Section title: Requests for Interpretation
Age limit with INS02 = 23 in 834

For 834 transaction, element 2000/INS02, code value 23 has a note:  "Dependents between the ages of 19 and 25 not attending school; age qualifications may vary depending on policy."

Does it mean that it may be used only when member defined in this loop 2000 is between ages of 19 and 25 and its use for any other age is not compliant with the TR3?


Files are sent to issuers with code 23 where member age in not necessarily within 19-25 range.

RFI Response

No, when using the INS02 code value ‘23’ in Loop 2000 of the 005010 X220A1 the code note does not restrict the valid ages to be only between 19 and 25.  The code note also states that the qualifications can depend on policy.  A policy can allow for a dependent to be covered regardless of age.  It is valid to use code ’23’ on INS02 regardless of the age of the dependent.

RFI Recommendation

Related RFIs: 1316