Defining Accumulation Criteria in a Specific Stop-Loss Pricing Rule

Procedure

To define accumulation criteria in a specific stop-loss pricing rule:

  1. Ensure that the Accumulation Criteria section is expanded when you have selected an option from the Parent Customer's SSL Pricing Rules field of Main section while defining or editing a specific stop-loss pricing rule.

    The Accumulation Criteria section contains the following fields:

    Field Name Field Description Mandatory (Yes or No)
    Accumulation Group ID Displays blank field, accumulation group ID is generated when accumulation criteria values are defined for a specific stop-loss. Not applicable
    Run-In Maximum Limit Used to specify the maximum specific stop-loss limit defined for the member when the claim transactions are received in the run-in period of the policy.
    Note: This field is enabled when the start date and end date selected from the Parent Customer's SSL Pricing Rules field of Main section is greater than today's date.
    		 Yes
    SSL Limit Used to specify whether the SSL limit indicating that the specific stop-loss amount beyond this limit will be paid by the insurance company. Yes
    Price Item Used to specify the price item information.
    Note: On clicking the Search (The Search Icon) icon that appears corresponding to the Price Item field, the Price Item Search window appears.
    		 No
    Price Item Parameters This field contains the following columns:
    Column Name Column Description Mandatory (Yes or No)
    Price Item Parameter Used to specify multiple parameters based on which you want to determine the price item utilization.
    Note: On clicking the Search (The Search Icon) icon that appears corresponding to the Price Item Parameter field, the Price Item Parameter Search window appears.
    		 No
    Parameter Value Used to specify the value of the parameter.
    Note:

    On selecting the Price Item Parameter, the Search (The Search Icon) icon appears corresponding to this field, and on clicking the icon, the Parameter Value Search window appears.

    		 No
    		No
  2. Enter the required details in the Accumulation Criteria section.
  3. If you want to define more than one price item in the accumulation group, click the Add (The Add Icon) icon and then repeat step 2.
    Note: However, if you want to remove a price item from the accumulation group, click the Delete (The Delete Icon) icon corresponding to the price item.
  4. If you want to define more than one price item parameters for the price item, click the Add (The Add Icon) icon and then repeat step 2.
    Note: However, if you want to remove a price item parameter from the price item, click the Delete (The Delete Icon) icon corresponding to the price item parameter.
  5. Click Save.
    The accumulation criteria is defined in the specific stop-loss pricing rule.
  6. You can define accumulation rules for each rule in a specific stop-loss pricing rule.
    Note: You can exclude a rule from the specific stop-loss pricing by selecting the Exclude Rule checkbox.

Related Topics

For more information on... See...
How to define a specific stop-loss pricing rule for a bill group Defining a Specific Stop-Loss Pricing Rule for a Bill Group
How to edit a specific stop-loss pricing rule of a bill group Editing a Specific Stop-Loss Pricing Rule of a Bill Group