412 (INSURANCE PRIMACY INDICATOR MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[null,null,null,null,null,null,"If OHIIND = Y, INSSEQ1 <> blanks and not equal to P, then assign UPLSTS = 1 and error code 330 (INSURANCE PRIMACY INDICATOR 1 MUST BE PRIMARY)"]
[]
[null,null,null,null,null,"Must be a valid value"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"P - Primary"]
[]
[]
["Insurance Group Number 1","A",30,"R","N","When registration indicator is I (Initial Registration) or R (Re-registration), must contain members primary insurance Information","If  REGIND = I or R and not populated, then assign UPLSTS = 1 and error code 175 (INSURANCE GROUP NUMBER 1 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)\n","If REGIND = D and populated, then assign UPLSTS = 1 and error code 413 (INSURANCE GROUP NUMBER MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"If no group number is known, please type UNKNOWN in this field"]
["Insurance Address Line 1 1","A",55,"R","N","When registration indicator is I (Initial Registration) or R (Re-registration), must contain members primary insurance Information","If  REGIND = I or R and not populated, then assign UPLSTS = 1 and error code 176 (INSURANCE ADDRESS LINE 1 1 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 414 (INSURANCE ADDRESS LINE 1 MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
["Insurance Address Line 2 1","A",55,"O","N",null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 415 (INSURANCE ADDRESS LINE 2 MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[]
["Insurance City 1","A",30,"R","N","When registration indicator is I (Initial Registration) or R (Re-registration), must contain members primary insurance Information","If  REGIND = I or R and not populated, then assign UPLSTS = 1 and error code 177 (INSURANCE CITY 1 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 416 (INSURANCE CITY MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
["Insurance State 1","A",2,"R","N","When registration indicator is I (Initial Registration) or R (Re-registration), must contain members primary insurance Information","If  REGIND = I or R and not populated, then assign UPLSTS = 1 and error code 178 (INSURANCE STATE 1 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 417 (INSURANCE STATE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
["Insurance Zip 1","A",10,"R","N","When registration indicator is I (Initial Registration) or R (Re-registration), must contain members primary insurance Information","If  REGIND = I or R and not populated, then assign UPLSTS = 1 and error code 179 (INSURANCE ZIP 1 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 418 (INSURANCE ZIP MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
["Insurance Phone 1","A",10,"R","N","When registration indicator is I (Initial Registration) or R (Re-registration), must contain members primary insurance Information","If  REGIND = I or R and not populated, then assign UPLSTS = 1 and error code 180 (INSURANCE PHONE 1 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 419 (INSURANCE PHONE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[]
[null,null,null,null,null,"Must be a valid and numeric"]
["Insurance Effective Date 1","N",8,"O","N","Populate if insurance effective date is known, if not populated, then the enrollment effective date will be utilized as the Insurance Effective Date.","If REGIND = I OR R and INSEFF1 not in MMDDYYYY format, assign UPLSTS = 1 and error code 181 (INSURANCE 1 EFFECTIVE DATE NOT IN A VALID FORMAT)"]
[]
[null,null,null,null,null,null,"If REGIND = I or R and INSEEFF <> spaces and greater than EFFDAT, then assign UPLSTS = 1 and error code 422 (INSURANCE EFFECTIVE DATE 1 CANNOT BE GREATER THAN ENROLLMENT DATE)"]
[]
[null,null,null,null,null,"Insurance effective date 1 cannot be greater than the enrollment effective date","If REGIND = D and populated, then assign UPLSTS = 1 and error code 420 (INSURANCE EFFECTIVE DATE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
[]
[]
[null,null,null,null,null,"Must be valid numeric date in the format MMDDYYYY"]
["Insurance Expiration Date 1","N",8,"O","N","Populate if insurance expiration date is known","If REGIND = I or R and INSEXP1 not in MMDDYYYY format, assign UPLSTS = 1 and error code 182 (INSURANCE 1 EXPIRATION DATE NOT IN A VALID FORMAT)"]
[]
[null,null,null,null,null,"Must be greater than or equal to insurance effective date 1","If REGIND = I or R and INSEXP1 < INSEFF1, then assign UPLSTS = 1 and error code 423 (INSURANCE EXPIRATION DATE 1 CANNOT BE LESS THAN INSURANCE EFFECTIVE DATE 1)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 421 (INSURANCE EXPIRATION DATE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[]
[null,null,null,null,null,"Must be valid numeric date in the format MMDDYYYY"]
[]
[]
[]
[]
["Insurance Carrier Code 2","A",3,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the member has multiple overlapping or continuos insurances ","If REGIND = I or R and populated and not valid per RFCMAS.REFTYP = INSR with a PARENT = CASB then assign error code 331 (INSURANCE CARRIER CODE 2 INVALID)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 408 (INSURANCE CARRIER CODE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[null,null,null,null,null,"If populated, the rest of the Insurance 2 fields must be populated.","If REGIND = I or R and INSCOD3, INSCOD4, or INSCOD5 <> spaces and INSCOD2 = spaces, assign UPLSTS = 1 and error code 405 (INSURANCE 2 FIELDS MUST BE POPULATED BEFORE INSURANCE 3 - 5)"]
[]
[null,null,null,null,null,"Must be a valid value","If REGIND = I or R, and INSCOD2 = spaces and any other INS***2 field <> spaces, then assign UPLSTS = 1 and error code 431 (INSURANCE CODE 2 MUST BE POPULATED WHEN OTHER INSURANCE 2 FIELDS ARE POPULATED)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"AU2  Aetna"]
[null,null,null,null,null,"AU5  Americas Health Plan"]
[null,null,null,null,null,"AL0  Anthem Blue Cross"]
[null,null,null,null,null,"AU4  Alameda Alliance for Health"]
[null,null,null,null,null,"BSC  Blue Shield of California Promise Health plan"]
[null,null,null,null,null,"CU2  CalOptima"]
[null,null,null,null,null,"CU3  CalViva Health"]
[null,null,null,null,null,"C73  CenCal Health"]
[null,null,null,null,null,"CU4  Central CA Alliance for Health"]
[null,null,null,null,null,"CU6  Cigna HealthCare"]
[null,null,null,null,null,"CU7  Community Care Health Plan"]
[null,null,null,null,null,"CU8  Community Health Group"]
[null,null,null,null,null,"PIV  Community Health Plan of Imperial Valley"]
[null,null,null,null,null,"CN6  Contra Costa Health Plan"]
[null,null,null,null,null,"EVN  Evernorth Behavioral Health of California"]
[null,null,null,null,null,"GCH  Gold Coast Health Plan"]
[null,null,null,null,null,"HU0  Health Plan of San Joaquin"]
[null,null,null,null,null,"HSN  Health Plan of San Mateo"]
[null,null,null,null,null,"HU1  Health Net"]
[null,null,null,null,null,"HU2  Heritage Provider Network"]
[null,null,null,null,null,"IEH  Inland Empire Health Plan"]
[null,null,null,null,null,"KAS  Kaiser Permanente - South"]
[null,null,null,null,null,"KPN  Kaiser Permanente - North"]
[null,null,null,null,null,"KRN  Kern Health Systems"]
[null,null,null,null,null,"LA2  LA Care Health Plan"]
[null,null,null,null,null,"CAF  Medi-Cal Fee for Service"]
[null,null,null,null,null,"MU4  MemorialCare Select Health Plan"]
[null,null,null,null,null,"MU5  Molina HealthCare"]
[null,null,null,null,null,"NPN  Nippon"]
[null,null,null,null,null,"OPM  US Behavioral Health Plan/Optum"]
[null,null,null,null,null,"PH9  Partnership Healthplan of CA"]
[null,null,null,null,null,"SH7  San Francisco Health Plan"]
[null,null,null,null,null,"SU3  Santa Clara Family Health Plan"]
[null,null,null,null,null,"SU4  Scripps Health Plan Services"]
[null,null,null,null,null,"SU5  Sharp Health Plan"]
[null,null,null,null,null,"SU2  Sutter Health Plan"]
[null,null,null,null,null,"UH0  UnitedHealthcare (UHC)"]
[null,null,null,null,null,"WED  Western Health Advantage"]
[null,null,null,null,null,"AX1  Aspire Health Plan"]
[null,null,null,null,null,"C75  Chinese Community Health Plan (CCHP)"]
