National Vision Associates Enrollment Data

Modified on Wed, Mar 8, 2023 at 10:18 AM

The output format is an XLSX file.

The following Health Tracking Records are included on this report:

One row is created for each employee and the members associated with the employee.

Field	Sample Value	Data Computation
Benefit Plan Type = V	V	Always V
Group Code	NVA	Main Group field on the Vision Health Plan
Cardholder ID		Always blank
Relation Code		Spec: Subscriber=1, Spouse=2, Child=3, Other=4, Student=5, Disabled Dep=6, Adult Dep=7, Significant Other=8 This value is 1 for the employee For each member, the value is determined by the drop down 1=Spouse 8=Partner 3=Child 4=All other values
Last name	Zinn	Demographics tab or member on health tracking record
First name	Christopher	Demographics tab or member on health tracking record
Middle Initial	M	Demographics tab or member on health tracking record
Date of Birth MM/DD/YYYY	06/01/1930	Demographics tab or member on health tracking record
Gender	M	Demographics tab or member on health tracking record
Coverage Effective Date MM/DD/YYYY	07/01/2024	Start date of the health tracking record
Coverage Termination Date MM/DD/YYYY	06/30/2024	End date of the health tracking record
Address Line1	300 Buckelew Ave	Staff Contact tab: First Address with Legal Address checked
Address Line 2	Suite 201
City	Jamesburg
State Code	NJ
Zip Code	08831
Zip Ext.	1234
Cobra Effective Date MM/DD/YYYY		Always blank
Leave Blank (Not used)		Always blank
Employee Hire Date MM/DD/YYYY		Demographics Tab
Employee Fire Date MM/DD/YYYY		Always blank
Coverage Type		Healthcare tab: membership dropdown for the Vision Plan: F Family E Member & Spouse/Partner E Parent & Child S All other Values