Defining a Policy

Prerequisites

To define a policy, you should have:

  • Policy types defined in the application.

  • Source systems defined in the application.

  • Policy person roles defined in the application.

  • Characteristic types defined in the application (where the characteristic entity is set to Policy)

Procedure

To define a policy:

  1. Ensure that the Policies & Plans section is expanded in the Policies page when you are defining, editing, or removing a policy from the person.

    The Policies & Plans section contains the following columns:

    Column Name Column Description Mandatory (Yes or No)
    Sequence No. Displays the sequence number of the policy. Not applicable
    Template Indicates the policy template using which the policy is defined for the person. Not applicable
    Policy Type Indicates the policy type using which the policy is defined for the person. Not applicable
    Policy Number Displays the policy number. Not applicable
    View / Edit On clicking the View / Edit (The Edit Icon) icon, you can view or edit the details of the policy. Not applicable
    Policy Plans On clicking the Add (The Add Icon) icon, you can add policy plans for the policy. Not applicable
    Note: No information appears in the above columns if a policy is not yet defined for the person.
  2. Click the Add New Policy button in the Policies & Plans section.
    The Select Policy Type screen appears. It contains the following field:
    Field Name Field Description Mandatory (Yes or No)
    Policy Type Used to indicate the policy type using which you want to define a policy.
    Note: If you want to create a fully-insured group policy, you must select a policy type where the policy category is set to Fully-Insured Group or Fully-Insured Individual. However, if you want to create a self-funded policy, you must select a policy type where the policy category is set to Self-Funded.
    		 Yes
  3. Select the required policy type from the Policy Type field.
  4. Click OK.

    The Policy screen appears. It contains the following sections:

    • Main - Used to specify the basic details about the policy.

    • Persons - Used to associate persons with the policy.

    • Characteristics - Used to define the characteristics for the policy.

    The Main section contains the following fields:

    Field Name Field Description Mandatory (Yes or No)
    Policy Type Indicates the policy type using which you are defining the policy. Not applicable
    Policy Number Used to specify the policy number. Yes
    Description Used to specify the description for the policy. Yes
    Source System Used to indicate the external system from where the policy is originated.
    Note: This field is enabled when you are defining a policy using a policy type where the policy category is set to Fully-Insured Group or Fully-Insured Individual.
    		 Yes
    Start Date Used to specify the date from when the policy is effective.
    Note: The policy start date cannot be later than the policy end date.
    		 Yes
    End Date Used to specify the date till when the policy is effective.
    Note: The policy end date cannot be earlier than the policy start date.
    		 Yes
    Policy Person Role Used to indicate the role of the person for whom you are defining the policy. Yes
    Note: The Policies page appears when you are defining, editing, or copying a customer registration which is created using the C1-CustomerRegistrationHC business object.
  5. Enter the required details in the Main section.
  6. Define characteristics for the policy in the Characteristics section, if required.
  7. Associate persons to the policy in the Persons section, if required.
  8. Click Validate and Save.
    The policy is defined for the person.

Related Topics

For more information on... See...
How to define a customer registration Defining a Customer Registration
How to edit a customer registration Editing the Customer Registration Details
How to copy a customer registration Copying a Customer Registration
How to edit the policy details Editing the Policy Details
How to define a characteristic for a policy Defining a Characteristic for a Policy
How to associate a person to a policy Associating a Person to a Policy
How to add a plan in a policy Adding a Plan in a Policy