POST api/Enrollment/SubmitEnrollment
Request Information
URI Parameters
None.
Body Parameters
EnrollmentRequest| Name | Description | Type | Additional information |
|---|---|---|---|
| ZipCode | string |
Required Max length: 10 |
|
| EnrollYear | integer |
None. |
|
| AppFilingEntity | string |
None. |
|
| EnrollmentQuestionnaire | Collection of Questionnaire |
None. |
|
| AuthorizedRepresentative | AuthorizedRepresentative |
None. |
|
| ApplicantInfo | ApplicantDetails |
None. |
|
| MedicareInfo | MemberMedicareDetails |
None. |
|
| PlanInfo | PlanDetails |
None. |
|
| PCPDetails | PCPInfo |
None. |
|
| EmergencyContactInfo | EmergencyContactDetails |
None. |
|
| StatementPreference | string |
None. |
|
| BillingInfo | string |
None. |
|
| ApplicationTC | string |
Required |
|
| EnrollAgent | EnrollAgent |
None. |
|
| CSNPPrequal | CSNPPrequal |
None. |
|
| CMSResponse | EligibilityResponse |
None. |
|
| Signature | Collection of DigitalSignature |
None. |
|
| UploadedFiles | Collection of FileRequest |
None. |
|
| CompanyCode | string |
None. |
|
| SalesType | string |
None. |
|
| ApplicationID | string |
None. |
|
| CommunicationPreference | CommunicationPreference |
None. |
|
| InfoMethod | string |
None. |
|
| ElectionPeriod | ElectionType |
None. |
Request Formats
text/json, application/json
Sample:
Request sample for request
--------------------------------------------------------------------------------------------------------------------------------
{
"ZipCode": "sample string 1",
"EnrollYear": 1,
"AppFilingEntity": "sample string 2",
"EnrollmentQuestionnaire": [
{
"QuestionType": "sample string 1",
"ID": 2,
"Response": "sample string 3",
"HasAdditionaInfo": "sample string 4",
"AdditionalInfo": [
{
"PropertyName": "sample string 1",
"PropertyValue": "sample string 2"
},
{
"PropertyName": "sample string 1",
"PropertyValue": "sample string 2"
}
]
},
{
"QuestionType": "sample string 1",
"ID": 2,
"Response": "sample string 3",
"HasAdditionaInfo": "sample string 4",
"AdditionalInfo": [
{
"PropertyName": "sample string 1",
"PropertyValue": "sample string 2"
},
{
"PropertyName": "sample string 1",
"PropertyValue": "sample string 2"
}
]
}
],
"AuthorizedRepresentative": {
"PersonalInfo": {
"DateOfBirth": "sample string 1",
"Sex": "sample string 2",
"ID": "sample string 3",
"GenderSelfIdentificationCode": "sample string 4",
"FirstName": "sample string 5",
"LastName": "sample string 6",
"MI": "sample string 7",
"Suffix": "sample string 8",
"Prefix": "sample string 9",
"Ethnicity": [
{
"Label": "sample string 1",
"Value": "sample string 2"
},
{
"Label": "sample string 1",
"Value": "sample string 2"
}
],
"Race": [
{
"Label": "sample string 1",
"Value": "sample string 2"
},
{
"Label": "sample string 1",
"Value": "sample string 2"
}
]
},
"Address": {
"State": "sample string 1",
"Zip4": "sample string 2",
"CountyName": "sample string 3",
"CountyCode": "sample string 4",
"Type": 0,
"AddressLine1": "sample string 5",
"AddressLine2": "sample string 6",
"City": "sample string 7",
"Zip": "sample string 8"
},
"ContactInfo": {
"ContactTye": 0,
"Value": "sample string 1",
"IsPrimary": true
},
"RelatedAs": 0
},
"ApplicantInfo": {
"PersonalInfo": {
"DateOfBirth": "sample string 1",
"Sex": "sample string 2",
"ID": "sample string 3",
"GenderSelfIdentificationCode": "sample string 4",
"FirstName": "sample string 5",
"LastName": "sample string 6",
"MI": "sample string 7",
"Suffix": "sample string 8",
"Prefix": "sample string 9",
"Ethnicity": [
{
"Label": "sample string 1",
"Value": "sample string 2"
},
{
"Label": "sample string 1",
"Value": "sample string 2"
}
],
"Race": [
{
"Label": "sample string 1",
"Value": "sample string 2"
},
{
"Label": "sample string 1",
"Value": "sample string 2"
}
]
},
"AddressInfo": [
{
"State": "sample string 1",
"Zip4": "sample string 2",
"CountyName": "sample string 3",
"CountyCode": "sample string 4",
"Type": 0,
"AddressLine1": "sample string 5",
"AddressLine2": "sample string 6",
"City": "sample string 7",
"Zip": "sample string 8"
},
{
"State": "sample string 1",
"Zip4": "sample string 2",
"CountyName": "sample string 3",
"CountyCode": "sample string 4",
"Type": 0,
"AddressLine1": "sample string 5",
"AddressLine2": "sample string 6",
"City": "sample string 7",
"Zip": "sample string 8"
}
],
"ContactInfo": [
{
"ContactTye": 0,
"Value": "sample string 1",
"IsPrimary": true
},
{
"ContactTye": 0,
"Value": "sample string 1",
