LIMRA Data Exchange Standards Community Support Forum

         Vijendra,

You would want to send the two coverage nodes:

Send two "coverage" data element for the "productType": "Dental", one with plan ABC with effectiveDate:2026-01-01 and terminationDate: "2026-06-30" and second with plan XYZ with effectiveDate:2026-07-01 and terminationDate: "2026-12-31"?

On the new coverage term date. You can leave it off the file, unless you know for sure the coverage ends at the end of the plan year, or your trading partners system requires a plan year term date every year. If you have any further questions we can scheuld a call to talk through this specific scenario. 

Hi Michael,

Thank you for the clarification.

I do have few more followup questions and Im happy to discuss these over a call. Anytime between 8AM - 10:30AM CST works for me. 

One such question is - does this apply to time of OpenEnrollment as well? i.e as the member chose a different plan for next year during the OE, then at that time should we send, for the same product type of Dental, two coverage data elements? one for current year's existing active coverage and one for next year's newly elected plan? 

Im assuming we should send two, as per the previous clarification.

         Vijendra,

You would want to send the two coverage nodes:

Send two "coverage" data element for the "productType": "Dental", one with plan ABC with effectiveDate:2026-01-01 and terminationDate: "2026-06-30" and second with plan XYZ with effectiveDate:2026-07-01 and terminationDate: "2026-12-31"?

On the new coverage term date. You can leave it off the file, unless you know for sure the coverage ends at the end of the plan year, or your trading partners system requires a plan year term date every year. If you have any further questions we can scheuld a call to talk through this specific scenario. 

Hi Vijendra,

i want to share my piece of expirience here and it's also to share it with Michael to know real-life examples.

What we noticed is that it's really depend on the carrier or let's call it receiving party. Some of the Carriers would like to have only "most recent" coverage block.

So their expectation might be to received one LDEX with "end date" for the coverage, and then another LDEX file with new coverage start date.

Hi Michael,

Thank you for the clarification.

I do have few more followup questions and Im happy to discuss these over a call. Anytime between 8AM - 10:30AM CST works for me. 

One such question is - does this apply to time of OpenEnrollment as well? i.e as the member chose a different plan for next year during the OE, then at that time should we send, for the same product type of Dental, two coverage data elements? one for current year's existing active coverage and one for next year's newly elected plan? 

Im assuming we should send two, as per the previous clarification.

         Vijendra,

You would want to send the two coverage nodes:

Send two "coverage" data element for the "productType": "Dental", one with plan ABC with effectiveDate:2026-01-01 and terminationDate: "2026-06-30" and second with plan XYZ with effectiveDate:2026-07-01 and terminationDate: "2026-12-31"?

On the new coverage term date. You can leave it off the file, unless you know for sure the coverage ends at the end of the plan year, or your trading partners system requires a plan year term date every year. If you have any further questions we can scheuld a call to talk through this specific scenario.