Setting the C1-ASOBLLNG Feature Configuration

The C1-ASOBLLNG feature configuration enables the system to determine the following:

  • Whether the approval transaction should be created while defining, editing, or deleting a self-funded pricing rule.

  • Various parameters, characteristic types, and extendable lookup business objects which should be used for the fully-insured group, fully-insured individual, and self-funded business.

  • Person relationship type using which the bill group should be related to the parent customer.

  • Policy person roles using which the parent customer and bill groups should be associated with the fully-insured group and self-funded policies.

  • Status to which a policy should be transitioned on terminating, reinstating, or renewing the fully-insured group policy.

  • Status to which a group membership should be transitioned on inactivating the main subscriber of the group membership.

  • Status to which a member person of a group membership should be transitioned on inactivating the group membership.

  • Status to which an individual membership should be transitioned on canceling the main subscriber of the individual membership.

  • Status to which a member person of an individual membership should be transitioned on canceling the individual membership.

  • Whether the plan-specific contracts should be created on the accounts for the fully-insured group policies.

Prerequisites

To set the C1-ASOBLLNG feature configuration, you should have:

  • Required policy person roles, account relationship types, and person relationship types defined in the application

  • Approval workflow settings configured for the C1PRCANC, C1PRCASL, C1PRCRLCLM, C1PRCDA, C1PRFLTFEE, C1PRCLVLFN, C1PRETCLM, C1PRRETENR, and C1PRCSSL approval workflow groups

  • Required approval workflow group defined for the Minimum Premium Program (MPP) pricing rule and approval workflow settings configured for the MPP approval workflow group

  • Required characteristic types defined in the application

  • Values defined for the C1-ExtLookClaimTemplate, C1-ExtLookPricingRuleLineItem, and C1-ExtLookRetTypeRateOpt extendable lookups

  • Predefined values defined for the C1INVTYP characteristic type

  • Required SQIs defined in the application

  • Pricing arrangement parameter defined in the application (where the value type is set to Adhoc, source entity is set to Transaction, and the parameter usage is set to Price Item

  • Billable charge line type parameter defined in the application (where the value type is set to Adhoc, source entity is set to Transaction, and the parameter usage is set to Price Item

  • Pricing group rule parameter defined in the application (where the value type is set to Adhoc, source entity is set to Transaction, and the parameter usage is set to Price Item

  • A predefined characteristic type named Active Employee Coverage Billing Arrangement defined with the following characteristic values:

    Characteristic Value Description
    DRT Direct Billing
    GRP Group Billing

    You must set the characteristic entity of the Active Employee Coverage Billing Arrangement characteristic type to Person.

  • A predefined characteristic type named Benefit Billing Arrangement defined with the following characteristic values:

    Characteristic Value Description
    DRT Direct Billing
    GRP Group Billing

    You must set the characteristic entity of the Benefit Billing Arrangement characteristic type to Person, Policy, and Policy Plan.

  • A predefined characteristic type named COBRA Billing Arrangement defined with the following characteristic values:

    Characteristic Value Description
    DRT Direct Billing
    GRP Group Billing
    TPA TPA Billing

    You must set the characteristic entity of the COBRA Billing Arrangement characteristic type to Person, Policy, and Policy Plan.

  • Required billing preference, binder payment preference, geographic rating area preference for fully-insured group and individual, medicare preference, member relationship and subscription tier preference, and membership status reason preference defined in the application.

