| | | | | # Transactions in the file | | | | | | |
|---|
| 1 | Scenario 1 | FAM | ZEUS-INT-TEST-1.1
| FFM-FL-One-Add.I834.edi
| 1 | ADD | NA | No | 52323FL0406335
| Florida FFM Trading Partner
| Add transaction for a family of 2. The total responsibility amount is zero. So the enrollment span is effectuated and the paid through date is set to 12/31/2020 |
| 2 | ZEUS-INT-TEST-1.2
| peterson-financial-change.edi | 1 | CHANGE | Yes | No | 52323FL0406335
| Florida FFM Trading Partner
| Financial Change effective 5/1/2020. The total responsibility amount is updated to $10, hence the paid through date is reset from 12/31/2020 to 4/30/2020 After the transaction is processed, a payment of $10 is made, which updates the PTD to 5/31/2020 |
| 3 | ZEUS-INT-TEST-1.3
| peterson-financial-change-2.edi | 1 | CHANGE | Yes | No | 52323FL0406335
| Florida FFM Trading Partner
| Financial Change effective 5/1/2020 which cancels the premium span created in the prior test case |
| 4 | Scenario 2 | FAM | ZEUS-INT-TEST-2.1
| mccall-family.edi
| 1 | ADD | NA | No | 52323FL0406336
| Florida FFM Trading Partner
| Add transaction with only primary subscriber (McCall)
|
| 5 | ZEUS-INT-TEST-2.2
| mccall-nfc.edi
| 1 | CHANGE | No | NA | 52323FL0406336
| Florida FFM Trading Partner
| Non Financial Change Transaction for McCall family
|
| 6 | Scenario 3 | FAM | ZEUS-INT-TEST-3.1
| reyes-family.edi | 1 | ADD | NA | Yes | 52323FL0406335
| Florida FFM Trading Partner
| ADD transaction with multiple financials (i.e. premium spans)
|
| 7 | Scenario 4 | DEP | ZEUS-INT-TEST-4.1
| weber-family.edi | 1 | ADD | NA | Yes | 52323FL0406335
| Florida FFM Trading Partner
| ADD transaction with dependent only coverage for first dependent Add transaction with dependent only coverage for two dependents Add transaction with dependent only coverage for last dependent
|
| 8 | Scenario 5 | DEP | ZEUS-INT-TEST-5.1
| miles-family.edi | 1 | ADD | NA | Yes | 52323FL0406336
| Florida FFM Trading Partner
| Add transaction with coverage for primary subscriber and spouse Add transaction with dependent only coverage for first dependent Add transaction with dependent only coverage for last two dependents
|
| 9 | Scenario 6 | DEP | ZEUS-INT-TEST-6.1
| levine-family.edi | 1 | ADD | NA | Yes | 52323FL0406336
| Florida FFM Trading Partner
| ADD transaction with dependent only coverage for first dependent
|
| 10 | | ZEUS-INT-TEST-6.2
| levine-dep-2-add.edi | 1 | ADD | NA | Yes | 52323FL0406335
| Florida FFM Trading Partner
| ADD transaction with dependent only coverage for second dependent
|
| 11 | Scenario 7 | DEP | ZEUS-INT-TEST-7.1
| leon-family.edi | 1 | ADD | NA | Yes | 52323FL0406336
| Florida FFM Trading Partner
| ADD transaction with dependent only coverage for spouse and one child
|
| 12 | Scenario 8 | DEP | ZEUS-INT-TEST-8.1
| potts-family.edi | 1 | ADD | NA | Yes | 52323FL0406336
| Florida FFM Trading Partner
| ADD transaction with dependent only coverage for spouse and two children
|
| 13 | Scenario 9 | DEP | ZEUS-INT-TEST-9.1
| dean-family.edi | 1 | ADD | NA | Yes | 52323FL0406336
| Florida FFM Trading Partner
| ADD transaction with dependent only coverage for spouse and three children
|
| 14 | Scenario 10 | DEP | ZEUS-INT-TEST-10.1
| snow-family.edi | 1 | ADD | NA | Yes | 52323FL0406336
| Florida FFM Trading Partner
| ADD transaction with dependent only coverage for spouse and four children. Four premium spans, CSR Variant changes in span 3 and 4
|
| 15 | Scenario 11 | DEP | ZEUS-INT-TEST-11.1
| kline-family.edi | 1 | ADD | NA | Yes | 23455MA0535264
| Massachusetts FFM Trading Partner
| ADD transaction with dependent only coverage for first dependent
|
| 16 | Scenario 12 | DEP | ZEUS-INT-TEST-12.1
| shah-family.edi | 1 | ADD | NA | Yes | 23455MA0535264
| Massachusetts FFM Trading Partner
| ADD transaction with dependent only coverage for spouse and one child
|
| 17 | Scenario 13 | DEP | ZEUS-INT-TEST-13.1
| gates-family.edi | 1 | ADD | NA | Yes | 23455MA0535265
| Massachusetts FFM Trading Partner
| ADD transaction with dependent only coverage for spouse and two children
|
| 18 | Scenario 14 | DEP | ZEUS-INT-TEST-14.1
| costa-family.edi | 1 | ADD | NA | Yes | 23455MA0535265
| Massachusetts FFM Trading Partner
| ADD transaction with dependent only coverage for spouse and three children
|
| 19 | Scenario 15 | DEP | ZEUS-INT-TEST-15.1
| mills-family.edi | 1 | ADD | NA | Yes | 23455MA0535265
| Massachusetts FFM Trading Partner
| ADD transaction with dependent only coverage for spouse and four children. Four premium spans, CSR Variant changes in span 3 and 4
|
| 20 | Scenario 16 | DEP | ZEUS-INT-TEST-16.1
| burch-family.edi | 1 | ADD | NA | Yes | 52323FL0406335
| Florida FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber and spouse Subsequent dependent only ADDs