"IsPrimary": true
}
],
"ContactPrefrence": 0,
"Language": "sample string 1"
},
"MedicareInfo": {
"HICNumber": "sample string 1",
"PartAEntitlementDate": "sample string 2",
"PartBEntitlementDate": "sample string 3",
"BenefitVerifiedBy": 1,
"SSAStartDate": "sample string 4"
},
"PlanInfo": {
"PlanInfo": {
"PBPCode": "sample string 1",
"HPCode": "sample string 2",
"Name": "sample string 3",
"PlanEffectiveDate": "sample string 4",
"IPACode": "sample string 5",
"IPAName": "sample string 6",
"PlanEndDate": "2026-06-03T09:19:53.5263158-07:00"
},
"MemberProspectiveEffDate": "sample string 1",
"SupplementalBuyUp": true
},
"PCPDetails": {
"Name": "sample string 1",
"Id": "sample string 2",
"Seq": "sample string 3",
"PcpTc": "sample string 4",
"LocationId": "sample string 5",
"IsExistingPatient": true,
"IPA": "sample string 6",
"Address1": "sample string 7",
"Address2": "sample string 8",
"City": "sample string 9",
"State": "sample string 10",
"Zip": "sample string 11",
"Phone": "sample string 12"
},
"EmergencyContactInfo": {
"ContactInfo": [
{
"ContactTye": 0,
"Value": "sample string 1",
"IsPrimary": true
},
{
"ContactTye": 0,
"Value": "sample string 1",
"IsPrimary": true
}
],
"RelatedAs": 0,
"DateOfBirth": "sample string 1",
"Sex": "sample string 2",
"ID": "sample string 3",
"GenderSelfIdentificationCode": "sample string 4",
"FirstName": "sample string 5",
"LastName": "sample string 6",
"MI": "sample string 7",
"Suffix": "sample string 8",
"Prefix": "sample string 9",
"Ethnicity": [
{
"Label": "sample string 1",
"Value": "sample string 2"
},
{
"Label": "sample string 1",
"Value": "sample string 2"
}
],
"Race": [
{
"Label": "sample string 1",
"Value": "sample string 2"
},
{
"Label": "sample string 1",
"Value": "sample string 2"
}
]
},
"StatementPreference": "sample string 3",
"BillingInfo": "sample string 4",
"ApplicationTC": "sample string 5",
"EnrollAgent": {
"AgencyId": "sample string 1",
"AgencyEmail": "sample string 2",
"agentInfo": {
"PhoneNumber": "sample string 1",
"IsAssistantRepid": "sample string 2",
"AssistantRepId": "sample string 3",
"DateOfBirth": "sample string 4",
"Sex": "sample string 5",
"ID": "sample string 6",
"GenderSelfIdentificationCode": "sample string 7",
"FirstName": "sample string 8",
"LastName": "sample string 9",
"MI": "sample string 10",
"Suffix": "sample string 11",
"Prefix": "sample string 12",
"Ethnicity": [
{
"Label": "sample string 1",
"Value": "sample string 2"
},
{
"Label": "sample string 1",
"Value": "sample string 2"
}
],
"Race": [
{
"Label": "sample string 1",
"Value": "sample string 2"
},
{
"Label": "sample string 1",
"Value": "sample string 2"
}
]
},
"recordingId": "sample string 3"
},
"CSNPPrequal": {
"CSNPQuestionnaire": [
{
"QuestionType": "sample string 1",
"ID": 2,
"Response": "sample string 3",
"HasAdditionaInfo": "sample string 4",
"AdditionalInfo": [
{
"PropertyName": "sample string 1",
"PropertyValue": "sample string 2"
},
{
"PropertyName": "sample string 1",
"PropertyValue": "sample string 2"
}
]
},
{
"QuestionType": "sample string 1",
"ID": 2,
"Response": "sample string 3",
"HasAdditionaInfo": "sample string 4",
"AdditionalInfo": [
{
"PropertyName": "sample string 1",
"PropertyValue": "sample string 2"
},
{
"PropertyName": "sample string 1",
"PropertyValue": "sample string 2"
}
]
}
],
"PhysicianName": "sample string 1",
"PhysicianPhone": "sample string 2",
"OtherPhysicianName": "sample string 3",
"OtherPhysicianPhone": "sample string 4",
"listOfMedications": "sample string 5",
"TCAcknowledgement": "sample string 6"
},
"CMSResponse": {
"TransactionDate": "sample string 1",
"mbdLoadEffDate": "sample string 2",
"RequestHicNbr": "sample string 3",
"RequestMedID": "sample string 4",
"RequestLastName": "sample string 5",
"RequestDOB": "sample string 6",
"FoundHICNNumber": "sample string 7",
"FoundMedID": "sample string 8",
"FoundNameOrDOB": "sample string 9",
"InquiryResponse": "sample string 10",
"HICNNumber": "sample string 11",
"MedID": "sample string 12",
"LastName": "sample string 13",
"FirstName": "sample string 14",
"MiddleInitial": "sample string 15",
"GenderCd": "sample string 16",
"RaceCd": "sample string 17",
"BirthDate": "sample string 18",
"PartAEntitlementDate": "sample string 19",
"PartAEntitleEndDate": "sample string 20",
"PartBEntitlementDate": "sample string 21",
"PartBEntitleEndDate": "sample string 22",
"StateCd": "sample string 23",
"CountyCd": "sample string 24",