Procedure

To set the C1-ASOBLLNG feature configuration:

  1. Click the Admin link in the Application toolbar.
    A list appears.
  2. From the Admin menu, select F and then click Feature Configuration.
    A sub-menu appears.
  3. Click the Search option from the Feature Configuration sub-menu.
    The Feature Configuration Query screen appears.
  4. In the Feature Configuration Search zone, enter C1-ASOBLLNG in the Feature Name field.
    Note: ORMB search engine supports wildcard search, where you can substitute the percentage (%) symbol as a stand in for any word or letter in a search criteria. You can use the '%' wildcard character in all input fields except the date and ID fields. The '%' wildcard character is suffixed automatically at the end of the partial search criteria. Therefore, you may or may not specify the wildcard character at the end of the partial search criteria. However, you have to prefix the wildcard character manually wherever required.
  5. Click Search.
    A list of feature configurations that meet the search criteria appears in the search results.
  6. In the Search Results section, click the link in the Description column corresponding to the feature configuration whose details you want to edit.

    The Feature Configuration screen appears. It contains the following option types:

    Option Type Description Mandatory (Yes or No)
    Account Identifier Type Char Type Used to specify the characteristic type which stores the account identifier type. It is used to determine the account to which you want to bill the group or individual membership.
    Note: You must specify a characteristic type where the characteristic entity is set to Membership.
    		 Yes (Conditional)
    Note: This data is required while billing a group or individual membership.
    Account Identifier Value Char Type Used to specify the characteristic type which stores the account identifier. It is used to determine the account to which you want to bill the group or individual membership.
    Note: You must specify a characteristic type where the characteristic entity is set to Membership.
    		 Yes (Conditional)
    Note: This data is required while billing a group or individual membership.
    Age Based Parameter Used to specify the parameter using which you want to define the lower age limit and upper age limit pricing eligibility criteria in an age based pricing.
    Note:

    The AGEBASED parameter is shipped with the product.

    By default, the value is set to AGEBASED. You can change the value, if required. However, note that you must specify an adhoc parameter where source entity is set to Algorithm, source type code is set to Calculate membership person's age, and the parameter usage is set to Pricing Eligibility Criteria.

    		 Yes (Conditional)
    Note: This data is required while defining an age based pricing rule.
    Approval Workflow Group for ASL Used to specify the approval workflow group for an aggregate stop-loss pricing rule. It helps the system to determine whether the approval transaction should be created while defining, editing, or deleting an aggregate stop-loss pricing rule.
    Note:

    The C1PRCASL approval workflow group for an aggregate stop-loss pricing rule is shipped with the product.

    By default, the value is set to C1PRCASL. You can change the value, if required.

    		 Yes (Conditional)
    Note: This data is required while enabling the approval workflow process for an aggregate stop-loss pricing rule.
    Approval Workflow Group for Ancillary Used to specify the approval workflow group for an ancillary pricing rule. It helps the system to determine whether the approval transaction should be created while defining, editing, or deleting an ancillary pricing rule.
    Note:

    The C1PRCANC approval workflow group for an ancillary pricing rule is shipped with the product.

    By default, the value is set to C1PRCANC. You can change the value, if required.

    		 Yes (Conditional)
    Note: This data is required while enabling the approval workflow process for an ancillary pricing rule.
    Approval Workflow Group for Claim Used to specify the approval workflow group for a claim pricing rule. It helps the system to determine whether the approval transaction should be created while defining, editing, or deleting a claim pricing rule.
    Note:

    The C1PRCRLCLM approval workflow group for a claim pricing rule is shipped with the product.

    By default, the value is set to C1PRCRLCLM. You can change the value, if required.

    		 Yes (Conditional)
    Note: This data is required while enabling the approval workflow process for a claim pricing rule.
    Approval Workflow Group for Flat Fees Used to specify the approval workflow group for the one-time and recurring flat fees pricing rules. It helps the system to determine whether the approval transaction should be created while defining, editing, or deleting the one-time and recurring flat fees pricing rules.
    Note:

    The C1PRFLTFEE approval workflow group for the one-time and recurring flat fees pricing rules is shipped with the product.

    By default, the value is set to C1PRFLTFEE. You can change the value, if required.

