Member Accumulators Report

Description and Important Notes

An accumulator is a running total that tracks spending toward a plan limit: a deductible or an out-of-pocket (OOP) maximum. This report is a progress report for every member in the group, showing how much each has spent toward each of those limits.

A few important notes:

• The report is a snapshot. The generation date is at the top of the file; regenerate it for current figures.

• Amounts count approved claims only, so recently submitted claims may not appear yet.

• This report is downloaded as a .csv and can be found on the group’s reports page.

If you are unable to download the report, try normal troubleshooting steps. If you’re still unable to access, email partners@yuzu.health.

Interpretation Guide

1. Each row is one covered person. Employees, spouses, and children each get their own row. Rows are sorted by member number, so dependents sit directly below their subscriber.

2. The first seven columns say who the person is. Name, plan number, coverage status (active, inactive, pending, annulled, or COBRA), member number, subscriber ID, and relationship to the subscriber. Everyone in a family shares the same base member number; when memberNumber equals subscriberId, the row is the subscriber.

3. Every column after that is one plan accumulator or limit. Read the header in four parts: plan number, network tier, limit type, and date range. For example, "504 In Network Deductible (01/01/2026 - 12/31/2026)" means: plan 504, in-network care, the deductible, during the 2026 plan year. Headers with "Family" track the family's combined limit instead of the individual's.

4. Read the date range carefully. It is the plan's accumulation period, and different groups run these differently. Some accumulate on the calendar year, others on the plan year.

5. Columns are both dollars spent so far and the limit. Adjacent pairs of columns show the member’s progress towards an accumulator and the accumulator limit. One number can also reflect care from another network tier: where the plan's benefits cross-accumulate, spending under one tier counts toward another tier's limit too, so a column can grow from claims that weren't in that tier.

6. Blank means "doesn't apply." The report has columns for every plan in the group, but each person only has values under their own plan. Family columns are blank for people without family coverage. And on plans with an aggregate family deductible, individual columns are blank because spending is tracked as one family pool.

7. Don't sum the Family columns. The same family total repeats on every family member's row, so adding a Family column across rows counts each family several times. Individual columns are per person and safe to total.

Data Definitions

This section explains each field, its format, any applicable calculations, and a basic definition.

Member Information

Accumulator Columns

These columns are dynamic: the report includes one set for every plan, accumulator, and accumulation period found across the group, so the exact headers vary from report to report. Accumulator columns come in groups of eight, roughly as follows: in-network (INN) deductible, INN deductible limit, INN out-of-pocket, INN out-of-pocket limit, out-of-network (OON) deductible, OON deductible limit, OON out-of-pocket, OON out-of-pocket limit. This set of eight is repeated for families. A cell is blank when the column does not apply to the person on that row.

In each header pattern below, {plan} is the plan number, {network tier} is the accumulator's categorization (usually a network tier, e.g., In Network), {accumulator} is the accumulator, (usually deductible or out-of-pocket spend) and the date range is the accumulation period. Periods follow each group's plan setup and are not always calendar years.