|
| 21 | Scenario 17 | DEP | ZEUS-INT-TEST-17.1
| odom-family.edi | 1 | ADD | NA | Yes | 52323FL0406336
| Florida FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and one child Subsequent dependent only ADDs
|
| 22 | Scenario 18 | DEP | ZEUS-INT-TEST-18.1
| ware-family | 1 | ADD | NA | Yes | 52323FL0406335
| Florida FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and two children Subsequent dependent only ADDs
|
| 23 | Scenario 19 | DEP | ZEUS-INT-TEST-19.1
| peck-family.edi | 1 | ADD | NA | Yes | 52323FL0406336
| Florida FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and three children Subsequent dependent only ADDs
|
| 24 | Scenario 20 | DEP | ZEUS-INT-TEST-20.1
| chase-family.edi | 1 | ADD | NA | Yes | 52323FL0406335
| Florida FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and four children Subsequent dependent only ADDs
|
| 25 | Scenario 21 | DEP | ZEUS-INT-TEST-21.1
| holder-family | 1 | ADD | NA | Yes | 23455MA0535265
| Massachusetts FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber and spouse Subsequent dependent only ADDs
|
| 26 | Scenario 22 | DEP | ZEUS-INT-TEST-22.1
| bean-family.edi | 1 | ADD | NA | Yes | 23455MA0535264
| Massachusetts FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and one child Subsequent dependent only ADDs
|
| 27 | Scenario 23 | DEP | | wall-family.edi | 1 | ADD | NA | Yes | | Massachusetts FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and two children Subsequent dependent only ADDs
|
| 28 | Scenario 24 | DEP | ZEUS-INT-TEST-24.1
| acosta-family.edi | 1 | ADD | NA | Yes | 23455MA0535264
| Massachusetts FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and three children Subsequent dependent only ADDs
|
| 29 | Scenario 25 | DEP | ZEUS-INT-TEST-25.1
| myers-family.edi | 1 | ADD | NA | Yes | 23455MA0535265
| Massachusetts FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and four children Subsequent dependent only ADDs
|
| 30 | Scenario 26 | FAM | ZEUS-INT-TEST-26.1
| golden-family.edi | 1 | ADD | NA | Yes | 52323FL0406335
| Florida FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber and spouse
|
| 31 | Scenario 27 | FAM | ZEUS-INT-TEST-27.1
| wells-family.edi | 1 | ADD | NA | Yes | 52323FL0406336
| Florida FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and one child
|
| 32 | Scenario 28 | FAM | ZEUS-INT-TEST-28.1
| mann-family | 1 | ADD | NA | Yes | 52323FL0406335
| Florida FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and two children
|
| 33 | Scenario 29 | FAM | ZEUS-INT-TEST-29.1
| nolan-family.edi | 1 | ADD | NA | Yes | 52323FL0406336
| Florida FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and three children
|
| 34 | Scenario 30 | FAM | ZEUS-INT-TEST-30.1
| wise-family.edi | 1 | ADD | NA | Yes | 52323FL0406335
| Florida FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and four children
|
| 35 | Scenario 31 | FAM | ZEUS-INT-TEST-31.1
| hays-family.edi | 1 | ADD | NA | Yes | 23455MA0535264
| Massachusetts FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber and spouse
|
| 36 | Scenario 32 | FAM | ZEUS-INT-TEST-32.1
| shaw-family.edi | 1 | ADD | NA | Yes | 23455MA0535265
| Massachusetts FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and one child
|
| 37 | Scenario 33 | FAM | ZEUS-INT-TEST-33.1
| cortez-family.edi | 1 | ADD | NA | Yes | 23455MA0535264
| Massachusetts FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and two children
|
| 38 | Scenario 34 | FAM | ZEUS-INT-TEST-34.1
| mullen-family.edi | 1 | ADD | NA | Yes | 23455MA0535265
| Massachusetts FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and three children
|
| 39 | Scenario 35 | FAM | ZEUS-INT-TEST-35.1
| barber-family.edi | 1 | ADD | NA | Yes | 23455MA0535264
| Massachusetts FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and four children
|
| 40 | Scenario 36 | | | combs-family.edi | 1 | ADD | NA | No | FAM | Florida FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber and spouse
|
| 41 | Scenario 37 | | | oliver-family.edi | 1 | ADD | NA | Yes | FAM | Florida FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and one child
|
| 42 | Scenario 38 | | | rivas-family | 1 | ADD | NA | No | FAM | Florida FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and two children
|
| 43 | Scenario 39 | FAM | ZEUS-INT-TEST-39.1
| bruce-family.edi | 1 | ADD | NA | Yes | 52323FL0406335
| Florida FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and three children
|
| 44 | Scenario 40 | DEP (This was intended to be FAM - Change it when you come to this scenario) | ZEUS-INT-TEST-40.1
| ho-family.edi | 1 | ADD | NA | No | 52323FL0406336
| Florida FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and four children.
