Person Audit Process

If you add or edit a person, the system checks whether an active audit event type exists for the C1_​PERSON_​BO business object. If an active audit event type exists for the business object, the system creates an audit event for the person using the audit event type. The audit event is created in the Pending status. An effective date is stamped corresponding to the audit event which later helps in deriving the timeline during premium calculation. Note that the system creates distinct audit events in the following scenarios:

Scenario System Behavior
Person fields are updated in the system. One audit event is created for the person. Here, the effective date in the audit event is set to the member person's start date.

For example, the following person identifier type is defined for MP1, MP2, and MP3 who are members of the M1 membership:

Member Person Member Person Start Date Person Identifier Type Person Identifier
MP1 03-10-2020 Social Security Number 987-65-4320
MP2 03-15-2020 Social Security Number 987-65-4321
MP3 03-25-2020 Social Security Number 987-65-4322

In such case, the system will create three audit events - one for MP1 with the effective date as 03-10-2020, another for MP2 with the effective date as 03-15-2020, and third for MP3 with the effective date as 03-25-2020.
Person characteristics are added or updated in the system. Multiple audit events are created for the person - one for each set of person characteristics with the same effective date. Here, the effective date in the audit event is set to the date from when the person's characteristic is effective.

For example, the following characteristics are added or updated for the persons who are members of the M1 membership:

Member Person Characteristic Effective Date Action
MP1 Marital Status 09-15-2020 Add
MP1 Garble Data 09-20-2020 Edit
MP2 Marital Status 09-15-2020 Add
MP2 Garble Data 09-20-2020 Edit

In such case, the system will create four audit events - one for MP1 with the effective date as 09-15-2020, another for MP1 with the effective date as 09-20-2020, third for MP2 with the effective date as 09-15-2020, and fourth for MP2 with the effective date as 09-20-2020.

For each audit event, the system identifies the memberships in which the person is added as a member person. It identifies the policy plan to which each membership belongs and the active pricing rules defined on the policy plan. It then identifies the pricing rule types using which these active pricing rules are created in the system. A repricing entity detail record is created for each membership, pricing rule type, and effective date combination in the CI_​REPRC_​ENTITY_​DTL table. The status of the repricing entity detail record is set to P.

Let us understand this with the help of an example.

The following table illustrates the audit event that is created while updating the MP1 person:
Audit Event AE1
Membership to which MP1 belongs M1 M2 M3
Member Person's Start Date 01-01-2019 01-01-2019 01-07-2019
Policy Plan to which Membership Belongs PP1 PP2 PP3
Pricing Rules Defined on the Policy Plan PR1 (Using PRT1), PR2 (Using PRT2) PR3 (Using PRT3), PR4 (Using PRT3) PR5 (Using PRT5), PR6 (Using PRT6)
Pricing Rule Types Associated with the Policy Plan PRT1, PRT2 PRT3, PRT4 PRT5, PRT6

For the AE1 audit event, the system creates five repricing entity detail records with the following combinations in the CI_​REPRC_​ENTITY_​DTL table:

  • M1, PRT1, 01-01-2019

  • M1, PRT2, 01-01-2019

  • M2, PRT3, 01-01-2019

  • M3, PRT5, 01-07-2019

  • M3, PRT6, 01-07-2019

Note: If the audit event's effective date is earlier than the member person's start date, the system sets the effective date in the repricing entity detail record to the member person's start date. Therefore, in such scenarios, the effective date of the audit event and repricing entity detail records will be different.

Once the repricing entity detail records are created successfully, the status of the audit event is set to Complete. However, if an error occurs while creating the repricing entity detail records for an audit event, the status of the audit event is set to Error.