[null,null,null,null,null,"VHP  Valley Health Plan"]
[null,null,null,null,null,"VCP  Ventura County Health Plan"]
[]
["Filler Field 6","A",50,"N","N"]
[]
[]
["Insurance Policy Member ID 2","A",30,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 2 is populated","If REGIND = I or R, not populated and INSCOD2 is populated, then assign UPLSTS = 1 and assign error code 358 (INSURANCE CARRIER CODE 2 POPULATED, INSURANCE POLICY ID 2 NOT POPULATED)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 409 (INSURANCE POLICY MEMBER ID MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance Subscriber First Name 2","A ",35,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 2 is populated","If REGIND = I or R, not populated and INSCOD2 is populated, then assign UPLSTS = 1 and assign error code 359 (INSURANCE CARRIER CODE 2 POPULATED, INSURANCE SUBSCRIBER FIRST NAME 2 NOT POPULATED)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 410 (INSURANCE POLICY SUBSCRIBER FIRST NAME MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance Subscriber Last Name 2"," A",60,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 2 is populated "," If REGIND = I or R, not populated and INSCOD2 is populated, then assign UPLSTS = 1 and assign error code 360 (INSURANCE CARRIER CODE 2 POPULATED, INSURANCE SUBSCRIBER LAST NAME 2 NOT POPULATED)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 411 (INSURANCE POLICY SUBSCRIBER LAST NAME MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance Primacy Indicator 2","A",1,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 2 is populated","If REGIND = I or R, INSSEQ2 <> blanks and not equal to P, S, or T, then assign UPLSTS = 1 and error code 332 (INSURANCE PRIMACY 2 INVALID)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = I or R, not populated and INSCOD2 is populated, then assign UPLSTS = 1 and assign error code 361 (INSURANCE CARRIER CODE 2 POPULATED, INSURANCE PRIMACY INDICATOR 2 NOT POPULATED)"]
[]
[null,null,null,null,null,"Valid Values:","If REGIND = D and populated, then assign UPLSTS = 1 and error code 412 (INSURANCE POLICY PRIMACY INDICATOR MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"P - Primary"]
[null,null,null,null,null,"S - Secondary"]
[null,null,null,null,null,"T - Tertiary"]
["Insurance Group Number 2","A",30,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 2 is populated "," If REGIND = I or R, not populated and INSCOD2 is populated, then assign UPLSTS = 1 and assign error code 362 (INSURANCE CARRIER CODE 2 POPULATED, INSURANCE GROUP NUMBER 2 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)\n\nIf no group number is known, please type UNKNOWN in this field","If REGIND = D and populated, then assign UPLSTS = 1 and error code 413 (INSURANCE GROUP NUMBER LAST NAME MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Address Line 1 2","A",55,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 2 is populated","If REGIND = I or R, not populated and INSCOD2 is populated, then assign UPLSTS = 1 and assign error code 363 (INSURANCE CARRIER CODE 2 POPULATED, INSURANCE ADDRESS LINE 1 2 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 414 (INSURANCE ADDRESS LINE 1 MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Address Line 2 2","A",55,"O","N",null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 415 (INSURANCE ADDRESS LINE 2 MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance City 2","A",30,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 2 is populated","If REGIND = I or R, not populated and INSCOD2 is populated, then assign UPLSTS = 1 and assign error code 364 (INSURANCE CARRIER CODE 2 POPULATED, INSURANCE CITY 2 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 416 (INSURANCE CITY MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance State 2","A",2,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 2 is populated","If REGIND = I or R, not populated and INSCOD2 is populated, then assign UPLSTS = 1 and assign error code 365 (INSURANCE CARRIER CODE 2 POPULATED, INSURANCE STATE 2 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 417 (INSURANCE STATE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Zip 2","A",10,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 2 is populated","If REGIND = I or R, not populated and INSCOD2 is populated, then assign UPLSTS = 1 and assign error code 365 (INSURANCE CARRIER CODE 2 POPULATED, INSURANCE ZIP 2 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 418 (INSURANCE ZIP MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Phone 2","A",10,"O","N","When registration indicator is  I (Initial Registration) or R (Re-registration),  populate if the insurance carrier code 2 is populated","If not populated and INSCOD2 is populated, then assign UPLSTS = 1 and assign error code 367 (INSURANCE CARRIER CODE 2 POPULATED, INSURANCE PHONE 2 NOT POPULATED)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 419 (INSURANCE PHONE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance Effective Date 2","N",8,"O","N","Populate if registration indicator is I (Initial Registration) or R (Re-registration), insurance carrier code 2 is populated and the insurance effective date for Insurance Carrier 2 is known. If not populated, then the enrollment effective date will be utilized as the Insurance Effective Date.","If REGIND = I or R and INSEFF2 not in MMDDYYYY format, assign UPLSTS = 1 and error code 333 (INSURANCE 2 EFFECTIVE DATE NOT IN A VALID FORMAT)"]
[]
[null,null,null,null,null,"Insurance effective date 2 cannot be greater than the  insurance expiration date 2, enrollment termination date (if populated) or the end of the calendar year","If REGIND = I or R and INSEFF2 <> spaces, and greater than INSEXP2 or EXPDAT or 1231||EFFDAT YY, then assign UPLSTS = 1 and error code 424 (INSURANCE EFFECTIVE DATE 2 CANNOT BE GREATER THAN EXPIRATION DATE)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 420 (INSURANCE EFFECTIVE DATE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
[]
[null,null,null,null,null,"Must be valid numeric date in the format MMDDYYYY"]
["Insurance Expiration Date 2","N",8,"O","N","Populate if registration indicator is I (Initial Registration) or R (Re-registration), insurance carrier code 2 is populated and the insurance expiration date for Insurance Carrier 2 is known. ","If REGIND = I or R and INSEXP2 not in MMDDYYYY format, assign UPLSTS = 1 and error code 334 (INSURANCE 2 EXPIRATION DATE NOT IN A VALID FORMAT)"]
[]
[null,null,null,null,null,null,"If REGIND = I or R and INSEXP2 < INSEFF2, then assign UPLSTS = 1 and error code 425 (INSURANCE EXPIRATION DATE 2 CANNOT BE LESS THAN INSURANCE EFFECTIVE DATE 2)"]
[null,null,null,null,null,"Must be greater than or equal to insurance effective date 2"]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 421 (INSURANCE EXPIRATION DATE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
[]
[null,null,null,null,null,"Must be valid numeric date in the format MMDDYYYY"]
["Insurance Carrier Code 3","A",3,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the member has multiple overlapping or continuos insurances ","If REGIND = I or R and populated and not valid per RFCMAS.REFTYP = INSR with a PARENT = CASB then assign error code 335 (INSURANCE CARRIER CODE 3 INVALID)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 408 (INSURANCE CARRIER CODE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[null,null,null,null,null,"If populated, the rest of the Insurance 3 fields must be populated.","If REGIND = I or R and INSCOD4 or INSCOD5 <> spaces and INSCOD3 = spaces, assign UPLSTS = 1 and error code 406 (INSURANCE 3 FIELDS MUST BE POPULATED BEFORE INSURANCE 4 - 5)"]
[]
[null,null,null,null,null,"Must be a valid value","If REGIND = I or R, and INSCOD3 = spaces and any other INS***3 field <> spaces, then assign UPLSTS = 1 and error code 432 (INSURANCE CODE 3 MUST BE POPULATED WHEN OTHER INSURANCE 3 FIELDS ARE POPULATED)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"AL0 Anthem Blue Cross Blue Shield of CA"]
[null,null,null,null,null,"CU6 Cigna Healthcare of CA"]
[null,null,null,null,null,"HU1 Healthnet of CA"]
