Enrollment Span Status Logic

Algorithm

Status

Algorithm

Status

1
Effectuation Date == NULL AND [(“Enrollment Span End Date” Greater than “Enrollment Span Start Date”) OR (“Enrollment Span One Day Span Indicator = TRUE”)] AND Delinquency Indicator is FALSE

PRE MEMBER

2
Effectuation Date != NULL AND [(“Enrollment Span End Date” Greater than “Enrollment Span Start Date”) OR (“Enrollment Span One Day Span Indicator = TRUE”)] AND Delinquency Indicator is FALSE

ENROLLED

3
(“Enrollment Span End Date” Less than “Enrollment Span Start Date”)

CANCELED

4

DELINQUENT

5

SUSPENDED