"HospiceStatus": "sample string 25",
"HospiceStartDate": "sample string 26",
"HospiceEndDate": "sample string 27",
"InstitutionalizedStatus": "sample string 28",
"InstitutionalizedStartDate": "sample string 29",
"InstitutionalizedEndDate": "sample string 30",
"ESRDStatus": "sample string 31",
"ESRDStartDate": "sample string 32",
"ESRDEndDate": "sample string 33",
"MedicaidStatus": "sample string 34",
"MedicaidStartDate": "sample string 35",
"MedicaidEndDate": "sample string 36",
"LivingStatus": "sample string 37",
"DeathDate": "sample string 38",
"XrefHicnNumber": "sample string 39",
"EnrollmentInfo": [
{
"PlanIdField": "sample string 1",
"PBPField": "sample string 2",
"EGHPField": "sample string 3",
"PlanTypeCodeField": "sample string 4",
"PlanEnrollmentDateField": "sample string 5",
"DrugPlanIndField": "sample string 6",
"EnrollSourceCode": "sample string 7"
},
{
"PlanIdField": "sample string 1",
"PBPField": "sample string 2",
"EGHPField": "sample string 3",
"PlanTypeCodeField": "sample string 4",
"PlanEnrollmentDateField": "sample string 5",
"DrugPlanIndField": "sample string 6",
"EnrollSourceCode": "sample string 7"
}
],
"PotentialUncvrdMths": "sample string 40",
"PotentialUncvrdMthsEffDate": "sample string 41",
"PartDEligibleDate": "sample string 42",
"ListInfo": [
{
"SubsidyStartDateField": "sample string 1",
"SubsidyEndDateField": "sample string 2",
"CopayLevelField": "sample string 3",
"PartDPremSubPctField": "sample string 4"
},
{
"SubsidyStartDateField": "sample string 1",
"SubsidyEndDateField": "sample string 2",
"CopayLevelField": "sample string 3",
"PartDPremSubPctField": "sample string 4"
}
],
"PartDHistoryInfo": [
{
"PartDStartDateField": "sample string 1",
"PartDEndDateField": "sample string 2"
},
{
"PartDStartDateField": "sample string 1",
"PartDEndDateField": "sample string 2"
}
],
"NuncMoInfo": [
{
"UncovMthsStartDateField": "sample string 1",
"UncovMthsField": "sample string 2",
"UncmoIndField": "sample string 3",
"TotUncovMthsField": "sample string 4"
},
{
"UncovMthsStartDateField": "sample string 1",
"UncovMthsField": "sample string 2",
"UncmoIndField": "sample string 3",
"TotUncovMthsField": "sample string 4"
}
],
"RDSHistoryInfo": [
{
"RDSStartDateField": "sample string 1",
"RDSEndDateField": "sample string 2"
},
{
"RDSStartDateField": "sample string 1",
"RDSEndDateField": "sample string 2"
}
],
"MedicareInEligibilityInfo": [
{
"MedicareIneligibilityStartDateField": "sample string 1",
"MedicareIneligibilityEndDateField": "sample string 2"
},
{
"MedicareIneligibilityStartDateField": "sample string 1",
"MedicareIneligibilityEndDateField": "sample string 2"
}
],
"PriorEnrollmentInfo": [
{
"PriorPlanIdField": "sample string 1",
"PriorPBPField": "sample string 2",
"PriorEGHPField": "sample string 3",
"PriorPlanTypeCodeField": "sample string 4",
"PriorPlanEnrollmentDateField": "sample string 5",
"priorPlanEnrollmentEndDate": "sample string 6",
"PriorDrugPlanIndField": "sample string 7",
"PriorEnrollSourceCode": "sample string 8"
},
{
"PriorPlanIdField": "sample string 1",
"PriorPBPField": "sample string 2",
"PriorEGHPField": "sample string 3",
"PriorPlanTypeCodeField": "sample string 4",
"PriorPlanEnrollmentDateField": "sample string 5",
"priorPlanEnrollmentEndDate": "sample string 6",
"PriorDrugPlanIndField": "sample string 7",
"PriorEnrollSourceCode": "sample string 8"
}
]
},
"Signature": [
{
"FileType": 0,
"Extension": 0,
"ID": "sample string 1",
"Name": "sample string 2",
"Base64Content": "sample string 3"
},
{
"FileType": 0,
"Extension": 0,
"ID": "sample string 1",
"Name": "sample string 2",
"Base64Content": "sample string 3"
}
],
"UploadedFiles": [
{
"EffectiveDate": "sample string 1",
"ThruDate": "sample string 2",
"Overwrite": true,
"FileType": 0,
"Extension": 0,
"ID": "sample string 3",
"Name": "sample string 4",
"Base64Content": "sample string 5"
},
{
"EffectiveDate": "sample string 1",
"ThruDate": "sample string 2",
"Overwrite": true,
"FileType": 0,
"Extension": 0,
"ID": "sample string 3",
"Name": "sample string 4",
"Base64Content": "sample string 5"
}
],
"CompanyCode": "sample string 6",
"SalesType": "sample string 7",
"ApplicationID": "sample string 8",
"CommunicationPreference": {
"ReceiveByMailEOBPartC": true,
"ReceiveByMailEOBPartD": true,
"ReceiveByMailANOC": true
},
"InfoMethod": "sample string 9",
"ElectionPeriod": {
"AEP": true,
"IEP_ICEP": true,
"SEP": true,
"OEP": true
}
