> ## Documentation Index
> Fetch the complete documentation index at: https://getprescience.com/docs/llms.txt
> Use this file to discover all available pages before exploring further.

# Compliance

> How the plan is structured, how data is handled, and what happens before go-live.

Health benefits are regulated. This page summarizes the plan structure, data handling boundaries, and go-live gates that affect the integration.

## Who is what: the plan structure

Use these roles when mapping the plan into regulated surfaces:

| Role                    | Who                      | What it means                                                                                                      |
| ----------------------- | ------------------------ | ------------------------------------------------------------------------------------------------------------------ |
| **Plan sponsor**        | The employer             | The employer sponsors the plan and owns the final plan decisions.                                                  |
| **Benefits operations** | Prescience               | We support rating, enrollment, claims workflows, care navigation, funding operations, and compliance coordination. |
| **Risk protection**     | Licensed carrier partner | Carrier-backed protection helps cap downside exposure for eligible high-cost claims.                               |

Use the approved plan display names from [`GET /plans`](/guides/marketplace-listing) in customer-facing surfaces. The `planType` value is backend classification for eligibility, quoting, and regulated workflows; do not expand it into marketing copy.

## Quotes are indicative

Every quote carries `"pricingBasis": "indicative"` and ships with its own `assumptions` strings. The contract:

* Quote numbers are **indicative pending underwriting confirmation**.
* They become binding only at **enrollment plus underwriting sign-off**.
* Material census changes re-rate.

Keep that framing attached to any displayed quote amount.

## Data handling

### What you send us

Census data (names, dates of birth, ZIP codes, emails, dependent relationships) is **enrollment and eligibility data**. Before live mode is enabled, Prescience and your company execute:

* a **Business Associate Agreement (BAA)**, and
* a **data processing agreement**

covering exactly this data. This is why `psk_live_` keys return `403 live_mode_disabled` until the partnership paperwork is done: the gate is contractual, not technical. Test mode is for development against the full API without that data relationship in place; use realistic-but-fake people in test mode if your policies require it.

### What we send you

The other direction is restricted by design:

* **Aggregate and de-identified only.** [`GET /account`](/guides/benefits-tab) returns funding, premium, spend, and savings aggregates: never named claims, never diagnoses, never any individual's health data.
* **k-anonymity suppression.** When a spend category could be traced to a small number of members, the API suppresses the categories (`spend.suppressed: true`) instead of returning them. You don't implement this; your only job is to render the suppressed state.
* **The roster is administrative.** [`GET /members`](/guides/benefits-tab#the-roster) carries enrollment status and a dependent *count*: no dependent identities, no health information.

The practical consequence: **your platform never holds PHI from Prescience**, which keeps your own compliance surface where it already is (HR data) rather than expanding it into claims data.

## Go-live checklist

1. Core flow green in test mode (group → census → quote → enrollment), webhook signatures verified end to end.
2. BAA + data processing agreement executed.
3. Required commercial and operational agreements completed.
4. Prescience enables live mode and issues your `psk_live_` key.
5. First real employer group created with the live key.

Items 2–4 can run in parallel with implementation.

<Info>
  Questions about a specific employer situation, state, or filing? Ask your Prescience partner engineer. Nothing on this page is legal advice for your own obligations as an HR platform.
</Info>