The Non-MSP Input File Sample Clauses

The Non-MSP Input File. This is the data set transmitted from a VDSA partner to CMS that is used to report information regarding the health insurance coverage information of a VDSA partner’s Inactive Covered Individuals – people who are currently not working (most are carried as retired), and a spouse and (or) other dependents, and who are enrolled in a health plan or policy, including but not limited to a GHP or policy, for which the partner or a subsidiary acts as an employer, insurer, third party administrator, health plan sponsor or any combination thereof – and who cannot be classified as Active Covered Individuals. The Non-MSP Input File is used to report drug coverage information that is secondary to Medicare Part D. The Non-MSP Input File can also be used to query CMS about potential beneficiary Part D coverage and can be used as a way to submit enrollment files to the Retiree Drug Subsidy (RDS) Center for those employers claiming the Employer Drug Subsidy. 1. Beneficiary Social Security Number 9 1-9 Numeric Covered Individual’s Social Security Number. Required if HICN not populated. Use any 9 digits, 0-9. Fill with spaces if SSN is not available. 2. HIC Number 12 10-21 Alpha- Numeric Covered Individual’s Health Insurance Claim Number. Required if SSN not populated. Populate with spaces if not available. 3. Covered Individual’s Surname 6 22-27 Text Covered Individual’s Last Name – Required. 4. Covered Individual’s First Initial 1 28-28 Alpha Covered Individual’s First Initial – Required. 5. Covered Individual’s Middle Initial 1 29-29 Alpha Covered Individual’s Middle Initial – Optional. 6. Covered Individual’s 8 30-37 Numeric Date Covered Individual’s DOB. (CCYYMMDD). Field Name Size Displacement Data type Description Date of Birth Required. 7. Covered Individual’s Sex Code 1 38-38 Numeric Covered Individual’s Sex – Valid values: 0 = Unknown 1 = Male 2 = Female Required. 8. Group Health Plan (GHP) Number 20 39-58 Text GHP Number assigned by Payer for action type D, or, Unique Benefit Option Identifier assigned by Payer for action type S. For use with Action Types D and S. Required for Action Type S when Coverage Type is V, Z, 4, 5 or 6. 9. Individual Policy Number 17 59-75 Text Unique Identifier assigned by the payer to identify the covered individual. For use with Action Types D and S. Required for Action Type D when coverage type is V, Z, 4, 5, and 6. 10. Effective Date 8 76-83 Numeric Date Start Date of Covered Individual’s Primary Coverage by Insurer. (CCYYMMDD) Requi...

The Non-MSP Input File. This is the data set transmitted from a VDSA partner to CMS that is used to report information regarding the health insurance coverage information of a VDSA partner‟s Inactive Covered Individuals – people who are currently not working (such as retirees), and a spouse and (or) other dependents, and who are enrolled in a health plan or policy, for which the partner or a subsidiary acts as an insurer, third party administrator, health plan sponsor or any combination thereof – and who cannot be classified as Active Covered Individuals. The Non-MSP Input File is used to report drug coverage information that is secondary to Medicare Part D. The Non- MSP Input File can also be used to query CMS about potential beneficiary Part D coverage. 1. Beneficiary Social Security Number 9 1-9 Numeric Covered Individual‟s Social Security Number. Required if HICN not populated. Use any 9 digits, 0-9. Fill with spaces if SSN is not available. 2. HIC Number (HICN) 12 10-21 Alpha- Numeric Covered Individual‟s Health Insurance Claim Number. Required. Populate with spaces if not available. 3. Covered Individual‟s Surname 6 22-27 Text Covered Individual‟s Last Name – Required. 4. Covered Individual‟s First Initial 1 28-28 Alpha Covered Individual‟s First Initial – Required. 5. Covered Individual‟s 1 29-29 Alpha Covered Individual‟s Middle Initial – Optional. Field Name Size Displacement Data type Description Middle Initial 6. Covered Individual‟s Date of Birth 8 30-37 Numeric Date Covered Individual‟s DOB. (CCYYMMDD). Required.