Member definition: In Pega Foundation for Healthcare, a member is defined as a person covered under a health plan, either the enrollee or eligible dependent. Pega Foundation for Healthcare (PFHC) allows users to create a unique member record, capturing details such as the member name, member address, DOB, gender, marital status, ethnicity, SSN, previous names, school information and employment information, Medicaid and Medicare information, account information, PCP information, address information, contact information, and guardian information.

The diagram above is a high-level representation of the type of data captured within the member record. It does not represent the complete information on the member record, nor does it represent the manual member entry user experience.