Coverage Specific Auto Maintenance

Traditional offset processing matches credits and debits at the account level. However, this may be too general when amounts need to be applied within a specific coverage period. The new feature matches related credit and debit financial transactions before creating adjustments. This makes it clear which debit bill each credit is used to offset. This new enhancement also supports partial matching. If the credit and debit amounts differ, the system applies the smaller amount and leaves the remaining balance open. One credit can be used against several debits, and several credits can be applied to one debit.

Note:
The Coverage Specific Auto Maintenance enhancement is applicable to both Fully-Insured Individual and Fully-Insured Group Line of Business.

Based on the offset request type configuration, it can create either transfer adjustments or non-transfer adjustments in match-mode. Existing offset request processing and FT retrieval remain available so the implementations that do not opt in retain their established behavior. The following table lists the required prerequisites for this new enhancement:

Prerequisite Implication
Auto Maintenance enabled The account must be eligible to perform auto maintenance processing.
C1-AUTOM Batch configured The batch must include the optional coverageSpecificAutom parameter.
Credit Bill available At least one credit bill must be open and eligible for coverage-specific offsetting.
Offset Request Type defined It’s the transfer adjustment option which determines whether the transfer or match-mode adjustments are created.

Processing Overview

The Auto Maintenance - Offset Request Creation (C1-AUTOM) batch first identifies the accounts that require auto maintenance. The batch then creates an offset request, validates the new batch parameter, and sets the coverage-specific value on the business object. The system then invokes the C1-OFST-DIST offset distribution algorithm once the offset request resides in Creating Adjustment status. The offset distribution algorithm reads the offset request and loads open credit and debit FT rows. The algorithm separates credits from debits using unpaid amount, such as, negative unpaid amounts identify credits, while positive unpaid amounts identify debits. Each list is sorted by the absolute remaining balance and the algorithm allocates minimum available amount for each match. Finally, the algorithm creates the offset adjustments and links them to the matched FT records.

New Control Flag and Decision Behavior

The core change of this enhancement is the optional coverageSpecificAutom batch parameter in the Auto Maintenance - Offset Request Creation (C1-AUTOM) batch. When the parameter is blank or set to N, the batch continues through the established offset generation flow. When the parameter is set to Y, the batch flags the offset request for coverage-period-aware matching. If configured, it also creates transfer adjustments for each matched credit/debit FT pair.

Note:
While offsetting coverage-specific data, the process does not evaluate the coverageSpecificAutom batch parameter, since this functionality operates independently of it.

The system deploys the following parameter wise scenarios:

Skip Auto Maintenance Coverage Specific Autom Transfer Adjustment Result
N Blank or N Y or N For zero account or coverage balance, a coverage-specific offset is created when transfer adjustment is enabled.
Y Blank or N Y or N Existing behavior applies where credit-to-debit offsets can be created for non-zero balances or coverage balance, with or without transfer adjustment.
Y or N Y Y or N Coverage-specific offsets are created for zero or non-zero accounts or coverage balances. Internal bill offsets for the selected coverage are prioritized; remaining credit may be applied to other eligible bills.