application

application.programsAppliedFor[]enum
Valuessnap medicaid chip tanf

ReasonDetermines which eligibility rules to apply and drives federal and state reporting.

ProgramsSNAPMEDICAIDTANFCHIP
application.channelenum
Valuesonline in_person phone mail

ReasonHow the application was filed; used for intake channel reporting and to route applications to appropriate processing queues.

ProgramsSNAPMEDICAIDTANF
application.ebtEbt
application.ebt.needsCardboolean

ReasonCollected at intake to trigger EBT card issuance at approval without a separate request.

application.ebt.deliveryPreferenceenum
Valuesby_mail in_person

ReasonDetermines whether the EBT card is mailed or held for in-person pickup.

application.registerToVoteboolean

ReasonPublic benefits agencies are required to offer voter registration to applicants.

ProgramsSNAPMEDICAIDTANFCHIP
Policies
nvra-voter-registration-offer42 USC § 1973gg-5

Public assistance agencies must offer voter registration to every applicant and person seeking to renew benefits, and must assist with completing the registration form on request. Refusal to register does not affect benefit eligibility.

application.deniesIevsConsentboolean

ReasonApplicants may opt out of income and asset verification against federal data sources. Denial does not disqualify but triggers manual verification.

ProgramsSNAP
Policies
snap-ssa-identity-check42 U.S.C. § 1320b-7

Agencies must use SSA data matches to verify identity and citizenship status for SNAP applicants. FDSH SSA is the electronic source for this check.

snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.expeditedSnapExpeditedSnap
ProgramsSNAP
Policies
snap-expedited-screening7 CFR § 273.2(i)

Agencies must screen every application on the day it is received for expedited service eligibility. Households qualify if gross monthly income is below $150 and liquid resources are $100 or less; if combined income and liquid resources are less than monthly rent or mortgage plus utilities; or if the household contains a migrant or seasonal farm worker with little or no income. Expedited benefits must be issued within 7 days.

snap-expedited-processing7 CFR § 273.2(i)(3)(i)

Benefits must be issued within 7 days for households with gross monthly income below $150 and liquid resources at or below $100, or households whose combined monthly gross income and liquid resources are less than the monthly rent or mortgage and utilities.

application.expeditedSnap.totalMoneyExpectedThisMonthnumber

ReasonGross monthly income is compared against the expedited SNAP threshold to determine whether same-day issuance is required.

ProgramsSNAP
Policies
snap-expedited-screening7 CFR § 273.2(i)

Agencies must screen every application on the day it is received for expedited service eligibility. Households qualify if gross monthly income is below $150 and liquid resources are $100 or less; if combined income and liquid resources are less than monthly rent or mortgage plus utilities; or if the household contains a migrant or seasonal farm worker with little or no income. Expedited benefits must be issued within 7 days.

snap-expedited-processing7 CFR § 273.2(i)(3)(i)

Benefits must be issued within 7 days for households with gross monthly income below $150 and liquid resources at or below $100, or households whose combined monthly gross income and liquid resources are less than the monthly rent or mortgage and utilities.

application.expeditedSnap.totalCashOnHandnumber

ReasonCash and liquid assets are combined with income for the expedited SNAP screening test.

ProgramsSNAP
Policies
snap-expedited-screening7 CFR § 273.2(i)

Agencies must screen every application on the day it is received for expedited service eligibility. Households qualify if gross monthly income is below $150 and liquid resources are $100 or less; if combined income and liquid resources are less than monthly rent or mortgage plus utilities; or if the household contains a migrant or seasonal farm worker with little or no income. Expedited benefits must be issued within 7 days.

snap-expedited-processing7 CFR § 273.2(i)(3)(i)

Benefits must be issued within 7 days for households with gross monthly income below $150 and liquid resources at or below $100, or households whose combined monthly gross income and liquid resources are less than the monthly rent or mortgage and utilities.

application.expeditedSnap.monthlyMortgagenumber

ReasonMonthly shelter costs are compared against income and cash for the expedited SNAP destitution test.

ProgramsSNAP
Policies
snap-expedited-screening7 CFR § 273.2(i)

Agencies must screen every application on the day it is received for expedited service eligibility. Households qualify if gross monthly income is below $150 and liquid resources are $100 or less; if combined income and liquid resources are less than monthly rent or mortgage plus utilities; or if the household contains a migrant or seasonal farm worker with little or no income. Expedited benefits must be issued within 7 days.

snap-expedited-processing7 CFR § 273.2(i)(3)(i)

Benefits must be issued within 7 days for households with gross monthly income below $150 and liquid resources at or below $100, or households whose combined monthly gross income and liquid resources are less than the monthly rent or mortgage and utilities.

application.expeditedSnap.monthlyRentnumber

ReasonMonthly shelter costs are compared against income and cash for the expedited SNAP destitution test.

ProgramsSNAP
Policies
snap-expedited-screening7 CFR § 273.2(i)

Agencies must screen every application on the day it is received for expedited service eligibility. Households qualify if gross monthly income is below $150 and liquid resources are $100 or less; if combined income and liquid resources are less than monthly rent or mortgage plus utilities; or if the household contains a migrant or seasonal farm worker with little or no income. Expedited benefits must be issued within 7 days.

snap-expedited-processing7 CFR § 273.2(i)(3)(i)

Benefits must be issued within 7 days for households with gross monthly income below $150 and liquid resources at or below $100, or households whose combined monthly gross income and liquid resources are less than the monthly rent or mortgage and utilities.

application.expeditedSnap.monthlyUtilitiesnumber

ReasonMonthly utility costs combined with shelter costs are compared against income for the expedited SNAP destitution test.

ProgramsSNAP
Policies
snap-expedited-screening7 CFR § 273.2(i)

Agencies must screen every application on the day it is received for expedited service eligibility. Households qualify if gross monthly income is below $150 and liquid resources are $100 or less; if combined income and liquid resources are less than monthly rent or mortgage plus utilities; or if the household contains a migrant or seasonal farm worker with little or no income. Expedited benefits must be issued within 7 days.

snap-expedited-processing7 CFR § 273.2(i)(3)(i)

Benefits must be issued within 7 days for households with gross monthly income below $150 and liquid resources at or below $100, or households whose combined monthly gross income and liquid resources are less than the monthly rent or mortgage and utilities.

application.expeditedSnap.receivedSnapInLast30Daysboolean

ReasonRecent SNAP receipt in another state may indicate duplicate participation or ongoing eligibility that affects expedited processing.

ProgramsSNAP
Policies
snap-expedited-screening7 CFR § 273.2(i)

Agencies must screen every application on the day it is received for expedited service eligibility. Households qualify if gross monthly income is below $150 and liquid resources are $100 or less; if combined income and liquid resources are less than monthly rent or mortgage plus utilities; or if the household contains a migrant or seasonal farm worker with little or no income. Expedited benefits must be issued within 7 days.

snap-expedited-processing7 CFR § 273.2(i)(3)(i)

Benefits must be issued within 7 days for households with gross monthly income below $150 and liquid resources at or below $100, or households whose combined monthly gross income and liquid resources are less than the monthly rent or mortgage and utilities.

application.utilitiesUtilities
ProgramsSNAP
Policies
snap-utility-allowance-standards7 CFR § 273.9(d)(6)

Households that do not receive LIHEAP may use a standard utility allowance instead of actual utility costs. Households that heat or cool their home qualify for the full heating and cooling standard (HCSUA). Residents of federally subsidized housing where utilities are included in rent are ineligible for the HCSUA. Receipt of even one dollar of LIHEAP automatically qualifies the household for the HCSUA.

application.utilities.heatCoolMethodenum
Valuesgas electric oil propane other

ReasonDetermines which utility allowance standard applies. Households that heat or cool with certain methods qualify for the full heating and cooling standard.

ProgramsSNAP
Policies
snap-utility-allowance-standards7 CFR § 273.9(d)(6)

Households that do not receive LIHEAP may use a standard utility allowance instead of actual utility costs. Households that heat or cool their home qualify for the full heating and cooling standard (HCSUA). Residents of federally subsidized housing where utilities are included in rent are ineligible for the HCSUA. Receipt of even one dollar of LIHEAP automatically qualifies the household for the HCSUA.

application.utilities.heatCoolMethodOtherstring

ReasonCaptures non-enumerated heating or cooling methods for adapter mapping to the appropriate utility standard.

ProgramsSNAP
Policies
snap-utility-allowance-standards7 CFR § 273.9(d)(6)

Households that do not receive LIHEAP may use a standard utility allowance instead of actual utility costs. Households that heat or cool their home qualify for the full heating and cooling standard (HCSUA). Residents of federally subsidized housing where utilities are included in rent are ineligible for the HCSUA. Receipt of even one dollar of LIHEAP automatically qualifies the household for the HCSUA.

application.utilities.receivesLiheapboolean

ReasonReceipt of even one dollar of LIHEAP automatically qualifies the household for the full heating and cooling standard utility allowance.

ProgramsSNAP
Policies
snap-utility-allowance-standards7 CFR § 273.9(d)(6)

Households that do not receive LIHEAP may use a standard utility allowance instead of actual utility costs. Households that heat or cool their home qualify for the full heating and cooling standard (HCSUA). Residents of federally subsidized housing where utilities are included in rent are ineligible for the HCSUA. Receipt of even one dollar of LIHEAP automatically qualifies the household for the HCSUA.

members

application.members[]list(ApplicationMember)

ReasonHousehold members on the application, including both applying and non-applying members whose data affects eligibility. Each member is linked to a contacts[] record via personId; shared identity and contact data lives there.

application.members[].personIduuid(Person)

ReasonFK to application.contacts[] linking the member to their person record, which holds name, address, phone, and email shared with non-member contacts.

application.members[].iduuid

ReasonUnique identifier for the member record; FK target for memberId fields throughout the application model.

application.members[].applicationIduuid(Application)
application.members[].roles[]enum
Valuesprimary_applicant household_member non_applying_member authorized_representative absent_parent

ReasonDetermines which application flows apply to the member and how their data is scoped within the application.

ProgramsSNAPMEDICAID
Policies
snap-authorized-representative7 CFR § 273.2(n)

A SNAP authorized representative must be a non-household member. They may apply, be interviewed, and obtain benefits on behalf of the household, but may not also appear as a regular household member on the same application.

medicaid-authorized-representative42 CFR § 435.923

A Medicaid authorized representative may be a household member. Unlike SNAP, Medicaid permits a person who lives in the household to act as authorized representative, meaning one person can simultaneously hold both the household member and authorized representative roles.

application.members[].programsAppliedFor[]enum
Valuessnap medicaid chip tanf

ReasonPer-member program application, distinct from the household-level programsAppliedFor[]. A member may apply for a subset of the programs the household is seeking.

ModelingA member's selection must be a subset of the household-level programsAppliedFor[] selection.

ProgramsSNAPMEDICAIDTANF
application.members[].purchasesAndPreparesFoodboolean

ReasonMembers who purchase and prepare food separately from the rest of the household form a separate SNAP household and are excluded from the applicant's SNAP unit.

ProgramsSNAP
Policies
snap-household-composition7 CFR § 273.1

All household members must be listed on the application regardless of whether they are individually applying for SNAP. Members who are ineligible — such as non-citizens who do not qualify — must still be listed because their income and resources are counted when calculating the benefit amount for the rest of the household.

application.members[].isMigrantFarmWorkerboolean

ReasonMigrant and seasonal farm workers qualify for expedited SNAP regardless of the standard income and asset thresholds.

ProgramsSNAP
Policies
snap-expedited-screening7 CFR § 273.2(i)

Agencies must screen every application on the day it is received for expedited service eligibility. Households qualify if gross monthly income is below $150 and liquid resources are $100 or less; if combined income and liquid resources are less than monthly rent or mortgage plus utilities; or if the household contains a migrant or seasonal farm worker with little or no income. Expedited benefits must be issued within 7 days.

application.members[].hasThirdPartyLiabilityClaimboolean

ReasonMedicaid is payer of last resort; the presence of a third-party liability claim triggers cost avoidance and recovery procedures.

ProgramsMEDICAID
Policies
medicaid-third-party-liability42 CFR § 433.136

Medicaid is payer of last resort. States must identify third-party liability — insurance, workers' compensation, or other coverage — and pursue cost avoidance and recovery before paying Medicaid claims. Applicants must cooperate with third-party liability identification as a condition of eligibility.

application.members[].personalInformationPersonalInformation
application.members[].personalInformation.ssnstring

ReasonRequired for identity verification and cross-matching against federal income and asset data sources under IEVS.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-ssn-requirement7 CFR § 273.6

Every household member applying for SNAP must provide a Social Security Number or apply for one. Members who refuse to provide an SSN are ineligible, but their income is still counted toward the household's SNAP calculation.

snap-ssa-identity-check42 U.S.C. § 1320b-7

Agencies must use SSA data matches to verify identity and citizenship status for SNAP applicants. FDSH SSA is the electronic source for this check.

application.members[].personalInformation.dateOfBirthdate

ReasonUsed for age-based eligibility rules including CHIP age limits, SNAP elderly and disabled deductions, ABAWD rules, and foster care extended eligibility.

ClassificationPII
ProgramsSNAPMEDICAIDCHIP
Policies
chip-age-eligibility42 USC § 1397jj

CHIP covers targeted low-income children under age 19 who are not eligible for Medicaid and who lack other insurance coverage. States set income limits up to 300% FPL (or higher with a waiver). CHIP also covers pregnant women in states with an unborn child option.

medicaid-foster-care-extended-eligibility42 USC § 1396a(a)(10)(A)(ii)(XX)

Youth who were in foster care and enrolled in Medicaid at age 18 are eligible for Medicaid coverage until age 26 regardless of income. Coverage applies to youth who aged out of foster care or who left care for adoption or guardianship. States must accept applications from eligible youth who were in care in any state.

snap-elderly-disabled-deductions7 CFR § 273.9(d)

Households with an elderly or disabled member are eligible for an excess medical expense deduction (unreimbursed costs above $35/month) in addition to the standard deductions. These households are also exempt from the gross income test and subject only to the net income test.

application.members[].personalInformation.sexAssignedAtBirthenum
Valuesmale female intersex unknown

ReasonUsed for clinical eligibility determinations including pregnancy Medicaid, sex-specific health screenings, and certain household composition rules.

ProgramsMEDICAIDCHIP
Policies
aca-section-1557-nondiscriminationACA § 1557

Section 1557 prohibits discrimination in health programs and activities on the basis of race, color, national origin, sex (including gender identity and sexual orientation), age, and disability. Applies to health programs receiving federal financial assistance, including state Medicaid and CHIP programs and marketplace plans.

application.members[].personalInformation.genderIdentityenum
Valuesman woman non_binary transgender_man transgender_woman prefer_not_to_answer other

ReasonRequired to honor anti-discrimination obligations and ensure accurate, respectful correspondence with applicants.

ProgramsMEDICAIDCHIP
Policies
aca-section-1557-nondiscriminationACA § 1557

Section 1557 prohibits discrimination in health programs and activities on the basis of race, color, national origin, sex (including gender identity and sexual orientation), age, and disability. Applies to health programs receiving federal financial assistance, including state Medicaid and CHIP programs and marketplace plans.

application.members[].personalInformation.maritalStatusenum
Valuessingle married divorced separated widowed civil_union domestic_partnership

ReasonAffects household composition, spousal income deeming, MAGI filing status determination, and two-parent TANF household rules.

ProgramsSNAPMEDICAID
Policies
snap-deeming-rules7 CFR § 273.11

Income of a non-applying spouse is deemed to the household. Special income averaging rules apply to households with irregular or self-employment income. Temporary income changes may be prorated over the benefit period.

medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.members[].personalInformation.races[]enum
Valuesamerican_indian_alaskan_native asian black_african_american native_hawaiian_pacific_islander white

ReasonRequired for civil rights reporting, equity monitoring, and program targeting.

ModelingArray to comply with OMB standards requiring that individuals be able to select all applicable races simultaneously.

ProgramsSNAPMEDICAIDTANFCHIP
Policies
omb-race-ethnicity-standardsOMB Statistical Policy Directive No. 15

OMB standards require federal agencies and programs receiving federal funds to collect race and ethnicity data using prescribed minimum categories. Individuals must be able to select all applicable races simultaneously. Hispanic or Latino ethnicity is collected separately from race.

title-vi-civil-rights42 USC § 2000d

Programs and activities receiving federal financial assistance may not discriminate on the basis of race, color, or national origin. Title VI requires agencies to provide meaningful access to persons with limited English proficiency through interpreter services and translated materials.

application.members[].personalInformation.isHispanicOrLatinoboolean

ReasonHispanic or Latino ethnicity is collected separately from race per OMB standards and is required for civil rights reporting.

ProgramsSNAPMEDICAIDTANFCHIP
Policies
omb-race-ethnicity-standardsOMB Statistical Policy Directive No. 15

OMB standards require federal agencies and programs receiving federal funds to collect race and ethnicity data using prescribed minimum categories. Individuals must be able to select all applicable races simultaneously. Hispanic or Latino ethnicity is collected separately from race.

title-vi-civil-rights42 USC § 2000d

Programs and activities receiving federal financial assistance may not discriminate on the basis of race, color, or national origin. Title VI requires agencies to provide meaningful access to persons with limited English proficiency through interpreter services and translated materials.

application.members[].personalInformation.preferredSpokenLanguagestring

ReasonDetermines which language interpreter services must be arranged for appointments and communications to ensure meaningful access.

ProgramsSNAPMEDICAID
Policies
medicaid-language-access42 CFR § 435.905(b)

States must provide translated notices and interpreter services to applicants and beneficiaries with limited English proficiency. Written materials must be translated into any language spoken by 5% or more of the service area population. Interpreter services must be provided free of charge.

eo-13166-language-accessExecutive Order 13166

Federal agencies and recipients of federal financial assistance must ensure meaningful access to services for persons with limited English proficiency. Each agency must develop a language access plan, and recipients must provide language services free of charge. Applies to all safety net benefit programs.

title-vi-civil-rights42 USC § 2000d

Programs and activities receiving federal financial assistance may not discriminate on the basis of race, color, or national origin. Title VI requires agencies to provide meaningful access to persons with limited English proficiency through interpreter services and translated materials.

application.members[].personalInformation.preferredWrittenLanguagestring

ReasonDetermines which language translated notices and written communications must be provided in for meaningful access.

ProgramsSNAPMEDICAID
Policies
medicaid-language-access42 CFR § 435.905(b)

States must provide translated notices and interpreter services to applicants and beneficiaries with limited English proficiency. Written materials must be translated into any language spoken by 5% or more of the service area population. Interpreter services must be provided free of charge.

eo-13166-language-accessExecutive Order 13166

Federal agencies and recipients of federal financial assistance must ensure meaningful access to services for persons with limited English proficiency. Each agency must develop a language access plan, and recipients must provide language services free of charge. Applies to all safety net benefit programs.

title-vi-civil-rights42 USC § 2000d

Programs and activities receiving federal financial assistance may not discriminate on the basis of race, color, or national origin. Title VI requires agencies to provide meaningful access to persons with limited English proficiency through interpreter services and translated materials.

application.members[].contactMemberContact
application.members[].contact.nameName
application.members[].contact.name.firstNamestring
application.members[].contact.name.middleNamestring
application.members[].contact.name.middleInitialstring
application.members[].contact.name.lastNamestring
application.members[].contact.name.maidenNamestring
application.members[].contact.name.suffixstring
application.members[].contact.primaryAddressAddress

ReasonUsed for residency determination, county routing for benefits administration, and physical location for home visits when required.

application.members[].contact.primaryAddress.addressLine1string
application.members[].contact.primaryAddress.addressLine2string
application.members[].contact.primaryAddress.citystring
application.members[].contact.primaryAddress.statestring
application.members[].contact.primaryAddress.zipstring
application.members[].contact.primaryAddress.countystring
application.members[].contact.primaryPhonestring

ReasonPrimary contact number for program notifications, interview scheduling, and verification follow-up.

application.members[].contact.emailemail

ReasonEmail address for electronic delivery of program notices when noticePreference includes email.

application.members[].contact.mailingAddressAddress

ReasonUsed for correspondence when the mailing address differs from the home address.

application.members[].contact.mailingAddress.addressLine1string
application.members[].contact.mailingAddress.addressLine2string
application.members[].contact.mailingAddress.citystring
application.members[].contact.mailingAddress.statestring
application.members[].contact.mailingAddress.zipstring
application.members[].contact.mailingAddress.countystring
application.members[].contact.alternatePhonestring

ReasonSecondary contact number used when the primary number is unavailable.

application.members[].contact.isExperiencingHomelessnessboolean

ReasonHomelessness affects address collection requirements, shelter deduction eligibility for SNAP, and may trigger expedited processing.

ProgramsSNAP
Policies
snap-residency-requirement7 CFR § 273.3

SNAP applicants must be residents of the state in which they apply. Residency is established by physical presence with intent to remain; a fixed address is not required. Migrant workers and homeless individuals may apply in the state where they currently reside.

application.members[].contact.noticePreferenceenum
Valuespaper email both

ReasonDetermines whether notices are delivered by paper mail, email, or both, per applicant preference.

ProgramsMEDICAID
Policies
medicaid-electronic-notices42 CFR § 435.918

States may send notices electronically to applicants and beneficiaries who affirmatively opt in to electronic delivery. Electronic notices must be equally accessible and must contain the same information as paper notices. Paper notices must be sent when an electronic notice cannot be delivered.

application.members[].contact.alternateNoticeAddressAddress

ReasonAlternative address for program notices, primarily used by domestic violence survivors and individuals receiving sensitive health services who need correspondence sent separately from their household address.