|
| 45 | Scenario 41 | | | mack-family.edi | 1 | ADD | NA | No | FAM | Massachusetts FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber and spouse
|
| 46 | Scenario 42 | | | parker-family.edi | 1 | ADD | NA | Yes | FAM | Massachusetts FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and one child
|
| 47 | Scenario 43 | | | berry-family.edi | 1 | ADD | NA | No | FAM | Massachusetts FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and two children
|
| 48 | Scenario 44 | FAM | ZEUS-INT-TEST-44.1
| flores-family.edi | 1 | ADD | NA | Yes | 23455MA0535264
| Massachusetts FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and three children
|
| 49 | Scenario 45 | FAM | ZEUS-INT-TEST-45.1
| yang-family.edi | 1 | ADD | NA | No | 23455MA0535265
| Massachusetts FFM Trading Partner
| ADD Transaction with Enrollments for primary subscriber, spouse and four children
|
| 50 | Scenario 46 | FAM | ZEUS-INT-TEST-46.1
| kirby-family.edi | 1 | ADD | NA | No | 52323FL0406336
| Florida FFM Trading Partner
| ADD Transaction with only primary subscriber
|
| 51 | ZEUS-INT-TEST-46.2
| kirby-new-add-2024.edi | 1 | ADD | NA | No | 52323FL0406336
| Florida FFM Trading Partner
| |
| 52 | ZEUS-INT-TEST-46.2
| kirby-cancel-5-1-2024-span.edi | 1 | CANCEL | NA | No | 52323FL0406336
| Florida FFM Trading Partner
| |
| 53 | Scenario 47 | FAM | ZEUS-INT-TEST-47.1
| brown-family.edi | 1 | ADD | NA | No | 52323FL0406336
| Florida FFM Trading Partner
| ADD Transaction with only primary subscriber
|
| 54 | ZEUS-INT-TEST-47.2
| brown-fc-2024.edi | 1 | CHANGE | NA | No | 52323FL0406336
| Florida FFM Trading Partner
| Financial change effective 5/1/2024 |
| 55 | ZEUS-INT-TEST-47.3
| brown-term-2024-span.edi | 1 | TERM | NA | No | 52323FL0406336
| Florida FFM Trading Partner
| Term enrollment span effective 4/30/2024 |
| 56 | ZEUS-INT-TEST-47.4
| brown-reinstate-2024-span.edi | 1 | REINSTATEMENT | NA | No | 52323FL0406336
| Florida FFM Trading Partner
| Reinstating the 2024 enrollment span |
| 57 | Scenario 48 | | | walls-family.edi | 1 | ADD | NA | No | FAM | Florida FFM Trading Partner
| ADD Transaction with only primary subscriber
|
| 58 | Scenario 49 | | | moyer-family.edi | 1 | ADD | NA | Yes | FAM | Massachusetts FFM Trading Partner
| ADD Transaction with only primary subscriber
|
| 59 | Scenario 50 | | | lynch-family | 1 | ADD | NA | Yes | FAM | Massachusetts FFM Trading Partner
| ADD Transaction with only primary subscriber
|
| 60 | Scenario 51 | | | bass-family.edi | 1 | ADD | NA | Yes | DEP | Florida FFM Trading Partner
| ADD Transaction (FAM) with only primary subscriber Subsequent dependent only ADDs
|
| 61 | Scenario 52 | | | barr-family.edi | 1 | ADD | NA | Yes | DEP | Florida FFM Trading Partner
| ADD Transaction (FAM) with only primary subscriber Subsequent dependent only ADDs
|
| 62 | Scenario 53 | | | larsen-family.edi | 1 | ADD | NA | No | DEP | | ADD Transaction (FAM) with only primary subscriber Subsequent dependent only ADDs
|
| 63 | Scenario 54 | | | sutton-family.edi | 1 | ADD | NA | No | DEP | | ADD Transaction (FAM) with only primary subscriber Subsequent dependent only ADDs
|
| 64 | Scenario 55 | | | garner-family.edi | 1 | ADD | NA | Yes | DEP | | ADD Transaction (FAM) with only primary subscriber Subsequent dependent only ADDs
|
| 65 | Scenario 56 | FAM | | walz-family.edi | 1 | ADD | NA | Yes | 23455MA0535265
| Massachusetts FFM Trading Partner
| ADD Transaction (FAM) with only primary subscriber for 2023. The member will be in PREMEM status. Multiple payments will be made until the PTD is set to 12/31/2023
|