[null,null,null,null,null,"UH0 United Healthcare"]
[null,null,null,null,null,"AU2 Aetna Health of CA"]
[null,null,null,null,null,"AU4 Alameda Health Alliance"]
[null,null,null,null,null,"AU3 AIDS Healthcare Foundation"]
[null,null,null,null,null,"AB7 Alignment Health Plan"]
[null,null,null,null,null,"AU5 America's Health Plan"]
[null,null,null,null,null,"CU3 CalViva"]
[null,null,null,null,null,"CU2 CalOptima"]
[null,null,null,null,null,"C73 CenCal Health"]
[null,null,null,null,null,"CU4 Central California Alliance for Health"]
[null,null,null,null,null,"CU5 Central Health Medicare Plan"]
[null,null,null,null,null,"CU7 Community Care Health"]
[null,null,null,null,null,"CU8 Community Health Group"]
[null,null,null,null,null,"CN6 Contra Costa Health Plan"]
[null,null,null,null,null,"HU0 Health Plan of San Joaquin"]
[null,null,null,null,null,"HU2 Heritage Provider Network"]
[null,null,null,null,null,"IEH Inland Empire Health Plan"]
[null,null,null,null,null,"KAI Kaiser Permanente"]
[null,null,null,null,null,"LA2 L.A. Care Health Plan"]
[null,null,null,null,null,"MU4 Memorial Care Select Health Plan"]
[null,null,null,null,null,"MU5 Molina Healthcare of CA"]
[null,null,null,null,null,"OU0 On Lok Pace"]
[null,null,null,null,null,"PH9 Partnership Health Plan"]
[null,null,null,null,null,"SU3 Santa Clara Health Plan"]
[null,null,null,null,null,"OU1 Oscar Health Plan"]
[null,null,null,null,null,"SCG SCAN Health Plan"]
[null,null,null,null,null,"SU4 Scripps Health Plan Services"]
[null,null,null,null,null,"SU5 Sharp Health Plan"]
[null,null,null,null,null,"SU6 SIMNSA Health Plan"]
[null,null,null,null,null,"SU2 Sutter Health Plus"]
[null,null,null,null,null,"UVC Universal Care"]
[null,null,null,null,null,"WED Western Health Advantage"]
[]
["Filler Field 7","A",50,"N","N"]
[]
[]
["Insurance Policy Member ID 3","A",30,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 3 is populated","If REGIND = I or R, not populated and INSCOD3 is populated, then assign UPLSTS = 1 and assign error code 368 (INSURANCE CARRIER CODE 3 POPULATED, INSURANCE POLICY ID 3 NOT POPULATED)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 409 (INSURANCE POLICY MEMBER ID MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance Subscriber First Name 3"," A",35,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 3 is populated","If REGIND = I or R, not populated and INSCOD3 is populated, then assign UPLSTS = 1 and assign error code 369 (INSURANCE CARRIER CODE 3 POPULATED, INSURANCE SUBSCRIBER FIRST NAME 3 NOT POPULATED)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 410 (INSURANCE POLICY SUBSCRIBER FIRST NAME MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance Subscriber Last Name 3"," A",60,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 3 is populated "," If REGIND = I or R, not populated and INSCOD3 is populated, then assign UPLSTS = 1 and assign error code 370 (INSURANCE CARRIER CODE 3 POPULATED, INSURANCE SUBSCRIBER LAST NAME 3 NOT POPULATED)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 411 (INSURANCE POLICY SUBSCRIBER LAST NAME MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance Primacy Indicator 3","A",1,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 3 is populated","If REGIND = I or R, INSSEQ3 <> blanks and not equal to P, S, or T, then assign UPLSTS = 1 and error code 336 (INSURANCE PRIMACY 3 INVALID)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = I or R, not populated and INSCOD3 is populated, then assign UPLSTS = 1 and assign error code 371 (INSURANCE CARRIER CODE 3 POPULATED, INSURANCE PRIMACY INDICATOR 3 NOT POPULATED)"]
[]
[null,null,null,null,null,"Valid Values:","If REGIND = D and populated, then assign UPLSTS = 1 and error code 412 (INSURANCE POLICY PRIMACY INDICATOR MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"P - Primary"]
[null,null,null,null,null,"S - Secondary"]
[null,null,null,null,null,"T - Tertiary"]
["Insurance Group Number 3","A",30,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 3 is populated "," If REGIND = I or R, not populated and INSCOD3 is populated, then assign UPLSTS = 1 and assign error code 372 (INSURANCE CARRIER CODE 3 POPULATED, INSURANCE GROUP NUMBER 3 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 413 (INSURANCE GROUP NUMBER LAST NAME MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Address Line 1 3","A",55,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 3 is populated","If REGIND = I or R, not populated and INSCOD3 is populated, then assign UPLSTS = 1 and assign error code 373 (INSURANCE CARRIER CODE 3 POPULATED, INSURANCE ADDRESS LINE 1 3 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 414 (INSURANCE ADDRESS LINE 1 MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Address Line 2 3","A",55,"O","N",null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 415 (INSURANCE ADDRESS LINE 2 MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance City 3","A",30,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 3 is populated","If REGIND = I or R, not populated and INSCOD3 is populated, then assign UPLSTS = 1 and assign error code 374 (INSURANCE CARRIER CODE 3 POPULATED, INSURANCE CITY 3 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 416 (INSURANCE CITY MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance State 3","A",2,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 3 is populated","If REGIND = I or R, not populated and INSCOD3 is populated, then assign UPLSTS = 1 and assign error code 375 (INSURANCE CARRIER CODE 3 POPULATED, INSURANCE STATE 3 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 417 (INSURANCE STATE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Zip 3","A",10,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 3 is populated","If REGIND = I or R, not populated and INSCOD3 is populated, then assign UPLSTS = 1 and assign error code 376 (INSURANCE CARRIER CODE 3 POPULATED, INSURANCE ZIP 3 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 418 (INSURANCE ZIP MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Phone 3","A",10,"O","N","When registration indicator is  I (Initial Registration) or R (Re-registration),  populate if the insurance carrier code 3 is populated","If not populated and INSCOD3 is populated, then assign UPLSTS = 1 and assign error code 377 (INSURANCE CARRIER CODE 3 POPULATED, INSURANCE PHONE 3 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 419 (INSURANCE PHONE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Effective Date 3","N",8,"O","N","Populate if registration indicator is I (Initial Registration) or R (Re-registration), insurance carrier code 3 is populated and the insurance effective date for Insurance Carrier 3 is known. If not populated, then the enrollment effective date will be utilized as the Insurance Effective Date.","If REGIND = I or R and INSEFF3 not in MMDDYYYY format, assign UPLSTS = 1 and error code 337 (INSURANCE EFFECTIVE DATE 3 NOT IN A VALID FORMAT)"]
[]
[null,null,null,null,null,"Insurance effective date 3 cannot be greater than the  insurance expiration date 3, enrollment termination date (if populated) or the end of the calendar year","If REGIND = I or R and INSEFF3 <> spaces, and greater than INSEXP3 or EXPDAT or 1231||EFFDAT YY, then assign UPLSTS = 1 and error code 426 (INSURANCE EFFECTIVE DATE 3 CANNOT BE GREATER THAN EXPIRATION DATE)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 420 (INSURANCE EFFECTIVE DATE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[null,null,null,null,null,"Must be valid numeric date in the format MMDDYYYY"]
["Insurance Expiration Date 3","N",8,"O","N","Populate if registration indicator is I (Initial Registration) or R (Re-registration), insurance carrier code 3 is populated and the insurance expiration date for Insurance Carrier 3 is known. ","If REGIND = I or R and INSEXP3 not in MMDDYYYY format, assign UPLSTS = 1 and error code 338 (INSURANCE 3 EXPIRATION DATE NOT IN A VALID FORMAT)"]
[]
