application
application.programsAppliedFor[]enumsnap medicaid chip tanfReasonDetermines which eligibility rules to apply and drives federal and state reporting.
application.channelenumonline in_person phone mailReasonHow the application was filed; used for intake channel reporting and to route applications to appropriate processing queues.
application.ebtEbtapplication.ebt.needsCardbooleanReasonCollected at intake to trigger EBT card issuance at approval without a separate request.
application.ebt.deliveryPreferenceenumby_mail in_personReasonDetermines whether the EBT card is mailed or held for in-person pickup.
application.registerToVotebooleanReasonPublic benefits agencies are required to offer voter registration to applicants.
nvra-voter-registration-offer42 USC § 1973gg-5Public 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.deniesIevsConsentbooleanReasonApplicants may opt out of income and asset verification against federal data sources. Denial does not disqualify but triggers manual verification.
snap-ssa-identity-check42 U.S.C. § 1320b-7Agencies 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 § 272.8Income 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.expeditedSnapExpeditedSnapsnap-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.totalMoneyExpectedThisMonthnumberReasonGross monthly income is compared against the expedited SNAP threshold to determine whether same-day issuance is required.
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.totalCashOnHandnumberReasonCash and liquid assets are combined with income for the expedited SNAP screening test.
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.monthlyMortgagenumberReasonMonthly shelter costs are compared against income and cash for the expedited SNAP destitution test.
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.monthlyRentnumberReasonMonthly shelter costs are compared against income and cash for the expedited SNAP destitution test.
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.monthlyUtilitiesnumberReasonMonthly utility costs combined with shelter costs are compared against income for the expedited SNAP destitution test.
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.receivedSnapInLast30DaysbooleanReasonRecent SNAP receipt in another state may indicate duplicate participation or ongoing eligibility that affects expedited processing.
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.utilitiesUtilitiessnap-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.heatCoolMethodenumgas electric oil propane otherReasonDetermines which utility allowance standard applies. Households that heat or cool with certain methods qualify for the full heating and cooling standard.
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.heatCoolMethodOtherstringReasonCaptures non-enumerated heating or cooling methods for adapter mapping to the appropriate utility standard.
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.receivesLiheapbooleanReasonReceipt of even one dollar of LIHEAP automatically qualifies the household for the full heating and cooling standard utility allowance.
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[].iduuidReasonUnique identifier for the member record; FK target for memberId fields throughout the application model.
application.members[].applicationIduuid(Application)application.members[].roles[]enumprimary_applicant household_member non_applying_member authorized_representative absent_parentReasonDetermines which application flows apply to the member and how their data is scoped within the application.
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 § 435.923A 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[]enumsnap medicaid chip tanfReasonPer-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.
application.members[].purchasesAndPreparesFoodbooleanReasonMembers 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.
snap-household-composition7 CFR § 273.1All 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[].isMigrantFarmWorkerbooleanReasonMigrant and seasonal farm workers qualify for expedited SNAP regardless of the standard income and asset thresholds.
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[].hasThirdPartyLiabilityClaimbooleanReasonMedicaid is payer of last resort; the presence of a third-party liability claim triggers cost avoidance and recovery procedures.
medicaid-third-party-liability42 CFR § 433.136Medicaid 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[].personalInformationPersonalInformationapplication.members[].personalInformation.ssnstringReasonRequired for identity verification and cross-matching against federal income and asset data sources under IEVS.
snap-ssn-requirement7 CFR § 273.6Every 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-7Agencies 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.dateOfBirthdateReasonUsed for age-based eligibility rules including CHIP age limits, SNAP elderly and disabled deductions, ABAWD rules, and foster care extended eligibility.
chip-age-eligibility42 USC § 1397jjCHIP 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.sexAssignedAtBirthenummale female intersex unknownReasonUsed for clinical eligibility determinations including pregnancy Medicaid, sex-specific health screenings, and certain household composition rules.
aca-section-1557-nondiscriminationACA § 1557Section 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.genderIdentityenumman woman non_binary transgender_man transgender_woman prefer_not_to_answer otherReasonRequired to honor anti-discrimination obligations and ensure accurate, respectful correspondence with applicants.
aca-section-1557-nondiscriminationACA § 1557Section 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.maritalStatusenumsingle married divorced separated widowed civil_union domestic_partnershipReasonAffects household composition, spousal income deeming, MAGI filing status determination, and two-parent TANF household rules.
snap-deeming-rules7 CFR § 273.11Income 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 § 435.603Medicaid 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[]enumamerican_indian_alaskan_native asian black_african_american native_hawaiian_pacific_islander whiteReasonRequired 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.
omb-race-ethnicity-standardsOMB Statistical Policy Directive No. 15OMB 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 § 2000dPrograms 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.isHispanicOrLatinobooleanReasonHispanic or Latino ethnicity is collected separately from race per OMB standards and is required for civil rights reporting.
omb-race-ethnicity-standardsOMB Statistical Policy Directive No. 15OMB 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 § 2000dPrograms 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.preferredSpokenLanguagestringReasonDetermines which language interpreter services must be arranged for appointments and communications to ensure meaningful access.
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 13166Federal 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 § 2000dPrograms 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.preferredWrittenLanguagestringReasonDetermines which language translated notices and written communications must be provided in for meaningful access.
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 13166Federal 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 § 2000dPrograms 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[].contactMemberContactapplication.members[].contact.nameNameapplication.members[].contact.name.firstNamestringapplication.members[].contact.name.middleNamestringapplication.members[].contact.name.middleInitialstringapplication.members[].contact.name.lastNamestringapplication.members[].contact.name.maidenNamestringapplication.members[].contact.name.suffixstringapplication.members[].contact.primaryAddressAddressReasonUsed for residency determination, county routing for benefits administration, and physical location for home visits when required.
application.members[].contact.primaryAddress.addressLine1stringapplication.members[].contact.primaryAddress.addressLine2stringapplication.members[].contact.primaryAddress.citystringapplication.members[].contact.primaryAddress.statestringapplication.members[].contact.primaryAddress.zipstringapplication.members[].contact.primaryAddress.countystringapplication.members[].contact.primaryPhonestringReasonPrimary contact number for program notifications, interview scheduling, and verification follow-up.
application.members[].contact.emailemailReasonEmail address for electronic delivery of program notices when noticePreference includes email.
application.members[].contact.mailingAddressAddressReasonUsed for correspondence when the mailing address differs from the home address.
application.members[].contact.mailingAddress.addressLine1stringapplication.members[].contact.mailingAddress.addressLine2stringapplication.members[].contact.mailingAddress.citystringapplication.members[].contact.mailingAddress.statestringapplication.members[].contact.mailingAddress.zipstringapplication.members[].contact.mailingAddress.countystringapplication.members[].contact.alternatePhonestringReasonSecondary contact number used when the primary number is unavailable.
