Employee Eligiblity File Format Requirements

Form Approved
OMB No. 0920-XXXX
Exp. Date: XX-XX-XXXX

Employee Eligibility File Format Requirements
Public reporting of this collection of information is estimated to average 15 minutes per response, including the
time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is
not required to respond to a collection of information unless it displays a currently valid OMB control number.
Send comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74,
Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX).
Instructions
Purpose: This document describes the required file format to upload eligibility data into the Viridian Health
Management database to identify employees eligible to participate in the CDC National Healthy Worksite
Program (NHWP) and link employees to their respective survey.
The file must be a Microsoft Excel spreadsheet with the data provided on the first worksheet in the workbook.
Other worksheets may exist in the file, but they will be ignored.
The data worksheet must conform to the format described in the table below. The column headings must
appear in Row 1 of the worksheet, starting with column A, and must match exactly the column header names
listed below. Note that there are no spaces in the column header names. Also, there should be no blank rows in
the worksheet. Optional columns may be omitted, but otherwise, the columns should appear in the order that
they are listed here. In optional columns, a value need not be supplied for all employees. Columns marked with
an asterisk in the “Required?” column are required only if the data is to be sent to Gordian Health using the file
format already established between Gordian Health and Diversity Wellness.
The “Data Type” and “Max Length/Value” columns specify what type of data may be supplied for this field. A
“Number” field may contain only the digits 0-9. In this case, the Max Length/Value field shows the highest
number which may be provided. A field specified as a “String” type may contain any alphanumeric or other
characters unless otherwise noted. The maximum number of characters is shown in the Max Length field. The
BirthDate field must be a value which Microsoft Excel interprets as a date. This makes the visual format of the
cell containing the date unimportant in Excel. To ensure that Excel handles the dates properly, use the format
mm/dd/yyyy when entering dates manually or if converting the data from another type of file, such as a CSV file.
All employees listed in the file are assumed to be active. If an employee’s eligibility is terminated, that
employee should not be included in the next eligibility file. The system will interpret this as a termination of
benefits.

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Eligibility File Format Requirements
Field

Required

LastName
FirstName
MiddleName
NickName
Gender
DOB
SSN/Last 4
Language
EmpNum
Relation
CustGrpId1
CustGrpId2
CustGrpId3
CustGrpId4
CustGrpId5
MailAddress1
MailAddress2
City
State
Zip
PhoneNum
CellNum
EMail

Yes
Yes
No
No
Yes
Yes
Yes
No
Yes
Yes
Yes
Yes
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
No

StartDate
TermDate
HasMedIns

Yes
Yes
Yes

MedInsDate

Yes

IsPgmElig

Yes

Field Description

May be substituted with Employee ID but must be a unique identifier
HR generated Employee ID or other unique identifier
Custom group Level 1 is the selected Community
Custom group Level 2 is the name of the Employer
Custom group Level 3 is the Department name or code
Custom group Level 4 is the Shift Worked
Custom group Level 5 is FT / PT status

This is not required as the employer may not have this information
This is ot required as some employees may not have a company email
address
Hire Date
Termination Date
Date employee began medical insurance coverage or is eligible for
coverage

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