[null,null,null,null,null,null,"If REGIND = I or R and INSEXP2 < INSEFF2, then assign UPLSTS = 1 and error code 427 (INSURANCE EXPIRATION DATE 3 CANNOT BE LESS THAN INSURANCE EFFECTIVE DATE 3)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 421 (INSURANCE EXPIRATION DATE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Must be greater than or equal to insurance effective date 3"]
[]
[null,null,null,null,null,"Must be valid numeric date in the format MMDDYYYY"]
["Insurance Carrier Code 4","A",3,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the member has multiple overlapping or continuos insurances ","If REGIND = I or R and populated and not valid per RFCMAS.REFTYP = INSR with a PARENT = CASB then assign error code 339 (INSURANCE CARRIER CODE 4 INVALID)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 408 (INSURANCE CARRIER CODE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[null,null,null,null,null,"If populated, the rest of the Insurance 4 fields must be populated.","If REGIND = I or R and  INSCOD5 <> spaces and INSCOD4 = spaces, assign UPLSTS = 1 and error code 407 (INSURANCE 4 FIELDS MUST BE POPULATED BEFORE INSURANCE 5)"]
[]
[null,null,null,null,null,"Must be a valid value","If REGIND = I or R, and INSCOD4 = spaces and any other INS***4 field <> spaces, then assign UPLSTS = 1 and error code 434 (INSURANCE CODE 4 MUST BE POPULATED WHEN OTHER INSURANCE 4 FIELDS ARE POPULATED)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"AL0 Anthem Blue Cross Blue Shield of CA"]
[null,null,null,null,null,"CU6 Cigna Healthcare of CA"]
[null,null,null,null,null,"HU1 Healthnet of CA"]
[null,null,null,null,null,"UH0 United Healthcare"]
[null,null,null,null,null,"AU2 Aetna Health of CA"]
[null,null,null,null,null,"AU4 Alameda Health Alliance"]
[null,null,null,null,null,"AU3 AIDS Healthcare Foundation"]
[null,null,null,null,null,"AB7 Alignment Health Plan"]
[null,null,null,null,null,"AU5 America's Health Plan"]
[null,null,null,null,null,"CU3 CalViva"]
[null,null,null,null,null,"CU2 CalOptima"]
[null,null,null,null,null,"C73 CenCal Health"]
[null,null,null,null,null,"CU4 Central California Alliance for Health"]
[null,null,null,null,null,"CU5 Central Health Medicare Plan"]
[null,null,null,null,null,"CU7 Community Care Health"]
[null,null,null,null,null,"CU8 Community Health Group"]
[null,null,null,null,null,"CN6 Contra Costa Health Plan"]
[null,null,null,null,null,"HU0 Health Plan of San Joaquin"]
[null,null,null,null,null,"HU2 Heritage Provider Network"]
[null,null,null,null,null,"IEH Inland Empire Health Plan"]
[null,null,null,null,null,"KAI Kaiser Permanente"]
[null,null,null,null,null,"LA2 L.A. Care Health Plan"]
[null,null,null,null,null,"MU4 Memorial Care Select Health Plan"]
[null,null,null,null,null,"MU5 Molina Healthcare of CA"]
[null,null,null,null,null,"OU0 On Lok Pace"]
[null,null,null,null,null,"PH9 Partnership Health Plan"]
[null,null,null,null,null,"SU3 Santa Clara Health Plan"]
[null,null,null,null,null,"OU1 Oscar Health Plan"]
[null,null,null,null,null,"SCG SCAN Health Plan"]
[null,null,null,null,null,"SU4 Scripps Health Plan Services"]
[null,null,null,null,null,"SU5 Sharp Health Plan"]
[null,null,null,null,null,"SU6 SIMNSA Health Plan"]
[null,null,null,null,null,"SU2 Sutter Health Plus"]
[null,null,null,null,null,"UVC Universal Care"]
[null,null,null,null,null,"WED Western Health Advantage "]
[]
["Filler Field 8","A",50,"N","N"]
[]
[]
["Insurance Policy Member ID 4","A",30,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 4 is populated","If REGIND = I or R, not populated and INSCOD4 is populated, then assign UPLSTS = 1 and assign error code 378 (INSURANCE CARRIER CODE 4 POPULATED, INSURANCE POLICY ID 4 NOT POPULATED)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 409 (INSURANCE POLICY MEMBER ID MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance Subscriber First Name 4","A ",35,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 4 is populated","If REGIND = I or R, not populated and INSCOD4 is populated, then assign UPLSTS = 1 and assign error code 379 (INSURANCE CARRIER CODE 4 POPULATED, INSURANCE SUBSCRIBER FIRST NAME 4 NOT POPULATED)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 410 (INSURANCE POLICY SUBSCRIBER FIRST NAME MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance Subscriber Last Name 4","A ",60,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 4 is populated "," If REGIND = I or R, not populated and INSCOD4 is populated, then assign UPLSTS = 1 and assign error code 380 (INSURANCE CARRIER CODE 4 POPULATED, INSURANCE SUBSCRIBER LAST NAME 4 NOT POPULATED)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 411 (INSURANCE POLICY SUBSCRIBER LAST NAME MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance Primacy Indicator 4","A",1,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 4 is populated","If REGIND = I or R, INSSEQ4 <> blanks and not equal to P, S, or T, then assign UPLSTS = 1 and error code 340 (INSURANCE PRIMACY 4 INVALID)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = I or R, not populated and INSCOD4 is populated, then assign UPLSTS = 1 and assign error code 381 (INSURANCE CARRIER CODE 4 POPULATED, INSURANCE PRIMACY INDICATOR 4 NOT POPULATED)"]
[]
[null,null,null,null,null,"Valid Values:","If REGIND = D and populated, then assign UPLSTS = 1 and error code 412 (INSURANCE POLICY PRIMACY INDICATOR MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"P - Primary"]
[null,null,null,null,null,"S - Secondary"]
[null,null,null,null,null,"T - Tertiary"]
["Insurance Group Number 4","A",30,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 3 is populated "," If not populated and INSCOD4 is populated, then assign UPLSTS = 1 and assign error code 382 (INSURANCE CARRIER CODE 4 POPULATED, INSURANCE GROUP NUMBER 4 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 413 (INSURANCE GROUP NUMBER LAST NAME MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Address Line 1 4","A",55,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 4 is populated","If not populated and INSCOD4 is populated, then assign UPLSTS = 1 and assign error code 383 (INSURANCE CARRIER CODE 4 POPULATED, INSURANCE ADDRESS LINE 1 4 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 414 (INSURANCE ADDRESS LINE 1 MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Address Line 2 4","A",55,"O","N",null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 415 (INSURANCE ADDRESS LINE 2 MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance City 4","A",30,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 4 is populated","If REGIND = I or R, not populated and INSCOD4 is populated, then assign UPLSTS = 1 and assign error code 384 (INSURANCE CARRIER CODE 4 POPULATED, INSURANCE CITY 4 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 416 (INSURANCE CITY MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance State 4","A",2,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 4 is populated","If REGIND = I or R, not populated and INSCOD4 is populated, then assign UPLSTS = 1 and assign error code 385 (INSURANCE CARRIER CODE 4 POPULATED, INSURANCE STATE 4 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 417 (INSURANCE STATE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Zip 4","A",10,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 4 is populated","If REGIND = I or R, not populated and INSCOD4 is populated, then assign UPLSTS = 1 and assign error code 386 (INSURANCE CARRIER CODE 4 POPULATED, INSURANCE ZIP 4 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 418 (INSURANCE ZIP MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Phone 4","A",10,"O","N","When registration indicator is  I (Initial Registration) or R (Re-registration),  populate if the insurance carrier code 4 is populated","If not populated and INSCOD4 is populated, then assign UPLSTS = 1 and assign error code 387 (INSURANCE CARRIER CODE 4 POPULATED, INSURANCE PHONE 4 NOT POPULATED)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 419 (INSURANCE PHONE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance Effective Date 4","N",8,"O","N","Populate if registration indicator is I (Initial Registration) or R (Re-registration), insurance carrier code 4 is populated and the insurance effective date for Insurance Carrier 4 is known. If not populated, then the enrollment effective date will be utilized as the Insurance Effective Date.","If REGIND = I or R and INSEFF4 not in MMDDYYYY format, assign UPLSTS = 1 and error code 341 (INSURANCE EFFECTIVE DATE 4 NOT IN A VALID FORMAT)"]