application.members[].contact.isExperiencingHomelessnessbooleanReasonHomelessness affects address collection requirements, shelter deduction eligibility for SNAP, and may trigger expedited processing.
snap-residency-requirement7 CFR § 273.3SNAP 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.noticePreferenceenumpaper email bothReasonDetermines whether notices are delivered by paper mail, email, or both, per applicant preference.
medicaid-electronic-notices42 CFR § 435.918States 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.alternateNoticeAddressAddressReasonAlternative 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.
hipaa-confidential-communications45 CFR § 164.522Individuals 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 § 1557Section 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.addressLine1stringhipaa-confidential-communications45 CFR § 164.522Individuals 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 § 1557Section 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.addressLine2stringhipaa-confidential-communications45 CFR § 164.522Individuals 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 § 1557Section 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.citystringhipaa-confidential-communications45 CFR § 164.522Individuals 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 § 1557Section 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.statestringhipaa-confidential-communications45 CFR § 164.522Individuals 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 § 1557Section 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.zipstringhipaa-confidential-communications45 CFR § 164.522Individuals 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 § 1557Section 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.countystringhipaa-confidential-communications45 CFR § 164.522Individuals 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 § 1557Section 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[].residencyResidencyapplication.members[].residency.isStateResidentbooleanReasonState residency is a universal eligibility requirement across all programs; non-residents are ineligible regardless of other criteria.
snap-residency-requirement7 CFR § 273.3SNAP 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 § 435.403Medicaid 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 § 260.52States 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.stateResidencyDatedateReasonRequired for states that verify residency duration and for determining benefit start dates when a household transfers from another state.
application.members[].citizenshipCitizenshipmedicaid-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.citizenshipStatusenumus_citizen us_national non_citizenReasonNon-citizens have restricted access to federal programs under PRWORA. Citizenship status determines which verification procedures and waiting periods apply.
snap-citizenship-eligibility7 CFR § 273.4Only 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. § 1611Federal 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.certificateNumberstringReasonUS naturalization or citizenship certificate number used for SAVE verification of citizenship claims.
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.immigrantStatusenumlawful_permanent_resident refugee asylee deportation_withheld parolee conditional_entrant cuban_haitian_entrant amerasian battered_non_citizen trafficking_victim temporary_protected_status otherReasonSpecific immigration category determines program eligibility, applicable waiting periods, and the required verification pathway.
qualified-alien-eligibility8 U.S.C. § 1611Federal 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 § 273.4Only U.S. citizens and qualified aliens are eligible for SNAP. Agency must verify citizenship or immigration status for all applicants.
prwora-sponsor-deeming8 USC § 1631Sponsors 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.uscisNumberOrI94stringReasonAlien registration number or I-94 admission number required to initiate FDSH VLP verification.
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.documentDocumentmedicaid-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.typeenumi_551 i_766 i_94 i_327 i_571 foreign_passport machine_readable_immigrant_visa otherReasonImmigration document type determines which fields FDSH VLP requires to initiate a verification check.
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.numberstringReasonDocument number required for FDSH VLP immigration status verification.
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.expirationDatedateReasonExpired immigration documents may indicate a change in immigration status that affects 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.
application.members[].citizenship.document.countryOfIssuancestringReasonCountry of issuance is required for foreign passport VLP verification lookups.
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.residedInUsSince1996booleanReasonContinuous 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.
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.hasQualifyingMilitaryConnectionbooleanReasonQualified non-citizens with a connection to US military service are exempt from PRWORA waiting periods.
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.sponsoredSponsoredprwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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.hasBeenAbandonedBySponsorbooleanReasonSponsor 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.
prwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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.hasBeenMistreatedBySponsorbooleanReasonBattery 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.
prwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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.qualifiesForSponsorDeemingExceptionbooleanReasonCertain sponsored non-citizens — pregnant women, children under 21 — are exempt from sponsor income deeming.
prwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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.receivesInKindSupportbooleanReasonIn-kind support and maintenance (non-cash housing and food) from a sponsor is counted as income for SSI and may affect other program determinations.
prwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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[].retroactiveMedicalCoverageRetroactiveMedicalCoveragemedicaid-retroactive-coverage42 CFR § 435.915Medicaid 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.isRequestedbooleanReasonMedicaid may cover medical expenses incurred up to 3 months before the application month for eligible individuals who would have qualified during that period.
medicaid-retroactive-coverage42 CFR § 435.915Medicaid 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.
medicaid-retroactive-coverage42 CFR § 435.915Medicaid 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[].monthstringReasonIdentifies the specific months for which retroactive coverage is requested, up to the 3-month retroactive period.
medicaid-retroactive-coverage42 CFR § 435.915Medicaid 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[].householdIncomenumberReasonIncome during the retroactive month must be evaluated against the eligibility threshold for that month to determine whether the applicant would have qualified.
medicaid-retroactive-coverage42 CFR § 435.915Medicaid 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[].disabilityDisabilitysnap-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 § 435.541States 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.isDisabledbooleanReasonA disabling condition lasting 12 or more months affects SNAP elderly and disabled household rules and categorical Medicaid eligibility determination.
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 § 435.541States 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.hasLongTermConditionbooleanReasonIdentifies 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.
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 § 435.541States 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.hasPhysicalDisabilitybooleanReasonIdentifies whether the member has a physical disability; collected to support SNAP elderly and disabled household deductions and Medicaid disability pathways.
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 § 435.541States 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.hasMentalDisabilitybooleanReasonIdentifies whether the member has a mental disability; collected alongside hasPhysicalDisability to support SNAP and Medicaid disability determinations.
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 § 435.541States 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.needsHelpWithSelfCarebooleanReasonIdentifies 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.
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 § 435.541States 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[].studentStatusStudentStatussnap-student-eligibility-restriction7 CFR § 273.5Students 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.enrollmentStatusenumfull_time part_time not_enrolledReasonFull-time students ages 18-49 are generally ineligible for SNAP unless they meet a specific exemption.
snap-student-eligibility-restriction7 CFR § 273.5Students 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.institutionTypeenumhigher_education vocational otherReasonThe SNAP student eligibility restriction applies specifically to higher education; vocational training institutions may not trigger the restriction.
snap-student-eligibility-restriction7 CFR § 273.5Students 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.schoolNamestringReasonSchool name used to verify enrollment status and institution type for the SNAP student restriction.
snap-student-eligibility-restriction7 CFR § 273.5Students 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.isParticipatingInWorkStudybooleanReasonParticipation in a federally funded work-study program is one of the exemptions from the SNAP student eligibility restriction.
snap-student-eligibility-restriction7 CFR § 273.5Students 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[].pregnancyPregnancymedicaid-pregnancy-eligibility42 CFR § 435.116States 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.isPregnantbooleanReasonPregnancy confers categorical Medicaid eligibility and affects CHIP unborn child coverage; the expected baby counts as a household member for SNAP.
medicaid-pregnancy-eligibility42 CFR § 435.116States 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.dueDatedateReasonDue date determines the benefit period for pregnancy Medicaid and the anticipated household size change for SNAP.
medicaid-pregnancy-eligibility42 CFR § 435.116States 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.numberOfBabiesExpectedintegerReasonEach expected baby counts as a separate household member for SNAP and Medicaid household size calculation.
medicaid-pregnancy-eligibility42 CFR § 435.116States 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[].fosterCareFosterCaremedicaid-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.startDatedateReasonStart date of the most recent foster care episode; used with end date and member age to determine whether extended Medicaid eligibility applies.