    		 Yes (Conditional)
    Note: This data is required while enabling the approval workflow process for the one-time and recurring flat fees pricing rules.
    Approval Workflow Group for Level Funded Used to specify the approval workflow group for the enrollment based premium and flat rate based premium level funded pricing rules. It helps the system to determine whether the approval transaction should be created while defining, editing, or deleting the enrollment based premium and flat rate based premium level funded pricing rules.
    Note:

    The C1PRCLVLFN approval workflow group for the enrollment based premium and flat rate based premium level funded pricing rules is shipped with the product.

    By default, the value is set to C1PRCLVLFN. You can change the value, if required.

    		 Yes (Conditional)
    Note: This data is required while enabling the approval workflow process for the enrollment based premium and flat rate based premium level funded pricing rules.
    Approval Workflow Group for MPP Used to specify the approval workflow group for a minimum premium program pricing rule. It helps the system to determine whether the approval transaction should be created while defining, editing, or deleting a minimum premium program pricing rule. Yes (Conditional)
    Note: This data is required while enabling the approval workflow process for the minimum premium program pricing rules.
    Approval Workflow Group for Retention Type Claim Based Used to specify the approval workflow group for a retention type claim based pricing rule. It helps the system to determine whether the approval transaction should be created while defining, editing, or deleting a retention type claim based pricing rule.
    Note:

    The C1PRETCLM approval workflow group for a retention type claim based pricing rule is shipped with the product.

    By default, the value is set to C1PRETCLM. You can change the value, if required.

    		 Yes (Conditional)
    Note: This data is required while enabling the approval workflow process for a retention type claim based pricing rule.
    Approval Workflow Group for Retention Type Enrollment Based Used to specify the approval workflow group for a retention type enrollment based pricing rule. It helps the system to determine whether the approval transaction should be created while defining, editing, or deleting a retention type enrollment based pricing rule.
    Note:

    The C1PRRETENR approval workflow group for a retention type enrollment based pricing rule is shipped with the product.

    By default, the value is set to C1PRRETENR. You can change the value, if required.

    		 Yes (Conditional)
    Note: This data is required while enabling the approval workflow process for a retention type enrollment based pricing rule.
    Approval Workflow Group for SSL Used to specify the approval workflow group for a specific stop-loss pricing rule. It helps the system to determine whether the approval transaction should be created while defining, editing, or deleting a specific stop-loss pricing rule.
    Note:

    The C1PRCSSL approval workflow group for a specific stop-loss pricing rule is shipped with the product.

    By default, the value is set to C1PRCSSL. You can change the value, if required.

    		 Yes (Conditional)
    Note: This data is required while enabling the approval workflow process for a specific stop-loss pricing rule.
    Approval Workflow Group-Discount Arrangement Used to specify the approval workflow group for the discount share and discount guarantee pricing rules. It helps the system to determine whether the approval transaction should be created while defining, editing, or deleting the discount share and discount guarantee pricing rules.
    Note:

    The C1PRCDA approval workflow group for the discount share and discount guarantee pricing rules is shipped with the product.

    By default, the value is set to C1PRCDA. You can change the value, if required.

    		 Yes (Conditional)
    Note: This data is required while enabling the approval workflow process for the discount share and discount guarantee pricing rules.
    Base Fee PC Sequence Characteristic Used to specify the characteristic type where you want to store the sequence number of the eligible base fee's price component. This characteristic is then passed to the rating engine for further processing.
    Note:

    The C1BSFESE characteristic type is shipped with the product.

    By default, the value is set to C1BSFESE. You can change the value, if required. However, note that you must specify an adhoc characteristic type where the characteristic entity is set to Rate Component.