[]
[null,null,null,null,null,"Insurance effective date 4 cannot be greater than the  insurance expiration date 4, enrollment termination date (if populated) or the end of the calendar year","If REGIND = I or R and INSEFF4 <> spaces, and greater than INSEXP4 or EXPDAT or 1231||EFFDAT YY, then assign UPLSTS = 1 and error code 428 (INSURANCE EFFECTIVE DATE 4 CANNOT BE GREATER THAN EXPIRATION DATE)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 420 (INSURANCE EFFECTIVE DATE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[null,null,null,null,null,"Must be valid numeric date in the format MMDDYYYY"]
["Insurance Expiration Date 4","N",8,"O","N","Populate if registration indicator is I (Initial Registration) or R (Re-registration), insurance carrier code 4 is populated and the insurance expiration date for Insurance Carrier 4 is known. ","If REGIND = I or R and INSEXP4 not in MMDDYYYY format, assign UPLSTS = 1 and error code 343 (INSURANCE 4 EXPIRATION DATE NOT IN A VALID FORMAT)"]
[]
[null,null,null,null,null,null,"If REGIND = I or R and INSEXP4 < INSEFF4, then assign UPLSTS = 1 and error code 429 (INSURANCE EXPIRATION DATE 4 CANNOT BE LESS THAN INSURANCE EFFECTIVE DATE 4)"]
[null,null,null,null,null,"Must be greater than or equal to insurance effective date 4"]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 421 (INSURANCE EXPIRATION DATE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[null,null,null,null,null,"Must be valid numeric date in the format MMDDYYYY"]
["Insurance Carrier Code 5","A",3,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the member has multiple overlapping or continuos insurances ","If REGIND = I or R and populated and not valid per RFCMAS.REFTYP = INSR with a PARENT = CASB then assign error code 344 (INSURANCE CARRIER CODE 5 INVALID)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 408 (INSURANCE CARRIER CODE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[null,null,null,null,null,"If populated, the rest of the Insurance 5 fields must be populated.","If REGIND = I or R, and INSCOD5 = spaces and any other INS***5 field <> spaces, then assign UPLSTS = 1 and error code 435 (INSURANCE CODE 5 MUST BE POPULATED WHEN OTHER INSURANCE 5 FIELDS ARE POPULATED)"]
[]
[null,null,null,null,null,"Must be a valid value"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"AL0 Anthem Blue Cross Blue Shield of CA"]
[null,null,null,null,null,"CU6 Cigna Healthcare of CA"]
[null,null,null,null,null,"HU1 Healthnet of CA"]
[null,null,null,null,null,"UH0 United Healthcare"]
[null,null,null,null,null,"AU2 Aetna Health of CA"]
[null,null,null,null,null,"AU4 Alameda Health Alliance"]
[null,null,null,null,null,"AU3 AIDS Healthcare Foundation"]
[null,null,null,null,null,"AB7 Alignment Health Plan"]
[null,null,null,null,null,"AU5 America's Health Plan"]
[null,null,null,null,null,"CU3 CalViva"]
[null,null,null,null,null,"CU2 CalOptima"]
[null,null,null,null,null,"C73 CenCal Health"]
[null,null,null,null,null,"CU4 Central California Alliance for Health"]
[null,null,null,null,null,"CU5 Central Health Medicare Plan"]
[null,null,null,null,null,"CU7 Community Care Health"]
[null,null,null,null,null,"CU8 Community Health Group"]
[null,null,null,null,null,"CN6 Contra Costa Health Plan"]
[null,null,null,null,null,"HU0 Health Plan of San Joaquin"]
[null,null,null,null,null,"HU2 Heritage Provider Network"]
[null,null,null,null,null,"IEH Inland Empire Health Plan"]
[null,null,null,null,null,"KAI Kaiser Permanente"]
[null,null,null,null,null,"LA2 L.A. Care Health Plan"]
[null,null,null,null,null,"MU4 Memorial Care Select Health Plan"]
[null,null,null,null,null,"MU5 Molina Healthcare of CA"]
[null,null,null,null,null,"OU0 On Lok Pace"]
[null,null,null,null,null,"PH9 Partnership Health Plan"]
[null,null,null,null,null,"SU3 Santa Clara Health Plan"]
[null,null,null,null,null,"OU1 Oscar Health Plan"]
[null,null,null,null,null,"SCG SCAN Health Plan"]
[null,null,null,null,null,"SU4 Scripps Health Plan Services"]
[null,null,null,null,null,"SU5 Sharp Health Plan"]
[null,null,null,null,null,"SU6 SIMNSA Health Plan"]
[null,null,null,null,null,"SU2 Sutter Health Plus"]
[null,null,null,null,null,"UVC Universal Care"]
[null,null,null,null,null,"WED Western Health Advantage"]
[]
["Filler Field 9","A",50,"N","N"]
[]
[]
["Insurance Policy Member ID 5","A",30,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 5 is populated","If REGIND = I or R, not populated and INSCOD5 is populated, then assign UPLSTS = 1 and assign error code 388 (INSURANCE CARRIER CODE 5 POPULATED, INSURANCE POLICY ID 5 NOT POPULATED)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 409 (INSURANCE POLICY MEMBER ID MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance Subscriber First Name 5","A",35,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 5 is populated","If REGIND = I or R, not populated and INSCOD5 is populated, then assign UPLSTS = 1 and assign error code 389 (INSURANCE CARRIER CODE 5 POPULATED, INSURANCE SUBSCRIBER FIRST NAME 5 NOT POPULATED)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 410 (INSURANCE POLICY SUBSCRIBER FIRST NAME MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance Subscriber Last Name 5","A",60,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 5 is populated "," If REGIND = I or R, not populated and INSCOD5 is populated, then assign UPLSTS = 1 and assign error code 390 (INSURANCE CARRIER CODE 5 POPULATED, INSURANCE SUBSCRIBER LAST NAME 5 NOT POPULATED)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 411 (INSURANCE POLICY SUBSCRIBER LAST NAME MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance Primacy Indicator 5","A",1,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 5 is populated ","If REGIND = I or R, INSSEQ5 <> blanks and not equal to P, S, or T, then assign UPLSTS = 1 and error code 345 (INSURANCE PRIMACY 5 INVALID)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = I or R, not populated and INSCOD5 is populated, then assign UPLSTS = 1 and assign error code 391 (INSURANCE CARRIER CODE 5 POPULATED, INSURANCE PRIMACY INDICATOR 5 NOT POPULATED)"]
[]
[null,null,null,null,null,"Valid Values:","If REGIND = D and populated, then assign UPLSTS = 1 and error code 412 (INSURANCE POLICY PRIMACY INDICATOR MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"P - Primary"]
[null,null,null,null,null,"S - Secondary"]
[null,null,null,null,null,"T - Tertiary"]
["Insurance Group Number 5","A",30,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 5 is populated "," If not populated and INSCOD5 is populated, then assign UPLSTS = 1 and assign error code 392 (INSURANCE CARRIER CODE 5 POPULATED, INSURANCE GROUP NUMBER 5 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 413 (INSURANCE GROUP NUMBER LAST NAME MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Address Line 1 5","A",55,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 5 is populated","If not populated and INSCOD5 is populated, then assign UPLSTS = 1 and assign error code 393 (INSURANCE CARRIER CODE 5 POPULATED, INSURANCE ADDRESS LINE 1 5 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 414 (INSURANCE ADDRESS LINE 1 MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Address Line 2 5","A",55,"O","N",null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 415 (INSURANCE ADDRESS LINE 2 MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance City 5","A",30,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 5 is populated","If REGIND = I or R, not populated and INSCOD5 is populated, then assign UPLSTS = 1 and assign error code 394 (INSURANCE CARRIER CODE 5 POPULATED, INSURANCE CITY 5 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 416 (INSURANCE CITY MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance State 5","A",2,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 5 is populated","If REGIND = I or R, not populated and INSCOD5 is populated, then assign UPLSTS = 1 and assign error code 395 (INSURANCE CARRIER CODE 5 POPULATED, INSURANCE STATE 5 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 417 (INSURANCE STATE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Zip 5","A",10,"O","N","When registration indicator is I (Initial Registration) or R (Re-registration), populate if the insurance carrier code 5 is populated","If REGIND = I or R, not populated and INSCOD5 is populated, then assign UPLSTS = 1 and assign error code 396 (INSURANCE CARRIER CODE 5 POPULATED, INSURANCE ZIP 5 NOT POPULATED)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 418 (INSURANCE ZIP MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