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.endDatedateReasonEnd 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.
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.exitReasonenumadopted reunified aged_out emancipatedReasonExit reason determines eligibility pathway — aged-out youth qualify for extended Medicaid; reunification and adoption have different eligibility implications.
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.exitStatestringReasonState in which the member was in foster care; required for cross-state Medicaid eligibility for youth who aged out in another state.
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.receivedMedicaidAtAge18booleanReasonYouth who were enrolled in Medicaid at age 18 qualify for extended Medicaid coverage to age 26 regardless of current income.
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.returnedAfterAdoptionbooleanReasonYouth who re-enter foster care after an adoption dissolution may regain extended Medicaid eligibility; this flag triggers review of the re-entry date.
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.returnDatedateReasonDate of re-entry into foster care after adoption dissolution; used to determine whether extended Medicaid eligibility resumes.
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[].militaryMilitaryapplication.members[].military.isVeteranbooleanReasonVeteran status may affect categorical SNAP eligibility in states with broad-based categorical eligibility and may affect Medicaid when TRICARE is present.
application.members[].military.isActiveDutybooleanReasonActive duty status affects SNAP income treatment for military households and may affect TANF work activity exemptions.
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.dischargeStatusenumhonorable general other_than_honorable bad_conduct dishonorable uncharacterizedReasonDishonorable discharge is a categorical disqualifier for SNAP; any member with a dishonorable discharge is ineligible regardless of other criteria.
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[].institutionalStatusInstitutionalStatussnap-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 § 435.1010Medicaid 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 § 435.1008Incarcerated 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.livesInInstitutionbooleanReasonInstitutionalized individuals are generally ineligible for SNAP and have restricted Medicaid eligibility under IMD exclusion and LTSS rules.
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 § 435.1010Medicaid 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 § 435.1008Incarcerated 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.facilityNamestringReasonFacility name used for verification and for determining the institution type when not explicitly collected.
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 § 435.1010Medicaid 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 § 435.1008Incarcerated 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.facilityTypeenumnursing_home hospital incarceration otherReasonFacility type determines which program restrictions apply — incarcerated individuals are ineligible for SNAP and Medicaid during incarceration.
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 § 435.1010Medicaid 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 § 435.1008Incarcerated 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.dateEntereddateReasonEntry date used to determine the period of ineligibility and whether a partial-month benefit applies.
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 § 435.1010Medicaid 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 § 435.1008Incarcerated 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.pendingDispositionOfChargesbooleanReasonIndividuals detained pending disposition of charges retain Medicaid eligibility; convicted and incarcerated individuals do not.
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 § 435.1010Medicaid 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 § 435.1008Incarcerated 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.mealsProvidedbooleanReasonInstitutions that provide meals may constitute a separate food purchasing unit, affecting SNAP household composition.
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 § 435.1010Medicaid 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 § 435.1008Incarcerated 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[].priorConvictionsPriorConvictionssnap-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 § 862aIndividuals 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.isFleeingFelonbooleanReasonIndividuals fleeing to avoid prosecution or confinement for a felony are ineligible for SNAP and TANF.
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 § 862aIndividuals 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.convictedOfDrugRelatedFelonybooleanReasonDrug-related felony convictions may disqualify a member from SNAP and TANF depending on state implementation of the federal option.
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 § 862aIndividuals 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.convictedDuplicateSnapBenefitsbooleanReasonConviction for receiving duplicate SNAP benefits results in a disqualification period proportional to the offense.
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 § 862aIndividuals 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.convictedOfSnapTraffickingbooleanReasonConviction for trafficking SNAP benefits over $500 results in permanent disqualification.
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 § 862aIndividuals 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.convictedTradingSnapForFirearmsOrExplosivesbooleanReasonConviction for trading SNAP benefits for firearms, ammunition, or explosives results in permanent disqualification.
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 § 862aIndividuals 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.convictedOfDisqualifyingViolentCrimebooleanReasonConviction for murder or certain sexual offenses results in permanent SNAP disqualification under the Agriculture Improvement Act.
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 § 862aIndividuals 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.disqualifiedForIPVbooleanReasonA prior intentional program violation (IPV) disqualification carries over and may trigger an extended or permanent disqualification period.
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 § 862aIndividuals 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.isViolatingProbationOrParolebooleanReasonIndividuals violating probation or parole conditions are ineligible for SNAP and TANF.
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 § 862aIndividuals 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[].tribalStatusTribalStatuschip-ai-an-eligibility42 CFR § 457.125American 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 § 1603Establishes 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.isAmericanIndianOrAlaskaNativebooleanReasonAmerican Indian and Alaska Native members have special Medicaid and CHIP eligibility protections and are eligible for Indian Health Service coordination.
chip-ai-an-eligibility42 CFR § 457.125American 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 § 1603Establishes 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.tribeNamestringReasonTribe name used to verify tribal membership and coordinate with IHS and tribal health programs.
chip-ai-an-eligibility42 CFR § 457.125American 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 § 1603Establishes 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.tribeStatestringReasonState where the tribe is located, used to identify the relevant IHS service area and tribal health program.
chip-ai-an-eligibility42 CFR § 457.125American 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 § 1603Establishes 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[].personMatchPersonMatchReasonPerson matching state for an application member. Populated when the client management domain resolves a match; null until matching begins.
application.members[].personMatch.matchStatusenumconfirmed review_required no_matchReasonOutcome 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[].confidenceScorenumberReasonMatch 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[].programstringReasonProgram identifier the determination applies to (e.g., snap, medicaid, tanf).
application.members[].programDeterminations[].outcomeenumapproved deniedReasonDetermination outcome — approved or denied — for this member/program combination.
application.members[].programDeterminations[].determinedAtdatetimeReasonWhen the determination was recorded by the rules engine.
household-info
application.householdInfo.iduuidapplication.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.
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[].iduuidReasonIdentifier of the referenced person record; points to application.members[].id when type = member, or application.contacts[].id when type = contact.
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[].typeenummember contactReasonDiscriminator identifying whether the roomer is a household member or a contact-only person record in application.contacts[].
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[].amountPaidForRentnumberReasonRent paid by a roomer is income to the household; distinguishes market-rate roomers from boarders.
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[].mealsIncludedWithRentbooleanReasonWhen 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.
