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Members With Claims But No Enrollment
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Members With Claims But No Enrollment

MediumSQL · PostgreSQL

Problem

Write a query to find all members who have a medical claim but do not have an active enrollment record in a specific month for Santa Clara Family Health Plan.

For this exercise, use January 2025 as the specific month. Treat an enrollment with a NULL end date as ongoing.

Output

  1. Return one row per qualifying member with member_id and member_name.
  2. Include only members with a medical claim in January 2025 and no active enrollment overlapping that month.
  3. Order by member_id ascending.

Schema

members
ColumnTypeDescription
member_idPKINTUnique Santa Clara Family Health Plan member identifier
member_nameVARCHAR(100)Member's full name
medical_claims
ColumnTypeDescription
claim_idPKINTUnique claim identifier
member_idINTMember associated with the claim
claim_typeVARCHAR(30)Claim category, such as medical or dental
claim_dateDATEDate the claim was received
enrollments
ColumnTypeDescription
enrollment_idPKINTUnique enrollment record identifier
member_idINTMember associated with the enrollment
enrollment_statusVARCHAR(20)Enrollment status
enrollment_startDATEEnrollment effective date
enrollment_endDATEEnrollment termination date, or NULL when ongoing
Tablesmembersmedical_claimsenrollments
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