ProgramsMEDICAIDCHIP
Policies
hipaa-confidential-communications45 CFR § 164.522

Individuals have the right to request that covered entities send protected health information to an alternative address or by alternative means. Health plans must accommodate reasonable requests when the individual states that disclosure to the usual address could endanger them. Applies particularly to domestic violence survivors and recipients of sensitive health services.

aca-section-1557-nondiscriminationACA § 1557

Section 1557 prohibits discrimination in health programs and activities on the basis of race, color, national origin, sex (including gender identity and sexual orientation), age, and disability. Applies to health programs receiving federal financial assistance, including state Medicaid and CHIP programs and marketplace plans.

application.members[].contact.alternateNoticeAddress.addressLine1string
ProgramsMEDICAIDCHIP
Policies
hipaa-confidential-communications45 CFR § 164.522

Individuals have the right to request that covered entities send protected health information to an alternative address or by alternative means. Health plans must accommodate reasonable requests when the individual states that disclosure to the usual address could endanger them. Applies particularly to domestic violence survivors and recipients of sensitive health services.

aca-section-1557-nondiscriminationACA § 1557

Section 1557 prohibits discrimination in health programs and activities on the basis of race, color, national origin, sex (including gender identity and sexual orientation), age, and disability. Applies to health programs receiving federal financial assistance, including state Medicaid and CHIP programs and marketplace plans.

application.members[].contact.alternateNoticeAddress.addressLine2string
ProgramsMEDICAIDCHIP
Policies
hipaa-confidential-communications45 CFR § 164.522

Individuals have the right to request that covered entities send protected health information to an alternative address or by alternative means. Health plans must accommodate reasonable requests when the individual states that disclosure to the usual address could endanger them. Applies particularly to domestic violence survivors and recipients of sensitive health services.

aca-section-1557-nondiscriminationACA § 1557

Section 1557 prohibits discrimination in health programs and activities on the basis of race, color, national origin, sex (including gender identity and sexual orientation), age, and disability. Applies to health programs receiving federal financial assistance, including state Medicaid and CHIP programs and marketplace plans.

application.members[].contact.alternateNoticeAddress.citystring
ProgramsMEDICAIDCHIP
Policies
hipaa-confidential-communications45 CFR § 164.522

Individuals have the right to request that covered entities send protected health information to an alternative address or by alternative means. Health plans must accommodate reasonable requests when the individual states that disclosure to the usual address could endanger them. Applies particularly to domestic violence survivors and recipients of sensitive health services.

aca-section-1557-nondiscriminationACA § 1557

Section 1557 prohibits discrimination in health programs and activities on the basis of race, color, national origin, sex (including gender identity and sexual orientation), age, and disability. Applies to health programs receiving federal financial assistance, including state Medicaid and CHIP programs and marketplace plans.

application.members[].contact.alternateNoticeAddress.statestring
ProgramsMEDICAIDCHIP
Policies
hipaa-confidential-communications45 CFR § 164.522

Individuals have the right to request that covered entities send protected health information to an alternative address or by alternative means. Health plans must accommodate reasonable requests when the individual states that disclosure to the usual address could endanger them. Applies particularly to domestic violence survivors and recipients of sensitive health services.

aca-section-1557-nondiscriminationACA § 1557

Section 1557 prohibits discrimination in health programs and activities on the basis of race, color, national origin, sex (including gender identity and sexual orientation), age, and disability. Applies to health programs receiving federal financial assistance, including state Medicaid and CHIP programs and marketplace plans.

application.members[].contact.alternateNoticeAddress.zipstring
ProgramsMEDICAIDCHIP
Policies
hipaa-confidential-communications45 CFR § 164.522

Individuals have the right to request that covered entities send protected health information to an alternative address or by alternative means. Health plans must accommodate reasonable requests when the individual states that disclosure to the usual address could endanger them. Applies particularly to domestic violence survivors and recipients of sensitive health services.

aca-section-1557-nondiscriminationACA § 1557

Section 1557 prohibits discrimination in health programs and activities on the basis of race, color, national origin, sex (including gender identity and sexual orientation), age, and disability. Applies to health programs receiving federal financial assistance, including state Medicaid and CHIP programs and marketplace plans.

application.members[].contact.alternateNoticeAddress.countystring
ProgramsMEDICAIDCHIP
Policies
hipaa-confidential-communications45 CFR § 164.522

Individuals have the right to request that covered entities send protected health information to an alternative address or by alternative means. Health plans must accommodate reasonable requests when the individual states that disclosure to the usual address could endanger them. Applies particularly to domestic violence survivors and recipients of sensitive health services.

aca-section-1557-nondiscriminationACA § 1557

Section 1557 prohibits discrimination in health programs and activities on the basis of race, color, national origin, sex (including gender identity and sexual orientation), age, and disability. Applies to health programs receiving federal financial assistance, including state Medicaid and CHIP programs and marketplace plans.

application.members[].residencyResidency
application.members[].residency.isStateResidentboolean

ReasonState residency is a universal eligibility requirement across all programs; non-residents are ineligible regardless of other criteria.

ProgramsSNAPMEDICAIDTANF
Policies
snap-residency-requirement7 CFR § 273.3

SNAP applicants must be residents of the state in which they apply. Residency is established by physical presence with intent to remain; a fixed address is not required. Migrant workers and homeless individuals may apply in the state where they currently reside.

medicaid-residency-requirement42 CFR § 435.403

Medicaid applicants must be residents of the state in which they apply. Residency is established by living in the state with the intent to remain. A fixed address is not required; homeless individuals who live in the state are residents.

tanf-residency-requirement45 CFR § 260.52

States may not impose a durational residency requirement on TANF applicants. States may pay reduced benefits to recent residents for up to 12 months if the sending state's benefit level was lower, subject to federal limits established after Saenz v. Roe.

application.members[].residency.stateResidencyDatedate

ReasonRequired for states that verify residency duration and for determining benefit start dates when a household transfers from another state.

application.members[].citizenshipCitizenship
ClassificationPII
ProgramsMEDICAID
Policies
medicaid-immigration-electronic-check42 CFR § 435.956(c)

States must use electronic data sources to verify immigration status before requesting paper documentation. FDSH VLP satisfies this requirement.

application.members[].citizenship.citizenshipStatusenum
Valuesus_citizen us_national non_citizen

ReasonNon-citizens have restricted access to federal programs under PRWORA. Citizenship status determines which verification procedures and waiting periods apply.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-citizenship-eligibility7 CFR § 273.4

Only U.S. citizens and qualified aliens are eligible for SNAP. Agency must verify citizenship or immigration status for all applicants.

qualified-alien-eligibility8 U.S.C. § 1611

Federal statute establishing that only qualified aliens are eligible for federal public benefits including SNAP. Defines the categories of immigration status that confer eligibility.

prwora-1996-grandfather-exemption8 USC § 1613(a)

Non-citizens who were lawfully residing in the US on August 22, 1996 and who were receiving SNAP or other federal benefits on that date are exempt from the 5-year bar on federal benefits. Continuous residence since that date is required to qualify for the grandfathering exception.

prwora-military-alien-exemption8 USC § 1641(b)(1)

Non-citizens with a qualifying connection to US military service — veterans, active duty service members, and their spouses and unmarried dependent children — are qualified aliens exempt from PRWORA waiting periods and restrictions on federal benefits.

application.members[].citizenship.certificateNumberstring

ReasonUS naturalization or citizenship certificate number used for SAVE verification of citizenship claims.

ClassificationPII
ProgramsMEDICAID
Policies
medicaid-immigration-electronic-check42 CFR § 435.956(c)

States must use electronic data sources to verify immigration status before requesting paper documentation. FDSH VLP satisfies this requirement.

application.members[].citizenship.immigrantStatusenum
Valueslawful_permanent_resident refugee asylee deportation_withheld parolee conditional_entrant cuban_haitian_entrant amerasian battered_non_citizen trafficking_victim temporary_protected_status other

ReasonSpecific immigration category determines program eligibility, applicable waiting periods, and the required verification pathway.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
qualified-alien-eligibility8 U.S.C. § 1611

Federal statute establishing that only qualified aliens are eligible for federal public benefits including SNAP. Defines the categories of immigration status that confer eligibility.

medicaid-immigration-electronic-check42 CFR § 435.956(c)

States must use electronic data sources to verify immigration status before requesting paper documentation. FDSH VLP satisfies this requirement.

snap-citizenship-eligibility7 CFR § 273.4

Only U.S. citizens and qualified aliens are eligible for SNAP. Agency must verify citizenship or immigration status for all applicants.

prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

application.members[].citizenship.uscisNumberOrI94string

ReasonAlien registration number or I-94 admission number required to initiate FDSH VLP verification.

ClassificationPII
ProgramsMEDICAID
Policies
medicaid-immigration-electronic-check42 CFR § 435.956(c)

States must use electronic data sources to verify immigration status before requesting paper documentation. FDSH VLP satisfies this requirement.

application.members[].citizenship.documentDocument
ClassificationPII
ProgramsMEDICAID
Policies
medicaid-immigration-electronic-check42 CFR § 435.956(c)

States must use electronic data sources to verify immigration status before requesting paper documentation. FDSH VLP satisfies this requirement.

application.members[].citizenship.document.typeenum
Valuesi_551 i_766 i_94 i_327 i_571 foreign_passport machine_readable_immigrant_visa other

ReasonImmigration document type determines which fields FDSH VLP requires to initiate a verification check.

ClassificationPII
ProgramsMEDICAID
Policies
medicaid-immigration-electronic-check42 CFR § 435.956(c)

States must use electronic data sources to verify immigration status before requesting paper documentation. FDSH VLP satisfies this requirement.

application.members[].citizenship.document.numberstring

ReasonDocument number required for FDSH VLP immigration status verification.

ClassificationPII
ProgramsMEDICAID
Policies
medicaid-immigration-electronic-check42 CFR § 435.956(c)

States must use electronic data sources to verify immigration status before requesting paper documentation. FDSH VLP satisfies this requirement.

application.members[].citizenship.document.expirationDatedate

ReasonExpired immigration documents may indicate a change in immigration status that affects eligibility.

ClassificationPII
ProgramsMEDICAID
Policies
medicaid-immigration-electronic-check42 CFR § 435.956(c)

States must use electronic data sources to verify immigration status before requesting paper documentation. FDSH VLP satisfies this requirement.

application.members[].citizenship.document.countryOfIssuancestring

ReasonCountry of issuance is required for foreign passport VLP verification lookups.

ClassificationPII
ProgramsMEDICAID
Policies
medicaid-immigration-electronic-check42 CFR § 435.956(c)

States must use electronic data sources to verify immigration status before requesting paper documentation. FDSH VLP satisfies this requirement.

application.members[].citizenship.residedInUsSince1996boolean

ReasonContinuous US residence since August 22, 1996 is required for the PRWORA grandfather exemption for certain non-citizens who were receiving benefits before the law took effect.

ClassificationPII
ProgramsSNAPMEDICAIDTANF
Policies
prwora-1996-grandfather-exemption8 USC § 1613(a)

Non-citizens who were lawfully residing in the US on August 22, 1996 and who were receiving SNAP or other federal benefits on that date are exempt from the 5-year bar on federal benefits. Continuous residence since that date is required to qualify for the grandfathering exception.

application.members[].citizenship.hasQualifyingMilitaryConnectionboolean

ReasonQualified non-citizens with a connection to US military service are exempt from PRWORA waiting periods.

ClassificationPII
ProgramsSNAPMEDICAIDTANF
Policies
prwora-military-alien-exemption8 USC § 1641(b)(1)

Non-citizens with a qualifying connection to US military service — veterans, active duty service members, and their spouses and unmarried dependent children — are qualified aliens exempt from PRWORA waiting periods and restrictions on federal benefits.

application.members[].citizenship.sponsoredSponsored
ClassificationPII
ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.members[].citizenship.sponsored.hasBeenAbandonedBySponsorboolean

ReasonSponsor abandonment is a basis for exempting a sponsored non-citizen from deeming of the sponsor's income.

ModelingKept separate from hasBeenMistreatedBySponsor because abandonment (documented through lack of financial support or sponsor departure) and battery/mistreatment (VAWA-based, requiring police reports, court orders, or professional statements) have distinct legal bases and different verification pathways. Forms that combine them into a single yes/no require a state overlay.

ClassificationPII
ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.members[].citizenship.sponsored.hasBeenMistreatedBySponsorboolean

ReasonBattery or extreme cruelty by a sponsor is a basis for exempting a sponsored non-citizen from deeming under VAWA protections.

ModelingKept separate from hasBeenAbandonedBySponsor; see that field's design note for the rationale.

ClassificationPII
ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.members[].citizenship.sponsored.qualifiesForSponsorDeemingExceptionboolean

ReasonCertain sponsored non-citizens — pregnant women, children under 21 — are exempt from sponsor income deeming.

ClassificationPII
ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.members[].citizenship.sponsored.receivesInKindSupportboolean

ReasonIn-kind support and maintenance (non-cash housing and food) from a sponsor is counted as income for SSI and may affect other program determinations.

ClassificationPII
ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.members[].retroactiveMedicalCoverageRetroactiveMedicalCoverage
ProgramsMEDICAID
Policies
medicaid-retroactive-coverage42 CFR § 435.915

Medicaid must cover medical expenses incurred in the three calendar months before the month of application if the individual would have been eligible during those months. Retroactive coverage applies to all covered Medicaid services and does not require a separate application.

application.members[].retroactiveMedicalCoverage.isRequestedboolean

ReasonMedicaid may cover medical expenses incurred up to 3 months before the application month for eligible individuals who would have qualified during that period.

ProgramsMEDICAID
Policies
medicaid-retroactive-coverage42 CFR § 435.915

Medicaid must cover medical expenses incurred in the three calendar months before the month of application if the individual would have been eligible during those months. Retroactive coverage applies to all covered Medicaid services and does not require a separate application.

application.members[].retroactiveMedicalCoverage.periods[]list(Period)

ReasonMonthly retroactive coverage periods for which Medicaid coverage is requested, each capturing the household income for that month to determine whether the applicant would have qualified.

ProgramsMEDICAID
Policies
medicaid-retroactive-coverage42 CFR § 435.915

Medicaid must cover medical expenses incurred in the three calendar months before the month of application if the individual would have been eligible during those months. Retroactive coverage applies to all covered Medicaid services and does not require a separate application.

application.members[].retroactiveMedicalCoverage.periods[].monthstring

ReasonIdentifies the specific months for which retroactive coverage is requested, up to the 3-month retroactive period.

ProgramsMEDICAID
Policies
medicaid-retroactive-coverage42 CFR § 435.915

Medicaid must cover medical expenses incurred in the three calendar months before the month of application if the individual would have been eligible during those months. Retroactive coverage applies to all covered Medicaid services and does not require a separate application.

application.members[].retroactiveMedicalCoverage.periods[].householdIncomenumber

ReasonIncome during the retroactive month must be evaluated against the eligibility threshold for that month to determine whether the applicant would have qualified.

ProgramsMEDICAID
Policies
medicaid-retroactive-coverage42 CFR § 435.915

Medicaid must cover medical expenses incurred in the three calendar months before the month of application if the individual would have been eligible during those months. Retroactive coverage applies to all covered Medicaid services and does not require a separate application.

application.members[].disabilityDisability
ProgramsSNAPMEDICAID
Policies
snap-elderly-disabled-deductions7 CFR § 273.9(d)

Households with an elderly or disabled member are eligible for an excess medical expense deduction (unreimbursed costs above $35/month) in addition to the standard deductions. These households are also exempt from the gross income test and subject only to the net income test.

medicaid-disability-determination42 CFR § 435.541

States must establish criteria and processes for determining disability for Medicaid eligibility purposes. States may use SSA disability determinations or conduct their own evaluations. A disabling condition must be expected to last at least 12 months or result in death.

application.members[].disability.isDisabledboolean

ReasonA disabling condition lasting 12 or more months affects SNAP elderly and disabled household rules and categorical Medicaid eligibility determination.

ProgramsSNAPMEDICAID
Policies
snap-elderly-disabled-deductions7 CFR § 273.9(d)

Households with an elderly or disabled member are eligible for an excess medical expense deduction (unreimbursed costs above $35/month) in addition to the standard deductions. These households are also exempt from the gross income test and subject only to the net income test.

medicaid-disability-determination42 CFR § 435.541

States must establish criteria and processes for determining disability for Medicaid eligibility purposes. States may use SSA disability determinations or conduct their own evaluations. A disabling condition must be expected to last at least 12 months or result in death.

application.members[].disability.hasLongTermConditionboolean

ReasonIdentifies members with a condition expected to last 12 or more months, used as a screening criterion alongside isDisabled for SNAP elderly and disabled household rules and Medicaid disability determination pathways.

ProgramsSNAPMEDICAID
Policies
snap-elderly-disabled-deductions7 CFR § 273.9(d)

Households with an elderly or disabled member are eligible for an excess medical expense deduction (unreimbursed costs above $35/month) in addition to the standard deductions. These households are also exempt from the gross income test and subject only to the net income test.

medicaid-disability-determination42 CFR § 435.541

States must establish criteria and processes for determining disability for Medicaid eligibility purposes. States may use SSA disability determinations or conduct their own evaluations. A disabling condition must be expected to last at least 12 months or result in death.

application.members[].disability.hasPhysicalDisabilityboolean

ReasonIdentifies whether the member has a physical disability; collected to support SNAP elderly and disabled household deductions and Medicaid disability pathways.

ProgramsSNAPMEDICAID
Policies
snap-elderly-disabled-deductions7 CFR § 273.9(d)

Households with an elderly or disabled member are eligible for an excess medical expense deduction (unreimbursed costs above $35/month) in addition to the standard deductions. These households are also exempt from the gross income test and subject only to the net income test.

medicaid-disability-determination42 CFR § 435.541

States must establish criteria and processes for determining disability for Medicaid eligibility purposes. States may use SSA disability determinations or conduct their own evaluations. A disabling condition must be expected to last at least 12 months or result in death.

application.members[].disability.hasMentalDisabilityboolean

ReasonIdentifies whether the member has a mental disability; collected alongside hasPhysicalDisability to support SNAP and Medicaid disability determinations.

ProgramsSNAPMEDICAID
Policies
snap-elderly-disabled-deductions7 CFR § 273.9(d)

Households with an elderly or disabled member are eligible for an excess medical expense deduction (unreimbursed costs above $35/month) in addition to the standard deductions. These households are also exempt from the gross income test and subject only to the net income test.

medicaid-disability-determination42 CFR § 435.541

States must establish criteria and processes for determining disability for Medicaid eligibility purposes. States may use SSA disability determinations or conduct their own evaluations. A disabling condition must be expected to last at least 12 months or result in death.

application.members[].disability.needsHelpWithSelfCareboolean

ReasonIdentifies members who require assistance with self-care activities; used to assess functional limitations relevant to Aid and Attendance eligibility for veterans and LTSS Medicaid pathways.

ProgramsSNAPMEDICAID
Policies
snap-elderly-disabled-deductions7 CFR § 273.9(d)

Households with an elderly or disabled member are eligible for an excess medical expense deduction (unreimbursed costs above $35/month) in addition to the standard deductions. These households are also exempt from the gross income test and subject only to the net income test.

medicaid-disability-determination42 CFR § 435.541

States must establish criteria and processes for determining disability for Medicaid eligibility purposes. States may use SSA disability determinations or conduct their own evaluations. A disabling condition must be expected to last at least 12 months or result in death.

application.members[].studentStatusStudentStatus
ProgramsSNAP
Policies
snap-student-eligibility-restriction7 CFR § 273.5

Students enrolled at least half-time in an institution of higher education are ineligible for SNAP unless they meet an exemption: employed 20+ hours per week, participating in work-study, responsible for a dependent child under 6, receiving TANF, or physically or mentally unable to work.

application.members[].studentStatus.enrollmentStatusenum
Valuesfull_time part_time not_enrolled

ReasonFull-time students ages 18-49 are generally ineligible for SNAP unless they meet a specific exemption.

ProgramsSNAP
Policies
snap-student-eligibility-restriction7 CFR § 273.5

Students enrolled at least half-time in an institution of higher education are ineligible for SNAP unless they meet an exemption: employed 20+ hours per week, participating in work-study, responsible for a dependent child under 6, receiving TANF, or physically or mentally unable to work.

application.members[].studentStatus.institutionTypeenum
Valueshigher_education vocational other

ReasonThe SNAP student eligibility restriction applies specifically to higher education; vocational training institutions may not trigger the restriction.

ProgramsSNAP
Policies
snap-student-eligibility-restriction7 CFR § 273.5

Students enrolled at least half-time in an institution of higher education are ineligible for SNAP unless they meet an exemption: employed 20+ hours per week, participating in work-study, responsible for a dependent child under 6, receiving TANF, or physically or mentally unable to work.

application.members[].studentStatus.schoolNamestring

ReasonSchool name used to verify enrollment status and institution type for the SNAP student restriction.

ProgramsSNAP
Policies
snap-student-eligibility-restriction7 CFR § 273.5

Students enrolled at least half-time in an institution of higher education are ineligible for SNAP unless they meet an exemption: employed 20+ hours per week, participating in work-study, responsible for a dependent child under 6, receiving TANF, or physically or mentally unable to work.

application.members[].studentStatus.isParticipatingInWorkStudyboolean

ReasonParticipation in a federally funded work-study program is one of the exemptions from the SNAP student eligibility restriction.

ProgramsSNAP
Policies
snap-student-eligibility-restriction7 CFR § 273.5

Students enrolled at least half-time in an institution of higher education are ineligible for SNAP unless they meet an exemption: employed 20+ hours per week, participating in work-study, responsible for a dependent child under 6, receiving TANF, or physically or mentally unable to work.

application.members[].pregnancyPregnancy
ProgramsSNAPMEDICAIDCHIP
Policies
medicaid-pregnancy-eligibility42 CFR § 435.116

States must provide Medicaid to pregnant women with income at or below 133% FPL. Coverage begins on the date of application and continues through the end of the month in which the 60-day postpartum period ends. States may extend postpartum coverage to 12 months under the ARP option.

chip-unborn-child-coverage42 USC § 1397bb(b)(1)(C)

States may elect to cover unborn children from conception through birth under CHIP, treating the unborn child as a targeted low-income child for purposes of program eligibility. Coverage is provided through the pregnant woman; the child is deemed enrolled at birth.

snap-pregnancy-household-rules7 CFR § 273.1(c)

Each unborn child of a pregnant household member counts as a separate household member for SNAP household size determination, increasing the maximum allotment.

application.members[].pregnancy.isPregnantboolean

ReasonPregnancy confers categorical Medicaid eligibility and affects CHIP unborn child coverage; the expected baby counts as a household member for SNAP.

ProgramsSNAPMEDICAIDCHIP
Policies
medicaid-pregnancy-eligibility42 CFR § 435.116

States must provide Medicaid to pregnant women with income at or below 133% FPL. Coverage begins on the date of application and continues through the end of the month in which the 60-day postpartum period ends. States may extend postpartum coverage to 12 months under the ARP option.

chip-unborn-child-coverage42 USC § 1397bb(b)(1)(C)

States may elect to cover unborn children from conception through birth under CHIP, treating the unborn child as a targeted low-income child for purposes of program eligibility. Coverage is provided through the pregnant woman; the child is deemed enrolled at birth.

snap-pregnancy-household-rules7 CFR § 273.1(c)

Each unborn child of a pregnant household member counts as a separate household member for SNAP household size determination, increasing the maximum allotment.

application.members[].pregnancy.dueDatedate

ReasonDue date determines the benefit period for pregnancy Medicaid and the anticipated household size change for SNAP.