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.utilitiesIncludedInRentbooleanReasonWhen utilities are included in rent, the household may not claim a utility standard deduction for SNAP.
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.isSubsidizedHousingbooleanReasonResidents of federally subsidized housing are ineligible for the heating and cooling standard utility allowance.
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.receivedTanfInAnotherStatebooleanReasonCross-state TANF receipt is verified to prevent duplicate participation and enforce time limits across states.
tanf-time-limits45 CFR § 264.1States 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 § 260.31Defines 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.
medicaid-magi-methodology42 CFR § 435.603Medicaid 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[].iduuidmedicaid-magi-methodology42 CFR § 435.603Medicaid 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[].
medicaid-magi-methodology42 CFR § 435.603Medicaid 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)medicaid-magi-methodology42 CFR § 435.603Medicaid 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[].filingJointlyWithSpousebooleanReasonJoint filing status affects MAGI household composition and income attribution for Medicaid and marketplace eligibility.
medicaid-magi-methodology42 CFR § 435.603Medicaid 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[].spousePersonRefmedicaid-magi-methodology42 CFR § 435.603Medicaid 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.iduuidReasonIdentifier of the referenced person record for the spouse; used to link a non-household spouse to their contacts[] entry.
medicaid-magi-methodology42 CFR § 435.603Medicaid 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.typeenummember contactReasonDiscriminator identifying whether the filing spouse is a household member or a contact-only person record in application.contacts[].
medicaid-magi-methodology42 CFR § 435.603Medicaid 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[].claimingDependentsbooleanReasonClaiming dependents affects MAGI household size and the income of dependents attributed to the tax household.
medicaid-magi-methodology42 CFR § 435.603Medicaid 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)medicaid-magi-methodology42 CFR § 435.603Medicaid 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[].iduuidReasonIdentifier of the referenced person record for the dependent; points to application.members[].id when type = member, or application.contacts[].id when type = contact.
medicaid-magi-methodology42 CFR § 435.603Medicaid 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[].typeenummember contactReasonDistinguishes 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).
medicaid-magi-methodology42 CFR § 435.603Medicaid 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[].expectedToBeClaimedByNonHouseholdMemberbooleanReasonA household member expected to be claimed as a dependent by someone outside the household uses that person's tax household for MAGI purposes.
medicaid-magi-methodology42 CFR § 435.603Medicaid 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[].personClaimingPersonRefmedicaid-magi-methodology42 CFR § 435.603Medicaid 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.iduuidReasonIdentifier of the person claiming this applicant as a dependent; used to determine the applicable tax household for MAGI purposes.
medicaid-magi-methodology42 CFR § 435.603Medicaid 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.typeenummember contactReasonDiscriminator identifying whether the person claiming this applicant as a dependent is a household member or a contact-only person record in application.contacts[].
medicaid-magi-methodology42 CFR § 435.603Medicaid 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[].isNonCustodialParentbooleanReasonNon-custodial parents who claim a child as a dependent use a different MAGI household composition rule.
medicaid-magi-methodology42 CFR § 435.603Medicaid 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[].hasDomesticViolenceTaxFilingExceptionbooleanReasonDomestic violence survivors may file separately from their spouse even if married, preventing their spouse's income from being included in the MAGI household.
irs-domestic-violence-filing-exceptionIRS Rev. Proc. 2013-34Domestic 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 § 435.603Medicaid 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.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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)type 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.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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[].iduuidReasonUnique identifier for the health plan record; FK target for application.healthEnrollments[].healthPlanId.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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)aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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[].typeenumemployer_sponsored cobra medicare tricare va marketplace peace_corps chip medicaid tribal_health_services other_federal otherReasonCoverage type determines minimum essential coverage (MEC) status, marketplace eligibility, and Medicare Savings Program (MSP) screening.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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[].typeOtherstringReasonCaptures non-enumerated coverage types for adapter review and manual classification.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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[].premiumAmountnumberReasonPremium 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.
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[].premiumFrequencyenumweekly every_two_weeks twice_monthly monthly yearlyReasonPremium frequency is needed to normalize the premium to a monthly figure for the affordability calculation.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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[].coverageContactNametype in [employer_sponsored, cobra]ReasonHR or benefits contact at the employer for plan verification and enrollment period confirmation.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.firstNamestringtype in [employer_sponsored, cobra]aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.middleNamestringtype in [employer_sponsored, cobra]aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.middleInitialstringtype in [employer_sponsored, cobra]aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.lastNamestringtype in [employer_sponsored, cobra]aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.maidenNamestringtype in [employer_sponsored, cobra]aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.suffixstringtype in [employer_sponsored, cobra]aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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[].hasMinimumValuePlanbooleantype in [employer_sponsored, cobra]ReasonAn employer plan that meets minimum value (covers at least 60% of costs) blocks marketplace premium tax credit eligibility.
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[].lowestCostPlanNamestringtype in [employer_sponsored, cobra]ReasonIdentifies the lowest-cost minimum value plan offered by the employer, used in the affordability test.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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[].lowestCostPlanPremiumnumbertype in [employer_sponsored, cobra]ReasonThe self-only premium of the lowest-cost minimum value plan is the benchmark for the ACA affordability test.
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-2Premium 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[].medicareIdstringtype = medicareReasonMedicare 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.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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[].partAMedicareParttype = medicaremedicaid-medicare-savings-program42 CFR § 435.119States 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 § 1395cMedicare 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.statusenumtype = medicareentitled enrolledReasonEntitled 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.
medicaid-medicare-savings-program42 CFR § 435.119States 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 § 1395cMedicare 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.startDatedatetype = medicareReasonPart A effective date used for coordination with Medicaid and the Medicare Savings Program.
medicaid-medicare-savings-program42 CFR § 435.119States 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 § 1395cMedicare 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.isPremiumFreebooleantype = medicareReasonBeneficiaries who did not earn 40 quarters of work pay a Part A premium; premium amount affects MSP and QMB eligibility.
medicaid-medicare-savings-program42 CFR § 435.119States 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 § 1395cMedicare 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.premiumAmountnumbertype = medicareReasonPart A premium amount for beneficiaries who did not earn 40 quarters of work and must pay a premium; used in Medicare Savings Program determination.
medicaid-medicare-savings-program42 CFR § 435.119States 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 § 1395cMedicare 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.premiumPaidByenumtype = medicareself state employer otherReasonIdentifies 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.
