Defining a Specific Stop-Loss Pricing Rule for a Parent Customer

Prerequisites

To define a specific stop-loss pricing rule for a parent customer, you should have:

  • Business Object C1-PricingRule defined for pricing rule.

  • Business Object C1-PricingRuleSSL defined for specific stop-loss pricing rule.

  • Pricing rule type defined in the application.

  • Price item defined in the application.

  • Rate option defined in the application.

  • Pricing rule usage defined in the application.

  • SSL accumulation level defined in the application.

  • Settlement frequency defined in the application.

  • Underwriter review defined in the application.

Procedure

To define a specific stop-loss pricing rule for a parent customer:

  1. Search for the account, person, or policy whose pricing details you want to view in the Customer 360° View screen.
  2. In the Search Results section, click the View (The View Icon) icon corresponding to the account, person, or policy whose pricing details you want to view.
    The Account, Person, or Policy tab in the Customer 360° Information screen appears.
  3. Click the Pricing tab and then click the Add link in the upper right corner of the Parent Customer Pricing Rules zone.

    The Pricing Rule screen appears. It contains the following fields:

    Field Name Field Description Mandatory (Yes or No)
    Person Name Displays the person name. Not applicable
    Person Type Displays the person type. Not applicable
    Pricing Rule Type Used to indicate the pricing rule type to create the pricing rule.
    Note: You can create a specific stop-loss pricing rule using the Pricing Rule Type for specific stop-loss.
    		 Yes
  4. Click OK.

    The Specific Stop-Loss (SSL) Pricing Rule screen appears. It contains the following sections:

    • Customer Information - Displays the customer information.

    • Main - Used to specify basic details about the specific stop-loss pricing rule.

    • Accumulation Parameters - Used to define the accumulation parameters based on which you want to accumulate the specific stop-loss for the transactions which are processed in the run-in or active period of the policy.

    • Run-In Parameters - Used to define run-in parameters in the run-in period of the policy.

    • Lasering and Exclusion - Used to define the lasering and exclusion information to inherit the accumulation parameters.

    • Characteristics - Used to define the characteristics for a specific stop-loss pricing rule.

    The Customer Information section contains the following fields:

    Field Name Field Description Mandatory (Yes or No)
    Parent Customer Information Displays the parent customer information Not applicable
    Pricing Rule Type Indicates the pricing rule type. Not applicable

    The Main section contains the following fields:

    Field Name Field Description Mandatory (Yes or No)
    Price Item Used to indicate the price item which you want to define for pricing. Yes
    Pricing Start Date Used to specify the pricing rule start date.
    Note:

    This field is enabled when an option from Price Item field is selected.

    By default it displays the Policy Start Date.

    		 Yes
    Pricing End Date Used to specify the pricing rule end date.
    Note:

    This field is enabled when an option from Price Item field is selected.

    By default it displays the Policy End Date.

    		 Yes
    Rate Option Used to indicate the rate option which you want to use for defining the specific stop-loss pricing rule for the price item. Yes
    Pricing Rule Usage Used to indicate whether the pricing rule is used only for pricing or for pricing and billing. The valid values are:

    • Pricing

    • Pricing and Billing

    Note: This field is enabled when an option from Price Item field is selected.
    		 Yes
    SSL Accumulation Level Used to indicate whether the specific stop-loss must be accumulated at the member or main subscriber level. The valid values are:

    • Member

    • Main Subscriber
    Settlement Frequency Used to indicate the settlement frequency which helps to determine the bill after date. The valid values are:

    • Immediately - The bill after date is not calculated. The specific stop-loss billable charge is billed immediately in the next cycle.

    • Manually (At Required Intervals) - The bill after date specified in the Manual Settlement Bill After Date parameter while executing the C1-BCSSL batch is stamped on the specific stop-loss billable charge.

    • Never - The bill after date specified in the Manual Settlement Bill After Date parameter while executing the C1-BCSSL batch is stamped on the specific stop-loss billable charge.

    • Yearly - The bill after date in the specific stop-loss billable charge is set to the pricing end date.

    Note: This field is disabled when you select Pricing and Billing option from the Pricing Rule Usage field.
    		 Yes
    Underwriter Review Used to indicate whether the underwriter settlement review flag is on or off. The valid values are:

    • Yes

    • No

    		 Yes
    Claim Template Used to indicate the claim template to define the claim pricing rule for a parent customer.
    Note: This field is enabled for selection when an option from Price Item field is selected.
    		 Yes
  5. Enter the required details in the Main section.
  6. Define accumulation parameters in a specific stop-loss pricing rule, if required.
    Note: The Accumulation Parameters section appears when an option from the Price Item field is selected.
  7. Define run-in parameters in a specific stop-loss pricing rule, if required.
    Note: The Run-In Parameters section appears when an option from the Price Item field is selected.
  8. Define lasering and exclusion information in a specific stop-loss pricing rule, if required.
    Note: The Lasering and Exclusion section appears when an option from the Price Item field is selected.
  9. Define characteristics for a specific stop-loss pricing rule, if required.
  10. Click Save.
    The specific stop-loss pricing rule for a parent customer is defined.

Related Topics

For more information on... See...
Customer 360° Information - Pricing tab Customer 360° Information - Pricing Information
Parent Customer Pricing Rules zone Parent Customer Pricing Rules
How to define accumulation parameters in a specific stop-loss pricing rule Defining Accumulation Parameters in a Specific Stop-Loss Pricing Rule
How to define run in parameters in a specific stop-loss pricing rule Defining Run-in Parameters in a Specific Stop-Loss Pricing Rule
How to define lasering and exclusion information in a specific stop-loss pricing rule Defining Lasering and Exclusion Information in a Specific Stop-Loss Pricing Rule
How to define a characteristic for a specific stop-loss pricing rule Defining a Characteristic for a Specific Stop-Loss Pricing Rule