}
--------------------------------------------------------------------------------------------------------------------------------
text/xml, application/xml
Sample:
Request sample for request
--------------------------------------------------------------------------------------------------------------------------------
<EnrollmentRequest xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.DTOs" xmlns:i="http://www.w3.org/2001/XMLSchema-instance">
<AppFilingEntity>sample string 2</AppFilingEntity>
<ApplicantInfo>
<AddressInfo xmlns:a="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">
<a:AddressDTO>
<a:AddressLine1>sample string 5</a:AddressLine1>
<a:AddressLine2>sample string 6</a:AddressLine2>
<a:City>sample string 7</a:City>
<a:State>sample string 1</a:State>
<a:Zip>sample string 8</a:Zip>
<a:CountyCode>sample string 4</a:CountyCode>
<a:CountyName>sample string 3</a:CountyName>
<a:Type>None</a:Type>
<a:Zip4>sample string 2</a:Zip4>
</a:AddressDTO>
<a:AddressDTO>
<a:AddressLine1>sample string 5</a:AddressLine1>
<a:AddressLine2>sample string 6</a:AddressLine2>
<a:City>sample string 7</a:City>
<a:State>sample string 1</a:State>
<a:Zip>sample string 8</a:Zip>
<a:CountyCode>sample string 4</a:CountyCode>
<a:CountyName>sample string 3</a:CountyName>
<a:Type>None</a:Type>
<a:Zip4>sample string 2</a:Zip4>
</a:AddressDTO>
</AddressInfo>
<ContactInfo xmlns:a="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">
<a:ContactInfoDTO>
<a:ContactTye>None</a:ContactTye>
<a:IsPrimary>true</a:IsPrimary>
<a:Value>sample string 1</a:Value>
</a:ContactInfoDTO>
<a:ContactInfoDTO>
<a:ContactTye>None</a:ContactTye>
<a:IsPrimary>true</a:IsPrimary>
<a:Value>sample string 1</a:Value>
</a:ContactInfoDTO>
</ContactInfo>
<ContactPrefrence>None</ContactPrefrence>
<Language>sample string 1</Language>
<PersonalInfo xmlns:a="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">
<a:Ethnicity>
<EthnicityInfo>
<Label>sample string 1</Label>
<Value>sample string 2</Value>
</EthnicityInfo>
<EthnicityInfo>
<Label>sample string 1</Label>
<Value>sample string 2</Value>
</EthnicityInfo>
</a:Ethnicity>
<a:FirstName>sample string 5</a:FirstName>
<a:LastName>sample string 6</a:LastName>
<a:MI>sample string 7</a:MI>
<a:Prefix>sample string 9</a:Prefix>
<a:Race>
<RaceInfo>
<Label>sample string 1</Label>
<Value>sample string 2</Value>
</RaceInfo>
<RaceInfo>
<Label>sample string 1</Label>
<Value>sample string 2</Value>
</RaceInfo>
</a:Race>
<a:Suffix>sample string 8</a:Suffix>
<a:DateOfBirth>sample string 1</a:DateOfBirth>
<a:GenderSelfIdentificationCode>sample string 4</a:GenderSelfIdentificationCode>
<a:ID>sample string 3</a:ID>
<a:Sex>sample string 2</a:Sex>
</PersonalInfo>
</ApplicantInfo>
<ApplicationID>sample string 8</ApplicationID>
<ApplicationTC>sample string 5</ApplicationTC>
<AuthorizedRepresentative>
<Address xmlns:a="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">
<a:AddressLine1>sample string 5</a:AddressLine1>
<a:AddressLine2>sample string 6</a:AddressLine2>
<a:City>sample string 7</a:City>
<a:State>sample string 1</a:State>
<a:Zip>sample string 8</a:Zip>
<a:CountyCode>sample string 4</a:CountyCode>
<a:CountyName>sample string 3</a:CountyName>
<a:Type>None</a:Type>
<a:Zip4>sample string 2</a:Zip4>
</Address>
<ContactInfo xmlns:a="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">
<a:ContactTye>None</a:ContactTye>
<a:IsPrimary>true</a:IsPrimary>
<a:Value>sample string 1</a:Value>
</ContactInfo>
<PersonalInfo xmlns:a="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">
<a:Ethnicity>
<EthnicityInfo>
<Label>sample string 1</Label>
<Value>sample string 2</Value>
</EthnicityInfo>
<EthnicityInfo>
<Label>sample string 1</Label>
<Value>sample string 2</Value>
</EthnicityInfo>
</a:Ethnicity>
<a:FirstName>sample string 5</a:FirstName>
<a:LastName>sample string 6</a:LastName>
<a:MI>sample string 7</a:MI>
<a:Prefix>sample string 9</a:Prefix>
<a:Race>
<RaceInfo>
<Label>sample string 1</Label>
<Value>sample string 2</Value>
</RaceInfo>
<RaceInfo>
<Label>sample string 1</Label>
<Value>sample string 2</Value>
</RaceInfo>
</a:Race>
<a:Suffix>sample string 8</a:Suffix>
<a:DateOfBirth>sample string 1</a:DateOfBirth>
<a:GenderSelfIdentificationCode>sample string 4</a:GenderSelfIdentificationCode>
<a:ID>sample string 3</a:ID>
<a:Sex>sample string 2</a:Sex>
</PersonalInfo>
<RelatedAs>None</RelatedAs>
</AuthorizedRepresentative>