    		 Yes (Conditional)
    Note: This data is required while billing fully-insured group and individual health plans.
    Benefit Billing Arrangement Used to specify the characteristic type which indicates whom to bill the premium for a Medicare group membership. This characteristic type is defined for a policy plan, policy, and/or parent customer. The system then uses this characteristic type to determine whom to bill the Medicare group membership premium. Yes (Conditional)
    Note: This data is required while billing the premium for a Medicare group membership.
    Bill Cycle Rule Code Used to specify the characteristic type which stores the billing preference of the account. This characteristic type is defined for an account. The system then uses this characteristic type to derive the bill cycle and bill period for the account.
    Note: You must specify a characteristic type where the characteristic entity is set to Account.
    		 Yes (Conditional)
    Note: This data is required when you want the bill cycle and bill period to be tightly coupled with each other.
    Bill Group Policy Person Role Used to specify the policy person role using which a bill group should be associated with a fully-insured group or self-funded policy when the policy information is given for the bill group in an inbound message.
    Note: You must specify a policy person role which is already defined in the system.
    		 Yes
    Bill Seg Req Reference Id Char Type Used to indicate the characteristic type where you want to store the request reference ID. During the fully-insured group and individual bill segment generation, this characteristic is stamped on a bill segment calculation line which indicates the repricing request for which the bill segment calculation line is created.
    Note: You must specify a characteristic type where the characteristic entity is set to Bill Segment Calc Line.
    		 Yes (Conditional)
    Note: This data is required while billing fully-insured group and individual health plans.
    Billable Charge Line Type Parameter Used to specify the parameter in which you want to store the billable charge line type. This parameter can then be used while defining an ancillary pricing rule type.
    Note: You must specify an adhoc parameter where the source entity is set to Transaction and the parameter usage is set to Price Item.
    		 Yes (Conditional)
    Note: This data is required while defining an ancillary pricing rule type.
    Billing Arrangement Used to specify the characteristic type which indicates whom to bill the premium for an active employee coverage group membership. This characteristic type is defined for a parent customer and/or bill group. The system then uses this characteristic type to determine whom to bill the active employee coverage group membership premium. Yes (Conditional)
    Note: This data is required while billing the premium for an active employee coverage group membership.
    Binder Payment Field Mapping Used to specify a binder payment preference. The system considers the various attributes of the binder payment preference while creating and monitoring binder payments for an individual membership.
    Note: You must specify a binder payment preference which is already defined in the system.
    		 Yes (Conditional)
    Note: This data is required while creating and monitoring binder payments for an individual membership.
    Claim Template Extendable Lookup Business Object Used to specify the claim template extendable lookup business object. The system displays the values of the specified extendable lookup in the Claim Template list while defining or editing a claim pricing rule type.
    Note:

    The C1-ExtLookClaimTemplate extendable lookup for claim template is shipped with the product.

    By default, the value is set to C1-ExtLookClaimTemplate. You can change the value, if required.

    		 Yes
    Cobra Billing Arrangement Used to specify the characteristic type which indicates whom to bill the premium for a COBRA group membership. This characteristic type is defined for a policy plan, policy, and/or parent customer. The system then uses this characteristic type to determine whom to bill the COBRA group membership premium. Yes (Conditional)
    Note: This data is required while billing the premium for a COBRA group membership.
    Customer Registration ID Characteristic for Inbound Log Used to specify the characteristic type where you want to store the customer registration ID. This characteristic type is used while creating a log entry for a health care inbound message. The log entry then indicates the customer registration object which is created through the health care inbound message.
    Note:

    The C1CRLOG characteristic type is shipped with the product.

    By default, the value is set to C1CRLOG. You can change the value, if required. However, note that you must specify a foreign key characteristic type where the characteristic entity is set to Inbound Message Log.