["Insurance Phone 5","A",10,"O","N","When registration indicator is  I (Initial Registration) or R (Re-registration),  populate if the insurance carrier code 5 is populated","If not populated and INSCOD5 is populated, then assign UPLSTS = 1 and assign error code 397 (INSURANCE CARRIER CODE 5 POPULATED, INSURANCE PHONE 5 NOT POPULATED)"]
[]
[null,null,null,null,null,null,"If REGIND = D and populated, then assign UPLSTS = 1 and error code 419 (INSURANCE PHONE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)"]
["Insurance Effective Date 5","N",8,"O","N","Populate if registration indicator is I (Initial Registration) or R (Re-registration), insurance carrier code 5 is populated and the insurance effective date for Insurance Carrier 5 is known. If not populated, then the enrollment effective date will be utilized as the Insurance Effective Date.","If REGIND = I or R and INSEFF5 not in MMDDYYYY format, assign UPLSTS = 1 and error code 346 (INSURANCE EFFECTIVE DATE 5 NOT IN A VALID FORMAT)"]
[]
[null,null,null,null,null,"Insurance effective date 4 cannot be greater than the  insurance expiration date 4, enrollment termination date (if populated) or the end of the calendar year","If REGIND = I or R and INSEFF5 <> spaces, and greater than INSEXP5 or EXPDAT or 1231||EFFDAT YY, then assign UPLSTS = 1 and error code 430 (INSURANCE EFFECTIVE DATE 5 CANNOT BE GREATER THAN EXPIRATION DATE)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 420 (INSURANCE EFFECTIVE DATE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[]
[null,null,null,null,null,"Must be valid numeric date in the format MMDDYYYY"]
["Insurance Expiration Date 5","N",8,"O","N","Populate if registration indicator is I (Initial Registration) or R (Re-registration), insurance carrier code 5 is populated and the insurance expiration date for Insurance Carrier 5 is known. ","If REGIND = I or R and INSEXP4 not in MMDDYYYY format, assign UPLSTS = 1 and error code 347 (INSURANCE 5 EXPIRATION DATE NOT IN A VALID FORMAT)"]
[]
[null,null,null,null,null,"Must be greater than or equal to insurance effective date 4","If REGIND = I or R and INSEXP4 < INSEFF5, then assign UPLSTS = 1 and error code 430 (INSURANCE EXPIRATION DATE 5 CANNOT BE LESS THAN INSURANCE EFFECTIVE DATE 5)"]
[]
[null,null,null,null,null,"Do not send when registration is a D (Demographic Change)","If REGIND = D and populated, then assign UPLSTS = 1 and error code 421 (INSURANCE EXPIRATION DATE MUST NOT BE POPULATED ON DEMOGRAPHIC CHANGE)"]
[]
[null,null,null,null,null,"Must be valid numeric date in the format MMDDYYYY"]
["Parent/Legal Guardian/Representative relationship to the member","A",4,"C","C","Required if member is younger than 12","If blank and the member is under 12, then assign UPLSTS =1 and error code 183 (GUARDIAN RELATIONSHIP IS REQUIRED WHEN MEMBER IS UNDER 12) **Note: The incoming EFFDAT will be used when determining the members age. If the REGIND = D, then todays date would be used."]
[]
[null,null,null,null,null,"Valid Values:","If populated and invalid per RFCMAS.REFTYP = RELI, then assign error UPLSTS = 1 and error code 195(GUARDIAN RELATIONSHIP CODE IS INVALID)"]
[null,null,null,null,null,"01          Spouse/Significant Other"]
[null,null,null,null,null,"02         Parent "]
[null,null,null,null,null,"03         Sibling"]
[null,null,null,null,null,"04         Child"]
[null,null,null,null,null,"05         Grandparent"]
[null,null,null,null,null,"06         In law relative"]
[null,null,null,null,null,"07          Other Family member"]
[null,null,null,null,null,"08         Friend"]
[null,null,null,null,null,"09         Neighbor"]
[null,null,null,null,null,"10          Roommate"]
[null,null,null,null,null,"11           Case Worker"]
[null,null,null,null,null,"12          School Counselor/Teacher"]
[null,null,null,null,null,"13          Substitute decision maker"]
[null,null,null,null,null,"14          Other"]
["Parent/Legal Guardian/Representative relationship to the member other","A",25,"C","C","Must be populated if 'Parent/Legal Guardian /Representative relationship' is '14’ ","If not populated and GRDREL = 14, assign UPLSTS = 1 and error code 184 (GUARDIAN RELATIONSHIP OTHER NOT POPULATED, GUARDIAN RELATIONSHIP IS OTHER)"]
[]
[null,null,null,null,null,null,"If populated and GRDREL <> 14, assign UPLSTS = 1 and error code 185 (GUARDIAN RELATIONSHIP OTHER POPULATED, GUARDIAN RELATIONSHIP IS NOT OTHER)"]
["Parent/Legal Guardian/Representative Spoken Language","A",4,"C","C","Required if member is younger than 12","If blank and the member is under 12, then assign UPLSTS =1 and error code 399 (GUARDIAN SPOKEN LANGUAGE IS REQUIRED WHEN MEMBER IS UNDER 12) **Note: The incoming EFFDAT will be used when determining the members age. If the REGIND = D, then todays date would be used."]
[]
[null,null,null,null,null,"Must be a valid value","If populated and invalid per RFCMAS.REFTYP = HESL, then assign error UPLSTS = 1 and error code 400 (GUARDIAN SPOKEN LANGUAGE SPECIFICATION INVALID)"]
[]
[null,null,null,null,null,"Valid Value: "]
[null,null,null,null,null,"ARBC - Arabic                "]
[null,null,null,null,null,"ARMN - Armenian              "]
[null,null,null,null,null,"ASLG - American Sign Language"]
[null,null,null,null,null,"BNGL - Bengali               "]
[null,null,null,null,null,"BSLG -  British Sign Language "]
[null,null,null,null,null,"CHNE - Chinese (Mandarin)    "]
[null,null,null,null,null,"CTNS - Cantonese             "]
[null,null,null,null,null,"DCAR - Declined to Answer    "]
[null,null,null,null,null,"ENGL - English               "]
[null,null,null,null,null,"FRCH - French                "]
[null,null,null,null,null,"FRSI - Farsi                 "]
[null,null,null,null,null,"GREK - Greek                 "]
[null,null,null,null,null,"GRMN - German                "]
[null,null,null,null,null,"HNCE - Creole                "]
[null,null,null,null,null,"ITLN - Italian               "]
[null,null,null,null,null,"JPNS - Japanese    "]
[null,null,null,null,null,"KRAN - Korean     "]
[null,null,null,null,null,"OTER - Other      "]
[null,null,null,null,null,"PTGS - Portuguese "]
[null,null,null,null,null,"RMNA - Romanian   "]
[null,null,null,null,null,"RSAN - Russian    "]
[null,null,null,null,null,"SPNH - Spanish    "]
[null,null,null,null,null,"SWAH - Swahili    "]
[null,null,null,null,null,"TGLG - Tagalog    "]
[null,null,null,null,null,"THAI - Thai       "]
[null,null,null,null,null,"UKR - Ukrainian  "]
[null,null,null,null,null,"VTNS - Vietnamese  "]
["Parent/Legal Guardian/Representative Spoken Language Other","A",25,"C","C","Required if Parent/Legal Guardian/Representative Spoken Language is 'OTER'","IF GRDLSO <> blank and GRDLSP <> OTER, assign UPLSTS = 1 and error code 401 (GUARDIAN SPOKEN LANGUAGE OTHER POPULATED, GUARDIAN SPOKEN LANGUAGE NOT EQUAL TO OTHER)"]
[]
[null,null,null,null,null,"Must not be populated if ' Parent/Legal Guardian/Representative Spoken Language ' is not 'OTER'","IF GRDLSO= blank and GRDLSP = OTER, assign UPLSTS = 1 and error code 402 (GUARDIAN SPOKEN LANGUAGE OTHER NOT POPULATED, GUARDIAN SPOKEN LANGUAGE EQUAL TO OTHER)"]
["Parent/Legal Guardian/Representative Last Name","A"," 60","C","C","Required if member is younger than 12","If blank and the member is under 12, then assign UPLSTS =1 and error code 186 (GUARDIAN LAST NAME IS REQUIRED WHEN MEMBER IS UNDER 12) **Note: The incoming EFFDAT will be used when determining the members age. If the REGIND = D, then todays date would be used."]
