Change in Benefits Notice

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It is a formal communication typically issued by an employer, insurance company, or government agency to inform an individual or group about changes to a benefits plan or program. This notice can apply to various types of benefits, including health insurance, retirement plans, welfare benefits, or any other employee or government assistance programs.

To use the Upload PDF endpoint endpoint for this document, you must use CHANGE_IN_BENEFITS_NOTICE in the form_type parameter.

Field descriptions

The following fields are available on this document type:

JSON Attribute	Data Type	Description
`change_in_benefits_notice-Part1-General:reference#`	Text	Reference #
`change_in_benefits_notice-Part1-General:issueDate`	Date	Issue Date
`change_in_benefits_notice-Part1-General:typeOfBenefit`	`DISABILITY`, `RETIREMENT`, `OTHER`	Type Of Benefit
`change_in_benefits_notice-Part1-General:typeOfBenefit-IfOther`	Text	Type Of Benefit - If Other
`change_in_benefits_notice-Part1-General:benefitExpirationDate`	Date	Benefit Expiration Date
`change_in_benefits_notice-Part1-General:issuingCompanyName`	Text	Issuing Company Name
`change_in_benefits_notice-Part1-General:socialSecurityNumber`	Social Security Number	Social Security Number
`change_in_benefits_notice-Part1-General:beneficiaryName`	Text	Beneficiary Name
`change_in_benefits_notice-Part1-General:beneficiaryAddress:addressLine1`	Text	Beneficiary Address
`change_in_benefits_notice-Part1-General:beneficiaryAddress:addressLine2`	Text	Beneficiary Address
`change_in_benefits_notice-Part1-General:beneficiaryAddress:city`	Text	Beneficiary Address
`change_in_benefits_notice-Part1-General:beneficiaryAddress:state`	State	Beneficiary Address
`change_in_benefits_notice-Part1-General:beneficiaryAddress:zipCode`	ZIP Code	Beneficiary Address
`change_in_benefits_notice-Part1-General:currentMonthlyBenefitAmount(Gross)`	Money	Current Monthly Benefit Amount (Gross)

Sample document

drive.google.com

CHANGE_IN_BENEFITS_NOTICE.pdf

Sample JSON result

{
  "pk": 47309449,
  "uuid": "dd8dcca2-eee3-46b7-a889-9ec9134321c3",
  "name": "CHANGE_IN_BENEFITS_NOTICE (API)",
  "created": "2024-03-08T20:54:50Z",
  "created_ts": "2024-03-08T20:54:50Z",
  "verified_pages_count": 2,
  "book_status": "ACTIVE",
  "id": 47309449,
  "forms": [
    {
      "pk": 53577242,
      "uuid": "ec5b99b5-3ec6-4ca6-ad13-37c43a1af6fc",
      "uploaded_doc_pk": 68028220,
      "form_type": "CHANGE_IN_BENEFITS_NOTICE",
      "raw_fields": {
        "change_in_benefits_notice-Part1-General:issueDate": {
          "value": "01/25/2022",
          "is_empty": false,
          "alias_used": null,
          "source_filename": "CHANGE_IN_BENEFITS_NOTICE.pdf",
          "confidence": 1.0
        },
        "change_in_benefits_notice-Part1-General:reference#": {
          "value": "12345679",
          "is_empty": false,
          "alias_used": null,
          "source_filename": "CHANGE_IN_BENEFITS_NOTICE.pdf",
          "confidence": 1.0
        },
        "change_in_benefits_notice-Part1-General:typeOfBenefit": {
          "value": "RETIREMENT",
          "is_empty": false,
          "alias_used": null,
          "source_filename": "CHANGE_IN_BENEFITS_NOTICE.pdf",
          "confidence": 1.0
        },
        "change_in_benefits_notice-Part1-General:beneficiaryName": {
          "value": "NATHAN FAKE",
          "is_empty": false,
          "alias_used": null,
          "source_filename": "CHANGE_IN_BENEFITS_NOTICE.pdf",
          "confidence": 1.0
        },
        "change_in_benefits_notice-Part1-General:issuingCompanyName": {
          "value": "FAKE STATE AND LOCAL RETIREMENT SYSTEM",
          "is_empty": false,
          "alias_used": null,
          "source_filename": "CHANGE_IN_BENEFITS_NOTICE.pdf",
          "confidence": 1.0
        },
        "change_in_benefits_notice-Part1-General:socialSecurityNumber": {
          "value": "123-45-6789",
          "is_empty": false,
          "alias_used": null,
          "source_filename": "CHANGE_IN_BENEFITS_NOTICE.pdf",
          "confidence": 1.0
        },
        "change_in_benefits_notice-Part1-General:benefitExpirationDate": {
          "value": "03/31/2032",
          "is_empty": false,
          "alias_used": null,
          "source_filename": "CHANGE_IN_BENEFITS_NOTICE.pdf",
          "confidence": 1.0
        },
        "change_in_benefits_notice-Part1-General:typeOfBenefit-IfOther": {
          "value": "",
          "is_empty": true,
          "alias_used": null,
          "source_filename": "CHANGE_IN_BENEFITS_NOTICE.pdf",
          "confidence": 1.0
        },
        "change_in_benefits_notice-Part1-General:beneficiaryAddress:city": {
          "value": "ANY CITY",
          "is_empty": false,
          "alias_used": null,
          "source_filename": "CHANGE_IN_BENEFITS_NOTICE.pdf",
          "confidence": 1.0
        },
        "change_in_benefits_notice-Part1-General:beneficiaryAddress:state": {
          "value": "CA",
          "is_empty": false,
          "alias_used": null,
          "source_filename": "CHANGE_IN_BENEFITS_NOTICE.pdf",
          "confidence": 1.0
        },
        "change_in_benefits_notice-Part1-General:beneficiaryAddress:zipCode": {
          "value": "12346",
          "is_empty": false,
          "alias_used": null,
          "source_filename": "CHANGE_IN_BENEFITS_NOTICE.pdf",
          "confidence": 1.0
        },
        "change_in_benefits_notice-Part1-General:beneficiaryAddress:addressLine1": {
          "value": "12 ANY STREET",
          "is_empty": false,
          "alias_used": null,
          "source_filename": "CHANGE_IN_BENEFITS_NOTICE.pdf",
          "confidence": 1.0
        },
        "change_in_benefits_notice-Part1-General:beneficiaryAddress:addressLine2": {
          "value": "",
          "is_empty": true,
          "alias_used": null,
          "source_filename": "CHANGE_IN_BENEFITS_NOTICE.pdf",
          "confidence": 1.0
        },
        "change_in_benefits_notice-Part1-General:currentMonthlyBenefitAmount(Gross)": {
          "value": "1760.00",
          "is_empty": false,
          "alias_used": null,
          "source_filename": "CHANGE_IN_BENEFITS_NOTICE.pdf",
          "confidence": 1.0
        }
      },
      "form_config_pk": 331206,
      "tables": [],
      "attribute_data": null
    }
  ],
  "book_is_complete": true
}

Updated 5 months ago