    		 Yes (Conditional)
    Note: This data is required while creating a person, account, policy, and/or policy plan through a health care inbound message.
    Default Flat Rate Option Used to specify the rate option which must be used by default when the rate option is not given and the modifier method is set to either FLAT or NULL in the pricing rule data of a health care inbound message.
    Note: You must specify a rate option where the rate schedule is set to HC_​FRTSC.
    		 Yes (Conditional)
    Note: This data is required while creating an age based and tier based pricing.
    Default Percentage Rate Option Used to specify the rate option which must be used by default when the rate option is not given and the modifier method is set to either EXPT or INPT in the pricing rule data of a health care inbound message.
    Note: You must specify a rate option where the rate schedule is set to HC_​PRTSC.
    		 Yes (Conditional)
    Note: This data is required while creating an age based and tier based pricing.
    Invoice Type Characteristic Type Used to specify the characteristic type which indicates the type of account. This characteristic type is defined for the account. The system then uses this characteristic type to determine the account on which the claim, specific stop-loss credits, aggregate stop-loss credits, claim based fee, enrollment based fee, one-time flat fees, recurring flat fees, ancillary, discount, or level funded billable charges should be created in the system. For more information, refer to Bill Group's Account.
    Note:

    The C1INVTYP characteristic type is shipped with the product.

    By default, the value is set to C1INVTYP. You can change the value, if required. However, note that you must specify a predefined characteristic type where the characteristic entity is set to Account.

    		 Yes
    Line Item Extendable Lookup Business Object Used to specify the line item extendable lookup business object. The system displays the values of the specified extendable lookup in the Line Item list while defining, editing, or copying a claim template.
    Note:

    The C1-ExtLookPricingRuleLineItem extendable lookup for line item is shipped with the product.

    By default, the value is set to C1-ExtLookPricingRuleLineItem. You can change the value, if required.

    		 Yes
    Medicare Used to specify a Medicare preference. The system considers the various attributes of the Medicare preference while creating charges for Medicare Part D Low Income Subsidy (LIS) and Late Enrollment Penalty (LEP).
    Note: You must specify a Medicare preference which is already defined in the system.
    		 Yes (Conditional)
    Note: This data is required while creating charges for Medicare Part D LIS and LEP.
    Membership Cancel Status Used to specify the status to which an individual membership should be transitioned when the status of its main subscriber is set to Canceled.
    Note: You must specify a status which is defined in the lifecycle of the C1-IndMembership business object.
    		 Yes (Conditional)
    Note: This data is required while canceling an individual membership.
    Membership Characteristic for Inbound Log Used to specify the characteristic type where you want to store the membership ID. This characteristic type is used while creating a log entry for a health care inbound message. The log entry then indicates the group or individual membership which is created through the health care inbound message.
    Note:

    The C1MBRLOG characteristic type is shipped with the product.

    By default, the value is set to C1MBRLOG. You can change the value, if required. However, note that you must specify a foreign key characteristic type where the characteristic entity is set to Inbound Message Log.