["Parent/Legal Guardian/Representative First Name","A"," 35","C","C","Required if member is younger than 12","If blank and the member is under 12, then assign UPLSTS =1 and error code 187 (GUARDIAN FIRST NAME IS REQUIRED WHEN MEMBER IS UNDER 12) **Note: The incoming EFFDAT will be used when determining the members age. If the REGIND = D, then todays date would be used."]
["Parent/Legal Guardian /Representative Address Line 1","A",55,"C","C","Required if member is younger than 12","If blank and the member is under 12, then assign UPLSTS =1 and error code 188 (GUARDIAN ADDRESS LINE 1 IS REQUIRED WHEN MEMBER IS UNDER 12) **Note: The incoming EFFDAT will be used when determining the members age. If the REGIND = D, then todays date would be used."]
["Parent/Legal Guardian /Representative Address Line 2","A",55,"O","O"]
["Parent/Legal Guardian /Representative City","A",30,"C","C","Required if member is younger than 12","If blank and the member is under 12, then assign UPLSTS =1 and error code 189 (GUARDIAN CITY IS REQUIRED WHEN MEMBER IS UNDER 12) **Note: The incoming EFFDAT will be used when determining the members age. If the REGIND = D then todays date would be used."]
[]
[null,null,null,null,null,"Must be a valid City","If GRDCTY <> blank, then compare GRDCTY1:28 to ZIPMAS/CITYCD and if not valid found, then assign UPLSTS = 1 and error code 102 (GUARDIAN CITY IS INVALID)"]
["Parent/Legal Guardian /Representative State","A",2,"C","C","Required if member is younger than 12","If blank and the member is under 12, then assign UPLSTS =1 and error code 190 (GUARDIAN STATE IS REQUIRED WHEN MEMBER IS UNDER 12) **Note: The incoming EFFDAT will be used when determining the members age. If the REGIND = D then todays date would be used."]
[]
[null,null,null,null,null,"Must be a valid State","If populated and not valid in ZIPMAS/STACOD, assign UPLSTS = 1 and error code 104 (GUARDIAN STATE IS INVALID)"]
["Parent/Legal Guardian /Representative Zip Code","N",5,"C","C","Required if member is younger than 12","If blank and the member is under 12, then assign UPLSTS =1 and error code 191 (GUARDIAN ZIP CODE IS REQUIRED WHEN MEMBER IS UNDER 12) **Note: The incoming EFFDAT will be used when determining the members age. If the REGIND = D then todays date would be used."]
[]
[null,null,null,null,null,"Must be a valid Zip Code","If not numeric, assign UPLSTS = 1 and error code 192 (GUARDIAN ZIP CODE IS NOT NUMERIC)"]
[]
[null,null,null,null,null,"Must be a valid combination of City, State, and ZIP when all 3 are populated","If populated and GRDZIP is not valid in ZIPMAS/ZIPCOD, then assign UPLSTS = 1 and error code 107 (GUARDIAN ZIP CODE IS INVALID)"]
[]
[null,null,null,null,null,null,"If GRDZIP <> blank and valid, then compare GRDCTY1:28, GRDSTA, and GRDZIP to ZIPMAS, and if not a valid combination, assign UPLSTS = 1, and error code 110(GUARDIAN CITY, STATE, AND ZIP CODE IS NOT A VALID USPS COMBINATION)."]
["Parent/Legal Guardian /Representative Zip Code Extension","N",4,"O","O",null,"If not numeric, assign UPLSTS = 1 and error code 097 (GUARDIAN ZIP CODE EXTENSION IS NOT NUMERIC)"]
[null,null,null,null,null,"Required if member is younger than 12"]
[null,null,null,null,null,null,"If GRDZXT <> blanks and not 4 bytes, assign UPLSTS = 1 and error code 099 (GUARDIAN ZIP CODE EXTENSION MUST BE 4 BYTES.)"]
[null,null,null,null,null,"Must be numeric"]
[]
[null,null,null,null,null,"Must be 4 bytes"]
["Parent/Legal Guardian /Representative Home Phone Area Code","N",3,"C","C","Required if member is younger than 12 and cell phone is not populated","If blank and GRDCH1 = spaces and the member is under 12, then assign UPLSTS =1 and error code 193 (GUARDIAN HOME PHONE OR CELL PHONE IS REQUIRED WHEN MEMBER IS UNDER 12) **Note: The incoming EFFDAT will be used when determining the members age. If the REGIND = D then todays date would be used."]
[]
[null,null,null,null,null,"Must be 3 bytes and numeric when populated","If not numeric, then assign UPLSTS = 1 and error code 194 (GUARDIANS HOME PHONE NUMBER MUST BE NUMERIC)"]
[]
[null,null,null,null,null,"Required if home phone exchange or suffix is populated","If GRDPH1 is populated and GRDPH2 or GRDPH3 is blank, or if GRDPH1 <> 3 bytes, assign UPLSTS=1 and error code 109 (GUARDIAN HOME PHONE NUMBER IS INCOMPLETE) "]
["Parent/Legal Guardian /Representative Home Phone Exchange","N",3,"C","C","Required if guardian home phone area code or suffix is populated "]
[]
[null,null,null,null,null,"Must be 3 bytes and numeric when populated","If not numeric, then assign UPLSTS = 1 and error code 194 (GUARDIANS HOME PHONE NUMBER MUST BE NUMERIC)"]
[]
[null,null,null,null,null,null,"If GRDPH2 is populated and GRDPH1 or GRDPH3 is blank or GRDPH2 <> 3 bytes, assign UPLSTS=1 and error code 109 (GUARDIAN HOME PHONE NUMBER IS INCOMPLETE)"]
["Parent/Legal Guardian /Representative Home Phone Suffix","N",4,"C","C","Required if guardian home phone area code or exchange is populated "]
[]
[null,null,null,null,null,null,"If not numeric, then assign UPLSTS = 1 and error code 194 (GUARDIANS HOME PHONE NUMBER MUST BE NUMERIC)"]
[null,null,null,null,null,"Must be 4 bytes and numeric when populated"]
[null,null,null,null,null,null,"If GRDPH3 is populated and GRDPH1 or GRDPH2 is blank or GRDPH3 <> 4 bytes, assign UPLSTS=1 and error code 109 (GUARDIAN HOME PHONE NUMBER IS INCOMPLETE)"]
["Parent/Legal Guardian /Representative Cell Phone Area Code","N",3,"C","C","Required if member is younger than 12 and home phone is not populated","If blank and GRDPH1 = spaces and the member is under 12, then assign UPLSTS =1 and error code 193 (GUARDIAN HOME PHONE OR CELL PHONE IS REQUIRED WHEN MEMBER IS UNDER 12) **Note: The incoming EFFDAT will be used when determining the members age. If the REGIND = D then todays date would be used."]
