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Member List API v2 Overview

1. Purpose​

This service helps authorized business partners access up-to-date information about individuals enrolled in a health plan. It simplifies the process of gathering member data—such as subscriber names, dependent details, enrollment status, and plan types—by securely packaging and delivering it from internal systems. Rather than navigating multiple platforms, partners receive a consolidated file that reflects current membership records.

2. Who can use this service​

  • Authorized Business Partners: This includes benefit administrators, brokers, aggregators, and other organizations that have formal agreements with the health plan provider.
  • Implementation Teams: Developers and technical staff working on behalf of these partners to integrate member data into their systems.

If your organization is working with UnitedHealthcare to exchange enrollment or census data, this service is designed for you.

3. What information is available​

The service provides a high-level summary of member-related data, including:

  • Census and Enrollment Details: Information about who is covered, including subscribers and dependents, along with enrollment status and relevant dates.
  • Plan and Coverage Types: General descriptions of benefits such as medical, dental, vision, and basic life insurance.
  • Group and Policy Attributes: Summary identifiers like plan type, sponsor name, and demographic markers—without exposing internal codes or technical formats.

Note: Supplemental benefits (e.g., disability coverage or riders) are typically not included.

4. Benefits of this service​

  • Automation: Reduces manual data entry by providing a ready-to-use member list for HR or benefits systems.
  • Data Accuracy: Helps partners reconcile their records with the health plan’s data, minimizing errors and mismatches.
  • Efficiency: Speeds up integration and reduces the need for custom development or manual data gathering.

5. Example uses​

  • New Group Onboarding: Quickly populate systems with member data when a new employer group joins.
  • Regular Reconciliation: Compare internal records with health plan data to identify and resolve discrepancies.
  • Eligibility and Reporting: Use member data to support analytics, eligibility checks, and reporting for HR or broker teams.

6. Important notes​

  • This service is available only to approved partners and is not open to the general public.
  • Partners must handle all data responsibly and in compliance with privacy regulations.
  • Service details may evolve; partners should stay informed through official UnitedHealthcare communications.
  • Occasional system updates or interruptions may affect data availability—partners should design systems to manage such scenarios.
  • For technical implementation details, approved partners should refer to internal documentation or contact their UnitedHealthcare representative.