medicaid-medicare-savings-program42 CFR § 435.119States 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 § 1395cMedicare 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[].partBMedicareParttype = medicareaca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.statusenumtype = medicareentitled enrolledReasonPart B enrollment status affects MSP eligibility and late enrollment penalty determination.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.startDatedatetype = medicareReasonPart B effective date used for late enrollment penalty calculation and MSP coordination.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.isPremiumFreebooleantype = medicareReasonIdentifies whether the beneficiary qualifies for a premium-free Part B; affects Medicare Savings Program cost calculation.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.premiumAmountnumbertype = medicareReasonPart B premium amount is used for QMB and SLMB determination under the Medicare Savings Program.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.premiumPaidByenumtype = medicareself state employer otherReasonIdentifies 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.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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[].partCMedicarePartCtype = medicareaca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.statusenumtype = medicareentitled enrolledReasonPart 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.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.startDatedatetype = medicareReasonPart C effective date for coordination with Medicaid dual-eligible programs.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.contractIdstringtype = medicareReasonCMS contract ID uniquely identifies the Medicare Advantage organization. Required for plan identification in CMS enrollment data.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.planIdstringtype = medicareReasonCMS plan ID combined with contract ID uniquely identifies the specific Medicare Advantage plan.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.planNamestringtype = medicareReasonHuman-readable Medicare Advantage plan name for applicant correspondence and worker review.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.premiumAmountnumbertype = medicareReasonPart C plan premium may be covered by certain Medicare Savings Programs.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.premiumPaidByenumtype = medicareself state employer otherReasonIdentifies 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.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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[].partDMedicarePartDtype = medicareaca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.statusenumtype = medicareentitled enrolledReasonPart D prescription drug coverage status for coordination of benefits.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.startDatedatetype = medicareReasonPart D effective date for coordination with Medicaid drug coverage.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.planNamestringtype = medicareReasonPrescription drug plan name for coordination of benefits identification.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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.premiumAmountnumbertype = medicareReasonPart D premium may be subsidized through the Low Income Subsidy (Extra Help) program.
medicare-part-d-low-income-subsidy42 USC § 1395w-114Low 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.premiumPaidByenumtype = medicareself state employer otherReasonIdentifies 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.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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[].programTypestringtype = tricareReasonIdentifies the specific federal health program (TRICARE, VA, Peace Corps, etc.) for verification and MEC determination.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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[].insuranceCompanyNamestringtype = tricareReasonInsurance carrier for TRICARE supplemental or managed care plans, required for coordination of benefits.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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[].policyNumberstringtype = tricareReasonPolicy number required for benefits verification and coordination of benefits.
aca-minimum-essential-coverage26 USC § 5000ADefines 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 § 435.119States 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[].iduuidReasonUnique 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[].roleenumsubscriber dependentReasonSubscriber vs. dependent role affects premium attribution for the ACA employer coverage affordability test.
application.healthEnrollments[].startDatedateReasonCoverage start date; used to determine coverage gap periods relevant to MEC analysis and special enrollment eligibility.
application.healthEnrollments[].endDatedateReasonDate coverage lapsed, triggering special enrollment period eligibility for marketplace.
aca-special-enrollment-periods45 CFR § 155.420Individuals 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[].eligibleDatedateReasonDate the member becomes eligible for coverage; used to determine whether a special enrollment period applies.
application.healthEnrollments[].enrollmentStatusenumeligible enrolled pending endedReasonDistinguishes 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.
aca-special-enrollment-periods45 CFR § 155.420Individuals 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 § 435.119States 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[].prefersSeparateMailingbooleanReasonMembers have the right to request that health coverage notices be sent to an alternative address, primarily for domestic violence safety and health information privacy.
hipaa-confidential-communications45 CFR § 164.522Individuals 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 § 1557Section 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[].sponsorPersonRefapplication.healthEnrollments[].sponsor.iduuidapplication.healthEnrollments[].sponsor.typeenummember contactchild-support
application.childSupport.iduuidapplication.childSupport.applicationIduuid(Application)application.childSupport.goodCauseChildSupportWaiverbooleanReasonApplicants who cooperate with child support enforcement may claim a good cause exception if cooperation would put them or their children at risk of harm.
snap-child-support-cooperation45 CFR § 303.6SNAP 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 § 433.147Medicaid 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.
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 § 303.6SNAP 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[].iduuidReasonIdentifier of the referenced person record for the non-custodial parent; the person record holds their name, address, and phone for enforcement contact.
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 § 303.6SNAP 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[].typeenummember contactReasonDiscriminator identifying whether the non-custodial parent is a household member or a contact-only person record in application.contacts[].
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 § 303.6SNAP 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.
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 § 303.6SNAP 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[].iduuidReasonIdentifier of the referenced child person record.
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 § 303.6SNAP 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[].typeenummember contactReasonDiscriminator identifying whether the child is a household member or a contact-only person record.
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 § 303.6SNAP 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[].attemptedMedicalSupportCooperationbooleanReasonMedicaid applicants are required to cooperate with medical support enforcement as a condition of eligibility.
medicaid-medical-support-cooperation42 CFR § 433.147Medicaid 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[].iduuidReasonUnique identifier for the person record; referenced throughout the model via member|contact discriminator pairs (type + id).
application.contacts[].applicationIduuid(Application)application.contacts[].nameNameReasonLegal name of the person for identity verification, correspondence, and data matching across programs.
application.contacts[].name.firstNamestringapplication.contacts[].name.middleNamestringapplication.contacts[].name.middleInitialstringapplication.contacts[].name.lastNamestringapplication.contacts[].name.maidenNamestringapplication.contacts[].name.suffixstringapplication.contacts[].primaryAddressAddressReasonMailing 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.addressLine1stringapplication.contacts[].primaryAddress.addressLine2stringapplication.contacts[].primaryAddress.citystringapplication.contacts[].primaryAddress.statestringapplication.contacts[].primaryAddress.zipstringapplication.contacts[].primaryAddress.countystringapplication.contacts[].primaryPhonestringReasonContact phone number for this person, used for non-member contacts such as authorized representatives and helpers.
application.contacts[].emailemailReasonEmail 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[].iduuidReasonUnique identifier for the organization record; referenced by FK fields throughout the model.
application.organizations[].applicationIduuid(Application)application.organizations[].namestringReasonLegal name of the organization for correspondence, verification, and reporting.
application.organizations[].einstringReasonEmployer Identification Number used for income verification and employer contact.
application.organizations[].addressAddressReasonOrganization's address for verification and contact when phone is unavailable.
application.organizations[].address.addressLine1stringapplication.organizations[].address.addressLine2stringapplication.organizations[].address.citystringapplication.organizations[].address.statestringapplication.organizations[].address.zipstringapplication.organizations[].address.countystringapplication.organizations[].phonestringReasonOrganization'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.
medicaid-caretaker-relative42 CFR § 435.4A 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 § 273.11Income 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[].iduuidmedicaid-caretaker-relative42 CFR § 435.4A 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 § 273.11Income 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)medicaid-caretaker-relative42 CFR § 435.4A 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 § 273.11Income 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[].fromPersonRefReasonSource person in a directed relationship; from IS THE [relationshipType] OF to.
medicaid-caretaker-relative42 CFR § 435.4A 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 § 273.11Income 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.iduuidReasonIdentifier of the source person record; points to application.members[].id when type = member, or application.contacts[].id when type = contact.