[]
[null,null,null,null,null,"Must be 3 bytes and numeric when populated","If not numeric, then assign UPLSTS = 1 and error code 196 (GUARDIANS CELL PHONE NUMBER MUST BE NUMERIC)"]
[]
[null,null,null,null,null,"Required if cell phone exchange or suffix is populated","If GRDCH1 is populated and GRDPH2 or GRDPH3 is blank, or if GRDPH1 <> 3 bytes, assign UPLSTS=1 and error code 197 (GUARDIAN CELL PHONE NUMBER IS INCOMPLETE) "]
["Parent/Legal Guardian /Representative Cell Phone Exchange","N",3,"C","C","Required if member is younger than 12","If blank and the member is under 12, then assign UPLSTS =1 and error code 193 (GUARDIAN HOME PHONE OR CELL PHONE IS REQUIRED WHEN MEMBER IS UNDER 12)  **Note: The incoming EFFDAT will be used when determining the members age. If the REGIND = D then todays date would be used."]
[]
[null,null,null,null,null,"Must be 3 bytes and numeric when populated","If not numeric, then assign UPLSTS = 1 and error code 196 (GUARDIANS CELL PHONE NUMBER MUST BE NUMERIC)"]
[]
[null,null,null,null,null,"Required if guardian cell phone area code or suffix is populated ","If GRDCH3 is populated and GRDPH1 or GRDPH3 is blank or GRDPH2 <> 3 bytes, assign UPLSTS=1 and error code 197 (GUARDIAN CELL PHONE NUMBER IS INCOMPLETE)"]
["Parent/Legal Guardian /Representative Cell Phone Suffix","N",4,"C","C","Required if member is younger than 12","If blank and the member is under 12, then assign UPLSTS =1 and error code 193 ( GUARDIAN HOME PHONE OR CELL PHONE IS REQUIRED WHEN MEMBER IS UNDER 12)  **Note: The incoming EFFDAT will be used when determining the members age. If the REGIND = D then todays date would be used."]
[]
[null,null,null,null,null,"Must be 4 bytes and numeric when populated","If not numeric, then assign UPLSTS = 1 and error code 196 (GUARDIANS CELL PHONE NUMBER MUST BE NUMERIC)"]
[]
[null,null,null,null,null,"Required if guardian home phone area code or exchange is populated ","If GRDCH3 is populated and GRDPH1 or GRDPH2 is blank or GRDPH3 <> 4 bytes, assign UPLSTS=1 and error code 197 (GUARDIAN CELL PHONE NUMBER IS INCOMPLETE)"]
["Parent/Legal Guardian /Representative Email address","A",100,"C","C","Required if member is younger than 12","If blank and the member is under 12, then assign UPLSTS =1 and error code 198 (GUARDIAN EMAIL IS REQUIRED WHEN MEMBER IS UNDER 12)  **Note: The incoming EFFDAT will be used when determining the members age. If the REGIND = D then todays date would be used."]
[]
[null,null,null,null,null,"Must be a valid format.  Valid format = address@ISP.nnn” (where the “address” can be any combination of letters and characters, the @ must be present and the value must contain a valid email extension (e.g., .net, .com, .org)","If populated and GRDEML is not in valid format, then assign error UPLSTS = 1 and error code 111 (GUARDIANS EMAIL MUST BE IN A VALID FORMAT)"]
["Parent/Legal Guardian /Representative Verbal Preference","A",1,"C","C","Required if member is younger than 12","If blank and the member is under 12, then assign UPLSTS =1 and error code 200 (GUARDIAN VERBAL PREFERENCE IS REQUIRED WHEN MEMBER IS UNDER 12)  **Note: The incoming EFFDAT will be used when determining the members age. If the REGIND = D then todays date would be used."]
[]
[null,null,null,null,null,"Must be a valid value","If populated and not valid in RFCMAS.REFTYP = VP, assign UPLSTS=1 and error code 199 (GUARDIANS VERBAL PREFERENCE INVALID)"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"E - Electronic"]
[null,null,null,null,null,"V - Verbal"]
[null,null,null,null,null,"T - Text "]
["CDS Code","A",14,"R","R","This 14-digit code is the official, unique identification of a school within California. The first two digits identify the county, the next five digits identify the school district, and the last seven digits identify the school.","If not populated or not equal to 14 bytes, assign UPLSTS = 1 and error code 231 (CDS CODE MUST BE POPULATED AND  14 BYTES)"]
[null,null,null,null,null,"Please note that a CDS code ending in '0000000' indicates a district record not a school."]
["Federal District ID","A",7,"R","R","This field represents the 7-digit National Center for Educational Statistics (NCES) school district identification number. The first 2 digits identify the state and the last 5 digits identify the school district. Combined, they make a unique 7-digit ID for each school district.","If not populated or not equal to 7 bytes, assign UPLSTS = 1 and error code 232 (FEDERAL DISTRICT CODE MUST BE POPULATED AND 7 BYTES)"]
["Federal School ID","A",5,"R","R","This field represents the 5-digit NCES school identification number. The federal school ID combined with the federal district ID form a unique 12-digit ID for each school.","If not populated or not equal to 5 bytes, assign UPLSTS = 1 and error code 233 (FEDERAL SCHOOL ID CODE MUST BE POPULATED AND 5 BYTES)"]
["District Type","A",4,"O","O","The entity type identifies the district or school type. This is also referred to as the ownership code/type.","If populated and not valid in RFCMAS.REFTYP = DTYP, assign UPLSTS=1 and error code 234 (DISTRICT TYPE INVALID)"]
[]
[null,null,null,null,null,"Must be a valid value"]
[]
[null,null,null,null,null,"Valid Values:"]
[null,null,null,null,null,"COED - County Office of Education"]
[null,null,null,null,null,"SBED - State Board of Education"]
[null,null,null,null,null,"SBCH - Statewide Benefit Charter"]
[null,null,null,null,null,"SSSC - State Special Schools"]
[null,null,null,null,null,"NSCL - Non-school Location"]
[null,null,null,null,null,"ESCD Elementary School District"]
[null,null,null,null,null,"USCD - Unified School District"]
[null,null,null,null,null,"HGSC - High School District"]
[null,null,null,null,null,"ROCP - Regional Occupational Center/Program (ROC/P)"]
["Federal Charter District ID","A",7,"O","O","This field represents the 7-digit NCES school district identification number for direct funded charter schools. Beginning in February 2019, direct funded charter schools were issued their own federal district ID and should no longer use the federal district ID associated with their authorizing agency.","If populated and not equal to 7 bytes, assign UPLSTS = 1 and error code 235 (FEDERAL CHARTER CODE MUST BE 7 BYTES)"]
["School County  ","A",4,"R","R","Must be a valid value","If not populated or not valid in RFCMAS.REFTYP = CNTY with PARENT = CASB, assign UPLSTS=1 and error code 236 (SCHOOL COUNTY MISSING OR INVALID)"]
[]
[null,null,null,null,null,"Valid Values:"," "]
[null,null,null,null,null," County Code      County"]
[null,null,null,null,null,"1              Alameda "]
[null,null,null,null,null,"7              Butte "]
[null,null,null,null,null,"13              Contra Costa "]
[null,null,null,null,null,"17              El Dorado "]
[null,null,null,null,null,"19              Fresno "]
[null,null,null,null,null,"23              Humboldt "]
[null,null,null,null,null,"25              Imperial "]
[null,null,null,null,null,"37              Los Angeles "]
[null,null,null,null,null,"39              Madera "]
[null,null,null,null,null,"57              Nevada "]
[null,null,null,null,null,"59              Orange "]
[null,null,null,null,null,"61              Placer "]
[null,null,null,null,null,"65              Riverside "]
[null,null,null,null,null,"67              Sacramento "]
[null,null,null,null,null,"71              San Bernardino "]
[null,null,null,null,null,"73              San Diego "]
[null,null,null,null,null,"77              San Joaquin "]
[null,null,null,null,null,"79              San Luis Obispo "]
[null,null,null,null,null,"85              Santa Clara "]
[null,null,null,null,null,"83              Santa Barbara "]
[null,null,null,null,null,"87              Santa Cruz "]
[]
["District or Administrative Authority name","A",50,"O","O","District or Administrative Authority name"]