ProgramsSNAPMEDICAIDCHIP
Policies
medicaid-pregnancy-eligibility42 CFR § 435.116

States must provide Medicaid to pregnant women with income at or below 133% FPL. Coverage begins on the date of application and continues through the end of the month in which the 60-day postpartum period ends. States may extend postpartum coverage to 12 months under the ARP option.

chip-unborn-child-coverage42 USC § 1397bb(b)(1)(C)

States may elect to cover unborn children from conception through birth under CHIP, treating the unborn child as a targeted low-income child for purposes of program eligibility. Coverage is provided through the pregnant woman; the child is deemed enrolled at birth.

snap-pregnancy-household-rules7 CFR § 273.1(c)

Each unborn child of a pregnant household member counts as a separate household member for SNAP household size determination, increasing the maximum allotment.

application.members[].pregnancy.numberOfBabiesExpectedinteger

ReasonEach expected baby counts as a separate household member for SNAP and Medicaid household size calculation.

ProgramsSNAPMEDICAIDCHIP
Policies
medicaid-pregnancy-eligibility42 CFR § 435.116

States must provide Medicaid to pregnant women with income at or below 133% FPL. Coverage begins on the date of application and continues through the end of the month in which the 60-day postpartum period ends. States may extend postpartum coverage to 12 months under the ARP option.

chip-unborn-child-coverage42 USC § 1397bb(b)(1)(C)

States may elect to cover unborn children from conception through birth under CHIP, treating the unborn child as a targeted low-income child for purposes of program eligibility. Coverage is provided through the pregnant woman; the child is deemed enrolled at birth.

snap-pregnancy-household-rules7 CFR § 273.1(c)

Each unborn child of a pregnant household member counts as a separate household member for SNAP household size determination, increasing the maximum allotment.

application.members[].fosterCareFosterCare
ProgramsMEDICAID
Policies
medicaid-foster-care-extended-eligibility42 USC § 1396a(a)(10)(A)(ii)(XX)

Youth who were in foster care and enrolled in Medicaid at age 18 are eligible for Medicaid coverage until age 26 regardless of income. Coverage applies to youth who aged out of foster care or who left care for adoption or guardianship. States must accept applications from eligible youth who were in care in any state.

application.members[].fosterCare.startDatedate

ReasonStart date of the most recent foster care episode; used with end date and member age to determine whether extended Medicaid eligibility applies.

ProgramsMEDICAID
Policies
medicaid-foster-care-extended-eligibility42 USC § 1396a(a)(10)(A)(ii)(XX)

Youth who were in foster care and enrolled in Medicaid at age 18 are eligible for Medicaid coverage until age 26 regardless of income. Coverage applies to youth who aged out of foster care or who left care for adoption or guardianship. States must accept applications from eligible youth who were in care in any state.

application.members[].fosterCare.endDatedate

ReasonEnd date of the most recent foster care episode; used to determine age at exit and whether the member aged out and qualifies for extended Medicaid coverage to age 26.

ProgramsMEDICAID
Policies
medicaid-foster-care-extended-eligibility42 USC § 1396a(a)(10)(A)(ii)(XX)

Youth who were in foster care and enrolled in Medicaid at age 18 are eligible for Medicaid coverage until age 26 regardless of income. Coverage applies to youth who aged out of foster care or who left care for adoption or guardianship. States must accept applications from eligible youth who were in care in any state.

application.members[].fosterCare.exitReasonenum
Valuesadopted reunified aged_out emancipated

ReasonExit reason determines eligibility pathway — aged-out youth qualify for extended Medicaid; reunification and adoption have different eligibility implications.

ProgramsMEDICAID
Policies
medicaid-foster-care-extended-eligibility42 USC § 1396a(a)(10)(A)(ii)(XX)

Youth who were in foster care and enrolled in Medicaid at age 18 are eligible for Medicaid coverage until age 26 regardless of income. Coverage applies to youth who aged out of foster care or who left care for adoption or guardianship. States must accept applications from eligible youth who were in care in any state.

application.members[].fosterCare.exitStatestring

ReasonState in which the member was in foster care; required for cross-state Medicaid eligibility for youth who aged out in another state.

ProgramsMEDICAID
Policies
medicaid-foster-care-extended-eligibility42 USC § 1396a(a)(10)(A)(ii)(XX)

Youth who were in foster care and enrolled in Medicaid at age 18 are eligible for Medicaid coverage until age 26 regardless of income. Coverage applies to youth who aged out of foster care or who left care for adoption or guardianship. States must accept applications from eligible youth who were in care in any state.

application.members[].fosterCare.receivedMedicaidAtAge18boolean

ReasonYouth who were enrolled in Medicaid at age 18 qualify for extended Medicaid coverage to age 26 regardless of current income.

ProgramsMEDICAID
Policies
medicaid-foster-care-extended-eligibility42 USC § 1396a(a)(10)(A)(ii)(XX)

Youth who were in foster care and enrolled in Medicaid at age 18 are eligible for Medicaid coverage until age 26 regardless of income. Coverage applies to youth who aged out of foster care or who left care for adoption or guardianship. States must accept applications from eligible youth who were in care in any state.

application.members[].fosterCare.returnedAfterAdoptionboolean

ReasonYouth who re-enter foster care after an adoption dissolution may regain extended Medicaid eligibility; this flag triggers review of the re-entry date.

ProgramsMEDICAID
Policies
medicaid-foster-care-extended-eligibility42 USC § 1396a(a)(10)(A)(ii)(XX)

Youth who were in foster care and enrolled in Medicaid at age 18 are eligible for Medicaid coverage until age 26 regardless of income. Coverage applies to youth who aged out of foster care or who left care for adoption or guardianship. States must accept applications from eligible youth who were in care in any state.

application.members[].fosterCare.returnDatedate

ReasonDate of re-entry into foster care after adoption dissolution; used to determine whether extended Medicaid eligibility resumes.

ProgramsMEDICAID
Policies
medicaid-foster-care-extended-eligibility42 USC § 1396a(a)(10)(A)(ii)(XX)

Youth who were in foster care and enrolled in Medicaid at age 18 are eligible for Medicaid coverage until age 26 regardless of income. Coverage applies to youth who aged out of foster care or who left care for adoption or guardianship. States must accept applications from eligible youth who were in care in any state.

application.members[].militaryMilitary
application.members[].military.isVeteranboolean

ReasonVeteran status may affect categorical SNAP eligibility in states with broad-based categorical eligibility and may affect Medicaid when TRICARE is present.

application.members[].military.isActiveDutyboolean

ReasonActive duty status affects SNAP income treatment for military households and may affect TANF work activity exemptions.

ProgramsSNAP
Policies
snap-military-household-rules7 CFR § 273.1(b)(2)

Military members on active duty are SNAP household members. Special income treatment applies to combat pay and certain military allowances. Dependents living with an active duty member share the same SNAP household.

application.members[].military.dischargeStatusenum
Valueshonorable general other_than_honorable bad_conduct dishonorable uncharacterized

ReasonDishonorable discharge is a categorical disqualifier for SNAP; any member with a dishonorable discharge is ineligible regardless of other criteria.

ProgramsSNAP
Policies
snap-ipv-disqualifications7 USC § 2015(b)(1)

Conviction for an intentional program violation (IPV) results in a 12-month disqualification for the first offense, 24 months for a second, and permanent disqualification for a third. Permanent disqualification applies to trafficking benefits over $500, trading benefits for firearms or controlled substances, or conviction for murder or certain sex offenses under the Agriculture Improvement Act of 2018.

application.members[].institutionalStatusInstitutionalStatus
ProgramsSNAPMEDICAID
Policies
snap-institutionalized-household7 CFR § 273.1(b)(7)

Residents of institutions (group living facilities, nursing homes, correctional facilities) are generally ineligible for SNAP. Exceptions exist for residents of certain drug treatment and group living facilities approved for SNAP.

medicaid-imd-exclusion42 CFR § 435.1010

Medicaid does not cover services for individuals ages 22-64 who are patients in an institution for mental diseases (IMD) with more than 16 beds. Exceptions exist for short-term acute inpatient stays and for states operating under an approved IMD waiver.

medicaid-incarceration-exclusion42 CFR § 435.1008

Incarcerated individuals are ineligible for Medicaid except for inpatient hospital services. Individuals detained pending disposition of charges retain Medicaid eligibility. Eligibility is suspended (not terminated) during incarceration so it can be restored upon release without reapplication.

application.members[].institutionalStatus.livesInInstitutionboolean

ReasonInstitutionalized individuals are generally ineligible for SNAP and have restricted Medicaid eligibility under IMD exclusion and LTSS rules.

ProgramsSNAPMEDICAID
Policies
snap-institutionalized-household7 CFR § 273.1(b)(7)

Residents of institutions (group living facilities, nursing homes, correctional facilities) are generally ineligible for SNAP. Exceptions exist for residents of certain drug treatment and group living facilities approved for SNAP.

medicaid-imd-exclusion42 CFR § 435.1010

Medicaid does not cover services for individuals ages 22-64 who are patients in an institution for mental diseases (IMD) with more than 16 beds. Exceptions exist for short-term acute inpatient stays and for states operating under an approved IMD waiver.

medicaid-incarceration-exclusion42 CFR § 435.1008

Incarcerated individuals are ineligible for Medicaid except for inpatient hospital services. Individuals detained pending disposition of charges retain Medicaid eligibility. Eligibility is suspended (not terminated) during incarceration so it can be restored upon release without reapplication.

application.members[].institutionalStatus.facilityNamestring

ReasonFacility name used for verification and for determining the institution type when not explicitly collected.

ProgramsSNAPMEDICAID
Policies
snap-institutionalized-household7 CFR § 273.1(b)(7)

Residents of institutions (group living facilities, nursing homes, correctional facilities) are generally ineligible for SNAP. Exceptions exist for residents of certain drug treatment and group living facilities approved for SNAP.

medicaid-imd-exclusion42 CFR § 435.1010

Medicaid does not cover services for individuals ages 22-64 who are patients in an institution for mental diseases (IMD) with more than 16 beds. Exceptions exist for short-term acute inpatient stays and for states operating under an approved IMD waiver.

medicaid-incarceration-exclusion42 CFR § 435.1008

Incarcerated individuals are ineligible for Medicaid except for inpatient hospital services. Individuals detained pending disposition of charges retain Medicaid eligibility. Eligibility is suspended (not terminated) during incarceration so it can be restored upon release without reapplication.

application.members[].institutionalStatus.facilityTypeenum
Valuesnursing_home hospital incarceration other

ReasonFacility type determines which program restrictions apply — incarcerated individuals are ineligible for SNAP and Medicaid during incarceration.

ProgramsSNAPMEDICAID
Policies
snap-institutionalized-household7 CFR § 273.1(b)(7)

Residents of institutions (group living facilities, nursing homes, correctional facilities) are generally ineligible for SNAP. Exceptions exist for residents of certain drug treatment and group living facilities approved for SNAP.

medicaid-imd-exclusion42 CFR § 435.1010

Medicaid does not cover services for individuals ages 22-64 who are patients in an institution for mental diseases (IMD) with more than 16 beds. Exceptions exist for short-term acute inpatient stays and for states operating under an approved IMD waiver.

medicaid-incarceration-exclusion42 CFR § 435.1008

Incarcerated individuals are ineligible for Medicaid except for inpatient hospital services. Individuals detained pending disposition of charges retain Medicaid eligibility. Eligibility is suspended (not terminated) during incarceration so it can be restored upon release without reapplication.

application.members[].institutionalStatus.dateEntereddate

ReasonEntry date used to determine the period of ineligibility and whether a partial-month benefit applies.

ProgramsSNAPMEDICAID
Policies
snap-institutionalized-household7 CFR § 273.1(b)(7)

Residents of institutions (group living facilities, nursing homes, correctional facilities) are generally ineligible for SNAP. Exceptions exist for residents of certain drug treatment and group living facilities approved for SNAP.

medicaid-imd-exclusion42 CFR § 435.1010

Medicaid does not cover services for individuals ages 22-64 who are patients in an institution for mental diseases (IMD) with more than 16 beds. Exceptions exist for short-term acute inpatient stays and for states operating under an approved IMD waiver.

medicaid-incarceration-exclusion42 CFR § 435.1008

Incarcerated individuals are ineligible for Medicaid except for inpatient hospital services. Individuals detained pending disposition of charges retain Medicaid eligibility. Eligibility is suspended (not terminated) during incarceration so it can be restored upon release without reapplication.

application.members[].institutionalStatus.pendingDispositionOfChargesboolean

ReasonIndividuals detained pending disposition of charges retain Medicaid eligibility; convicted and incarcerated individuals do not.

ProgramsSNAPMEDICAID
Policies
snap-institutionalized-household7 CFR § 273.1(b)(7)

Residents of institutions (group living facilities, nursing homes, correctional facilities) are generally ineligible for SNAP. Exceptions exist for residents of certain drug treatment and group living facilities approved for SNAP.

medicaid-imd-exclusion42 CFR § 435.1010

Medicaid does not cover services for individuals ages 22-64 who are patients in an institution for mental diseases (IMD) with more than 16 beds. Exceptions exist for short-term acute inpatient stays and for states operating under an approved IMD waiver.

medicaid-incarceration-exclusion42 CFR § 435.1008

Incarcerated individuals are ineligible for Medicaid except for inpatient hospital services. Individuals detained pending disposition of charges retain Medicaid eligibility. Eligibility is suspended (not terminated) during incarceration so it can be restored upon release without reapplication.

application.members[].institutionalStatus.mealsProvidedboolean

ReasonInstitutions that provide meals may constitute a separate food purchasing unit, affecting SNAP household composition.

ProgramsSNAPMEDICAID
Policies
snap-institutionalized-household7 CFR § 273.1(b)(7)

Residents of institutions (group living facilities, nursing homes, correctional facilities) are generally ineligible for SNAP. Exceptions exist for residents of certain drug treatment and group living facilities approved for SNAP.

medicaid-imd-exclusion42 CFR § 435.1010

Medicaid does not cover services for individuals ages 22-64 who are patients in an institution for mental diseases (IMD) with more than 16 beds. Exceptions exist for short-term acute inpatient stays and for states operating under an approved IMD waiver.

medicaid-incarceration-exclusion42 CFR § 435.1008

Incarcerated individuals are ineligible for Medicaid except for inpatient hospital services. Individuals detained pending disposition of charges retain Medicaid eligibility. Eligibility is suspended (not terminated) during incarceration so it can be restored upon release without reapplication.

application.members[].priorConvictionsPriorConvictions
ProgramsSNAPTANF
Policies
snap-fleeing-felon-disqualification7 USC § 2015(k)

Individuals fleeing to avoid prosecution, custody, or confinement for a felony are ineligible for SNAP. Individuals violating a condition of probation or parole are also ineligible.

snap-ipv-disqualifications7 USC § 2015(b)(1)

Conviction for an intentional program violation (IPV) results in a 12-month disqualification for the first offense, 24 months for a second, and permanent disqualification for a third. Permanent disqualification applies to trafficking benefits over $500, trading benefits for firearms or controlled substances, or conviction for murder or certain sex offenses under the Agriculture Improvement Act of 2018.

snap-drug-felony-disqualification21 USC § 862a

Individuals convicted of a federal or state felony for possession, use, or distribution of a controlled substance are ineligible for SNAP and TANF under federal law. States may opt out of the ban entirely or limit the restriction by statute.

tanf-felony-disqualifications42 USC § 608(a)(9)

Individuals fleeing prosecution for a felony or violating probation or parole are ineligible for TANF cash assistance. States must verify and report fleeing felons to law enforcement agencies.

application.members[].priorConvictions.isFleeingFelonboolean

ReasonIndividuals fleeing to avoid prosecution or confinement for a felony are ineligible for SNAP and TANF.

ProgramsSNAPTANF
Policies
snap-fleeing-felon-disqualification7 USC § 2015(k)

Individuals fleeing to avoid prosecution, custody, or confinement for a felony are ineligible for SNAP. Individuals violating a condition of probation or parole are also ineligible.

snap-ipv-disqualifications7 USC § 2015(b)(1)

Conviction for an intentional program violation (IPV) results in a 12-month disqualification for the first offense, 24 months for a second, and permanent disqualification for a third. Permanent disqualification applies to trafficking benefits over $500, trading benefits for firearms or controlled substances, or conviction for murder or certain sex offenses under the Agriculture Improvement Act of 2018.

snap-drug-felony-disqualification21 USC § 862a

Individuals convicted of a federal or state felony for possession, use, or distribution of a controlled substance are ineligible for SNAP and TANF under federal law. States may opt out of the ban entirely or limit the restriction by statute.

tanf-felony-disqualifications42 USC § 608(a)(9)

Individuals fleeing prosecution for a felony or violating probation or parole are ineligible for TANF cash assistance. States must verify and report fleeing felons to law enforcement agencies.

application.members[].priorConvictions.convictedOfDrugRelatedFelonyboolean

ReasonDrug-related felony convictions may disqualify a member from SNAP and TANF depending on state implementation of the federal option.

ProgramsSNAPTANF
Policies
snap-fleeing-felon-disqualification7 USC § 2015(k)

Individuals fleeing to avoid prosecution, custody, or confinement for a felony are ineligible for SNAP. Individuals violating a condition of probation or parole are also ineligible.

snap-ipv-disqualifications7 USC § 2015(b)(1)

Conviction for an intentional program violation (IPV) results in a 12-month disqualification for the first offense, 24 months for a second, and permanent disqualification for a third. Permanent disqualification applies to trafficking benefits over $500, trading benefits for firearms or controlled substances, or conviction for murder or certain sex offenses under the Agriculture Improvement Act of 2018.

snap-drug-felony-disqualification21 USC § 862a

Individuals convicted of a federal or state felony for possession, use, or distribution of a controlled substance are ineligible for SNAP and TANF under federal law. States may opt out of the ban entirely or limit the restriction by statute.

tanf-felony-disqualifications42 USC § 608(a)(9)

Individuals fleeing prosecution for a felony or violating probation or parole are ineligible for TANF cash assistance. States must verify and report fleeing felons to law enforcement agencies.

application.members[].priorConvictions.convictedDuplicateSnapBenefitsboolean

ReasonConviction for receiving duplicate SNAP benefits results in a disqualification period proportional to the offense.

ProgramsSNAPTANF
Policies
snap-fleeing-felon-disqualification7 USC § 2015(k)

Individuals fleeing to avoid prosecution, custody, or confinement for a felony are ineligible for SNAP. Individuals violating a condition of probation or parole are also ineligible.

snap-ipv-disqualifications7 USC § 2015(b)(1)

Conviction for an intentional program violation (IPV) results in a 12-month disqualification for the first offense, 24 months for a second, and permanent disqualification for a third. Permanent disqualification applies to trafficking benefits over $500, trading benefits for firearms or controlled substances, or conviction for murder or certain sex offenses under the Agriculture Improvement Act of 2018.

snap-drug-felony-disqualification21 USC § 862a

Individuals convicted of a federal or state felony for possession, use, or distribution of a controlled substance are ineligible for SNAP and TANF under federal law. States may opt out of the ban entirely or limit the restriction by statute.

tanf-felony-disqualifications42 USC § 608(a)(9)

Individuals fleeing prosecution for a felony or violating probation or parole are ineligible for TANF cash assistance. States must verify and report fleeing felons to law enforcement agencies.

application.members[].priorConvictions.convictedOfSnapTraffickingboolean

ReasonConviction for trafficking SNAP benefits over $500 results in permanent disqualification.

ProgramsSNAPTANF
Policies
snap-fleeing-felon-disqualification7 USC § 2015(k)

Individuals fleeing to avoid prosecution, custody, or confinement for a felony are ineligible for SNAP. Individuals violating a condition of probation or parole are also ineligible.

snap-ipv-disqualifications7 USC § 2015(b)(1)

Conviction for an intentional program violation (IPV) results in a 12-month disqualification for the first offense, 24 months for a second, and permanent disqualification for a third. Permanent disqualification applies to trafficking benefits over $500, trading benefits for firearms or controlled substances, or conviction for murder or certain sex offenses under the Agriculture Improvement Act of 2018.

snap-drug-felony-disqualification21 USC § 862a

Individuals convicted of a federal or state felony for possession, use, or distribution of a controlled substance are ineligible for SNAP and TANF under federal law. States may opt out of the ban entirely or limit the restriction by statute.

tanf-felony-disqualifications42 USC § 608(a)(9)

Individuals fleeing prosecution for a felony or violating probation or parole are ineligible for TANF cash assistance. States must verify and report fleeing felons to law enforcement agencies.

application.members[].priorConvictions.convictedTradingSnapForFirearmsOrExplosivesboolean

ReasonConviction for trading SNAP benefits for firearms, ammunition, or explosives results in permanent disqualification.

ProgramsSNAPTANF
Policies
snap-fleeing-felon-disqualification7 USC § 2015(k)

Individuals fleeing to avoid prosecution, custody, or confinement for a felony are ineligible for SNAP. Individuals violating a condition of probation or parole are also ineligible.

snap-ipv-disqualifications7 USC § 2015(b)(1)

Conviction for an intentional program violation (IPV) results in a 12-month disqualification for the first offense, 24 months for a second, and permanent disqualification for a third. Permanent disqualification applies to trafficking benefits over $500, trading benefits for firearms or controlled substances, or conviction for murder or certain sex offenses under the Agriculture Improvement Act of 2018.

snap-drug-felony-disqualification21 USC § 862a

Individuals convicted of a federal or state felony for possession, use, or distribution of a controlled substance are ineligible for SNAP and TANF under federal law. States may opt out of the ban entirely or limit the restriction by statute.

tanf-felony-disqualifications42 USC § 608(a)(9)

Individuals fleeing prosecution for a felony or violating probation or parole are ineligible for TANF cash assistance. States must verify and report fleeing felons to law enforcement agencies.

application.members[].priorConvictions.convictedOfDisqualifyingViolentCrimeboolean

ReasonConviction for murder or certain sexual offenses results in permanent SNAP disqualification under the Agriculture Improvement Act.

