Plan Facts Parsing Analysis · v1

Hospital Indemnity

Single-class parse covering hospital admission and ICU benefits, daily confinement, HSA compatibility, mental-health and pre-existing condition rules, plus four-tier composite rates.

Endpoint: POST /hospitalIndemnity
Parse method: parseQuoteHospitalIndemnity()
Source range: PlanfactService.php:1703–1921
Source pull: plansight - Bit Bucket Pull 4.26

Bottom line

Cross-write: Substance Abuse reads from Mental/Nervous source.

Lines 1830–1860: the Mental/Nervous Plan Facts field is read once and assigned to BOTH the hospitalIndemnityMentalNervousDisorders field AND hospitalIndemnityDrugAndAlchoholAbuse. If Plan Facts has a separate Substance Abuse field, it's silently dropped, and the Mental/Nervous value overwrites Substance Abuse data on the Quote. This is a real bug.

Per-class handling

Single-class. The parser reads $class = $data['Hospital Indemnity']['Classes'][0] at line 1710 and uses that one class for every subsequent lookup. No multi-class iteration.

What's mapped

Plan Facts field	Quote field	Notes
Plan Name	name	Direct
Participation.[Class].Minimum Participation %	hospitalIndemnityParticipationRequired	Strip %
Participation.[Class].Minimum Enrolled Lives	hospitalIndemnityMinimumLives	Numeric
HSA Compatibility.[Class].HSA Compatibility	hospitalIndemnityHsaCompatible	"true"/true → Yes (line 1742)
Wellness Benefit.[Class].Employee	hospitalIndemnityWellnessBenefit	Direct
Admission Benefits.[Class].Hospital Admission Benefit Amount	hospitalIndemnityHospitalAdmission	Currency stripped
Admission Benefits.[Class].Hospital Admissions Per Year	hospitalIndemnityAdmissionLimits	"X per year"
Admission Benefits.[Class].ICU Admission Benefit Amount	hospitalIndemnityIcuAdmission	Currency stripped
Confinement Benefits.[Class].Daily Hospital Confinement Benefit Amount	hospitalIndemnityHospitalConfinement	Currency stripped
Confinement Benefits.[Class].Daily Hospital Confinement Benefit Duration	hospitalIndemnityHospitalMaxDays	Direct (e.g. "30 days")
Confinement Benefits.[Class].Daily ICU Confinement Benefit Amount	hospitalIndemnityHospitalIcuConfinement	Currency stripped
Confinement Benefits.[Class].Daily ICU Confinement Benefit Duration	hospitalIndemnityIcuMaxDays	Direct
Other Conditions.[Class].Pregnancy Waiting Period	hospitalIndemnityMaternityWait	Direct
Other Conditions.[Class].Mental/Nervous	hospitalIndemnityMentalNervousDisorders	Covered / Not Covered (line 1830)
Other Conditions.[Class].Mental/Nervous	hospitalIndemnityDrugAndAlchoholAbuse	⚠ Reads same source as above — should be Substance Abuse field (line 1847)
Pre-existing Conditions.[Class].Look-back Period	hospitalIndemnityPreExistingConditionsLookback	Direct
Pre-existing Conditions.[Class].Exclusion Period	hospitalIndemnityPreExistingConditionsExclusion	Direct
Portability.[Class].Portability	hospitalIndemnityPortability	Included / Not Included
Rates.[Class].Employee Only / + Spouse / + Children / Family	hospitalIndemnityEE, …ES, …EC, …EF	Currency stripped (line 1899)

Plan-level / not mapped

Emergency Room benefit — not parsed (typically a medical-side concern)
Surgery benefit — not parsed (Accident has it; Hospital Indemnity does not)
Hospital room type limits (private vs. shared)
Surgical center benefits
Organ transplant or acute care center riders
Rate basis (composite vs. age-banded) — implied by data shape, not stored as a field

Potentially mapped incorrectly

Substance Abuse cross-writes from Mental/Nervous source PlanfactService.php:1847–1860

Lines 1830–1843 correctly read 'Other Conditions.' . $class . '.Mental/Nervous' and write to hospitalIndemnityMentalNervousDisorders. Lines 1847–1860 read the same source path again and write to hospitalIndemnityDrugAndAlchoholAbuse. If Plan Facts returns a separate Substance Abuse field, it's silently dropped; the Mental/Nervous value gets used in its place.

Cursor prompt

In app/Services/PlanfactService.php at lines 1847–1860, inside parseQuoteHospitalIndemnity(), the assignment for hospitalIndemnityDrugAndAlchoholAbuse reads from the same Plan Facts path as Mental/Nervous:
'Other Conditions.' . $class . '.Mental/Nervous'

This is almost certainly wrong. It should read from a separate Substance Abuse field — likely something like:
'Other Conditions.' . $class . '.Substance Abuse'
or:
'Other Conditions.' . $class . '.Substance Abuse and Mental Health'

Please:
1. Show me lines 1830–1860 — the Mental/Nervous and Substance Abuse blocks.
2. Look at sample Plan Facts response data (or the schema docs if available) to identify the correct Substance Abuse path key.
3. Fix the source path on lines 1847–1860 to use the correct key.
4. Then grep the rest of PlanfactService.php for any other places where the same source path appears in two consecutive blocks — there may be similar copy-paste errors. Report any you find.

Note the field name typo: "DrugAndAlchohol" should probably be "DrugAndAlcohol" — but DO NOT rename the field unless that's a separate ask, since it would touch the Quote model and form templates.

Rate keys assumed to be in fixed order PlanfactService.php:1899–1918

The rate parsing maps coverage tiers by position in the array (Employee Only → EE, +Spouse → ES, +Children → EC, Family → EF). If Plan Facts ever returns these keys in a different order, the alignment breaks silently. Worth confirming whether order is guaranteed.

Cursor prompt

In app/Services/PlanfactService.php at lines 1899–1918, inside parseQuoteHospitalIndemnity(), the rate parsing iterates the Rates array in order and maps positions to coverage tiers (EE, ES, EC, EF).

If Plan Facts ever returns the rate tiers in a different order (or with different/extra keys), the mapping silently misaligns.

Please:
1. Show me the current iteration logic.
2. Refactor it to look up rates by explicit coverage tier name ("Employee Only", "Employee plus Spouse", "Employee plus Children", "Family") rather than by array position.
3. If a known coverage tier is missing from the response, leave the corresponding Quote field empty rather than substituting a wrong value.
4. Show me the proposed change.

Manual-entry-only fields

Benefit waiting period (days/months before coverage begins)
Hospital room type limits (private vs. shared)
Organ transplant / acute care rider

Recommendations

Fix the Substance Abuse cross-write 15 minutes

Change line 1847's source path from Mental/Nervous to the correct Substance Abuse key.
Make rate-tier lookup explicit by name Hour

Replace position-based iteration with explicit name-based lookup so out-of-order responses don't silently misalign.
Document HSA boolean parsing 5 minutes

Line 1742–1747 accepts "true", true, "false". Add a comment listing the accepted values, or normalize at one entry point.

Code references

File	Lines	Purpose
app/Services/PlanfactService.php	259	Hospital Indemnity endpoint config
app/Services/PlanfactService.php	461	Dispatch to `parseQuoteHospitalIndemnity`
app/Services/PlanfactService.php	1703–1921	Full parser
app/Services/PlanfactService.php	1710	Single-class selection
app/Services/PlanfactService.php	1847–1860	Substance Abuse cross-write
app/Services/PlanfactService.php	1899–1918	Rate position-based lookup