Code identifying the reason for the maintenance change
Type
ID
Length
Max 3 / Min 2
Codes
<> 01
Divorce
<> 02
Birth
<> 03
Death
<> 04
Retirement
<> 4A
Business Name Change
<> 4B
Business Name Correction
<> 4C
Physical or Mailing Address Correction
<> 05
Adoption
<> 06
Strike
<> 07
Termination of Benefits
<> 08
Termination of Employment
<> 09
Consolidation Omnibus Budget Reconciliation Act (COBRA)
<> 10
Consolidation Omnibus Budget Reconciliation Act (COBRA) Premium Paid
<> 11
Surviving Spouse
<> 12
Lay Off
<> 13
Leave of Absence
<> 14
Voluntary Withdrawal
<> 15
Primary Care Provider (PCP) Change
<> 16
Quit
<> 17
Fired
<> 18
Suspended
<> 19
Sabbatical
<> 20
Active
<> 21
Disability
<> 22
Plan Change
<> 23
Furloughed
<> 24
Resigned
<> 25
Change in Identifying Data Elements
<> 26
Declined Coverage
<> 27
Pre-Enrollment
<> 28
Initial Enrollment
<> 29
Benefit Selection
<> 30
Discrimination Test
<> 31
Legal Separation
<> 32
Marriage
<> 33
Personnel Data
<> 34
Investment Elections and Contribution Rates
<> 35
Loan Repayment
<> 36
Contribution or Plan Allocation
<> 37
Leave of Absence with Benefits
<> 38
Leave of Absence without Benefits
<> 39
Lay Off with Benefits
<> 40
Lay Off without Benefits
<> 41
Re-enrollment
<> 42
New Entity
<> 43
Change of Location
<> 44
Change of Telephone Number
<> 45
Went Out of Business
<> 46
Current Customer Information File in Error
<> 47
Account Balance Reporting
<> 48
Fees Processing
<> 49
Interfund Transfer
<> 50
Loan Request
<> 51
Enrollment in Subsequent Benefit Plan
<> 52
Health Care Facility Change
<> 53
Name Synonym Add
<> 54
Sub Location Add
<> 55
Sub Location Change
<> 56
Sub Location Expire
<> 57
Buyout
<> 58
Merger
<> 59
Non Payment
<> 60
Coverage Placed Elsewhere
<> 61
Duplicate Coverage
<> 62
Change in Ownership
<> 63
Business Sold
<> 64
Underwriting Reason
<> 65
No Employees, Exposure or Operations
<> 66
Revocation of Voluntary Market Acceptance
<> 67
Include Primary Business Management
<> 68
Exclude Primary Business Management
<> 69
Failure to Pay Deductible
<> 70
Misrepresented Information
<> 71
Rewritten
<> 72
Adding a Jurisdiction
<> 73
Deleting a Jurisdiction
<> 75
Occupational Illness
<> 76
Change Insured Federal Employer Identification Number (FEIN)
<> 77
Change Employer Federal Employer Identification Number (FEIN)
<> 78
Change Employer Unemployment Insurance (UI) Code
<> 79
Change Policy Number
<> 80
Modification without a Specific Operating Unit Location in Jurisdiction
<> 81
Change Policy Effective Date
<> 82
Change Policy Expiration Date
<> 83
Change Insurer Federal Employer Identification Number (FEIN)
<> 84
No Eligible Employees
<> 85
Reinstatement - Canceled in Error
<> 86
Change in Insured Information
<> 87
Change in Employer Information
<> 88
Parent Identification Change
<> 89
Change to Expiration Date
<> 90
Phone Verify Only
<> AA
Dissatisfaction with Office Staff
<> AB
Dissatisfaction with Medical Care/Services Rendered
<> AC
Inconvenient Office Location
<> AD
Dissatisfaction with Office Hours
<> AE
Unable to Schedule Appointments in a Timely Manner
<> AF
Dissatisfaction with Physician's Referral Policy
<> AG
Less Respect and Attention Time Given than to Other Patients
<> AH
Patient Moved to a New Location
<> AI
No Reason Given
<> AJ
Appointment Times not Met in a Timely Manner
<> XB
Became Medical Only
<> XI
Indemnity
<> XL
Became Lost Time
<> XM
Medical Only
<> XN
Notification Only
<> XT
Transfer
<> ZZ
Mutually Defined
