Editing an Aggregate Stop-Loss Pricing Rule of a Bill Group

Prerequisites

To edit an aggregate stop-loss pricing rule of a bill group, you should have:

  • Business Object C1-PricingRuleASL defined for aggregate stop-loss pricing rule.

Procedure

To edit an aggregate stop-loss pricing rule of a bill group:

  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, in the Bill Group ASO Policy Pricing Rules zone click the Edit (The Edit Icon) icon in the Edit column corresponding to the pricing rule type for aggregate stop-loss whose aggregate stop-loss pricing rule details you want to edit.

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

    • Customer Information - Displays the customer information for bill group.

    • Main - Displays the basic details of the aggregate stop-loss pricing rule.

    • Accumulation Criteria - Used to define the accumulation criteria in an aggregate stop-loss pricing rule.

    • Pricing Information - Used to define stop-loss eligibility for claim line items.

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

    The Customer Information section contains the following fields:

    Field Name Field Description Mandatory (Yes or No)
    Bill Group Information Displays the bill group information. Not applicable
    Policy Start Date Displays the policy start date. Not applicable
    Policy End Date Displays the policy end date. Not applicable
    Policy Status Indicates the policy status for pricing rule. The valid values are:

    • In Force/Active

    • Post Runout

    • Runout

    		 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 Indicates the price item. Not applicable
    Parent Customer's SSL or ASL Pricing Rules Indicates the pricing date range derived from the parent customer's specific stop-loss or aggregate stop-loss pricing rule. Not applicable
    Pricing Start Date Displays the pricing rule start date. Not applicable
    Pricing End Date Displays the pricing rule end date. Not applicable
    Rate Option Indicates the rate option of the aggregate stop-loss pricing rule for the price item. Not applicable
  4. Modify the accumulation criteria in an aggregate stop-loss pricing rule, if required.
    Note: You can add, edit, or remove price item and its price item parameters in the accumulation criteria for an aggregate stop-loss, if required.
  5. Modify the stop-loss eligibility for claim line items, if required.
    Note: This section also consists of a button, Reapply Claim Template, on clicking the button a message occurs indicating that updating the claim template will reset all the default fields on the claim pricing rule.
  6. Add, edit, or remove characteristics for an aggregate stop-loss pricing rule, if required.
  7. Click Save.
    The changes made to an aggregate stop-loss pricing rule for a bill group are saved.

Related Topics

For more information on... See...
Customer 360° Information - Pricing tab Customer 360° Information - Pricing Information
Bill Group ASO Policy Pricing Rules zone Bill Group Self-Funded Policy Pricing Rules
How to define accumulation criteria in an aggregate stop-loss pricing rule Defining Accumulation Criteria in an Aggregate Stop-Loss Pricing Rule
How to define stop-loss eligibility for claim line items Defining Claim Pricing Rules in an Aggregate Stop-Loss Pricing Rule
How to define a characteristic for an aggregate stop-loss pricing rule Defining a Characteristic for an Aggregate Stop-Loss Pricing Rule