<BillingInfo>sample string 4</BillingInfo>
<CMSResponse>
<BirthDate>sample string 18</BirthDate>
<CountyCd>sample string 24</CountyCd>
<DeathDate>sample string 38</DeathDate>
<ESRDEndDate>sample string 33</ESRDEndDate>
<ESRDStartDate>sample string 32</ESRDStartDate>
<ESRDStatus>sample string 31</ESRDStatus>
<EnrollmentInfo>
<CMSEnrollmentData>
<DrugPlanIndField>sample string 6</DrugPlanIndField>
<EGHPField>sample string 3</EGHPField>
<EnrollSourceCode>sample string 7</EnrollSourceCode>
<PBPField>sample string 2</PBPField>
<PlanEnrollmentDateField>sample string 5</PlanEnrollmentDateField>
<PlanIdField>sample string 1</PlanIdField>
<PlanTypeCodeField>sample string 4</PlanTypeCodeField>
</CMSEnrollmentData>
<CMSEnrollmentData>
<DrugPlanIndField>sample string 6</DrugPlanIndField>
<EGHPField>sample string 3</EGHPField>
<EnrollSourceCode>sample string 7</EnrollSourceCode>
<PBPField>sample string 2</PBPField>
<PlanEnrollmentDateField>sample string 5</PlanEnrollmentDateField>
<PlanIdField>sample string 1</PlanIdField>
<PlanTypeCodeField>sample string 4</PlanTypeCodeField>
</CMSEnrollmentData>
</EnrollmentInfo>
<FirstName>sample string 14</FirstName>
<FoundHICNNumber>sample string 7</FoundHICNNumber>
<FoundMedID>sample string 8</FoundMedID>
<FoundNameOrDOB>sample string 9</FoundNameOrDOB>
<GenderCd>sample string 16</GenderCd>
<HICNNumber>sample string 11</HICNNumber>
<HospiceEndDate>sample string 27</HospiceEndDate>
<HospiceStartDate>sample string 26</HospiceStartDate>
<HospiceStatus>sample string 25</HospiceStatus>
<InquiryResponse>sample string 10</InquiryResponse>
<InstitutionalizedEndDate>sample string 30</InstitutionalizedEndDate>
<InstitutionalizedStartDate>sample string 29</InstitutionalizedStartDate>
<InstitutionalizedStatus>sample string 28</InstitutionalizedStatus>
<LastName>sample string 13</LastName>
<ListInfo>
<CMSLisData>
<CopayLevelField>sample string 3</CopayLevelField>
<PartDPremSubPctField>sample string 4</PartDPremSubPctField>
<SubsidyEndDateField>sample string 2</SubsidyEndDateField>
<SubsidyStartDateField>sample string 1</SubsidyStartDateField>
</CMSLisData>
<CMSLisData>
<CopayLevelField>sample string 3</CopayLevelField>
<PartDPremSubPctField>sample string 4</PartDPremSubPctField>
<SubsidyEndDateField>sample string 2</SubsidyEndDateField>
<SubsidyStartDateField>sample string 1</SubsidyStartDateField>
</CMSLisData>
</ListInfo>
<LivingStatus>sample string 37</LivingStatus>
<MedID>sample string 12</MedID>
<MedicaidEndDate>sample string 36</MedicaidEndDate>
<MedicaidStartDate>sample string 35</MedicaidStartDate>
<MedicaidStatus>sample string 34</MedicaidStatus>
<MedicareInEligibilityInfo>
<CMSMedicareInEligibilityData>
<MedicareIneligibilityEndDateField>sample string 2</MedicareIneligibilityEndDateField>
<MedicareIneligibilityStartDateField>sample string 1</MedicareIneligibilityStartDateField>
</CMSMedicareInEligibilityData>
<CMSMedicareInEligibilityData>
<MedicareIneligibilityEndDateField>sample string 2</MedicareIneligibilityEndDateField>
<MedicareIneligibilityStartDateField>sample string 1</MedicareIneligibilityStartDateField>
</CMSMedicareInEligibilityData>
</MedicareInEligibilityInfo>
<MiddleInitial>sample string 15</MiddleInitial>
<NuncMoInfo>
<CMSNuncMoData>
<TotUncovMthsField>sample string 4</TotUncovMthsField>
<UncmoIndField>sample string 3</UncmoIndField>
<UncovMthsField>sample string 2</UncovMthsField>
<UncovMthsStartDateField>sample string 1</UncovMthsStartDateField>
</CMSNuncMoData>
<CMSNuncMoData>
<TotUncovMthsField>sample string 4</TotUncovMthsField>
<UncmoIndField>sample string 3</UncmoIndField>
<UncovMthsField>sample string 2</UncovMthsField>
<UncovMthsStartDateField>sample string 1</UncovMthsStartDateField>
</CMSNuncMoData>
</NuncMoInfo>
<PartAEntitleEndDate>sample string 20</PartAEntitleEndDate>
<PartAEntitlementDate>sample string 19</PartAEntitlementDate>
<PartBEntitleEndDate>sample string 22</PartBEntitleEndDate>
<PartBEntitlementDate>sample string 21</PartBEntitlementDate>
<PartDEligibleDate>sample string 42</PartDEligibleDate>
<PartDHistoryInfo>
<CMSPartDHistory>
<PartDEndDateField>sample string 2</PartDEndDateField>
<PartDStartDateField>sample string 1</PartDStartDateField>
</CMSPartDHistory>
<CMSPartDHistory>
<PartDEndDateField>sample string 2</PartDEndDateField>
<PartDStartDateField>sample string 1</PartDStartDateField>
</CMSPartDHistory>
</PartDHistoryInfo>
<PotentialUncvrdMths>sample string 40</PotentialUncvrdMths>
