When you upload a census for community-rated quoting, Plansight standardizes it before pulling rates. It recognizes whatever column names your file uses, cleans and converts the data into a consistent format, and checks it against the rules carriers expect. This article walks through how to upload your census correctly and what Plansight does to your file along the way, so you get accurate rates.

How Plansight reads your file

Drop in a CSV or Excel file. It doesn't matter that one carrier calls a column “DOB,” another “Birthdate,” and a third “Birth_Date.” Plansight recognizes hundreds of common header names and matches them to the fields it needs. You confirm the matches on screen before continuing, so you can correct anything that was mapped to the wrong field.

What Plansight cleans and converts

As each row comes in, Plansight standardizes it so everything is consistent:

• Relationships are simplified. “Insured,” “Subscriber,” and “Self” become Employee. “Domestic partner,” “Husband,” and “Wife” become Spouse. “Son,” “Daughter,” and “Step child” become Child.
• Gender is set to M or F.
• Dates are reformatted to one standard, and a two-digit year like “55” is read as 1955, not 2055.
• Zip codes are trimmed to five digits, and a blank dependent zip is filled in from the employee.
• Coverage tier (employee only, employee plus spouse, family, and so on) is determined from the family members listed under each employee.
• Missing answers get sensible defaults. For example, “same household” defaults to Yes.

What does checkPlansight check before the file goes out?

Plansight validates the file, so bad data doesn't reach the rating API. A birthdate in the future is rejected because it breaks the rating. Each family group has to make sense — one employee, at most one spouse, and dependents. Anything that fails is flagged on screen so you can fix it before you continue.

Dependents over 26, wards, and waivers

Dependents over age 26

Health plans generally don't cover adult children past 26, so Plansight removes any child who is 26 or older as of the effective date before sending the file for rating. You don't have to scrub them out yourself, and Plansight records who was removed and why, so nothing happens silently. A Spouse and a Ward are never removed for being over 26 — they stay on the census at any age. Because the removal is based on age alone, a disabled adult child who is still eligible is one case you'll want to handle manually.

Wards

A Ward is treated as a full member and kept on the census as its own relationship rather than relabeled as a regular child. For coverage-tier and group counts, a ward is grouped with the children. “Court Appointed Guardian” and “Foster Child” are also recognized, but only a true Ward (and a Spouse) is protected from the over-26 removal. For an over-26 guardianship situation, use the Ward label.

Waivers

A community-rated census has no waiver field, so there's no place to mark someone as waiving. The cleanest approach is to leave waiving employees off the census, so it reflects who is currently enrolled. Don't try to flag a waiver in the file — there's no “waive” column, the plan-option column only accepts a plan number, and anyone you list is treated as enrolled and rated.

Whether you include or exclude waivers doesn't really change the value of the quote. Community-rated rates are based on each person's age, so an employee who is waiving today but picks up coverage later would be rated the same way. If you want to see what those employees would cost once they enroll, you can include them, and Plansight will rate them; if you'd rather show only the current enrolled group, leave them off. Either way, the rates you see are accurate.

After the file is clean

Once your census passes these checks, Plansight formats it and sends it to Ideon (formerly Vericred) to return your community-rated rates. Plansight records every change it makes along the way, so you can always see what happened to your file before it went out.

One thing to remember is that this census is used only for generating community-rated plans and rates, comma. It is not sent as an attachment or shared with carriers in a marketing event. Therefore, removing waivers is really just to only illustrate rates for participants or potential participants.