ProgramsSNAPTANF
Policies
snap-fleeing-felon-disqualification7 USC § 2015(k)

Individuals fleeing to avoid prosecution, custody, or confinement for a felony are ineligible for SNAP. Individuals violating a condition of probation or parole are also ineligible.

snap-ipv-disqualifications7 USC § 2015(b)(1)

Conviction for an intentional program violation (IPV) results in a 12-month disqualification for the first offense, 24 months for a second, and permanent disqualification for a third. Permanent disqualification applies to trafficking benefits over $500, trading benefits for firearms or controlled substances, or conviction for murder or certain sex offenses under the Agriculture Improvement Act of 2018.

snap-drug-felony-disqualification21 USC § 862a

Individuals convicted of a federal or state felony for possession, use, or distribution of a controlled substance are ineligible for SNAP and TANF under federal law. States may opt out of the ban entirely or limit the restriction by statute.

tanf-felony-disqualifications42 USC § 608(a)(9)

Individuals fleeing prosecution for a felony or violating probation or parole are ineligible for TANF cash assistance. States must verify and report fleeing felons to law enforcement agencies.

application.members[].priorConvictions.disqualifiedForIPVboolean

ReasonA prior intentional program violation (IPV) disqualification carries over and may trigger an extended or permanent disqualification period.

ProgramsSNAPTANF
Policies
snap-fleeing-felon-disqualification7 USC § 2015(k)

Individuals fleeing to avoid prosecution, custody, or confinement for a felony are ineligible for SNAP. Individuals violating a condition of probation or parole are also ineligible.

snap-ipv-disqualifications7 USC § 2015(b)(1)

Conviction for an intentional program violation (IPV) results in a 12-month disqualification for the first offense, 24 months for a second, and permanent disqualification for a third. Permanent disqualification applies to trafficking benefits over $500, trading benefits for firearms or controlled substances, or conviction for murder or certain sex offenses under the Agriculture Improvement Act of 2018.

snap-drug-felony-disqualification21 USC § 862a

Individuals convicted of a federal or state felony for possession, use, or distribution of a controlled substance are ineligible for SNAP and TANF under federal law. States may opt out of the ban entirely or limit the restriction by statute.

tanf-felony-disqualifications42 USC § 608(a)(9)

Individuals fleeing prosecution for a felony or violating probation or parole are ineligible for TANF cash assistance. States must verify and report fleeing felons to law enforcement agencies.

application.members[].priorConvictions.isViolatingProbationOrParoleboolean

ReasonIndividuals violating probation or parole conditions are ineligible for SNAP and TANF.

ProgramsSNAPTANF
Policies
snap-fleeing-felon-disqualification7 USC § 2015(k)

Individuals fleeing to avoid prosecution, custody, or confinement for a felony are ineligible for SNAP. Individuals violating a condition of probation or parole are also ineligible.

snap-ipv-disqualifications7 USC § 2015(b)(1)

Conviction for an intentional program violation (IPV) results in a 12-month disqualification for the first offense, 24 months for a second, and permanent disqualification for a third. Permanent disqualification applies to trafficking benefits over $500, trading benefits for firearms or controlled substances, or conviction for murder or certain sex offenses under the Agriculture Improvement Act of 2018.

snap-drug-felony-disqualification21 USC § 862a

Individuals convicted of a federal or state felony for possession, use, or distribution of a controlled substance are ineligible for SNAP and TANF under federal law. States may opt out of the ban entirely or limit the restriction by statute.

tanf-felony-disqualifications42 USC § 608(a)(9)

Individuals fleeing prosecution for a felony or violating probation or parole are ineligible for TANF cash assistance. States must verify and report fleeing felons to law enforcement agencies.

application.members[].tribalStatusTribalStatus
ProgramsMEDICAIDCHIP
Policies
chip-ai-an-eligibility42 CFR § 457.125

American Indian and Alaska Native children are exempt from CHIP cost-sharing and must not be charged premiums, enrollment fees, or cost-sharing. States must coordinate CHIP eligibility with Indian Health Service and tribal health programs.

indian-health-care-improvement-act25 USC § 1603

Establishes the Indian Health Service and defines its mission to raise the health status of American Indians and Alaska Natives to the highest possible level. States must coordinate Medicaid and CHIP coverage for AI/AN individuals with IHS and tribal health programs, and may not consider IHS services as third-party liability.

application.members[].tribalStatus.isAmericanIndianOrAlaskaNativeboolean

ReasonAmerican Indian and Alaska Native members have special Medicaid and CHIP eligibility protections and are eligible for Indian Health Service coordination.

ProgramsMEDICAIDCHIP
Policies
chip-ai-an-eligibility42 CFR § 457.125

American Indian and Alaska Native children are exempt from CHIP cost-sharing and must not be charged premiums, enrollment fees, or cost-sharing. States must coordinate CHIP eligibility with Indian Health Service and tribal health programs.

indian-health-care-improvement-act25 USC § 1603

Establishes the Indian Health Service and defines its mission to raise the health status of American Indians and Alaska Natives to the highest possible level. States must coordinate Medicaid and CHIP coverage for AI/AN individuals with IHS and tribal health programs, and may not consider IHS services as third-party liability.

application.members[].tribalStatus.tribeNamestring

ReasonTribe name used to verify tribal membership and coordinate with IHS and tribal health programs.

ProgramsMEDICAIDCHIP
Policies
chip-ai-an-eligibility42 CFR § 457.125

American Indian and Alaska Native children are exempt from CHIP cost-sharing and must not be charged premiums, enrollment fees, or cost-sharing. States must coordinate CHIP eligibility with Indian Health Service and tribal health programs.

indian-health-care-improvement-act25 USC § 1603

Establishes the Indian Health Service and defines its mission to raise the health status of American Indians and Alaska Natives to the highest possible level. States must coordinate Medicaid and CHIP coverage for AI/AN individuals with IHS and tribal health programs, and may not consider IHS services as third-party liability.

application.members[].tribalStatus.tribeStatestring

ReasonState where the tribe is located, used to identify the relevant IHS service area and tribal health program.

ProgramsMEDICAIDCHIP
Policies
chip-ai-an-eligibility42 CFR § 457.125

American Indian and Alaska Native children are exempt from CHIP cost-sharing and must not be charged premiums, enrollment fees, or cost-sharing. States must coordinate CHIP eligibility with Indian Health Service and tribal health programs.

indian-health-care-improvement-act25 USC § 1603

Establishes the Indian Health Service and defines its mission to raise the health status of American Indians and Alaska Natives to the highest possible level. States must coordinate Medicaid and CHIP coverage for AI/AN individuals with IHS and tribal health programs, and may not consider IHS services as third-party liability.

application.members[].personMatchPersonMatch

ReasonPerson matching state for an application member. Populated when the client management domain resolves a match; null until matching begins.

application.members[].personMatch.matchStatusenum
Valuesconfirmed review_required no_match

ReasonOutcome of the person matching process — confirmed (single high-confidence match), review_required (multiple candidates need caseworker review), or no_match.

application.members[].personMatch.candidates[]list(PersonMatchCandidate)

ReasonMatch candidates returned by the person matching process. Populated for review_required; empty otherwise.

application.members[].personMatch.candidates[].personIduuid(Person)

ReasonID of the candidate person record in the client management domain.

application.members[].personMatch.candidates[].confidenceScorenumber

ReasonMatch confidence score from 0 (no confidence) to 1 (certain); used by caseworkers to prioritize candidate review.

application.members[].programDeterminations[]list(ApplicationMemberProgramDetermination)

ReasonPer-program eligibility determination results for this member, populated by the rules engine at determination. One record per program evaluated.

application.members[].programDeterminations[].programstring

ReasonProgram identifier the determination applies to (e.g., snap, medicaid, tanf).

application.members[].programDeterminations[].outcomeenum
Valuesapproved denied

ReasonDetermination outcome — approved or denied — for this member/program combination.

application.members[].programDeterminations[].determinedAtdatetime

ReasonWhen the determination was recorded by the rules engine.

household-info

application.householdInfo.iduuid
application.householdInfo.applicationIduuid(Application)
application.householdInfo.roomers[]list(Roomer)

ReasonIdentifies roomers and boarders in the home who are not SNAP household members because they purchase and prepare food separately.

ProgramsSNAP
Policies
snap-roomers-boarders7 CFR § 273.1(b)(5)

Roomers (persons who pay a household for lodging only) and boarders (persons who pay for both lodging and meals) are not SNAP household members because they purchase and prepare food separately. Payments received from roomers or boarders count as household income.

application.householdInfo.roomers[].iduuid

ReasonIdentifier of the referenced person record; points to application.members[].id when type = member, or application.contacts[].id when type = contact.

ProgramsSNAP
Policies
snap-roomers-boarders7 CFR § 273.1(b)(5)

Roomers (persons who pay a household for lodging only) and boarders (persons who pay for both lodging and meals) are not SNAP household members because they purchase and prepare food separately. Payments received from roomers or boarders count as household income.

application.householdInfo.roomers[].typeenum
Valuesmember contact

ReasonDiscriminator identifying whether the roomer is a household member or a contact-only person record in application.contacts[].

ProgramsSNAP
Policies
snap-roomers-boarders7 CFR § 273.1(b)(5)

Roomers (persons who pay a household for lodging only) and boarders (persons who pay for both lodging and meals) are not SNAP household members because they purchase and prepare food separately. Payments received from roomers or boarders count as household income.

application.householdInfo.roomers[].amountPaidForRentnumber

ReasonRent paid by a roomer is income to the household; distinguishes market-rate roomers from boarders.

ProgramsSNAP
Policies
snap-roomers-boarders7 CFR § 273.1(b)(5)

Roomers (persons who pay a household for lodging only) and boarders (persons who pay for both lodging and meals) are not SNAP household members because they purchase and prepare food separately. Payments received from roomers or boarders count as household income.

application.householdInfo.roomers[].mealsIncludedWithRentboolean

ReasonWhen meals are included, the person is a boarder; meal revenue is income. When meals are not included, rent revenue is income.

ModelingBoarders are not modeled as a separate type — they are roomers where mealsIncludedWithRent = true. A single roomers[] array with this boolean covers both cases without a discriminated union.

ProgramsSNAP
Policies
snap-roomers-boarders7 CFR § 273.1(b)(5)

Roomers (persons who pay a household for lodging only) and boarders (persons who pay for both lodging and meals) are not SNAP household members because they purchase and prepare food separately. Payments received from roomers or boarders count as household income.

application.householdInfo.utilitiesIncludedInRentboolean

ReasonWhen utilities are included in rent, the household may not claim a utility standard deduction for SNAP.

ProgramsSNAP
Policies
snap-utility-allowance-standards7 CFR § 273.9(d)(6)

Households that do not receive LIHEAP may use a standard utility allowance instead of actual utility costs. Households that heat or cool their home qualify for the full heating and cooling standard (HCSUA). Residents of federally subsidized housing where utilities are included in rent are ineligible for the HCSUA. Receipt of even one dollar of LIHEAP automatically qualifies the household for the HCSUA.

application.householdInfo.isSubsidizedHousingboolean

ReasonResidents of federally subsidized housing are ineligible for the heating and cooling standard utility allowance.

ProgramsSNAP
Policies
snap-utility-allowance-standards7 CFR § 273.9(d)(6)

Households that do not receive LIHEAP may use a standard utility allowance instead of actual utility costs. Households that heat or cool their home qualify for the full heating and cooling standard (HCSUA). Residents of federally subsidized housing where utilities are included in rent are ineligible for the HCSUA. Receipt of even one dollar of LIHEAP automatically qualifies the household for the HCSUA.

application.householdInfo.receivedTanfInAnotherStateboolean

ReasonCross-state TANF receipt is verified to prevent duplicate participation and enforce time limits across states.

ProgramsTANF
Policies
tanf-time-limits45 CFR § 264.1

States must enforce the 60-month lifetime limit on TANF-funded assistance. Cross-state receipt is tracked to prevent households from circumventing the limit by moving between states. States may use state funds to continue assistance after the federal limit is reached.

tanf-work-activities45 CFR § 260.31

Defines the countable work activities (unsubsidized employment, subsidized employment, on-the-job training, work experience, etc.) that satisfy the TANF work participation requirement. States must document each activity category for federal reporting.

tax-filers

application.taxFilers[]list(TaxFiler)

ReasonTax filing units within the household, used to determine MAGI tax household composition for Medicaid and marketplace eligibility. Each record represents one tax filer and their dependents.

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].iduuid
ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].memberIduuid(ApplicationMember)

ReasonLinks the tax filer record to the household member. Null when the filer is a non-household member claiming a household dependent.

ModelingA null memberId encodes a non-household filer (e.g. a non-custodial parent not on this application). This is the mechanism for representing filers whose name and identity are not already in application.members[].

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].applicationIduuid(Application)
ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].filingJointlyWithSpouseboolean

ReasonJoint filing status affects MAGI household composition and income attribution for Medicaid and marketplace eligibility.

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].spousePersonRef
ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].spouse.iduuid

ReasonIdentifier of the referenced person record for the spouse; used to link a non-household spouse to their contacts[] entry.

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].spouse.typeenum
Valuesmember contact

ReasonDiscriminator identifying whether the filing spouse is a household member or a contact-only person record in application.contacts[].

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].claimingDependentsboolean

ReasonClaiming dependents affects MAGI household size and the income of dependents attributed to the tax household.

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].dependents[]list(PersonRef)
ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].dependents[].iduuid

ReasonIdentifier of the referenced person record for the dependent; points to application.members[].id when type = member, or application.contacts[].id when type = contact.

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].dependents[].typeenum
Valuesmember contact

ReasonDistinguishes household members (who have a member record) from non-household dependents (who are contact-only person records in application.contacts[]).

ModelingPolymorphic discriminator enabling FK linkage for both household members (via application.members[].id) and non-household dependents (via application.contacts[].id).

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].expectedToBeClaimedByNonHouseholdMemberboolean

ReasonA household member expected to be claimed as a dependent by someone outside the household uses that person's tax household for MAGI purposes.

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].personClaimingPersonRef
ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].personClaiming.iduuid

ReasonIdentifier of the person claiming this applicant as a dependent; used to determine the applicable tax household for MAGI purposes.

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].personClaiming.typeenum
Valuesmember contact

ReasonDiscriminator identifying whether the person claiming this applicant as a dependent is a household member or a contact-only person record in application.contacts[].

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].isNonCustodialParentboolean

ReasonNon-custodial parents who claim a child as a dependent use a different MAGI household composition rule.

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

application.taxFilers[].hasDomesticViolenceTaxFilingExceptionboolean

ReasonDomestic violence survivors may file separately from their spouse even if married, preventing their spouse's income from being included in the MAGI household.

ProgramsMEDICAIDCHIP
Policies
irs-domestic-violence-filing-exceptionIRS Rev. Proc. 2013-34

Domestic violence survivors may file taxes as head of household or as single even when legally married, if they meet conditions for innocent spouse or separation of liability relief. This exception allows survivors to exclude their abusive spouse's income from their MAGI tax household for Medicaid eligibility purposes.

medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

health-plans

application.healthPlans[]list(HealthPlan)

ReasonHealth insurance plans reported by the household, covering all coverage types — employer-sponsored, COBRA, Medicare, TRICARE, VA, marketplace, and others. Each plan record is shared across members via healthEnrollments[].

ModelingMedicare plans use a single healthPlan record per person (type = medicare) with named sub-objects for each part (partA, partB, partC, partD). Parts A–D are a fixed closed set, so named sub-objects are cleaner than a discriminated array.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].organizationIduuid(Organization)
Applies whentype in [employer_sponsored, cobra]

ReasonFK to application.organizations[] for employer-sponsored and COBRA plans, linking the plan to the employer organization record without duplicating employer contact data.

ModelingApplies only when type = employer_sponsored or cobra.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].iduuid

ReasonUnique identifier for the health plan record; FK target for application.healthEnrollments[].healthPlanId.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].applicationIduuid(Application)
ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].typeenum
Valuesemployer_sponsored cobra medicare tricare va marketplace peace_corps chip medicaid tribal_health_services other_federal other

ReasonCoverage type determines minimum essential coverage (MEC) status, marketplace eligibility, and Medicare Savings Program (MSP) screening.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].typeOtherstring

ReasonCaptures non-enumerated coverage types for adapter review and manual classification.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].premiumAmountnumber

ReasonPremium cost is used in the ACA employer coverage affordability test.

ModelingA null value means the premium amount is unknown, not that no premium exists. Adapters should preserve null rather than defaulting to zero when the applicant cannot provide the amount.

ProgramsACA
Policies
aca-employer-coverage-affordability26 USC § 36B(c)(2)(C)

Employer-sponsored coverage is considered affordable if the employee's share of the lowest-cost self-only premium does not exceed the applicable percentage of household income (approximately 9.5%, inflation-adjusted annually). If employer coverage is affordable and meets minimum value, the employee is ineligible for marketplace premium tax credits.

application.healthPlans[].premiumFrequencyenum
Valuesweekly every_two_weeks twice_monthly monthly yearly

ReasonPremium frequency is needed to normalize the premium to a monthly figure for the affordability calculation.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].coverageContactName
Applies whentype in [employer_sponsored, cobra]

ReasonHR or benefits contact at the employer for plan verification and enrollment period confirmation.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].coverageContact.firstNamestring
Applies whentype in [employer_sponsored, cobra]
ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].coverageContact.middleNamestring
Applies whentype in [employer_sponsored, cobra]
ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].coverageContact.middleInitialstring
Applies whentype in [employer_sponsored, cobra]
ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].coverageContact.lastNamestring
Applies whentype in [employer_sponsored, cobra]
ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].coverageContact.maidenNamestring
Applies whentype in [employer_sponsored, cobra]
ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].coverageContact.suffixstring
Applies whentype in [employer_sponsored, cobra]
ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].hasMinimumValuePlanboolean
Applies whentype in [employer_sponsored, cobra]

ReasonAn employer plan that meets minimum value (covers at least 60% of costs) blocks marketplace premium tax credit eligibility.

ProgramsACA
Policies
aca-employer-coverage-affordability26 USC § 36B(c)(2)(C)

Employer-sponsored coverage is considered affordable if the employee's share of the lowest-cost self-only premium does not exceed the applicable percentage of household income (approximately 9.5%, inflation-adjusted annually). If employer coverage is affordable and meets minimum value, the employee is ineligible for marketplace premium tax credits.

application.healthPlans[].lowestCostPlanNamestring
Applies whentype in [employer_sponsored, cobra]

ReasonIdentifies the lowest-cost minimum value plan offered by the employer, used in the affordability test.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].lowestCostPlanPremiumnumber
Applies whentype in [employer_sponsored, cobra]

ReasonThe self-only premium of the lowest-cost minimum value plan is the benchmark for the ACA affordability test.

ProgramsACA
Policies
aca-employer-coverage-affordability26 USC § 36B(c)(2)(C)

Employer-sponsored coverage is considered affordable if the employee's share of the lowest-cost self-only premium does not exceed the applicable percentage of household income (approximately 9.5%, inflation-adjusted annually). If employer coverage is affordable and meets minimum value, the employee is ineligible for marketplace premium tax credits.

aca-premium-tax-credit26 CFR § 1.36B-2

Premium tax credit eligibility rules for marketplace coverage. A household member is ineligible for the credit if they are eligible for other MEC (Medicaid, Medicare, employer coverage meeting affordability and minimum value standards) or if the employer's lowest-cost self-only plan costs less than the applicable percentage of household income.

application.healthPlans[].medicareIdstring
Applies whentype = medicare

ReasonMedicare Beneficiary Identifier (MBI) is required for all Medicare processing. One MBI covers all parts for a beneficiary.

ModelingTreat as PII. The MBI replaced the SSN-based Health Insurance Claim Number (HICN) in 2018–2020.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partAMedicarePart
Applies whentype = medicare
ProgramsMEDICAID
Policies
medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

medicare-part-a-entitlement42 USC § 1395c

Medicare Part A hospital insurance is available to individuals age 65 or older who are entitled to Social Security or Railroad Retirement benefits, and to disabled individuals who have received SSDI for 24 months. Individuals who do not meet the work requirement may enroll by paying a premium.

application.healthPlans[].partA.statusenum
Applies whentype = medicare
Valuesentitled enrolled

ReasonEntitled vs. enrolled distinction affects Medicare Savings Program eligibility; entitled-but-not-enrolled may qualify for MSP to cover Part A premiums. Parts C and D have no entitled-without-enrolled state — status will always be enrolled for those parts.

Modelingentitled = meets eligibility criteria but not yet actively receiving benefits (e.g., deferred Part B enrollment while on employer coverage); enrolled = actively receiving.

ProgramsMEDICAID
Policies
medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

medicare-part-a-entitlement42 USC § 1395c

Medicare Part A hospital insurance is available to individuals age 65 or older who are entitled to Social Security or Railroad Retirement benefits, and to disabled individuals who have received SSDI for 24 months. Individuals who do not meet the work requirement may enroll by paying a premium.

application.healthPlans[].partA.startDatedate
Applies whentype = medicare

ReasonPart A effective date used for coordination with Medicaid and the Medicare Savings Program.

ProgramsMEDICAID
Policies
medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

medicare-part-a-entitlement42 USC § 1395c

Medicare Part A hospital insurance is available to individuals age 65 or older who are entitled to Social Security or Railroad Retirement benefits, and to disabled individuals who have received SSDI for 24 months. Individuals who do not meet the work requirement may enroll by paying a premium.

application.healthPlans[].partA.isPremiumFreeboolean
Applies whentype = medicare

ReasonBeneficiaries who did not earn 40 quarters of work pay a Part A premium; premium amount affects MSP and QMB eligibility.

ProgramsMEDICAID
Policies
medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

medicare-part-a-entitlement42 USC § 1395c

Medicare Part A hospital insurance is available to individuals age 65 or older who are entitled to Social Security or Railroad Retirement benefits, and to disabled individuals who have received SSDI for 24 months. Individuals who do not meet the work requirement may enroll by paying a premium.

application.healthPlans[].partA.premiumAmountnumber
Applies whentype = medicare

ReasonPart A premium amount for beneficiaries who did not earn 40 quarters of work and must pay a premium; used in Medicare Savings Program determination.

ProgramsMEDICAID
Policies
medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

medicare-part-a-entitlement42 USC § 1395c

Medicare Part A hospital insurance is available to individuals age 65 or older who are entitled to Social Security or Railroad Retirement benefits, and to disabled individuals who have received SSDI for 24 months. Individuals who do not meet the work requirement may enroll by paying a premium.

application.healthPlans[].partA.premiumPaidByenum
Applies whentype = medicare
Valuesself state employer other

ReasonIdentifies whether a Medicare Savings Program is already covering the Part A premium, which affects MSP screening.

ModelingStored as a controlled enum [self, state, employer, other] rather than free text to support automated MSP determination logic without string matching.