<PotentialUncvrdMthsEffDate>sample string 41</PotentialUncvrdMthsEffDate>
<PriorEnrollmentInfo>
<CMSPriorEnrollmentData>
<PriorDrugPlanIndField>sample string 7</PriorDrugPlanIndField>
<PriorEGHPField>sample string 3</PriorEGHPField>
<PriorEnrollSourceCode>sample string 8</PriorEnrollSourceCode>
<PriorPBPField>sample string 2</PriorPBPField>
<PriorPlanEnrollmentDateField>sample string 5</PriorPlanEnrollmentDateField>
<PriorPlanIdField>sample string 1</PriorPlanIdField>
<PriorPlanTypeCodeField>sample string 4</PriorPlanTypeCodeField>
<priorPlanEnrollmentEndDate>sample string 6</priorPlanEnrollmentEndDate>
</CMSPriorEnrollmentData>
<CMSPriorEnrollmentData>
<PriorDrugPlanIndField>sample string 7</PriorDrugPlanIndField>
<PriorEGHPField>sample string 3</PriorEGHPField>
<PriorEnrollSourceCode>sample string 8</PriorEnrollSourceCode>
<PriorPBPField>sample string 2</PriorPBPField>
<PriorPlanEnrollmentDateField>sample string 5</PriorPlanEnrollmentDateField>
<PriorPlanIdField>sample string 1</PriorPlanIdField>
<PriorPlanTypeCodeField>sample string 4</PriorPlanTypeCodeField>
<priorPlanEnrollmentEndDate>sample string 6</priorPlanEnrollmentEndDate>
</CMSPriorEnrollmentData>
</PriorEnrollmentInfo>
<RDSHistoryInfo>
<CMSRDSHistoryData>
<RDSEndDateField>sample string 2</RDSEndDateField>
<RDSStartDateField>sample string 1</RDSStartDateField>
</CMSRDSHistoryData>
<CMSRDSHistoryData>
<RDSEndDateField>sample string 2</RDSEndDateField>
<RDSStartDateField>sample string 1</RDSStartDateField>
</CMSRDSHistoryData>
</RDSHistoryInfo>
<RaceCd>sample string 17</RaceCd>
<RequestDOB>sample string 6</RequestDOB>
<RequestHicNbr>sample string 3</RequestHicNbr>
<RequestLastName>sample string 5</RequestLastName>
<RequestMedID>sample string 4</RequestMedID>
<StateCd>sample string 23</StateCd>
<TransactionDate>sample string 1</TransactionDate>
<XrefHicnNumber>sample string 39</XrefHicnNumber>
<mbdLoadEffDate>sample string 2</mbdLoadEffDate>
</CMSResponse>
<CSNPPrequal>
<CSNPQuestionnaire>
<Questionnaire>
<AdditionalInfo>
<QuestionnaireAdditionalInfo>
<PropertyName>sample string 1</PropertyName>
<PropertyValue>sample string 2</PropertyValue>
</QuestionnaireAdditionalInfo>
<QuestionnaireAdditionalInfo>
<PropertyName>sample string 1</PropertyName>
<PropertyValue>sample string 2</PropertyValue>
</QuestionnaireAdditionalInfo>
</AdditionalInfo>
<HasAdditionaInfo>sample string 4</HasAdditionaInfo>
<ID>2</ID>
<QuestionType>sample string 1</QuestionType>
<Response>sample string 3</Response>
</Questionnaire>
<Questionnaire>
<AdditionalInfo>
<QuestionnaireAdditionalInfo>
<PropertyName>sample string 1</PropertyName>
<PropertyValue>sample string 2</PropertyValue>
</QuestionnaireAdditionalInfo>
<QuestionnaireAdditionalInfo>
<PropertyName>sample string 1</PropertyName>
<PropertyValue>sample string 2</PropertyValue>
</QuestionnaireAdditionalInfo>
</AdditionalInfo>
<HasAdditionaInfo>sample string 4</HasAdditionaInfo>
<ID>2</ID>
<QuestionType>sample string 1</QuestionType>
<Response>sample string 3</Response>
</Questionnaire>
</CSNPQuestionnaire>
<OtherPhysicianName>sample string 3</OtherPhysicianName>
<OtherPhysicianPhone>sample string 4</OtherPhysicianPhone>
<PhysicianName>sample string 1</PhysicianName>
<PhysicianPhone>sample string 2</PhysicianPhone>
<TCAcknowledgement>sample string 6</TCAcknowledgement>
<listOfMedications>sample string 5</listOfMedications>
</CSNPPrequal>
<CommunicationPreference xmlns:a="http://schemas.datacontract.org/2004/07/AHC.BusinessEntities.ArgumentsEntities.Enrollment">
<a:ReceiveByMailANOC>true</a:ReceiveByMailANOC>
<a:ReceiveByMailEOBPartC>true</a:ReceiveByMailEOBPartC>
<a:ReceiveByMailEOBPartD>true</a:ReceiveByMailEOBPartD>
</CommunicationPreference>
<CompanyCode>sample string 6</CompanyCode>
<ElectionPeriod>
<AEP>true</AEP>
<IEP_ICEP>true</IEP_ICEP>
<OEP>true</OEP>
<SEP>true</SEP>
</ElectionPeriod>
<EmergencyContactInfo>
<Ethnicity xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs" xmlns:a="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.DTOs">
<a:EthnicityInfo>
<a:Label>sample string 1</a:Label>
<a:Value>sample string 2</a:Value>
</a:EthnicityInfo>
<a:EthnicityInfo>
<a:Label>sample string 1</a:Label>
<a:Value>sample string 2</a:Value>
</a:EthnicityInfo>
</Ethnicity>
<FirstName xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 5</FirstName>
<LastName xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 6</LastName>
