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member waiting period

mbr_wait_prd
member·Updated Jun 23, 2026

Definition

ISO-11179 Definition

The employer-imposed delay between an employee hire date or benefits eligibility date and the date employer-sponsored health insurance coverage becomes effective. The ACA limits waiting periods to a maximum of 90 days for most employer-sponsored plans. During the waiting period an employee is not covered under the employer group health plan and must seek coverage through a spouse plan, COBRA, or ACA marketplace plan.

Waiting period data is used in eligibility verification to explain coverage gaps, in coordination of benefits to determine whether an employee had other coverage available during the waiting period, and in HIPAA portability calculations for pre-existing condition exclusion periods. Healthcare data teams track mbr_wait_prd start and end dates in enrollment tables to support eligibility dispute resolution and compliance with ACA waiting period limitations.

Standard Abbreviation

mbr_wait_prd

Category

member

Production DDL — DIM_MEMBER

DIM_MEMBER.sql
CREATE OR REPLACE TABLE DIM_MEMBER (
    mbr_key           INTEGER        NOT NULL  -- surrogate key,
    mbr_id            VARCHAR(50)    NOT NULL  -- member identifier,
    mbr_first_nm      VARCHAR(100)             -- first name,
    mbr_last_nm       VARCHAR(100)             -- last name,
    mbr_birth_dt      DATE                     -- date of birth,
    mbr_gndr_cd       CHAR(1)                  -- gender code M/F/U,
    mbr_age           SMALLINT                 -- age in years,
    mbr_state_cd      CHAR(2)                  -- state code,
    mbr_zip_cd        VARCHAR(10)              -- zip code,
    mbr_elig_ind      BOOLEAN                  -- eligibility indicator,
    mbr_enrl_dt       DATE                     -- enrollment date,
    mbr_term_dt       DATE                     -- termination date,
    mbr_plan_cd       VARCHAR(20)              -- plan code,
    mbr_dual_elig_cd  VARCHAR(10)              -- dual eligibility code,
    load_dt           TIMESTAMP_NTZ  NOT NULL  -- load timestamp
);

Standard Snowflake DDL for the canonical member table. Convert to BigQuery or Databricks →

Why This Term Matters

Member and enrollment data governs who receives care and who pays for it — making it foundational to every downstream healthcare analytics workflow. Data engineers who understand member terminology build eligibility pipelines that prevent coverage gaps, correctly identify dual-eligible members, and support accurate risk adjustment submissions to CMS. Enrollment errors directly affect capitation payments and can trigger CMS corrective action plans.

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