availity · JSON Structure

Eligibility Benefit Structure

Benefit schema from Availity API

Type: object Properties: 7

Benefit is a JSON Structure definition published by availity, describing 7 properties. It conforms to the https://json-structure.org/meta/core/v0/# meta-schema.

Properties

code name coverageLevel benefitAmount benefitPercent inPlanNetworkIndicator timeQualifier

Meta-schema: https://json-structure.org/meta/core/v0/#

JSON Structure

Raw ↑ 
{
  "$schema": "https://json-structure.org/meta/core/v0/#",
  "$id": "https://raw.githubusercontent.com/api-evangelist/availity/refs/heads/main/json-structure/eligibility-benefit-structure.json",
  "description": "Benefit schema from Availity API",
  "type": "object",
  "properties": {
    "code": {
      "type": "string",
      "description": "X12 benefit information code"
    },
    "name": {
      "type": "string"
    },
    "coverageLevel": {
      "type": "string",
      "enum": [
        "INDIVIDUAL",
        "FAMILY",
        "EMPLOYEE",
        "EMPLOYEE_AND_SPOUSE"
      ]
    },
    "benefitAmount": {
      "type": "object",
      "properties": {
        "value": {
          "type": "double"
        },
        "currency": {
          "type": "string"
        }
      }
    },
    "benefitPercent": {
      "type": "double",
      "minimum": 0,
      "maximum": 100
    },
    "inPlanNetworkIndicator": {
      "type": "string",
      "enum": [
        "Y",
        "N",
        "W"
      ]
    },
    "timeQualifier": {
      "type": "string",
      "description": "Benefit period (e.g., Calendar Year, Plan Year, Lifetime)"
    }
  },
  "name": "Benefit"
}