ProgramsMEDICAID
Policies
medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

medicare-part-a-entitlement42 USC § 1395c

Medicare Part A hospital insurance is available to individuals age 65 or older who are entitled to Social Security or Railroad Retirement benefits, and to disabled individuals who have received SSDI for 24 months. Individuals who do not meet the work requirement may enroll by paying a premium.

application.healthPlans[].partBMedicarePart
Applies whentype = medicare
ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partB.statusenum
Applies whentype = medicare
Valuesentitled enrolled

ReasonPart B enrollment status affects MSP eligibility and late enrollment penalty determination.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partB.startDatedate
Applies whentype = medicare

ReasonPart B effective date used for late enrollment penalty calculation and MSP coordination.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partB.isPremiumFreeboolean
Applies whentype = medicare

ReasonIdentifies whether the beneficiary qualifies for a premium-free Part B; affects Medicare Savings Program cost calculation.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partB.premiumAmountnumber
Applies whentype = medicare

ReasonPart B premium amount is used for QMB and SLMB determination under the Medicare Savings Program.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partB.premiumPaidByenum
Applies whentype = medicare
Valuesself state employer other

ReasonIdentifies whether an MSP is already covering the Part B premium.

ModelingStored as a controlled enum [self, state, employer, other] rather than free text to support automated MSP determination logic without string matching.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partCMedicarePartC
Applies whentype = medicare
ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partC.statusenum
Applies whentype = medicare
Valuesentitled enrolled

ReasonPart C (Medicare Advantage) enrollment status; a Part C enrollee receives Parts A and B benefits through the plan.

ModelingPart C replaces traditional Parts A and B — a member enrolled in Part C should not also have Part A and Part B populated.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partC.startDatedate
Applies whentype = medicare

ReasonPart C effective date for coordination with Medicaid dual-eligible programs.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partC.contractIdstring
Applies whentype = medicare

ReasonCMS contract ID uniquely identifies the Medicare Advantage organization. Required for plan identification in CMS enrollment data.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partC.planIdstring
Applies whentype = medicare

ReasonCMS plan ID combined with contract ID uniquely identifies the specific Medicare Advantage plan.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partC.planNamestring
Applies whentype = medicare

ReasonHuman-readable Medicare Advantage plan name for applicant correspondence and worker review.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partC.premiumAmountnumber
Applies whentype = medicare

ReasonPart C plan premium may be covered by certain Medicare Savings Programs.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partC.premiumPaidByenum
Applies whentype = medicare
Valuesself state employer other

ReasonIdentifies whether an MSP is covering the Part C premium.

ModelingStored as a controlled enum [self, state, employer, other] rather than free text to support automated MSP determination logic without string matching.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partDMedicarePartD
Applies whentype = medicare
ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partD.statusenum
Applies whentype = medicare
Valuesentitled enrolled

ReasonPart D prescription drug coverage status for coordination of benefits.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partD.startDatedate
Applies whentype = medicare

ReasonPart D effective date for coordination with Medicaid drug coverage.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partD.planNamestring
Applies whentype = medicare

ReasonPrescription drug plan name for coordination of benefits identification.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].partD.premiumAmountnumber
Applies whentype = medicare

ReasonPart D premium may be subsidized through the Low Income Subsidy (Extra Help) program.

ProgramsMEDICAID
Policies
medicare-part-d-low-income-subsidy42 USC § 1395w-114

Low Income Subsidy (Extra Help) reduces Part D premiums, deductibles, and cost-sharing for Medicare beneficiaries with limited income and resources. Individuals receiving full Medicaid, SSI, or MSP benefits are automatically eligible. Others may apply through SSA.

application.healthPlans[].partD.premiumPaidByenum
Applies whentype = medicare
Valuesself state employer other

ReasonIdentifies whether a subsidy program is already covering the Part D premium.

ModelingStored as a controlled enum [self, state, employer, other] rather than free text to support automated MSP and Low Income Subsidy determination logic without string matching.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].programTypestring
Applies whentype = tricare

ReasonIdentifies the specific federal health program (TRICARE, VA, Peace Corps, etc.) for verification and MEC determination.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].insuranceCompanyNamestring
Applies whentype = tricare

ReasonInsurance carrier for TRICARE supplemental or managed care plans, required for coordination of benefits.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthPlans[].policyNumberstring
Applies whentype = tricare

ReasonPolicy number required for benefits verification and coordination of benefits.

ProgramsMEDICAIDCHIPACA
Policies
aca-minimum-essential-coverage26 USC § 5000A

Defines minimum essential coverage (MEC) for ACA purposes. MEC includes employer-sponsored coverage, Medicare, Medicaid, CHIP, TRICARE, VA coverage, and marketplace plans. Coverage must meet MEC standards to satisfy eligibility rules for marketplace premium tax credits and to block premium tax credit eligibility when offered through an employer.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

health-enrollments

application.healthEnrollments[]list(HealthEnrollment)

ReasonJoin records linking household members to health plans, capturing each member's role and enrollment status. A plan record in healthPlans[] may have multiple enrollment records — one per covered member.

application.healthEnrollments[].healthPlanIduuid(HealthPlan)

ReasonFK to application.healthPlans[] identifying the plan this member is enrolled in.

application.healthEnrollments[].jobIduuid(Job)

ReasonFK to application.jobs[] linking an employer-sponsored enrollment to the specific job, enabling employer contact lookup without duplicating employer data.

application.healthEnrollments[].iduuid

ReasonUnique identifier for the enrollment record.

application.healthEnrollments[].memberIduuid(ApplicationMember)

ReasonFK to members[] identifying the household member enrolled in this plan.

application.healthEnrollments[].applicationIduuid(Application)
application.healthEnrollments[].roleenum
Valuessubscriber dependent

ReasonSubscriber vs. dependent role affects premium attribution for the ACA employer coverage affordability test.

application.healthEnrollments[].startDatedate

ReasonCoverage start date; used to determine coverage gap periods relevant to MEC analysis and special enrollment eligibility.

application.healthEnrollments[].endDatedate

ReasonDate coverage lapsed, triggering special enrollment period eligibility for marketplace.

ProgramsACA
Policies
aca-special-enrollment-periods45 CFR § 155.420

Individuals may enroll in marketplace coverage outside open enrollment following a qualifying life event: loss of coverage, household size change, change in residency, or loss of eligibility for other MEC. The special enrollment period is generally 60 days from the qualifying event.

application.healthEnrollments[].eligibleDatedate

ReasonDate the member becomes eligible for coverage; used to determine whether a special enrollment period applies.

application.healthEnrollments[].enrollmentStatusenum
Valueseligible enrolled pending ended

ReasonDistinguishes members who are eligible (offered coverage) from those who are enrolled (actively covered) and those whose coverage has ended; each status has different implications for marketplace eligibility and MSP screening.

ProgramsMEDICAIDACA
Policies
aca-special-enrollment-periods45 CFR § 155.420

Individuals may enroll in marketplace coverage outside open enrollment following a qualifying life event: loss of coverage, household size change, change in residency, or loss of eligibility for other MEC. The special enrollment period is generally 60 days from the qualifying event.

medicaid-medicare-savings-program42 CFR § 435.119

States must provide Medicare Savings Program (MSP) benefits to Medicare beneficiaries who meet income and resource limits. MSP categories include QMB (pays Part A and B premiums, deductibles, and coinsurance), SLMB (pays Part B premium only), QI (pays Part B premium only, federally funded), and QDWI (pays Part A premium for certain working disabled individuals).

application.healthEnrollments[].prefersSeparateMailingboolean

ReasonMembers have the right to request that health coverage notices be sent to an alternative address, primarily for domestic violence safety and health information privacy.

ProgramsMEDICAIDCHIPACA
Policies
hipaa-confidential-communications45 CFR § 164.522

Individuals have the right to request that covered entities send protected health information to an alternative address or by alternative means. Health plans must accommodate reasonable requests when the individual states that disclosure to the usual address could endanger them. Applies particularly to domestic violence survivors and recipients of sensitive health services.

aca-section-1557-nondiscriminationACA § 1557

Section 1557 prohibits discrimination in health programs and activities on the basis of race, color, national origin, sex (including gender identity and sexual orientation), age, and disability. Applies to health programs receiving federal financial assistance, including state Medicaid and CHIP programs and marketplace plans.

application.healthEnrollments[].sponsorPersonRef
application.healthEnrollments[].sponsor.iduuid
application.healthEnrollments[].sponsor.typeenum
Valuesmember contact

child-support

application.childSupport.iduuid
application.childSupport.applicationIduuid(Application)
application.childSupport.goodCauseChildSupportWaiverboolean

ReasonApplicants who cooperate with child support enforcement may claim a good cause exception if cooperation would put them or their children at risk of harm.

ProgramsSNAPMEDICAIDTANF
Policies
snap-child-support-cooperation45 CFR § 303.6

SNAP applicants with children who have an absent parent must cooperate with child support enforcement as a condition of eligibility for the children. Good cause exceptions apply when cooperation would endanger the applicant or their children; the applicant must apply for good cause at the time of application.

tanf-child-support-cooperation42 USC § 608(a)(2)

TANF recipients must cooperate with child support enforcement as a condition of eligibility. Non-cooperation results in a benefit reduction of at least 25%. A good cause exception protects recipients for whom cooperation would endanger them or their children.

medicaid-medical-support-cooperation42 CFR § 433.147

Medicaid applicants must assign their right to medical support and cooperate with the state in establishing paternity and obtaining medical support as a condition of eligibility. A good cause exception applies when cooperation would endanger the applicant or their child.

application.childSupport.parentsOutsideHome[]list(ParentOutsideHome)

ReasonNon-custodial parents outside the home identified for child support enforcement referral, which is a condition of TANF receipt.

ProgramsSNAPTANF
Policies
tanf-child-support-cooperation42 USC § 608(a)(2)

TANF recipients must cooperate with child support enforcement as a condition of eligibility. Non-cooperation results in a benefit reduction of at least 25%. A good cause exception protects recipients for whom cooperation would endanger them or their children.

snap-child-support-cooperation45 CFR § 303.6

SNAP applicants with children who have an absent parent must cooperate with child support enforcement as a condition of eligibility for the children. Good cause exceptions apply when cooperation would endanger the applicant or their children; the applicant must apply for good cause at the time of application.

application.childSupport.parentsOutsideHome[].iduuid

ReasonIdentifier of the referenced person record for the non-custodial parent; the person record holds their name, address, and phone for enforcement contact.

ProgramsSNAPTANF
Policies
tanf-child-support-cooperation42 USC § 608(a)(2)

TANF recipients must cooperate with child support enforcement as a condition of eligibility. Non-cooperation results in a benefit reduction of at least 25%. A good cause exception protects recipients for whom cooperation would endanger them or their children.

snap-child-support-cooperation45 CFR § 303.6

SNAP applicants with children who have an absent parent must cooperate with child support enforcement as a condition of eligibility for the children. Good cause exceptions apply when cooperation would endanger the applicant or their children; the applicant must apply for good cause at the time of application.

application.childSupport.parentsOutsideHome[].typeenum
Valuesmember contact

ReasonDiscriminator identifying whether the non-custodial parent is a household member or a contact-only person record in application.contacts[].

ProgramsSNAPTANF
Policies
tanf-child-support-cooperation42 USC § 608(a)(2)

TANF recipients must cooperate with child support enforcement as a condition of eligibility. Non-cooperation results in a benefit reduction of at least 25%. A good cause exception protects recipients for whom cooperation would endanger them or their children.

snap-child-support-cooperation45 CFR § 303.6

SNAP applicants with children who have an absent parent must cooperate with child support enforcement as a condition of eligibility for the children. Good cause exceptions apply when cooperation would endanger the applicant or their children; the applicant must apply for good cause at the time of application.

application.childSupport.parentsOutsideHome[].children[]list(PersonRef)

ReasonIdentifies which children in the household are associated with this non-custodial parent for child support enforcement purposes.

ModelingArray because one non-custodial parent may be the parent of multiple children in the household.

ProgramsSNAPTANF
Policies
tanf-child-support-cooperation42 USC § 608(a)(2)

TANF recipients must cooperate with child support enforcement as a condition of eligibility. Non-cooperation results in a benefit reduction of at least 25%. A good cause exception protects recipients for whom cooperation would endanger them or their children.

snap-child-support-cooperation45 CFR § 303.6

SNAP applicants with children who have an absent parent must cooperate with child support enforcement as a condition of eligibility for the children. Good cause exceptions apply when cooperation would endanger the applicant or their children; the applicant must apply for good cause at the time of application.

application.childSupport.parentsOutsideHome[].children[].iduuid

ReasonIdentifier of the referenced child person record.

ProgramsSNAPTANF
Policies
tanf-child-support-cooperation42 USC § 608(a)(2)

TANF recipients must cooperate with child support enforcement as a condition of eligibility. Non-cooperation results in a benefit reduction of at least 25%. A good cause exception protects recipients for whom cooperation would endanger them or their children.

snap-child-support-cooperation45 CFR § 303.6

SNAP applicants with children who have an absent parent must cooperate with child support enforcement as a condition of eligibility for the children. Good cause exceptions apply when cooperation would endanger the applicant or their children; the applicant must apply for good cause at the time of application.

application.childSupport.parentsOutsideHome[].children[].typeenum
Valuesmember contact

ReasonDiscriminator identifying whether the child is a household member or a contact-only person record.

ProgramsSNAPTANF
Policies
tanf-child-support-cooperation42 USC § 608(a)(2)

TANF recipients must cooperate with child support enforcement as a condition of eligibility. Non-cooperation results in a benefit reduction of at least 25%. A good cause exception protects recipients for whom cooperation would endanger them or their children.

snap-child-support-cooperation45 CFR § 303.6

SNAP applicants with children who have an absent parent must cooperate with child support enforcement as a condition of eligibility for the children. Good cause exceptions apply when cooperation would endanger the applicant or their children; the applicant must apply for good cause at the time of application.

application.childSupport.parentsOutsideHome[].attemptedMedicalSupportCooperationboolean

ReasonMedicaid applicants are required to cooperate with medical support enforcement as a condition of eligibility.

ProgramsMEDICAID
Policies
medicaid-medical-support-cooperation42 CFR § 433.147

Medicaid applicants must assign their right to medical support and cooperate with the state in establishing paternity and obtaining medical support as a condition of eligibility. A good cause exception applies when cooperation would endanger the applicant or their child.

contacts

application.contacts[]list(Contact)

ReasonRegistry of all individuals referenced in the application — household members and non-members alike (authorized representatives, helpers, sponsors, tax dependents, non-custodial parents, etc.). Members link to their contacts[] record via application.members[].personId. Non-member individuals are "contacts" with a contacts[] record but no application.members[] entry.

application.contacts[].iduuid

ReasonUnique identifier for the person record; referenced throughout the model via member|contact discriminator pairs (type + id).

application.contacts[].applicationIduuid(Application)
application.contacts[].nameName

ReasonLegal name of the person for identity verification, correspondence, and data matching across programs.

application.contacts[].name.firstNamestring
application.contacts[].name.middleNamestring
application.contacts[].name.middleInitialstring
application.contacts[].name.lastNamestring
application.contacts[].name.maidenNamestring
application.contacts[].name.suffixstring
application.contacts[].primaryAddressAddress

ReasonMailing address for correspondence directed to this person, used when the person is a non-member contact such as an authorized representative or sponsor.

application.contacts[].primaryAddress.addressLine1string
application.contacts[].primaryAddress.addressLine2string
application.contacts[].primaryAddress.citystring
application.contacts[].primaryAddress.statestring
application.contacts[].primaryAddress.zipstring
application.contacts[].primaryAddress.countystring
application.contacts[].primaryPhonestring

ReasonContact phone number for this person, used for non-member contacts such as authorized representatives and helpers.

application.contacts[].emailemail

ReasonEmail address for electronic correspondence, used for non-member contacts who opt in to electronic notices.

organizations

application.organizations[]list(Organization)

ReasonRegistry of legal entities referenced in the application — employers, organizational authorized representatives, and other entities. Members reference organizations via healthPlans[].organizationId, jobs[].employerId, and authorized representative records.

application.organizations[].iduuid

ReasonUnique identifier for the organization record; referenced by FK fields throughout the model.

application.organizations[].applicationIduuid(Application)
application.organizations[].namestring

ReasonLegal name of the organization for correspondence, verification, and reporting.

application.organizations[].einstring

ReasonEmployer Identification Number used for income verification and employer contact.

application.organizations[].addressAddress

ReasonOrganization's address for verification and contact when phone is unavailable.

application.organizations[].address.addressLine1string
application.organizations[].address.addressLine2string
application.organizations[].address.citystring
application.organizations[].address.statestring
application.organizations[].address.zipstring
application.organizations[].address.countystring
application.organizations[].phonestring

ReasonOrganization's phone number for income verification and plan enrollment contact.

person-relationships

application.personRelationships[]list(PersonRelationship)

ReasonDirected relationship records between people in the application, used for caretaker relative eligibility, spousal income deeming, dependent care attribution, and co-applicant signature traversal. Both directions are always stored.

ModelingConvention — from IS THE [relationshipType] OF to. Storing both directions (A→B parent, B→A child) means callers can query from = X to get all of X's relationships with the correct type label without requiring bidirectional joins.

ProgramsSNAPMEDICAID
Policies
medicaid-caretaker-relative42 CFR § 435.4

A caretaker relative is an adult who lives with and cares for a dependent child and who is related to the child within the fifth degree. Caretaker relative status is a basis for Medicaid eligibility separate from MAGI pathways and is used to determine household composition for MAGI-exempt populations.

snap-deeming-rules7 CFR § 273.11

Income of a non-applying spouse is deemed to the household. Special income averaging rules apply to households with irregular or self-employment income. Temporary income changes may be prorated over the benefit period.

application.personRelationships[].iduuid
ProgramsSNAPMEDICAID
Policies
medicaid-caretaker-relative42 CFR § 435.4

A caretaker relative is an adult who lives with and cares for a dependent child and who is related to the child within the fifth degree. Caretaker relative status is a basis for Medicaid eligibility separate from MAGI pathways and is used to determine household composition for MAGI-exempt populations.

snap-deeming-rules7 CFR § 273.11

Income of a non-applying spouse is deemed to the household. Special income averaging rules apply to households with irregular or self-employment income. Temporary income changes may be prorated over the benefit period.

application.personRelationships[].applicationIduuid(Application)
ProgramsSNAPMEDICAID
Policies
medicaid-caretaker-relative42 CFR § 435.4

A caretaker relative is an adult who lives with and cares for a dependent child and who is related to the child within the fifth degree. Caretaker relative status is a basis for Medicaid eligibility separate from MAGI pathways and is used to determine household composition for MAGI-exempt populations.

snap-deeming-rules7 CFR § 273.11

Income of a non-applying spouse is deemed to the household. Special income averaging rules apply to households with irregular or self-employment income. Temporary income changes may be prorated over the benefit period.

application.personRelationships[].fromPersonRef

ReasonSource person in a directed relationship; from IS THE [relationshipType] OF to.

ProgramsSNAPMEDICAID
Policies
medicaid-caretaker-relative42 CFR § 435.4

A caretaker relative is an adult who lives with and cares for a dependent child and who is related to the child within the fifth degree. Caretaker relative status is a basis for Medicaid eligibility separate from MAGI pathways and is used to determine household composition for MAGI-exempt populations.

snap-deeming-rules7 CFR § 273.11

Income of a non-applying spouse is deemed to the household. Special income averaging rules apply to households with irregular or self-employment income. Temporary income changes may be prorated over the benefit period.

application.personRelationships[].from.iduuid

ReasonIdentifier of the source person record; points to application.members[].id when type = member, or application.contacts[].id when type = contact.

ProgramsSNAPMEDICAID
Policies
medicaid-caretaker-relative42 CFR § 435.4

A caretaker relative is an adult who lives with and cares for a dependent child and who is related to the child within the fifth degree. Caretaker relative status is a basis for Medicaid eligibility separate from MAGI pathways and is used to determine household composition for MAGI-exempt populations.

snap-deeming-rules7 CFR § 273.11

Income of a non-applying spouse is deemed to the household. Special income averaging rules apply to households with irregular or self-employment income. Temporary income changes may be prorated over the benefit period.

application.personRelationships[].from.typeenum
Valuesmember contact

ReasonDiscriminator identifying whether the source person is a household member or a contact-only person record.

ProgramsSNAPMEDICAID
Policies
medicaid-caretaker-relative42 CFR § 435.4

A caretaker relative is an adult who lives with and cares for a dependent child and who is related to the child within the fifth degree. Caretaker relative status is a basis for Medicaid eligibility separate from MAGI pathways and is used to determine household composition for MAGI-exempt populations.

snap-deeming-rules7 CFR § 273.11

Income of a non-applying spouse is deemed to the household. Special income averaging rules apply to households with irregular or self-employment income. Temporary income changes may be prorated over the benefit period.

application.personRelationships[].toPersonRef

ReasonTarget person in a directed relationship.

ProgramsSNAPMEDICAID
Policies
medicaid-caretaker-relative42 CFR § 435.4

A caretaker relative is an adult who lives with and cares for a dependent child and who is related to the child within the fifth degree. Caretaker relative status is a basis for Medicaid eligibility separate from MAGI pathways and is used to determine household composition for MAGI-exempt populations.

snap-deeming-rules7 CFR § 273.11

Income of a non-applying spouse is deemed to the household. Special income averaging rules apply to households with irregular or self-employment income. Temporary income changes may be prorated over the benefit period.

application.personRelationships[].to.iduuid

ReasonIdentifier of the target person record; points to application.members[].id when type = member, or application.contacts[].id when type = contact.

ProgramsSNAPMEDICAID
Policies
medicaid-caretaker-relative42 CFR § 435.4

A caretaker relative is an adult who lives with and cares for a dependent child and who is related to the child within the fifth degree. Caretaker relative status is a basis for Medicaid eligibility separate from MAGI pathways and is used to determine household composition for MAGI-exempt populations.

snap-deeming-rules7 CFR § 273.11

Income of a non-applying spouse is deemed to the household. Special income averaging rules apply to households with irregular or self-employment income. Temporary income changes may be prorated over the benefit period.

application.personRelationships[].to.typeenum
Valuesmember contact

ReasonDiscriminator identifying whether the target person is a household member or a contact-only person record.

ProgramsSNAPMEDICAID
Policies
medicaid-caretaker-relative42 CFR § 435.4

A caretaker relative is an adult who lives with and cares for a dependent child and who is related to the child within the fifth degree. Caretaker relative status is a basis for Medicaid eligibility separate from MAGI pathways and is used to determine household composition for MAGI-exempt populations.

snap-deeming-rules7 CFR § 273.11

Income of a non-applying spouse is deemed to the household. Special income averaging rules apply to households with irregular or self-employment income. Temporary income changes may be prorated over the benefit period.

application.personRelationships[].relationshipTypes[]enum
Valuesparent child spouse domestic_partner sibling grandparent grandchild legal_guardian caregiver primary_caregiver other_relative unrelated

ReasonRelationship type(s) from the source person's perspective. An array to support compound relationships (e.g., both sibling and caregiver). Both directions are always stored so queries on either party return the correct type label.