medicaid-caretaker-relative42 CFR § 435.4A 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 § 273.11Income 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.typeenummember contactReasonDiscriminator identifying whether the source person is a household member or a contact-only person record.
medicaid-caretaker-relative42 CFR § 435.4A 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 § 273.11Income 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[].toPersonRefReasonTarget person in a directed relationship.
medicaid-caretaker-relative42 CFR § 435.4A 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 § 273.11Income 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.iduuidReasonIdentifier of the target person record; points to application.members[].id when type = member, or application.contacts[].id when type = contact.
medicaid-caretaker-relative42 CFR § 435.4A 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 § 273.11Income 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.typeenummember contactReasonDiscriminator identifying whether the target person is a household member or a contact-only person record.
medicaid-caretaker-relative42 CFR § 435.4A 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 § 273.11Income 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[]enumparent child spouse domestic_partner sibling grandparent grandchild legal_guardian caregiver primary_caregiver other_relative unrelatedReasonRelationship 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.
medicaid-caretaker-relative42 CFR § 435.4A 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 § 273.11Income 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.
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 § 435.923A 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[].iduuidReasonIdentifier of the referenced person or organization record; points to application.members[].id, application.contacts[].id, or application.organizations[].id depending on type.
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 § 435.923A 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.
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 § 435.923A 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)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 § 435.923A 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[].typeenummember contact organizationReasonDetermines 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.
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 § 435.923A 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[].inCareOfPersonRefsnap-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 § 435.923A 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.iduuidReasonIdentifier of the person within the organization to whom correspondence should be directed.
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 § 435.923A 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.typeenummember contactReasonDiscriminator 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.
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 § 435.923A 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[].receivesNoticesbooleanReasonDetermines whether program notices are sent to the representative instead of, or in addition to, the applicant.
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 § 435.923A 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[]enumsnap medicaid chip tanf acaReasonScopes the representative's authority to specific programs. A representative may be authorized for some programs but not others on a multi-program application.
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 § 435.923A 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.
medicaid-application-signature42 CFR § 435.907States 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.
esign-act15 USC § 7001Electronic 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[].iduuidmedicaid-application-signature42 CFR § 435.907States 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.
esign-act15 USC § 7001Electronic 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)medicaid-application-signature42 CFR § 435.907States 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.
esign-act15 USC § 7001Electronic 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[].signerSignermedicaid-application-signature42 CFR § 435.907States 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.
esign-act15 USC § 7001Electronic 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.iduuidReasonIdentifier of the referenced person or organization record who is the signer.
medicaid-application-signature42 CFR § 435.907States 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.
esign-act15 USC § 7001Electronic 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.typeenummember contact organizationReasonDiscriminator identifying whether the signer is a household member, a contact-only person, or an organization.
medicaid-application-signature42 CFR § 435.907States 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.
esign-act15 USC § 7001Electronic 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.roleenumapplicant authorized_representative helperReasonIdentifies 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.
medicaid-application-signature42 CFR § 435.907States 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.
esign-act15 USC § 7001Electronic 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[].purposeenumapplication authorized_representative_appointment authorized_representative_acceptance rights_and_responsibilities hipaa_consent otherReasonA 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.
medicaid-application-signature42 CFR § 435.907States 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.
esign-act15 USC § 7001Electronic 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[].signedAtdatetimeReasonDate and time of signature required for audit trail, benefit period determination, and legal validity.
medicaid-application-signature42 CFR § 435.907States 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.
esign-act15 USC § 7001Electronic 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[].signatureMethodenumelectronic wet_signature verbalReasonDistinguishes electronic, wet ink, and verbal signatures; states must track method for legal validity and audit purposes.
medicaid-application-signature42 CFR § 435.907States 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.
esign-act15 USC § 7001Electronic 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.
prwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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.
prwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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[].iduuidReasonUnique identifier for the sponsor record.
prwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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)prwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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[].typeenummember contactReasonDiscriminator identifying whether the sponsor is a household member or a contact-only person record in application.contacts[].
prwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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[].ssnstringReasonSponsor's SSN required for income and asset verification through IEVS and FDSH.
snap-ssa-identity-check42 U.S.C. § 1320b-7Agencies 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[].spouseSpouseprwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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.iduuidReasonIdentifier of the referenced person record for the sponsor's spouse.
prwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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.typeenummember contactReasonDiscriminator identifying whether the sponsor's spouse is a household member or a contact-only person record in application.contacts[].
prwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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.ssnstringReasonSponsor spouse's SSN required for verification of the spouse's income, which may also be deemed to the sponsored non-citizen.
prwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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.signedAffidavitbooleanReasonIndicates whether the sponsor's spouse co-signed the I-864 affidavit of support, which affects the scope of income deeming.
prwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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[].householdSizeintegerReasonSponsor household size is used in the deeming formula to calculate the sponsor's available income attributable to the sponsored non-citizen.
prwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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[].incomenumberReasonSponsor's gross income is the starting point for the deeming calculation; a portion is attributed to the sponsored non-citizen as deemed income.
prwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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[].livesWithSponsoredbooleanReasonWhen the sponsor lives with the sponsored non-citizen, a different deeming formula applies.
prwora-sponsor-deeming8 USC § 1631Sponsors 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 § 1183aSponsors 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.
snap-income-verification7 CFR § 272.8Income 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)type = employedReasonFK 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.
snap-income-verification7 CFR § 272.8Income 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[].iduuidReasonUnique identifier for the job record; FK target for application.incomes[].jobId and application.healthEnrollments[].jobId.
snap-income-verification7 CFR § 272.8Income 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.
snap-income-verification7 CFR § 272.8Income 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)snap-income-verification7 CFR § 272.8Income 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[].typeenumemployed self_employedReasonEmployed vs. self-employed status determines the income calculation method, allowable expense deductions, and applicable verification documents.
snap-income-verification7 CFR § 272.8Income 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[].statusenumactive on_strike endedReasonCurrent employment status; on_strike triggers SNAP household strike disqualification rules for the striking member.
