{ "$schema": "http://json-schema.org/draft-07/schema#", "$id": "https://api-evangelist.github.io/triple-s-management/json-schema/triple-s-management-member-schema.json", "title": "Triple-S Management Health Plan Member", "description": "Schema for a Triple-S health plan member including coverage and eligibility information", "type": "object", "required": ["memberId", "name", "planType"], "properties": { "memberId": { "type": "string", "description": "Unique member identifier" }, "name": { "type": "object", "description": "Member name", "properties": { "first": { "type": "string" }, "last": { "type": "string" }, "middle": { "type": "string" } } }, "dateOfBirth": { "type": "string", "format": "date", "description": "Member date of birth" }, "planType": { "type": "string", "description": "Type of health plan", "enum": ["Commercial", "Medicare Advantage", "Government", "Life", "Property and Casualty"] }, "planId": { "type": "string", "description": "Health plan identifier" }, "groupNumber": { "type": "string", "description": "Employer group number" }, "effectiveDate": { "type": "string", "format": "date", "description": "Coverage effective date" }, "terminationDate": { "type": "string", "format": "date", "description": "Coverage termination date" }, "eligibilityStatus": { "type": "string", "description": "Current eligibility status", "enum": ["Active", "Inactive", "Terminated", "Pending"] }, "primaryCareProvider": { "type": "object", "description": "Assigned primary care provider", "properties": { "npi": { "type": "string", "description": "Provider NPI number" }, "name": { "type": "string", "description": "Provider name" }, "phone": { "type": "string", "description": "Provider phone number" } } }, "network": { "type": "string", "description": "Provider network (BlueCross BlueShield, Puerto Rico, USVI)" } } }