ProgramsSNAPMEDICAID
Policies
medicaid-caretaker-relative42 CFR § 435.4

A caretaker relative is an adult who lives with and cares for a dependent child and who is related to the child within the fifth degree. Caretaker relative status is a basis for Medicaid eligibility separate from MAGI pathways and is used to determine household composition for MAGI-exempt populations.

snap-deeming-rules7 CFR § 273.11

Income of a non-applying spouse is deemed to the household. Special income averaging rules apply to households with irregular or self-employment income. Temporary income changes may be prorated over the benefit period.

authorized-representatives

application.authorizedRepresentatives[]list(AuthorizedRepresentative)

ReasonIndividuals or organizations designated by household members to act on their behalf for specific benefit programs. Authority may be scoped to a subset of programs and may differ by member.

ProgramsSNAPMEDICAID
Policies
snap-authorized-representative7 CFR § 273.2(n)

A SNAP authorized representative must be a non-household member. They may apply, be interviewed, and obtain benefits on behalf of the household, but may not also appear as a regular household member on the same application.

medicaid-authorized-representative42 CFR § 435.923

A Medicaid authorized representative may be a household member. Unlike SNAP, Medicaid permits a person who lives in the household to act as authorized representative, meaning one person can simultaneously hold both the household member and authorized representative roles.

application.authorizedRepresentatives[].iduuid

ReasonIdentifier of the referenced person or organization record; points to application.members[].id, application.contacts[].id, or application.organizations[].id depending on type.

ProgramsSNAPMEDICAID
Policies
snap-authorized-representative7 CFR § 273.2(n)

A SNAP authorized representative must be a non-household member. They may apply, be interviewed, and obtain benefits on behalf of the household, but may not also appear as a regular household member on the same application.

medicaid-authorized-representative42 CFR § 435.923

A Medicaid authorized representative may be a household member. Unlike SNAP, Medicaid permits a person who lives in the household to act as authorized representative, meaning one person can simultaneously hold both the household member and authorized representative roles.

application.authorizedRepresentatives[].appointedByMemberIduuid(ApplicationMember)

ReasonFK to application.members[] identifying which household member appointed this representative; required when members on the same application may designate different representatives for different programs.

ProgramsSNAPMEDICAID
Policies
snap-authorized-representative7 CFR § 273.2(n)

A SNAP authorized representative must be a non-household member. They may apply, be interviewed, and obtain benefits on behalf of the household, but may not also appear as a regular household member on the same application.

medicaid-authorized-representative42 CFR § 435.923

A Medicaid authorized representative may be a household member. Unlike SNAP, Medicaid permits a person who lives in the household to act as authorized representative, meaning one person can simultaneously hold both the household member and authorized representative roles.

application.authorizedRepresentatives[].applicationIduuid(Application)
ProgramsSNAPMEDICAID
Policies
snap-authorized-representative7 CFR § 273.2(n)

A SNAP authorized representative must be a non-household member. They may apply, be interviewed, and obtain benefits on behalf of the household, but may not also appear as a regular household member on the same application.

medicaid-authorized-representative42 CFR § 435.923

A Medicaid authorized representative may be a household member. Unlike SNAP, Medicaid permits a person who lives in the household to act as authorized representative, meaning one person can simultaneously hold both the household member and authorized representative roles.

application.authorizedRepresentatives[].typeenum
Valuesmember contact organization

ReasonDetermines whether the representative is a natural person or an organization, which affects which record the id field points to and how authority is verified.

ModelingPolymorphic discriminator; id points to application.contacts[].id when type = individual and application.organizations[].id when type = organization.

ProgramsSNAPMEDICAID
Policies
snap-authorized-representative7 CFR § 273.2(n)

A SNAP authorized representative must be a non-household member. They may apply, be interviewed, and obtain benefits on behalf of the household, but may not also appear as a regular household member on the same application.

medicaid-authorized-representative42 CFR § 435.923

A Medicaid authorized representative may be a household member. Unlike SNAP, Medicaid permits a person who lives in the household to act as authorized representative, meaning one person can simultaneously hold both the household member and authorized representative roles.

application.authorizedRepresentatives[].inCareOfPersonRef
ProgramsSNAPMEDICAID
Policies
snap-authorized-representative7 CFR § 273.2(n)

A SNAP authorized representative must be a non-household member. They may apply, be interviewed, and obtain benefits on behalf of the household, but may not also appear as a regular household member on the same application.

medicaid-authorized-representative42 CFR § 435.923

A Medicaid authorized representative may be a household member. Unlike SNAP, Medicaid permits a person who lives in the household to act as authorized representative, meaning one person can simultaneously hold both the household member and authorized representative roles.

application.authorizedRepresentatives[].inCareOf.iduuid

ReasonIdentifier of the person within the organization to whom correspondence should be directed.

ProgramsSNAPMEDICAID
Policies
snap-authorized-representative7 CFR § 273.2(n)

A SNAP authorized representative must be a non-household member. They may apply, be interviewed, and obtain benefits on behalf of the household, but may not also appear as a regular household member on the same application.

medicaid-authorized-representative42 CFR § 435.923

A Medicaid authorized representative may be a household member. Unlike SNAP, Medicaid permits a person who lives in the household to act as authorized representative, meaning one person can simultaneously hold both the household member and authorized representative roles.

application.authorizedRepresentatives[].inCareOf.typeenum
Valuesmember contact

ReasonDiscriminator identifying whether the in-care-of contact is a household member or a contact-only person record in application.contacts[]; used when mail to an organizational representative should be directed to a specific individual.

ProgramsSNAPMEDICAID
Policies
snap-authorized-representative7 CFR § 273.2(n)

A SNAP authorized representative must be a non-household member. They may apply, be interviewed, and obtain benefits on behalf of the household, but may not also appear as a regular household member on the same application.

medicaid-authorized-representative42 CFR § 435.923

A Medicaid authorized representative may be a household member. Unlike SNAP, Medicaid permits a person who lives in the household to act as authorized representative, meaning one person can simultaneously hold both the household member and authorized representative roles.

application.authorizedRepresentatives[].receivesNoticesboolean

ReasonDetermines whether program notices are sent to the representative instead of, or in addition to, the applicant.

ProgramsSNAPMEDICAID
Policies
snap-authorized-representative7 CFR § 273.2(n)

A SNAP authorized representative must be a non-household member. They may apply, be interviewed, and obtain benefits on behalf of the household, but may not also appear as a regular household member on the same application.

medicaid-authorized-representative42 CFR § 435.923

A Medicaid authorized representative may be a household member. Unlike SNAP, Medicaid permits a person who lives in the household to act as authorized representative, meaning one person can simultaneously hold both the household member and authorized representative roles.

application.authorizedRepresentatives[].programs[]enum
Valuessnap medicaid chip tanf aca

ReasonScopes the representative's authority to specific programs. A representative may be authorized for some programs but not others on a multi-program application.

ProgramsSNAPMEDICAID
Policies
snap-authorized-representative7 CFR § 273.2(n)

A SNAP authorized representative must be a non-household member. They may apply, be interviewed, and obtain benefits on behalf of the household, but may not also appear as a regular household member on the same application.

medicaid-authorized-representative42 CFR § 435.923

A Medicaid authorized representative may be a household member. Unlike SNAP, Medicaid permits a person who lives in the household to act as authorized representative, meaning one person can simultaneously hold both the household member and authorized representative roles.

signatures

application.signatures[]list(Signature)

ReasonSignature events on the application, each capturing who signed, in what capacity, for what legal purpose, and by what method. A single application may have multiple distinct signature events.

ProgramsSNAPMEDICAID
Policies
medicaid-application-signature42 CFR § 435.907

States must accept electronic signatures on Medicaid applications. An authorized representative may sign on behalf of an applicant. Signature certifies that information is accurate and authorizes release of information for verification purposes.

Electronic signatures and records have the same legal effect as paper signatures and documents in interstate commerce. Agencies accepting applications electronically must ensure applicants can provide legally valid signatures. UETA provides equivalent state-law authority.

application.signatures[].iduuid
ProgramsSNAPMEDICAID
Policies
medicaid-application-signature42 CFR § 435.907

States must accept electronic signatures on Medicaid applications. An authorized representative may sign on behalf of an applicant. Signature certifies that information is accurate and authorizes release of information for verification purposes.

Electronic signatures and records have the same legal effect as paper signatures and documents in interstate commerce. Agencies accepting applications electronically must ensure applicants can provide legally valid signatures. UETA provides equivalent state-law authority.

application.signatures[].applicationIduuid(Application)
ProgramsSNAPMEDICAID
Policies
medicaid-application-signature42 CFR § 435.907

States must accept electronic signatures on Medicaid applications. An authorized representative may sign on behalf of an applicant. Signature certifies that information is accurate and authorizes release of information for verification purposes.

Electronic signatures and records have the same legal effect as paper signatures and documents in interstate commerce. Agencies accepting applications electronically must ensure applicants can provide legally valid signatures. UETA provides equivalent state-law authority.

application.signatures[].signerSigner
ProgramsSNAPMEDICAID
Policies
medicaid-application-signature42 CFR § 435.907

States must accept electronic signatures on Medicaid applications. An authorized representative may sign on behalf of an applicant. Signature certifies that information is accurate and authorizes release of information for verification purposes.

Electronic signatures and records have the same legal effect as paper signatures and documents in interstate commerce. Agencies accepting applications electronically must ensure applicants can provide legally valid signatures. UETA provides equivalent state-law authority.

application.signatures[].signer.iduuid

ReasonIdentifier of the referenced person or organization record who is the signer.

ProgramsSNAPMEDICAID
Policies
medicaid-application-signature42 CFR § 435.907

States must accept electronic signatures on Medicaid applications. An authorized representative may sign on behalf of an applicant. Signature certifies that information is accurate and authorizes release of information for verification purposes.

Electronic signatures and records have the same legal effect as paper signatures and documents in interstate commerce. Agencies accepting applications electronically must ensure applicants can provide legally valid signatures. UETA provides equivalent state-law authority.

application.signatures[].signer.typeenum
Valuesmember contact organization

ReasonDiscriminator identifying whether the signer is a household member, a contact-only person, or an organization.

ProgramsSNAPMEDICAID
Policies
medicaid-application-signature42 CFR § 435.907

States must accept electronic signatures on Medicaid applications. An authorized representative may sign on behalf of an applicant. Signature certifies that information is accurate and authorizes release of information for verification purposes.

Electronic signatures and records have the same legal effect as paper signatures and documents in interstate commerce. Agencies accepting applications electronically must ensure applicants can provide legally valid signatures. UETA provides equivalent state-law authority.

application.signatures[].signer.roleenum
Valuesapplicant authorized_representative helper

ReasonIdentifies the capacity in which the signer is signing — as the applicant member, their authorized representative, or a third-party helper who assisted with the form.

ProgramsSNAPMEDICAID
Policies
medicaid-application-signature42 CFR § 435.907

States must accept electronic signatures on Medicaid applications. An authorized representative may sign on behalf of an applicant. Signature certifies that information is accurate and authorizes release of information for verification purposes.

Electronic signatures and records have the same legal effect as paper signatures and documents in interstate commerce. Agencies accepting applications electronically must ensure applicants can provide legally valid signatures. UETA provides equivalent state-law authority.

application.signatures[].purposeenum
Valuesapplication authorized_representative_appointment authorized_representative_acceptance rights_and_responsibilities hipaa_consent other

ReasonA single application may require multiple legally distinct signature events with different legal bases, signers, and timing.

ModelingDiscriminator enabling each signature event to be stored and audited independently on the same application record.

ProgramsSNAPMEDICAID
Policies
medicaid-application-signature42 CFR § 435.907

States must accept electronic signatures on Medicaid applications. An authorized representative may sign on behalf of an applicant. Signature certifies that information is accurate and authorizes release of information for verification purposes.

Electronic signatures and records have the same legal effect as paper signatures and documents in interstate commerce. Agencies accepting applications electronically must ensure applicants can provide legally valid signatures. UETA provides equivalent state-law authority.

application.signatures[].signedAtdatetime

ReasonDate and time of signature required for audit trail, benefit period determination, and legal validity.

ProgramsSNAPMEDICAID
Policies
medicaid-application-signature42 CFR § 435.907

States must accept electronic signatures on Medicaid applications. An authorized representative may sign on behalf of an applicant. Signature certifies that information is accurate and authorizes release of information for verification purposes.

Electronic signatures and records have the same legal effect as paper signatures and documents in interstate commerce. Agencies accepting applications electronically must ensure applicants can provide legally valid signatures. UETA provides equivalent state-law authority.

application.signatures[].signatureMethodenum
Valueselectronic wet_signature verbal

ReasonDistinguishes electronic, wet ink, and verbal signatures; states must track method for legal validity and audit purposes.

ProgramsSNAPMEDICAID
Policies
medicaid-application-signature42 CFR § 435.907

States must accept electronic signatures on Medicaid applications. An authorized representative may sign on behalf of an applicant. Signature certifies that information is accurate and authorizes release of information for verification purposes.

Electronic signatures and records have the same legal effect as paper signatures and documents in interstate commerce. Agencies accepting applications electronically must ensure applicants can provide legally valid signatures. UETA provides equivalent state-law authority.

sponsors

application.sponsors[]list(Sponsor)

ReasonImmigration sponsors whose income is deemed to sponsored non-citizen household members under PRWORA. Each record links a sponsor to the specific member whose benefits are subject to deeming.

ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.sponsors[].sponsoredMemberIduuid(ApplicationMember)

ReasonFK to application.members[] identifying the household member whose benefits may be subject to sponsor income deeming.

ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.sponsors[].iduuid

ReasonUnique identifier for the sponsor record.

ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.sponsors[].applicationIduuid(Application)
ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.sponsors[].typeenum
Valuesmember contact

ReasonDiscriminator identifying whether the sponsor is a household member or a contact-only person record in application.contacts[].

ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.sponsors[].ssnstring

ReasonSponsor's SSN required for income and asset verification through IEVS and FDSH.

ClassificationPII
ProgramsSNAPMEDICAIDTANF
Policies
snap-ssa-identity-check42 U.S.C. § 1320b-7

Agencies must use SSA data matches to verify identity and citizenship status for SNAP applicants. FDSH SSA is the electronic source for this check.

application.sponsors[].spouseSpouse
ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.sponsors[].spouse.iduuid

ReasonIdentifier of the referenced person record for the sponsor's spouse.

ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.sponsors[].spouse.typeenum
Valuesmember contact

ReasonDiscriminator identifying whether the sponsor's spouse is a household member or a contact-only person record in application.contacts[].

ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.sponsors[].spouse.ssnstring

ReasonSponsor spouse's SSN required for verification of the spouse's income, which may also be deemed to the sponsored non-citizen.

ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.sponsors[].spouse.signedAffidavitboolean

ReasonIndicates whether the sponsor's spouse co-signed the I-864 affidavit of support, which affects the scope of income deeming.

ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.sponsors[].householdSizeinteger

ReasonSponsor household size is used in the deeming formula to calculate the sponsor's available income attributable to the sponsored non-citizen.

ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.sponsors[].incomenumber

ReasonSponsor's gross income is the starting point for the deeming calculation; a portion is attributed to the sponsored non-citizen as deemed income.

ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

application.sponsors[].livesWithSponsoredboolean

ReasonWhen the sponsor lives with the sponsored non-citizen, a different deeming formula applies.

ProgramsSNAPMEDICAIDTANF
Policies
prwora-sponsor-deeming8 USC § 1631

Sponsors of immigrant non-citizens are deemed to have provided income and resources to the sponsored alien for federal benefit eligibility purposes. The sponsor's income and resources are attributed to the non-citizen at levels determined by household size. Deeming continues until the non-citizen becomes a citizen or completes 40 qualifying quarters of work.

prwora-affidavit-of-support8 USC § 1183a

Sponsors must sign a legally enforceable affidavit of support (Form I-864) committing to maintain the sponsored non-citizen at or above 125% of the federal poverty level. The affidavit creates a legally enforceable obligation that government agencies may use to recover benefit costs from the sponsor.

jobs

application.jobs[]list(Job)

ReasonEmployment records for household members, covering both employed and self-employed income sources. Each record represents one job and links to income records via jobId.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.jobs[].employerIduuid(Organization)
Applies whentype = employed

ReasonFK to application.organizations[] linking the job to the employer organization record; avoids duplicating employer name, address, and EIN across multiple jobs at the same employer.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.jobs[].iduuid

ReasonUnique identifier for the job record; FK target for application.incomes[].jobId and application.healthEnrollments[].jobId.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.jobs[].memberIduuid(ApplicationMember)

ReasonFK to members[] linking this job to the household member who holds it.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.jobs[].applicationIduuid(Application)
ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.jobs[].typeenum
Valuesemployed self_employed

ReasonEmployed vs. self-employed status determines the income calculation method, allowable expense deductions, and applicable verification documents.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.jobs[].statusenum
Valuesactive on_strike ended

ReasonCurrent employment status; on_strike triggers SNAP household strike disqualification rules for the striking member.

ClassificationPIIFTI
ProgramsSNAP
Policies
snap-strike-disqualification7 CFR § 273.1(f)

A household member on strike is ineligible for SNAP unless the household was eligible immediately before the strike began. A striking member's income from before the strike is counted during the disqualification period.

application.jobs[].hoursPerWeeknumber

ReasonAverage weekly hours used for TANF work participation rate calculation and SNAP ABAWD employment exemption determination.

ClassificationPIIFTI
ProgramsSNAPTANF
Policies
tanf-work-participation45 CFR § 261.22

States must meet a 50% overall work participation rate and a 90% two-parent family rate. Average weekly hours for each recipient are calculated and reported monthly. Failure to meet participation rates results in federal financial penalties.

snap-abawd-work-requirement7 CFR § 273.24

Able-bodied adults without dependents (ABAWDs) ages 18–49 may receive SNAP for only 3 months in a 36-month period unless they work or participate in an approved work or training program for at least 80 hours per month. Exemptions apply for pregnancy, disability, and caring for a dependent child.

application.jobs[].isTemporaryboolean

ReasonTemporary employment affects SNAP income averaging rules and TANF work activity categorization.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.jobs[].startDatedate

ReasonEmployment start date used to verify duration and determine which income is countable in the current benefit period.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.jobs[].endDatedate

ReasonEmployment end date used to identify recent job loss for expedited processing screening and income change evaluation.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.jobs[].endReasonenum
Valuesvoluntary_separation involuntary_separation

ReasonVoluntary separation without good cause may result in TANF disqualification; participation in a labor strike disqualifies the striking member from SNAP.

ClassificationPIIFTI
ProgramsSNAPTANF
Policies
tanf-voluntary-quit45 CFR § 261.50

A TANF recipient who voluntarily quits a job or reduces work hours without good cause may be sanctioned, reducing or terminating their benefit. States define good cause criteria within federal minimum standards.

snap-strike-disqualification7 CFR § 273.1(f)

A household member on strike is ineligible for SNAP unless the household was eligible immediately before the strike began. A striking member's income from before the strike is counted during the disqualification period.

application.jobs[].strikeStartDatedate

ReasonDate the labor strike began; used to determine whether the SNAP strike disqualification period applies and to establish the duration of the disqualification.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.jobs[].lastPaycheckDatedate

ReasonDate of last paycheck required to determine the income counting period when employment recently ended.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.jobs[].lastPaycheckGrossAmountnumber

ReasonGross amount of last paycheck used for income verification when pay stubs from the current period are unavailable.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.jobs[].businessNamestring
Applies whentype = self_employed

ReasonTrade name or DBA name of the self-employment business for verification and worker review.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.jobs[].businessTypestring
Applies whentype = self_employed

ReasonType of self-employment business may affect which expense categories are allowable deductions.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.jobs[].reportingMonthdate
Applies whentype = self_employed

ReasonThe month for which self-employment income is being reported; used when income varies month to month and a single reporting period must be designated for calculation.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.jobs[].expensesSelfEmploymentExpenses
Applies whentype = self_employed
ClassificationPIIFTI
ProgramsSNAP
Policies
snap-self-employment-expenses7 CFR § 273.11(b)

Self-employment income is calculated as gross receipts minus allowable business expenses. Deductible expenses include costs of goods sold, labor, rent, utilities, depreciation, and taxes directly attributable to the business. Personal expenses and capital expenditures are not deductible.

application.jobs[].expenses.utilitiesnumber
Applies whentype = self_employed

ReasonUtility costs paid for business use are an allowable deduction from self-employment gross income.

ClassificationPIIFTI
ProgramsSNAP
Policies
snap-self-employment-expenses7 CFR § 273.11(b)

Self-employment income is calculated as gross receipts minus allowable business expenses. Deductible expenses include costs of goods sold, labor, rent, utilities, depreciation, and taxes directly attributable to the business. Personal expenses and capital expenditures are not deductible.

application.jobs[].expenses.taxesnumber
Applies whentype = self_employed

ReasonBusiness taxes paid are an allowable deduction from self-employment gross income.

ClassificationPIIFTI
ProgramsSNAP
Policies
snap-self-employment-expenses7 CFR § 273.11(b)

Self-employment income is calculated as gross receipts minus allowable business expenses. Deductible expenses include costs of goods sold, labor, rent, utilities, depreciation, and taxes directly attributable to the business. Personal expenses and capital expenditures are not deductible.

application.jobs[].expenses.interestnumber
Applies whentype = self_employed

ReasonBusiness interest payments are an allowable deduction from self-employment gross income.

ClassificationPIIFTI
ProgramsSNAP
Policies
snap-self-employment-expenses7 CFR § 273.11(b)

Self-employment income is calculated as gross receipts minus allowable business expenses. Deductible expenses include costs of goods sold, labor, rent, utilities, depreciation, and taxes directly attributable to the business. Personal expenses and capital expenditures are not deductible.

application.jobs[].expenses.laborCostsnumber
Applies whentype = self_employed

ReasonGross labor costs paid to employees are an allowable deduction from self-employment gross income.

ClassificationPIIFTI
ProgramsSNAP
Policies
snap-self-employment-expenses7 CFR § 273.11(b)

Self-employment income is calculated as gross receipts minus allowable business expenses. Deductible expenses include costs of goods sold, labor, rent, utilities, depreciation, and taxes directly attributable to the business. Personal expenses and capital expenditures are not deductible.

application.jobs[].expenses.costOfMerchandisenumber
Applies whentype = self_employed

ReasonCost of goods or merchandise sold is an allowable deduction from self-employment gross income.