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[].hoursPerWeeknumberReasonAverage weekly hours used for TANF work participation rate calculation and SNAP ABAWD employment exemption determination.
tanf-work-participation45 CFR § 261.22States 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 § 273.24Able-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[].isTemporarybooleanReasonTemporary employment affects SNAP income averaging rules and TANF work activity categorization.
snap-income-verification7 CFR § 272.8Income 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[].startDatedateReasonEmployment start date used to verify duration and determine which income is countable in the current benefit period.
snap-income-verification7 CFR § 272.8Income 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[].endDatedateReasonEmployment end date used to identify recent job loss for expedited processing screening and income change evaluation.
snap-income-verification7 CFR § 272.8Income 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[].endReasonenumvoluntary_separation involuntary_separationReasonVoluntary separation without good cause may result in TANF disqualification; participation in a labor strike disqualifies the striking member from SNAP.
tanf-voluntary-quit45 CFR § 261.50A 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[].strikeStartDatedateReasonDate the labor strike began; used to determine whether the SNAP strike disqualification period applies and to establish the duration of the disqualification.
snap-income-verification7 CFR § 272.8Income 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[].lastPaycheckDatedateReasonDate of last paycheck required to determine the income counting period when employment recently ended.
snap-income-verification7 CFR § 272.8Income 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[].lastPaycheckGrossAmountnumberReasonGross amount of last paycheck used for income verification when pay stubs from the current period are unavailable.
snap-income-verification7 CFR § 272.8Income 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[].businessNamestringtype = self_employedReasonTrade name or DBA name of the self-employment business for verification and worker review.
snap-income-verification7 CFR § 272.8Income 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[].businessTypestringtype = self_employedReasonType of self-employment business may affect which expense categories are allowable deductions.
snap-income-verification7 CFR § 272.8Income 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[].reportingMonthdatetype = self_employedReasonThe 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.
snap-income-verification7 CFR § 272.8Income 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[].expensesSelfEmploymentExpensestype = self_employedsnap-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.utilitiesnumbertype = self_employedReasonUtility costs paid for business use are an allowable deduction from self-employment gross income.
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.taxesnumbertype = self_employedReasonBusiness taxes paid are an allowable deduction from self-employment gross income.
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.interestnumbertype = self_employedReasonBusiness interest payments are an allowable deduction from self-employment gross income.
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.laborCostsnumbertype = self_employedReasonGross labor costs paid to employees are an allowable deduction from self-employment gross income.
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.costOfMerchandisenumbertype = self_employedReasonCost of goods or merchandise sold is an allowable deduction from self-employment gross income.
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.othernumbertype = self_employedReasonOther allowable business expenses not captured in the enumerated categories, subject to worker review.
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.
snap-income-verification7 CFR § 272.8Income 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)type 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.
snap-income-verification7 CFR § 272.8Income 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[].iduuidReasonUnique identifier for the income record.
snap-income-verification7 CFR § 272.8Income 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.
snap-income-verification7 CFR § 272.8Income 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)snap-income-verification7 CFR § 272.8Income 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[].typeenumemployed self_employed unearned lump_sum in_kind_support tribal education_grant other prior_periodReasonIncome type determines the calculation method, applicable exclusions, verification requirements, and program-specific treatment.
snap-income-verification7 CFR § 272.8Income 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[].typeOtherstringReasonCaptures non-enumerated income types for adapter mapping and worker review.
snap-income-verification7 CFR § 272.8Income 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[].amountnumberReasonThe 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.
snap-income-verification7 CFR § 272.8Income 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[].frequencyenumdaily weekly every_two_weeks twice_monthly monthly yearly variableReasonFrequency 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.
snap-income-verification7 CFR § 272.8Income 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[].dateReceiveddateReasonDate of receipt required for lump sum income to determine which benefit month is affected by the payment.
snap-income-verification7 CFR § 272.8Income 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[].changeReasonenumstopped_working hours_reduced new_job change_in_employment marital_status_change otherReasonCategorical reason for a recent income change, used for case worker review and to validate projected annual income under MAGI rules.
snap-income-verification7 CFR § 272.8Income 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[].changeExplanationstringReasonFree-text narrative explaining an income change; required by MAGI rules when projected income differs materially from annualized pay stubs.
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[].unearnedTypeenumtype = unearnedunemployment 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 otherReasonSpecific unearned income type determines exclusion rules, verification source, and program-specific counting treatment.
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[].inKindSupportTypeenumtype = in_kind_supportshelter food utilities otherReasonType of in-kind support received — shelter, food, utilities, or other — determines the applicable income counting rule and SSI valuation method.
ssi-in-kind-support20 CFR § 416.1102In-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[].payerNamestringtype = in_kind_supportReasonName of the person or organization providing in-kind support, for verification and determination of whether support is from a sponsor subject to deeming rules.
snap-income-verification7 CFR § 272.8Income 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[].lumpSumTypeenumtype = lump_sumlawsuit_settlement insurance_settlement social_security_ssi_ssdi_payment veterans inheritance surrender_of_annuity life_insurance_payout lottery_gambling_winnings otherReasonLump sum type determines how the payment is treated across programs — some types are excluded, others are counted in the month of receipt or prorated.
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 § 435.603Medicaid 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.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].iduuidReasonUnique identifier for the asset record.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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)snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].typeenumliquid vehicle real_property retirement_account insurance otherReasonAsset type determines which countability rules apply and what verification is required.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].typeOtherstringReasonCaptures non-enumerated asset types for worker review and manual classification.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].valuenumberReasonCurrent market value of the asset, used in the SNAP asset test and Medicaid resource determination.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].financialInstitutionNamestringtype in [liquid, retirement_account]ReasonFinancial institution name for liquid asset verification through bank statements or electronic verification.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].accountNumberstringtype in [liquid, retirement_account]ReasonAccount number for liquid asset verification and cross-matching.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].yearstringtype = vehicleReasonVehicle year is used with make and model to determine fair market value for the SNAP vehicle asset test.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].makestringtype = vehicleReasonVehicle make used with year and model for fair market value determination.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].modelstringtype = vehicleReasonVehicle model used with year and make for fair market value determination.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].policyTypeenumtype = insuranceterm permanent burial otherReasonPolicy type determines whether the cash surrender value is countable as a liquid asset.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].companyNamestringtype = insuranceReasonInsurance company name for policy verification and cash value lookup.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].policyNumberstringtype = insuranceReasonPolicy number required for insurance verification and cash value determination.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].faceValuenumbertype = insuranceReasonFace value is the starting point for determining cash surrender value; policies with face value above the exemption threshold have their cash value counted.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].isRevocablebooleantype = insuranceReasonOnly revocable life insurance policies have a countable cash surrender value; irrevocable policies are generally exempt.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].addressAddresstype = real_propertyReasonProperty address used for valuation and to determine whether the property is the primary residence (which may be exempt).
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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.addressLine1stringtype = real_propertysnap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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.addressLine2stringtype = real_propertysnap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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.citystringtype = real_propertysnap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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.statestringtype = real_propertysnap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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.zipstringtype = real_propertysnap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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.countystringtype = real_propertysnap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].primaryUseenumtype = real_propertyprimary_residence rental self_employment for_sale otherReasonPrimary use determines exemption status — primary residences are exempt; rental and investment properties are countable.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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[].primaryUseOtherstringtype = real_propertyReasonCaptures non-enumerated primary uses for worker review.
snap-resource-limit7 CFR § 273.8Most 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 § 435.601States 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.
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[].iduuidReasonUnique identifier for the asset disposal record.
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.
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)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[].typeenumliquid vehicle real_property retirement_account insurance otherReasonType of transferred asset determines which countability rules apply to the transfer.