<MI xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 7</MI>
<Prefix xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 9</Prefix>
<Race xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs" xmlns:a="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.DTOs">
<a:RaceInfo>
<a:Label>sample string 1</a:Label>
<a:Value>sample string 2</a:Value>
</a:RaceInfo>
<a:RaceInfo>
<a:Label>sample string 1</a:Label>
<a:Value>sample string 2</a:Value>
</a:RaceInfo>
</Race>
<Suffix xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 8</Suffix>
<DateOfBirth xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 1</DateOfBirth>
<GenderSelfIdentificationCode xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 4</GenderSelfIdentificationCode>
<ID xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 3</ID>
<Sex xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 2</Sex>
<ContactInfo xmlns:a="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">
<a:ContactInfoDTO>
<a:ContactTye>None</a:ContactTye>
<a:IsPrimary>true</a:IsPrimary>
<a:Value>sample string 1</a:Value>
</a:ContactInfoDTO>
<a:ContactInfoDTO>
<a:ContactTye>None</a:ContactTye>
<a:IsPrimary>true</a:IsPrimary>
<a:Value>sample string 1</a:Value>
</a:ContactInfoDTO>
</ContactInfo>
<RelatedAs>None</RelatedAs>
</EmergencyContactInfo>
<EnrollAgent>
<AgencyEmail>sample string 2</AgencyEmail>
<AgencyId>sample string 1</AgencyId>
<agentInfo>
<Ethnicity xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs" xmlns:a="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.DTOs">
<a:EthnicityInfo>
<a:Label>sample string 1</a:Label>
<a:Value>sample string 2</a:Value>
</a:EthnicityInfo>
<a:EthnicityInfo>
<a:Label>sample string 1</a:Label>
<a:Value>sample string 2</a:Value>
</a:EthnicityInfo>
</Ethnicity>
<FirstName xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 8</FirstName>
<LastName xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 9</LastName>
<MI xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 10</MI>
<Prefix xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 12</Prefix>
<Race xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs" xmlns:a="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.DTOs">
<a:RaceInfo>
<a:Label>sample string 1</a:Label>
<a:Value>sample string 2</a:Value>
</a:RaceInfo>
<a:RaceInfo>
<a:Label>sample string 1</a:Label>
<a:Value>sample string 2</a:Value>
</a:RaceInfo>
</Race>
<Suffix xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 11</Suffix>
<DateOfBirth xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 4</DateOfBirth>
<GenderSelfIdentificationCode xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 7</GenderSelfIdentificationCode>
<ID xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 6</ID>
<Sex xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 5</Sex>
<AssistantRepId>sample string 3</AssistantRepId>
<IsAssistantRepid>sample string 2</IsAssistantRepid>
<PhoneNumber>sample string 1</PhoneNumber>
</agentInfo>
<recordingId>sample string 3</recordingId>
</EnrollAgent>
<EnrollYear>1</EnrollYear>
<EnrollmentQuestionnaire>
<Questionnaire>
<AdditionalInfo>
<QuestionnaireAdditionalInfo>
<PropertyName>sample string 1</PropertyName>
<PropertyValue>sample string 2</PropertyValue>
</QuestionnaireAdditionalInfo>
<QuestionnaireAdditionalInfo>
<PropertyName>sample string 1</PropertyName>
<PropertyValue>sample string 2</PropertyValue>
</QuestionnaireAdditionalInfo>
</AdditionalInfo>
<HasAdditionaInfo>sample string 4</HasAdditionaInfo>
<ID>2</ID>
<QuestionType>sample string 1</QuestionType>
<Response>sample string 3</Response>
</Questionnaire>
<Questionnaire>
<AdditionalInfo>
<QuestionnaireAdditionalInfo>
<PropertyName>sample string 1</PropertyName>
<PropertyValue>sample string 2</PropertyValue>
</QuestionnaireAdditionalInfo>
<QuestionnaireAdditionalInfo>
<PropertyName>sample string 1</PropertyName>
<PropertyValue>sample string 2</PropertyValue>
</QuestionnaireAdditionalInfo>
</AdditionalInfo>
<HasAdditionaInfo>sample string 4</HasAdditionaInfo>
<ID>2</ID>
<QuestionType>sample string 1</QuestionType>
<Response>sample string 3</Response>
</Questionnaire>
</EnrollmentQuestionnaire>
<InfoMethod>sample string 9</InfoMethod>
<MedicareInfo>
<BenefitVerifiedBy>MC</BenefitVerifiedBy>
<HICNumber>sample string 1</HICNumber>
<PartAEntitlementDate>sample string 2</PartAEntitlementDate>
<PartBEntitlementDate>sample string 3</PartBEntitlementDate>