ClassificationPIIFTI
ProgramsSNAP
Policies
snap-self-employment-expenses7 CFR § 273.11(b)

Self-employment income is calculated as gross receipts minus allowable business expenses. Deductible expenses include costs of goods sold, labor, rent, utilities, depreciation, and taxes directly attributable to the business. Personal expenses and capital expenditures are not deductible.

application.jobs[].expenses.othernumber
Applies whentype = self_employed

ReasonOther allowable business expenses not captured in the enumerated categories, subject to worker review.

ClassificationPIIFTI
ProgramsSNAP
Policies
snap-self-employment-expenses7 CFR § 273.11(b)

Self-employment income is calculated as gross receipts minus allowable business expenses. Deductible expenses include costs of goods sold, labor, rent, utilities, depreciation, and taxes directly attributable to the business. Personal expenses and capital expenditures are not deductible.

incomes

application.incomes[]list(Income)

ReasonIncome records for household members across all income types — employed, self-employed, unearned, lump sum, and in-kind. Each record represents one income source for one member. The prior_period type captures income from earlier in the current tax year not reflected in current reported income (e.g. a job that ended mid-year).

ModelingFor prior_period records, only amount is relevant; frequency is inapplicable and jobId should be populated where the source is known.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.incomes[].jobIduuid(Job)
Applies whentype in [employed, self_employed]

ReasonFK to application.jobs[] linking employed income to the specific job that generated it. Enables per-job income calculation when a member holds multiple jobs.

Modelinguuid type because it is a foreign key reference, not a free-text identifier.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.incomes[].iduuid

ReasonUnique identifier for the income record.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.incomes[].memberIduuid(ApplicationMember)

ReasonFK to application.members[] linking this income record to the household member who receives it.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.incomes[].applicationIduuid(Application)
ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.incomes[].typeenum
Valuesemployed self_employed unearned lump_sum in_kind_support tribal education_grant other prior_period

ReasonIncome type determines the calculation method, applicable exclusions, verification requirements, and program-specific treatment.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.incomes[].typeOtherstring

ReasonCaptures non-enumerated income types for adapter mapping and worker review.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.incomes[].amountnumber

ReasonThe income amount for the given frequency period, used as the basis for all income calculations.

ModelingStored as reported (per-period amount) rather than normalized to monthly, to preserve the precision of the applicant's reported figure and allow adapters to apply program-specific normalization methods.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.incomes[].frequencyenum
Valuesdaily weekly every_two_weeks twice_monthly monthly yearly variable

ReasonFrequency is required to normalize income to a monthly or annual figure for eligibility calculation and comparison against program thresholds. When frequency = variable, programs using projected annual income (MAGI Medicaid, marketplace) use the amount directly; programs using current periodic income (SNAP, TANF) should treat it as an estimate requiring worker review.

Modelingfrequency = variable means amount is the projected annual income, not a per-period figure. Applies to employed and self_employed types only.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.incomes[].dateReceiveddate

ReasonDate of receipt required for lump sum income to determine which benefit month is affected by the payment.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.incomes[].changeReasonenum
Valuesstopped_working hours_reduced new_job change_in_employment marital_status_change other

ReasonCategorical reason for a recent income change, used for case worker review and to validate projected annual income under MAGI rules.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.incomes[].changeExplanationstring

ReasonFree-text narrative explaining an income change; required by MAGI rules when projected income differs materially from annualized pay stubs.

ClassificationPIIFTI
ProgramsMEDICAIDCHIP
Policies
medicaid-magi-income-projection42 CFR § 435.603(h)

When projected annual income differs from annualized current income due to a recent change, states must accept the applicant's reasonable projection. A change in circumstances (job change, income increase or decrease, new household member) is required to support a projection that differs materially from annualized pay stubs.

application.incomes[].unearnedTypeenum
Applies whentype = unearned
Valuesunemployment kinship_payment veterans_programs adoption_and_refugee_services ssi_or_ssdi private_disability workers_compensation disability_from_veterans_programs legal_settlement scholarship educational_grant work_study spousal_support child_support retirement_or_pension investment_interest_and_dividends social_security_retirement rental_income gambling_or_lottery_winnings gifts_or_donations loan_or_mortgage_income research_participation other

ReasonSpecific unearned income type determines exclusion rules, verification source, and program-specific counting treatment.

ClassificationPIIFTI
ProgramsSNAP
Policies
snap-unearned-income7 CFR § 273.9(c)

Defines countable unearned income types including Social Security benefits, SSI, unemployment compensation, workers' compensation, child support, and veterans' benefits. Most unearned income is counted in full with limited exclusions.

application.incomes[].inKindSupportTypeenum
Applies whentype = in_kind_support
Valuesshelter food utilities other

ReasonType of in-kind support received — shelter, food, utilities, or other — determines the applicable income counting rule and SSI valuation method.

ClassificationPIIFTI
ProgramsMEDICAID
Policies
ssi-in-kind-support20 CFR § 416.1102

In-kind support and maintenance (ISM) — food or shelter received from outside the household — reduces an SSI recipient's benefit by up to one- third of the federal benefit rate. When a sponsor provides ISM to a non-citizen, the value is counted as income for SSI eligibility purposes.

application.incomes[].payerNamestring
Applies whentype = in_kind_support

ReasonName of the person or organization providing in-kind support, for verification and determination of whether support is from a sponsor subject to deeming rules.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-income-verification7 CFR § 272.8

Income must be verified through available electronic data sources (SSA IEVS, IRS IEVS, SWICA, UIB) before relying on applicant statements. Electronic verification reduces documentation burden on applicants.

application.incomes[].lumpSumTypeenum
Applies whentype = lump_sum
Valueslawsuit_settlement insurance_settlement social_security_ssi_ssdi_payment veterans inheritance surrender_of_annuity life_insurance_payout lottery_gambling_winnings other

ReasonLump sum type determines how the payment is treated across programs — some types are excluded, others are counted in the month of receipt or prorated.

ClassificationPIIFTI
ProgramsSNAPMEDICAID
Policies
snap-lump-sum-income7 CFR § 273.9(c)(14)

Lump sum payments received by a SNAP household are counted as income in the month received. Amounts that push income above the gross income limit result in ineligibility only for that month; they do not affect subsequent months.

medicaid-magi-methodology42 CFR § 435.603

Medicaid uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most non-elderly, non-disabled individuals. MAGI includes wages, self- employment income, Social Security, and most other income sources; it excludes child support received, certain Native American income, and tax-exempt interest. The tax filing unit (not household) is the unit of calculation. Tax filers include their own income; non-filers are evaluated as a separate household.

assets

application.assets[]list(Asset)

ReasonAsset records for household members — liquid assets, vehicles, real property, retirement accounts, and insurance — used in the SNAP asset test and Medicaid resource determination.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].iduuid

ReasonUnique identifier for the asset record.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].memberIduuid(ApplicationMember)

ReasonFK to application.members[] linking this asset to the household member who owns it.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].applicationIduuid(Application)
ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].typeenum
Valuesliquid vehicle real_property retirement_account insurance other

ReasonAsset type determines which countability rules apply and what verification is required.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].typeOtherstring

ReasonCaptures non-enumerated asset types for worker review and manual classification.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].valuenumber

ReasonCurrent market value of the asset, used in the SNAP asset test and Medicaid resource determination.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].financialInstitutionNamestring
Applies whentype in [liquid, retirement_account]

ReasonFinancial institution name for liquid asset verification through bank statements or electronic verification.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].accountNumberstring
Applies whentype in [liquid, retirement_account]

ReasonAccount number for liquid asset verification and cross-matching.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].yearstring
Applies whentype = vehicle

ReasonVehicle year is used with make and model to determine fair market value for the SNAP vehicle asset test.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].makestring
Applies whentype = vehicle

ReasonVehicle make used with year and model for fair market value determination.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].modelstring
Applies whentype = vehicle

ReasonVehicle model used with year and make for fair market value determination.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].policyTypeenum
Applies whentype = insurance
Valuesterm permanent burial other

ReasonPolicy type determines whether the cash surrender value is countable as a liquid asset.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].companyNamestring
Applies whentype = insurance

ReasonInsurance company name for policy verification and cash value lookup.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].policyNumberstring
Applies whentype = insurance

ReasonPolicy number required for insurance verification and cash value determination.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].faceValuenumber
Applies whentype = insurance

ReasonFace value is the starting point for determining cash surrender value; policies with face value above the exemption threshold have their cash value counted.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].isRevocableboolean
Applies whentype = insurance

ReasonOnly revocable life insurance policies have a countable cash surrender value; irrevocable policies are generally exempt.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].addressAddress
Applies whentype = real_property

ReasonProperty address used for valuation and to determine whether the property is the primary residence (which may be exempt).

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].address.addressLine1string
Applies whentype = real_property
ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].address.addressLine2string
Applies whentype = real_property
ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].address.citystring
Applies whentype = real_property
ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].address.statestring
Applies whentype = real_property
ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].address.zipstring
Applies whentype = real_property
ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].address.countystring
Applies whentype = real_property
ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].primaryUseenum
Applies whentype = real_property
Valuesprimary_residence rental self_employment for_sale other

ReasonPrimary use determines exemption status — primary residences are exempt; rental and investment properties are countable.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

application.assets[].primaryUseOtherstring
Applies whentype = real_property

ReasonCaptures non-enumerated primary uses for worker review.

ClassificationPII
ProgramsSNAPMEDICAID
Policies
snap-resource-limit7 CFR § 273.8

Most households may not have countable liquid resources exceeding $2,750. Households with an elderly or disabled member have a limit of $4,250.

medicaid-asset-rules42 CFR § 435.601

States operating a Medicaid program with a resource test must apply resource limits no more restrictive than those in effect on January 1, 1972. MAGI-based eligibility groups are exempt from resource tests. Non-MAGI groups (elderly, blind, disabled) may be subject to resource limits established by state plan.

asset-disposals

application.assetDisposals[]list(AssetDisposal)

ReasonRecords of assets transferred or disposed of within the lookback period, reviewed to determine whether the transfer was for less than fair market value.

ProgramsSNAP
Policies
snap-asset-disposal-lookback7 CFR § 273.8(h)

Households that transfer assets for less than fair market value within 36 months of application may be disqualified or have the transferred value counted as a resource for the period that the transferred amount would have made them ineligible.

application.assetDisposals[].iduuid

ReasonUnique identifier for the asset disposal record.

ProgramsSNAP
Policies
snap-asset-disposal-lookback7 CFR § 273.8(h)

Households that transfer assets for less than fair market value within 36 months of application may be disqualified or have the transferred value counted as a resource for the period that the transferred amount would have made them ineligible.

application.assetDisposals[].memberIduuid(ApplicationMember)

ReasonFK to application.members[] linking this disposal to the household member who made the transfer.

ProgramsSNAP
Policies
snap-asset-disposal-lookback7 CFR § 273.8(h)

Households that transfer assets for less than fair market value within 36 months of application may be disqualified or have the transferred value counted as a resource for the period that the transferred amount would have made them ineligible.

application.assetDisposals[].applicationIduuid(Application)
ProgramsSNAP
Policies
snap-asset-disposal-lookback7 CFR § 273.8(h)

Households that transfer assets for less than fair market value within 36 months of application may be disqualified or have the transferred value counted as a resource for the period that the transferred amount would have made them ineligible.

application.assetDisposals[].typeenum
Valuesliquid vehicle real_property retirement_account insurance other

ReasonType of transferred asset determines which countability rules apply to the transfer.

ProgramsSNAP
Policies
snap-asset-disposal-lookback7 CFR § 273.8(h)

Households that transfer assets for less than fair market value within 36 months of application may be disqualified or have the transferred value counted as a resource for the period that the transferred amount would have made them ineligible.

application.assetDisposals[].typeOtherstring

ReasonCaptures non-enumerated transferred asset types for worker review.

ProgramsSNAP
Policies
snap-asset-disposal-lookback7 CFR § 273.8(h)

Households that transfer assets for less than fair market value within 36 months of application may be disqualified or have the transferred value counted as a resource for the period that the transferred amount would have made them ineligible.

application.assetDisposals[].dateOfDisposaldate

ReasonDate of transfer determines whether the transfer falls within the applicable lookback period for the asset test.

ProgramsSNAP
Policies
snap-asset-disposal-lookback7 CFR § 273.8(h)

Households that transfer assets for less than fair market value within 36 months of application may be disqualified or have the transferred value counted as a resource for the period that the transferred amount would have made them ineligible.

application.assetDisposals[].amountReceivednumber

ReasonAmount received for the transfer; compared against fair market value to determine whether the transfer was for less than fair market value.

ProgramsSNAP
Policies
snap-asset-disposal-lookback7 CFR § 273.8(h)

Households that transfer assets for less than fair market value within 36 months of application may be disqualified or have the transferred value counted as a resource for the period that the transferred amount would have made them ineligible.

application.assetDisposals[].fairMarketValuenumber

ReasonFair market value at time of transfer; if the amount received is below fair market value, the difference may be counted as a resource.

ProgramsSNAP
Policies
snap-asset-disposal-lookback7 CFR § 273.8(h)

Households that transfer assets for less than fair market value within 36 months of application may be disqualified or have the transferred value counted as a resource for the period that the transferred amount would have made them ineligible.

expenses

application.expenses[]list(Expense)

ReasonExpense records for household members — shelter, dependent care, medical, child support, and alimony — used to calculate SNAP net income deductions and Medicaid spend-down amounts.

ProgramsSNAPMEDICAID
Policies
snap-alimony-deduction7 CFR § 273.9(d)(5)

Legally obligated child support and alimony payments made to non-household members are deductible from SNAP gross income. Only the legally required amount is deductible — voluntary payments above the obligation are not.

snap-elderly-disabled-deductions7 CFR § 273.9(d)

Households with an elderly or disabled member are eligible for an excess medical expense deduction (unreimbursed costs above $35/month) in addition to the standard deductions. These households are also exempt from the gross income test and subject only to the net income test.

application.expenses[].iduuid

ReasonUnique identifier for the expense record.

ProgramsSNAPMEDICAID
Policies
snap-alimony-deduction7 CFR § 273.9(d)(5)

Legally obligated child support and alimony payments made to non-household members are deductible from SNAP gross income. Only the legally required amount is deductible — voluntary payments above the obligation are not.

snap-elderly-disabled-deductions7 CFR § 273.9(d)

Households with an elderly or disabled member are eligible for an excess medical expense deduction (unreimbursed costs above $35/month) in addition to the standard deductions. These households are also exempt from the gross income test and subject only to the net income test.

application.expenses[].memberIduuid(ApplicationMember)

ReasonFK to application.members[] linking this expense to the household member who incurs it.

ProgramsSNAPMEDICAID
Policies
snap-alimony-deduction7 CFR § 273.9(d)(5)

Legally obligated child support and alimony payments made to non-household members are deductible from SNAP gross income. Only the legally required amount is deductible — voluntary payments above the obligation are not.

snap-elderly-disabled-deductions7 CFR § 273.9(d)

Households with an elderly or disabled member are eligible for an excess medical expense deduction (unreimbursed costs above $35/month) in addition to the standard deductions. These households are also exempt from the gross income test and subject only to the net income test.

application.expenses[].applicationIduuid(Application)
ProgramsSNAPMEDICAID
Policies
snap-alimony-deduction7 CFR § 273.9(d)(5)

Legally obligated child support and alimony payments made to non-household members are deductible from SNAP gross income. Only the legally required amount is deductible — voluntary payments above the obligation are not.

snap-elderly-disabled-deductions7 CFR § 273.9(d)

Households with an elderly or disabled member are eligible for an excess medical expense deduction (unreimbursed costs above $35/month) in addition to the standard deductions. These households are also exempt from the gross income test and subject only to the net income test.

application.expenses[].typeenum
Valuesrent mortgage dependent_care medical child_support alimony other

ReasonExpense type determines which deduction rules apply for SNAP net income calculation and which expenses are counted for Medicaid spend-down.

ProgramsSNAPMEDICAID
Policies
snap-alimony-deduction7 CFR § 273.9(d)(5)

Legally obligated child support and alimony payments made to non-household members are deductible from SNAP gross income. Only the legally required amount is deductible — voluntary payments above the obligation are not.

snap-elderly-disabled-deductions7 CFR § 273.9(d)

Households with an elderly or disabled member are eligible for an excess medical expense deduction (unreimbursed costs above $35/month) in addition to the standard deductions. These households are also exempt from the gross income test and subject only to the net income test.

application.expenses[].typeOtherstring

ReasonCaptures non-enumerated expense types for worker review.

ProgramsSNAPMEDICAID
Policies
snap-alimony-deduction7 CFR § 273.9(d)(5)

Legally obligated child support and alimony payments made to non-household members are deductible from SNAP gross income. Only the legally required amount is deductible — voluntary payments above the obligation are not.

snap-elderly-disabled-deductions7 CFR § 273.9(d)

Households with an elderly or disabled member are eligible for an excess medical expense deduction (unreimbursed costs above $35/month) in addition to the standard deductions. These households are also exempt from the gross income test and subject only to the net income test.

application.expenses[].amountnumber

ReasonActual amount paid for the expense, used in the deduction calculation.

ProgramsSNAPMEDICAID
Policies
snap-alimony-deduction7 CFR § 273.9(d)(5)

Legally obligated child support and alimony payments made to non-household members are deductible from SNAP gross income. Only the legally required amount is deductible — voluntary payments above the obligation are not.

snap-elderly-disabled-deductions7 CFR § 273.9(d)

Households with an elderly or disabled member are eligible for an excess medical expense deduction (unreimbursed costs above $35/month) in addition to the standard deductions. These households are also exempt from the gross income test and subject only to the net income test.

application.expenses[].legallyObligatedAmountnumber

ReasonOnly the legally obligated portion of child support and alimony payments is deductible from SNAP income; voluntary payments above the obligation are not deductible.

ProgramsSNAPMEDICAID
Policies
snap-alimony-deduction7 CFR § 273.9(d)(5)

Legally obligated child support and alimony payments made to non-household members are deductible from SNAP gross income. Only the legally required amount is deductible — voluntary payments above the obligation are not.

snap-elderly-disabled-deductions7 CFR § 273.9(d)

Households with an elderly or disabled member are eligible for an excess medical expense deduction (unreimbursed costs above $35/month) in addition to the standard deductions. These households are also exempt from the gross income test and subject only to the net income test.

disability-benefits

application.disabilityBenefits[]list(DisabilityBenefit)

ReasonSSI and SSDI benefit records for household members, used for categorical Medicaid eligibility screening, income counting, and Medicare Part A entitlement determination.

ProgramsMEDICAID
Policies
medicaid-ssi-categorical-eligibility42 CFR § 435.120

SSI recipients are categorically eligible for Medicaid in most states (1634 states). Receipt of SSI establishes Medicaid eligibility without a separate Medicaid income or resource test. In 209(b) states, a separate determination is required using state eligibility criteria no more restrictive than the state's January 1972 Medicaid plan.

medicare-part-a-entitlement42 USC § 1395c

Medicare Part A hospital insurance is available to individuals age 65 or older who are entitled to Social Security or Railroad Retirement benefits, and to disabled individuals who have received SSDI for 24 months. Individuals who do not meet the work requirement may enroll by paying a premium.

application.disabilityBenefits[].iduuid

ReasonUnique identifier for the disability benefit record.

ProgramsMEDICAID
Policies
medicaid-ssi-categorical-eligibility42 CFR § 435.120

SSI recipients are categorically eligible for Medicaid in most states (1634 states). Receipt of SSI establishes Medicaid eligibility without a separate Medicaid income or resource test. In 209(b) states, a separate determination is required using state eligibility criteria no more restrictive than the state's January 1972 Medicaid plan.

medicare-part-a-entitlement42 USC § 1395c

Medicare Part A hospital insurance is available to individuals age 65 or older who are entitled to Social Security or Railroad Retirement benefits, and to disabled individuals who have received SSDI for 24 months. Individuals who do not meet the work requirement may enroll by paying a premium.

application.disabilityBenefits[].memberIduuid(ApplicationMember)

ReasonFK to application.members[] linking this benefit record to the household member.

ProgramsMEDICAID
Policies
medicaid-ssi-categorical-eligibility42 CFR § 435.120

SSI recipients are categorically eligible for Medicaid in most states (1634 states). Receipt of SSI establishes Medicaid eligibility without a separate Medicaid income or resource test. In 209(b) states, a separate determination is required using state eligibility criteria no more restrictive than the state's January 1972 Medicaid plan.

medicare-part-a-entitlement42 USC § 1395c

Medicare Part A hospital insurance is available to individuals age 65 or older who are entitled to Social Security or Railroad Retirement benefits, and to disabled individuals who have received SSDI for 24 months. Individuals who do not meet the work requirement may enroll by paying a premium.

application.disabilityBenefits[].applicationIduuid(Application)
ProgramsMEDICAID
Policies
medicaid-ssi-categorical-eligibility42 CFR § 435.120

SSI recipients are categorically eligible for Medicaid in most states (1634 states). Receipt of SSI establishes Medicaid eligibility without a separate Medicaid income or resource test. In 209(b) states, a separate determination is required using state eligibility criteria no more restrictive than the state's January 1972 Medicaid plan.

medicare-part-a-entitlement42 USC § 1395c

Medicare Part A hospital insurance is available to individuals age 65 or older who are entitled to Social Security or Railroad Retirement benefits, and to disabled individuals who have received SSDI for 24 months. Individuals who do not meet the work requirement may enroll by paying a premium.

application.disabilityBenefits[].programTypeenum
Valuesssi ssdi

ReasonSSI or SSDI — determines the eligibility pathway and income counting rules. SSI receipt confers categorical Medicaid eligibility in most states; SSDI affects income counting and Medicare entitlement.

ProgramsMEDICAID
Policies
medicaid-ssi-categorical-eligibility42 CFR § 435.120

SSI recipients are categorically eligible for Medicaid in most states (1634 states). Receipt of SSI establishes Medicaid eligibility without a separate Medicaid income or resource test. In 209(b) states, a separate determination is required using state eligibility criteria no more restrictive than the state's January 1972 Medicaid plan.

medicare-part-a-entitlement42 USC § 1395c

Medicare Part A hospital insurance is available to individuals age 65 or older who are entitled to Social Security or Railroad Retirement benefits, and to disabled individuals who have received SSDI for 24 months. Individuals who do not meet the work requirement may enroll by paying a premium.

application.disabilityBenefits[].statusenum
Valuespending approved active ended denied appealed

ReasonCurrent benefit status; pending applications affect categorical eligibility screening, active and ended statuses affect income counting.