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[].typeOtherstringReasonCaptures non-enumerated transferred asset types for worker review.
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[].dateOfDisposaldateReasonDate of transfer determines whether the transfer falls within the applicable lookback period for the asset test.
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[].amountReceivednumberReasonAmount received for the transfer; compared against fair market value to determine whether the transfer was for less than fair market value.
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[].fairMarketValuenumberReasonFair market value at time of transfer; if the amount received is below fair market value, the difference may be counted as a resource.
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.
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[].iduuidReasonUnique identifier for the expense record.
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.
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)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[].typeenumrent mortgage dependent_care medical child_support alimony otherReasonExpense type determines which deduction rules apply for SNAP net income calculation and which expenses are counted for Medicaid spend-down.
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[].typeOtherstringReasonCaptures non-enumerated expense types for worker review.
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[].amountnumberReasonActual amount paid for the expense, used in the deduction calculation.
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[].legallyObligatedAmountnumberReasonOnly the legally obligated portion of child support and alimony payments is deductible from SNAP income; voluntary payments above the obligation are not deductible.
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.
medicaid-ssi-categorical-eligibility42 CFR § 435.120SSI 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 § 1395cMedicare 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[].iduuidReasonUnique identifier for the disability benefit record.
medicaid-ssi-categorical-eligibility42 CFR § 435.120SSI 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 § 1395cMedicare 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.
medicaid-ssi-categorical-eligibility42 CFR § 435.120SSI 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 § 1395cMedicare 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)medicaid-ssi-categorical-eligibility42 CFR § 435.120SSI 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 § 1395cMedicare 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[].programTypeenumssi ssdiReasonSSI 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.
medicaid-ssi-categorical-eligibility42 CFR § 435.120SSI 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 § 1395cMedicare 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[].statusenumpending approved active ended denied appealedReasonCurrent benefit status; pending applications affect categorical eligibility screening, active and ended statuses affect income counting.
medicaid-ssi-categorical-eligibility42 CFR § 435.120SSI 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 § 1395cMedicare 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[].applicationDatedateReasonDate of SSI/SSDI application used for determining the benefit start date if approved and for tracking pending applications.
medicaid-ssi-categorical-eligibility42 CFR § 435.120SSI 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 § 1395cMedicare 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[].startDatedateReasonBenefit start date used for income counting and Medicare Part A entitlement determination.
medicaid-ssi-categorical-eligibility42 CFR § 435.120SSI 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 § 1395cMedicare 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[].endDatedateReasonBenefit end date used to identify members with a history of SSI or SSDI and to assess whether continued eligibility applies.
medicaid-ssi-categorical-eligibility42 CFR § 435.120SSI 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 § 1395cMedicare 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.
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 § 62Defines 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[].iduuidReasonUnique identifier for the deduction record.
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 § 62Defines 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.
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 § 62Defines 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)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 § 62Defines 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[].typeenumalimony_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_periodReasonAbove-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.
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 § 62Defines 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[].typeOtherstringReasonCaptures non-enumerated deduction types for adapter mapping and worker review.
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 § 62Defines 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[].frequencyenumone_time_only weekly every_two_weeks twice_monthly monthly yearly variableReasonFrequency is needed to normalize the deduction amount for annualized MAGI income calculation.
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 § 62Defines 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[].amountnumberReasonPer-period deduction amount; combined with frequency to calculate the annual deduction figure.
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 § 62Defines 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[].annualAmountnumberReasonProjected annual deduction used directly in the MAGI calculation. Populated when frequency is variable and the per-period amount cannot be reliably annualized.
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 § 62Defines 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.
medicaid-electronic-verification-first42 CFR § 435.940When 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)medicaid-electronic-verification-first42 CFR § 435.940When 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.
medicaid-electronic-verification-first42 CFR § 435.940When 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[].iduuidmedicaid-electronic-verification-first42 CFR § 435.940When 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[].statusenumpending inconclusive satisfied waived cannot_verifyReasonCurrent lifecycle status of the verification obligation — pending, inconclusive, satisfied, waived, or cannot_verify. Read-only; set by the rules engine.
medicaid-electronic-verification-first42 CFR § 435.940When 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[]stringReasonElectronic and document evidence items accumulated against this obligation. Populated as checks run and documents are received.
medicaid-electronic-verification-first42 CFR § 435.940When 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.
medicaid-electronic-verification-first42 CFR § 435.940When 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.
medicaid-electronic-verification-first42 CFR § 435.940When 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[].typeenumdocument_request_citizenship_verification document_request_identity_verification document_request_immigration_verification document_request_income_verification document_request_residency_verificationReasonTemplate identifier for the notice, matching the type field on the communication.notice.sent event (e.g., document_request_income_verification).
medicaid-electronic-verification-first42 CFR § 435.940When 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[].sentAtdatetimeReasonWhen the document request notice was sent; used to calculate response deadlines and track aging obligations.
medicaid-electronic-verification-first42 CFR § 435.940When 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[].dueAtdatetimeReasonDeadline by which the applicant must respond with documents. Null if no deadline was set.
medicaid-electronic-verification-first42 CFR § 435.940When 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[].channelenumemail in_person mail portalReasonChannel through which the document request notice was sent — email, in_person, or mail.
medicaid-electronic-verification-first42 CFR § 435.940When 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[].sourceTypeenummember incomeReasonIdentifies what sourceId refers to — member or income. Required when sourceId is set; null for household-level obligations.
medicaid-electronic-verification-first42 CFR § 435.940When 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[].categoryenumcitizenship identity immigration income residencyReasonVerification obligation category — citizenship, identity, immigration, income, or residency — determines which document types and electronic checks are applicable.
medicaid-electronic-verification-first42 CFR § 435.940When 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[].verificationTypeenumdocument electronicReasonHow this obligation is to be fulfilled — document (paper evidence from applicant) or electronic (automated service check).
medicaid-electronic-verification-first42 CFR § 435.940When 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)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.
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.iduuidsnap-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.waiverStatusenumpending granted deniedReasonStatus of the interview waiver for this applicant. Caseworker-set field.
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.waiverReasonstringReasonReason the interview was waived. Required when waiverStatus is granted; used for audit and supervisory review.
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.completedAtdatetimeReasonWhen the caseworker attested the interview obligation was satisfied. Not set automatically — requires explicit caseworker action to record which appointment fulfilled the regulatory obligation.
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[].iduuidapplication.reviewProgress[].items[].itemIduuidapplication.reviewProgress[].items[].statusenumnot_started in_progress complete flaggedapplication.reviewProgress[].items[].notesobjectapplication.reviewProgress[].items[].notes.textstringapplication.reviewProgress[].items[].notes.textFormatenumplain markdown htmlapplication.reviewProgress[].items[].sectionstringapplication.reviewProgress[].totalintegerapplication.reviewProgress[].limitintegerapplication.reviewProgress[].offsetintegerapplication.reviewProgress[].hasNextboolean