<SSAStartDate>sample string 4</SSAStartDate>
</MedicareInfo>
<PCPDetails>
<Address1>sample string 7</Address1>
<Address2>sample string 8</Address2>
<City>sample string 9</City>
<IPA>sample string 6</IPA>
<Id>sample string 2</Id>
<IsExistingPatient>true</IsExistingPatient>
<LocationId>sample string 5</LocationId>
<Name>sample string 1</Name>
<PcpTc>sample string 4</PcpTc>
<Phone>sample string 12</Phone>
<Seq>sample string 3</Seq>
<State>sample string 10</State>
<Zip>sample string 11</Zip>
</PCPDetails>
<PlanInfo>
<MemberProspectiveEffDate>sample string 1</MemberProspectiveEffDate>
<PlanInfo>
<HPCode>sample string 2</HPCode>
<IPACode>sample string 5</IPACode>
<IPAName>sample string 6</IPAName>
<Name>sample string 3</Name>
<PBPCode>sample string 1</PBPCode>
<PlanEffectiveDate>sample string 4</PlanEffectiveDate>
<PlanEndDate>2026-06-03T09:19:53.541938-07:00</PlanEndDate>
</PlanInfo>
<SupplementalBuyUp>true</SupplementalBuyUp>
</PlanInfo>
<SalesType>sample string 7</SalesType>
<Signature>
<DigitalSignature>
<Base64Content xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 3</Base64Content>
<ID xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 1</ID>
<Name xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 2</Name>
<Extension xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">PDF</Extension>
<FileType xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">POA</FileType>
</DigitalSignature>
<DigitalSignature>
<Base64Content xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 3</Base64Content>
<ID xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 1</ID>
<Name xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 2</Name>
<Extension xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">PDF</Extension>
<FileType xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">POA</FileType>
</DigitalSignature>
</Signature>
<StatementPreference>sample string 3</StatementPreference>
<UploadedFiles>
<FileRequest>
<Base64Content xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 5</Base64Content>
<ID xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 3</ID>
<Name xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 4</Name>
<Extension xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">PDF</Extension>
<FileType xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">POA</FileType>
<EffectiveDate>sample string 1</EffectiveDate>
<Overwrite>true</Overwrite>
<ThruDate>sample string 2</ThruDate>
</FileRequest>
<FileRequest>
<Base64Content xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 5</Base64Content>
<ID xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 3</ID>
<Name xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">sample string 4</Name>
<Extension xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">PDF</Extension>
<FileType xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.CommonDTOs">POA</FileType>
<EffectiveDate>sample string 1</EffectiveDate>
<Overwrite>true</Overwrite>
<ThruDate>sample string 2</ThruDate>
</FileRequest>
</UploadedFiles>
<ZipCode>sample string 1</ZipCode>
</EnrollmentRequest>
--------------------------------------------------------------------------------------------------------------------------------
application/x-www-form-urlencoded
Sample:
Response Information
Resource Description
IHttpActionResultNone.
Response Formats
text/json, application/json
Sample:
--------------------------------------------------------------------------------------------------------------------------------
[
{
"ReferenceNumber": "sample string 1"
},
{
"ReferenceNumber": "sample string 1"
}
]
--------------------------------------------------------------------------------------------------------------------------------
text/xml, application/xml
Sample:
--------------------------------------------------------------------------------------------------------------------------------
<ArrayOfEnrollmentResponse xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.DTOs" xmlns:i="http://www.w3.org/2001/XMLSchema-instance">
<EnrollmentResponse>
<ReferenceNumber>sample string 1</ReferenceNumber>
</EnrollmentResponse>
<EnrollmentResponse>
<ReferenceNumber>sample string 1</ReferenceNumber>
</EnrollmentResponse>
</ArrayOfEnrollmentResponse>
--------------------------------------------------------------------------------------------------------------------------------