ProgramsMEDICAID
Policies
medicaid-ssi-categorical-eligibility42 CFR § 435.120

SSI recipients are categorically eligible for Medicaid in most states (1634 states). Receipt of SSI establishes Medicaid eligibility without a separate Medicaid income or resource test. In 209(b) states, a separate determination is required using state eligibility criteria no more restrictive than the state's January 1972 Medicaid plan.

medicare-part-a-entitlement42 USC § 1395c

Medicare Part A hospital insurance is available to individuals age 65 or older who are entitled to Social Security or Railroad Retirement benefits, and to disabled individuals who have received SSDI for 24 months. Individuals who do not meet the work requirement may enroll by paying a premium.

application.disabilityBenefits[].applicationDatedate

ReasonDate of SSI/SSDI application used for determining the benefit start date if approved and for tracking pending applications.

ProgramsMEDICAID
Policies
medicaid-ssi-categorical-eligibility42 CFR § 435.120

SSI recipients are categorically eligible for Medicaid in most states (1634 states). Receipt of SSI establishes Medicaid eligibility without a separate Medicaid income or resource test. In 209(b) states, a separate determination is required using state eligibility criteria no more restrictive than the state's January 1972 Medicaid plan.

medicare-part-a-entitlement42 USC § 1395c

Medicare Part A hospital insurance is available to individuals age 65 or older who are entitled to Social Security or Railroad Retirement benefits, and to disabled individuals who have received SSDI for 24 months. Individuals who do not meet the work requirement may enroll by paying a premium.

application.disabilityBenefits[].startDatedate

ReasonBenefit start date used for income counting and Medicare Part A entitlement determination.

ProgramsMEDICAID
Policies
medicaid-ssi-categorical-eligibility42 CFR § 435.120

SSI recipients are categorically eligible for Medicaid in most states (1634 states). Receipt of SSI establishes Medicaid eligibility without a separate Medicaid income or resource test. In 209(b) states, a separate determination is required using state eligibility criteria no more restrictive than the state's January 1972 Medicaid plan.

medicare-part-a-entitlement42 USC § 1395c

Medicare Part A hospital insurance is available to individuals age 65 or older who are entitled to Social Security or Railroad Retirement benefits, and to disabled individuals who have received SSDI for 24 months. Individuals who do not meet the work requirement may enroll by paying a premium.

application.disabilityBenefits[].endDatedate

ReasonBenefit end date used to identify members with a history of SSI or SSDI and to assess whether continued eligibility applies.

ProgramsMEDICAID
Policies
medicaid-ssi-categorical-eligibility42 CFR § 435.120

SSI recipients are categorically eligible for Medicaid in most states (1634 states). Receipt of SSI establishes Medicaid eligibility without a separate Medicaid income or resource test. In 209(b) states, a separate determination is required using state eligibility criteria no more restrictive than the state's January 1972 Medicaid plan.

medicare-part-a-entitlement42 USC § 1395c

Medicare Part A hospital insurance is available to individuals age 65 or older who are entitled to Social Security or Railroad Retirement benefits, and to disabled individuals who have received SSDI for 24 months. Individuals who do not meet the work requirement may enroll by paying a premium.

deductions

application.deductions[]list(Deduction)

ReasonAbove-the-line tax deductions for MAGI income calculation, stored per member to support accurate per-member income attribution.

ModelingSome intake forms do not collect per-member deduction attribution; in those cases the adapter assigns deduction records to the primary applicant or the tax filer. States whose forms collect per-member attribution should map directly to that member.

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-deductions42 CFR § 435.603(e)

Above-the-line tax deductions reduce MAGI for Medicaid eligibility purposes. Deductible amounts include student loan interest, alimony paid, IRA contributions, and self-employment taxes. These deductions are applied at the member level and must be annualized for the MAGI income projection.

magi-above-line-deductions26 USC § 62

Defines above-the-line (adjusted gross income) deductions allowable for federal income tax purposes that are also deductible for MAGI Medicaid eligibility. Includes student loan interest, IRA contributions, self- employment taxes and health insurance, alimony paid (pre-2019 agreements), and educator expenses.

application.deductions[].iduuid

ReasonUnique identifier for the deduction record.

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-deductions42 CFR § 435.603(e)

Above-the-line tax deductions reduce MAGI for Medicaid eligibility purposes. Deductible amounts include student loan interest, alimony paid, IRA contributions, and self-employment taxes. These deductions are applied at the member level and must be annualized for the MAGI income projection.

magi-above-line-deductions26 USC § 62

Defines above-the-line (adjusted gross income) deductions allowable for federal income tax purposes that are also deductible for MAGI Medicaid eligibility. Includes student loan interest, IRA contributions, self- employment taxes and health insurance, alimony paid (pre-2019 agreements), and educator expenses.

application.deductions[].memberIduuid(ApplicationMember)

ReasonFK to application.members[] attributing this deduction to a specific household member for MAGI income calculation.

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-deductions42 CFR § 435.603(e)

Above-the-line tax deductions reduce MAGI for Medicaid eligibility purposes. Deductible amounts include student loan interest, alimony paid, IRA contributions, and self-employment taxes. These deductions are applied at the member level and must be annualized for the MAGI income projection.

magi-above-line-deductions26 USC § 62

Defines above-the-line (adjusted gross income) deductions allowable for federal income tax purposes that are also deductible for MAGI Medicaid eligibility. Includes student loan interest, IRA contributions, self- employment taxes and health insurance, alimony paid (pre-2019 agreements), and educator expenses.

application.deductions[].applicationIduuid(Application)
ProgramsMEDICAIDCHIP
Policies
medicaid-magi-deductions42 CFR § 435.603(e)

Above-the-line tax deductions reduce MAGI for Medicaid eligibility purposes. Deductible amounts include student loan interest, alimony paid, IRA contributions, and self-employment taxes. These deductions are applied at the member level and must be annualized for the MAGI income projection.

magi-above-line-deductions26 USC § 62

Defines above-the-line (adjusted gross income) deductions allowable for federal income tax purposes that are also deductible for MAGI Medicaid eligibility. Includes student loan interest, IRA contributions, self- employment taxes and health insurance, alimony paid (pre-2019 agreements), and educator expenses.

application.deductions[].typeenum
Valuesalimony_paid capital_losses early_withdrawal_penalty student_loan_interest domestic_production_activities reimbursement_of_expenses hsa_deduction moving_expenses traditional_ira_contribution reservist_performing_artist_government_official_expenses other prior_period

ReasonAbove-the-line deduction type determines eligibility and the deductible amount under MAGI income calculation rules. The prior_period type captures the summarized total of above-the-line deductions paid earlier in the current tax year.

ModelingStored at the application level with a memberId FK for per-member attribution. When a state's intake form does not associate deductions with specific members, the adapter should assign deduction records to the primary applicant. For prior_period records, only amount is relevant and all other fields are inapplicable.

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-deductions42 CFR § 435.603(e)

Above-the-line tax deductions reduce MAGI for Medicaid eligibility purposes. Deductible amounts include student loan interest, alimony paid, IRA contributions, and self-employment taxes. These deductions are applied at the member level and must be annualized for the MAGI income projection.

magi-above-line-deductions26 USC § 62

Defines above-the-line (adjusted gross income) deductions allowable for federal income tax purposes that are also deductible for MAGI Medicaid eligibility. Includes student loan interest, IRA contributions, self- employment taxes and health insurance, alimony paid (pre-2019 agreements), and educator expenses.

application.deductions[].typeOtherstring

ReasonCaptures non-enumerated deduction types for adapter mapping and worker review.

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-deductions42 CFR § 435.603(e)

Above-the-line tax deductions reduce MAGI for Medicaid eligibility purposes. Deductible amounts include student loan interest, alimony paid, IRA contributions, and self-employment taxes. These deductions are applied at the member level and must be annualized for the MAGI income projection.

magi-above-line-deductions26 USC § 62

Defines above-the-line (adjusted gross income) deductions allowable for federal income tax purposes that are also deductible for MAGI Medicaid eligibility. Includes student loan interest, IRA contributions, self- employment taxes and health insurance, alimony paid (pre-2019 agreements), and educator expenses.

application.deductions[].frequencyenum
Valuesone_time_only weekly every_two_weeks twice_monthly monthly yearly variable

ReasonFrequency is needed to normalize the deduction amount for annualized MAGI income calculation.

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-deductions42 CFR § 435.603(e)

Above-the-line tax deductions reduce MAGI for Medicaid eligibility purposes. Deductible amounts include student loan interest, alimony paid, IRA contributions, and self-employment taxes. These deductions are applied at the member level and must be annualized for the MAGI income projection.

magi-above-line-deductions26 USC § 62

Defines above-the-line (adjusted gross income) deductions allowable for federal income tax purposes that are also deductible for MAGI Medicaid eligibility. Includes student loan interest, IRA contributions, self- employment taxes and health insurance, alimony paid (pre-2019 agreements), and educator expenses.

application.deductions[].amountnumber

ReasonPer-period deduction amount; combined with frequency to calculate the annual deduction figure.

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-deductions42 CFR § 435.603(e)

Above-the-line tax deductions reduce MAGI for Medicaid eligibility purposes. Deductible amounts include student loan interest, alimony paid, IRA contributions, and self-employment taxes. These deductions are applied at the member level and must be annualized for the MAGI income projection.

magi-above-line-deductions26 USC § 62

Defines above-the-line (adjusted gross income) deductions allowable for federal income tax purposes that are also deductible for MAGI Medicaid eligibility. Includes student loan interest, IRA contributions, self- employment taxes and health insurance, alimony paid (pre-2019 agreements), and educator expenses.

application.deductions[].annualAmountnumber

ReasonProjected annual deduction used directly in the MAGI calculation. Populated when frequency is variable and the per-period amount cannot be reliably annualized.

ProgramsMEDICAIDCHIP
Policies
medicaid-magi-deductions42 CFR § 435.603(e)

Above-the-line tax deductions reduce MAGI for Medicaid eligibility purposes. Deductible amounts include student loan interest, alimony paid, IRA contributions, and self-employment taxes. These deductions are applied at the member level and must be annualized for the MAGI income projection.

magi-above-line-deductions26 USC § 62

Defines above-the-line (adjusted gross income) deductions allowable for federal income tax purposes that are also deductible for MAGI Medicaid eligibility. Includes student loan interest, IRA contributions, self- employment taxes and health insurance, alimony paid (pre-2019 agreements), and educator expenses.

verifications

application.verifications[]list(Verification)

ReasonThe household's verification checklist — one item per verification obligation, covering both electronic service check results and paper document requirements on a single lifecycle. Created automatically by state machine event handlers at submission.

ProgramsSNAPMEDICAID
Policies
medicaid-electronic-verification-first42 CFR § 435.940

When verification is required, electronic data sources must be checked before requesting paper documentation from applicants. Applies to citizenship, immigration status, and income verification. Paper documents may only be requested when an electronic check returns inconclusive.

snap-verification-requirements7 CFR § 273.2(f)

Before certifying a household, the agency must verify income, identity, and residency. Verification may occur via electronic check, document review, or interview. States may not require verification of items beyond those listed in this section.

application.verifications[].applicationIduuid(Application)
ProgramsSNAPMEDICAID
Policies
medicaid-electronic-verification-first42 CFR § 435.940

When verification is required, electronic data sources must be checked before requesting paper documentation from applicants. Applies to citizenship, immigration status, and income verification. Paper documents may only be requested when an electronic check returns inconclusive.

snap-verification-requirements7 CFR § 273.2(f)

Before certifying a household, the agency must verify income, identity, and residency. Verification may occur via electronic check, document review, or interview. States may not require verification of items beyond those listed in this section.

application.verifications[].sourceIduuid(Polymorphic)

ReasonID of the specific record that triggered this verification obligation (e.g., a specific income or member record). Null for household-level obligations.

ProgramsSNAPMEDICAID
Policies
medicaid-electronic-verification-first42 CFR § 435.940

When verification is required, electronic data sources must be checked before requesting paper documentation from applicants. Applies to citizenship, immigration status, and income verification. Paper documents may only be requested when an electronic check returns inconclusive.

snap-verification-requirements7 CFR § 273.2(f)

Before certifying a household, the agency must verify income, identity, and residency. Verification may occur via electronic check, document review, or interview. States may not require verification of items beyond those listed in this section.

application.verifications[].iduuid
ProgramsSNAPMEDICAID
Policies
medicaid-electronic-verification-first42 CFR § 435.940

When verification is required, electronic data sources must be checked before requesting paper documentation from applicants. Applies to citizenship, immigration status, and income verification. Paper documents may only be requested when an electronic check returns inconclusive.

snap-verification-requirements7 CFR § 273.2(f)

Before certifying a household, the agency must verify income, identity, and residency. Verification may occur via electronic check, document review, or interview. States may not require verification of items beyond those listed in this section.

application.verifications[].statusenum
Valuespending inconclusive satisfied waived cannot_verify

ReasonCurrent lifecycle status of the verification obligation — pending, inconclusive, satisfied, waived, or cannot_verify. Read-only; set by the rules engine.

ProgramsSNAPMEDICAID
Policies
medicaid-electronic-verification-first42 CFR § 435.940

When verification is required, electronic data sources must be checked before requesting paper documentation from applicants. Applies to citizenship, immigration status, and income verification. Paper documents may only be requested when an electronic check returns inconclusive.

snap-verification-requirements7 CFR § 273.2(f)

Before certifying a household, the agency must verify income, identity, and residency. Verification may occur via electronic check, document review, or interview. States may not require verification of items beyond those listed in this section.

application.verifications[].evidence[]string

ReasonElectronic and document evidence items accumulated against this obligation. Populated as checks run and documents are received.

ProgramsSNAPMEDICAID
Policies
medicaid-electronic-verification-first42 CFR § 435.940

When verification is required, electronic data sources must be checked before requesting paper documentation from applicants. Applies to citizenship, immigration status, and income verification. Paper documents may only be requested when an electronic check returns inconclusive.

snap-verification-requirements7 CFR § 273.2(f)

Before certifying a household, the agency must verify income, identity, and residency. Verification may occur via electronic check, document review, or interview. States may not require verification of items beyond those listed in this section.

application.verifications[].documentRequests[]list(VerificationDocumentRequest)

ReasonOutbound notices requesting documents from the applicant for this obligation. Populated when an electronic check is inconclusive and a document request is sent.

ProgramsSNAPMEDICAID
Policies
medicaid-electronic-verification-first42 CFR § 435.940

When verification is required, electronic data sources must be checked before requesting paper documentation from applicants. Applies to citizenship, immigration status, and income verification. Paper documents may only be requested when an electronic check returns inconclusive.

snap-verification-requirements7 CFR § 273.2(f)

Before certifying a household, the agency must verify income, identity, and residency. Verification may occur via electronic check, document review, or interview. States may not require verification of items beyond those listed in this section.

application.verifications[].documentRequests[].noticeIduuid(External)

ReasonID of the notice in the communication domain, used to track delivery and link back to the outbound notice record.

ProgramsSNAPMEDICAID
Policies
medicaid-electronic-verification-first42 CFR § 435.940

When verification is required, electronic data sources must be checked before requesting paper documentation from applicants. Applies to citizenship, immigration status, and income verification. Paper documents may only be requested when an electronic check returns inconclusive.

snap-verification-requirements7 CFR § 273.2(f)

Before certifying a household, the agency must verify income, identity, and residency. Verification may occur via electronic check, document review, or interview. States may not require verification of items beyond those listed in this section.

application.verifications[].documentRequests[].typeenum
Valuesdocument_request_citizenship_verification document_request_identity_verification document_request_immigration_verification document_request_income_verification document_request_residency_verification

ReasonTemplate identifier for the notice, matching the type field on the communication.notice.sent event (e.g., document_request_income_verification).

ProgramsSNAPMEDICAID
Policies
medicaid-electronic-verification-first42 CFR § 435.940

When verification is required, electronic data sources must be checked before requesting paper documentation from applicants. Applies to citizenship, immigration status, and income verification. Paper documents may only be requested when an electronic check returns inconclusive.

snap-verification-requirements7 CFR § 273.2(f)

Before certifying a household, the agency must verify income, identity, and residency. Verification may occur via electronic check, document review, or interview. States may not require verification of items beyond those listed in this section.

application.verifications[].documentRequests[].sentAtdatetime

ReasonWhen the document request notice was sent; used to calculate response deadlines and track aging obligations.

ProgramsSNAPMEDICAID
Policies
medicaid-electronic-verification-first42 CFR § 435.940

When verification is required, electronic data sources must be checked before requesting paper documentation from applicants. Applies to citizenship, immigration status, and income verification. Paper documents may only be requested when an electronic check returns inconclusive.

snap-verification-requirements7 CFR § 273.2(f)

Before certifying a household, the agency must verify income, identity, and residency. Verification may occur via electronic check, document review, or interview. States may not require verification of items beyond those listed in this section.

application.verifications[].documentRequests[].dueAtdatetime

ReasonDeadline by which the applicant must respond with documents. Null if no deadline was set.

ProgramsSNAPMEDICAID
Policies
medicaid-electronic-verification-first42 CFR § 435.940

When verification is required, electronic data sources must be checked before requesting paper documentation from applicants. Applies to citizenship, immigration status, and income verification. Paper documents may only be requested when an electronic check returns inconclusive.

snap-verification-requirements7 CFR § 273.2(f)

Before certifying a household, the agency must verify income, identity, and residency. Verification may occur via electronic check, document review, or interview. States may not require verification of items beyond those listed in this section.

application.verifications[].documentRequests[].channelenum
Valuesemail in_person mail portal

ReasonChannel through which the document request notice was sent — email, in_person, or mail.

ProgramsSNAPMEDICAID
Policies
medicaid-electronic-verification-first42 CFR § 435.940

When verification is required, electronic data sources must be checked before requesting paper documentation from applicants. Applies to citizenship, immigration status, and income verification. Paper documents may only be requested when an electronic check returns inconclusive.

snap-verification-requirements7 CFR § 273.2(f)

Before certifying a household, the agency must verify income, identity, and residency. Verification may occur via electronic check, document review, or interview. States may not require verification of items beyond those listed in this section.

application.verifications[].sourceTypeenum
Valuesmember income

ReasonIdentifies what sourceId refers to — member or income. Required when sourceId is set; null for household-level obligations.

ProgramsSNAPMEDICAID
Policies
medicaid-electronic-verification-first42 CFR § 435.940

When verification is required, electronic data sources must be checked before requesting paper documentation from applicants. Applies to citizenship, immigration status, and income verification. Paper documents may only be requested when an electronic check returns inconclusive.

snap-verification-requirements7 CFR § 273.2(f)

Before certifying a household, the agency must verify income, identity, and residency. Verification may occur via electronic check, document review, or interview. States may not require verification of items beyond those listed in this section.

application.verifications[].categoryenum
Valuescitizenship identity immigration income residency

ReasonVerification obligation category — citizenship, identity, immigration, income, or residency — determines which document types and electronic checks are applicable.

ProgramsSNAPMEDICAID
Policies
medicaid-electronic-verification-first42 CFR § 435.940

When verification is required, electronic data sources must be checked before requesting paper documentation from applicants. Applies to citizenship, immigration status, and income verification. Paper documents may only be requested when an electronic check returns inconclusive.

snap-verification-requirements7 CFR § 273.2(f)

Before certifying a household, the agency must verify income, identity, and residency. Verification may occur via electronic check, document review, or interview. States may not require verification of items beyond those listed in this section.

application.verifications[].verificationTypeenum
Valuesdocument electronic

ReasonHow this obligation is to be fulfilled — document (paper evidence from applicant) or electronic (automated service check).

ProgramsSNAPMEDICAID
Policies
medicaid-electronic-verification-first42 CFR § 435.940

When verification is required, electronic data sources must be checked before requesting paper documentation from applicants. Applies to citizenship, immigration status, and income verification. Paper documents may only be requested when an electronic check returns inconclusive.

snap-verification-requirements7 CFR § 273.2(f)

Before certifying a household, the agency must verify income, identity, and residency. Verification may occur via electronic check, document review, or interview. States may not require verification of items beyond those listed in this section.

interview

application.interview.applicationIduuid(Application)
ProgramsSNAP
Policies
snap-interview-requirement7 CFR § 273.2(e)

SNAP applicants must complete an in-person or telephone interview before certification. The interview must be conducted by a qualified eligibility worker.

application.interview.appointments[]uuid(External)

ReasonAppointment IDs from the scheduling domain accumulated for this interview obligation. Populated by the rules engine when a scheduling event fires; one interview obligation may span multiple appointments due to rescheduling or no-shows.

ProgramsSNAP
Policies
snap-interview-requirement7 CFR § 273.2(e)

SNAP applicants must complete an in-person or telephone interview before certification. The interview must be conducted by a qualified eligibility worker.

application.interview.iduuid
ProgramsSNAP
Policies
snap-interview-requirement7 CFR § 273.2(e)

SNAP applicants must complete an in-person or telephone interview before certification. The interview must be conducted by a qualified eligibility worker.

application.interview.waiverStatusenum
Valuespending granted denied

ReasonStatus of the interview waiver for this applicant. Caseworker-set field.

ProgramsSNAP
Policies
snap-interview-requirement7 CFR § 273.2(e)

SNAP applicants must complete an in-person or telephone interview before certification. The interview must be conducted by a qualified eligibility worker.

application.interview.waiverReasonstring

ReasonReason the interview was waived. Required when waiverStatus is granted; used for audit and supervisory review.

ProgramsSNAP
Policies
snap-interview-requirement7 CFR § 273.2(e)

SNAP applicants must complete an in-person or telephone interview before certification. The interview must be conducted by a qualified eligibility worker.

application.interview.completedAtdatetime

ReasonWhen the caseworker attested the interview obligation was satisfied. Not set automatically — requires explicit caseworker action to record which appointment fulfilled the regulatory obligation.

ProgramsSNAP
Policies
snap-interview-requirement7 CFR § 273.2(e)

SNAP applicants must complete an in-person or telephone interview before certification. The interview must be conducted by a qualified eligibility worker.

review-progress

application.reviewProgress[]list(ReviewProgressListResponse)
application.reviewProgress[].items[]list(ReviewProgress)
application.reviewProgress[].items[].iduuid
application.reviewProgress[].items[].itemIduuid
application.reviewProgress[].items[].statusenum
Valuesnot_started in_progress complete flagged
application.reviewProgress[].items[].notesobject
application.reviewProgress[].items[].notes.textstring
application.reviewProgress[].items[].notes.textFormatenum
Valuesplain markdown html
application.reviewProgress[].items[].sectionstring
application.reviewProgress[].totalinteger
application.reviewProgress[].limitinteger
application.reviewProgress[].offsetinteger
application.reviewProgress[].hasNextboolean