    		 Yes (Conditional)
    Note: This data is required while creating a group or individual membership through a health care inbound message.
    Membership ID Characteristic for Billable Charge Used to specify the characteristic type where you want to store the membership ID. During the fully-insured group and individual billable charge creation process, this characteristic is stamped on a billable charge which indicates the group or individual membership for which the billable charge is created.
    Note: You must specify a foreign key characteristic type where the characteristic entity is set to Billable Charge.
    		 Yes (Conditional)
    Note: This data is required while billing a group or individual membership.
    Membership Inactive Status Used to specify the status to which a group membership should be transitioned when its main subscriber is inactivated.
    Note: You must specify a status which is defined in the lifecycle of the C1-Membership business object.
    		 Yes (Conditional)
    Note: This data is required while inactivating a group membership.
    Membership Person Cancel Status Used to specify the status to which the member persons of an individual membership should be transitioned when the individual membership is canceled.
    Note: You must specify a status which is defined in the MEMBER_​PER_​STATUS_​FLG lookup field.
    Note: This data is required while canceling an individual membership.
    Membership Person Inactive Status Used to specify the status to which the member persons of a group membership should be transitioned when the group membership is inactivated.
    Note: You must specify a status which is defined in the MEMBER_​PER_​STATUS_​FLG lookup field.
    		 Yes (Conditional)
    Note: This data is required while inactivating a group membership.
    Off-process Request Detail Maximum Count Used to indicate the maximum number of amendment details you can specify in an off-process request. Yes (Conditional)
    Note: This data is required while creating an off-process request.
    Override Proration Applicability Characteristic Type Used to specify the characteristic type which indicates whether the proration rule should be overridden for a member person. At present, the override proration feature is used for a new born when the gift days are offered to a new born. This characteristic type can be defined for the group membership, policy plan, policy, and state.
    Note: You must specify a characteristic type where the characteristic entity is set to Membership, Policy Plan, Policy, and State. Here, the predefined values for the characteristic type can be Y and N.
    		 Yes (Conditional)
    Note: This data is required when you want to override the proration rule.
    Override Proration Effective Date Characteristic Type Used to specify the characteristic type where you want to store the date from when the premium should be calculated for the new born. This characteristic is used during the bill segment generation to determine the bill period in which the date falls. The system then accordingly prorates the premium amount for the new born.
    Note: You must specify a characteristic type where the characteristic entity is set to Membership Person.
    		 Yes (Conditional)
    Note: This data is required when you want to override the proration rule.
    Override Proration Rule Characteristic Type Used to specify the characteristic type where you want to store the override SQ rule for a new born. This characteristic type can be defined for the group membership, policy plan, policy, and state. If this characteristic is not defined at any level, the system uses the SQ rule of the rate schedule attached to the active contract to prorate the premium amount of a new born child.
    Note: You must specify a characteristic type where the characteristic entity is set to Membership, Policy Plan, Policy, and State.
    		 Yes (Conditional)
    Note: This data is required when you want to override the proration rule.
    Parent Customer Policy Person Role Used to specify the policy person role using which the parent customer should be associated with a fully-insured group or self-funded policy when the policy information is given for the bill group or parent customer in an inbound message.
    Note: You must specify a policy person role which is already defined in the system.
    		 Yes
    Person ID Characteristic for Inbound Log Used to specify the characteristic type where you want to store the person ID. This characteristic type is used while creating a log entry for a health care inbound message. The log entry then indicates the person whose record is created through the health care inbound message.
    Note:

    The C1PERLOG characteristic type is shipped with the product.

    By default, the value is set to C1PERLOG. You can change the value, if required. However, note that you must specify a foreign key characteristic type where the characteristic entity is set to Inbound Message Log.

    		 Yes (Conditional)
    Note: This data is required while creating a person through a health care inbound message.
    Person Identifier Type Char Type Used to specify the characteristic type which stores the person identifier type. It is used to determine the person to whom you want to bill the group or individual membership.
    Note: You must specify a characteristic type where the characteristic entity is set to Membership.
    		 Yes (Conditional)
    Note: This data is required while billing a group or individual membership.
    Person Identifier Value Char Type Used to specify the characteristic type which stores the person identifier. It is used to determine the person to whom you want to bill the group or individual membership.
    Note: You must specify a characteristic type where the characteristic entity is set to Membership.
    		 Yes (Conditional)
    Note: This data is required while billing a group or individual membership.
    Person Relationship Type Used to indicate how a bill group should be related to a parent customer. The system uses the person relationship type while:

    • Creating a bill group for a parent customer through an inbound message

    • Viewing the 360° information of a parent customer

    Note: You must specify a person relationship type which is already defined in the system.
    		 Yes
    Plan Based Contract Characteristic Type Used to specify the characteristic type which helps to determine whether the system should create plan-specific contracts for a price item. This characteristic must be defined on the person for whom you want to create plan-specific contracts on the accounts.
    Note: You must specify a characteristic type where the characteristic entity is set to Person.
    		 Yes (Conditional)
    Note: This data is required when you want to enable the plan-specific contract creation feature for specific persons in the fully-insured group health plan business.
    Plan Based Contract Characteristic Value Used to specify the characteristic value which indicates that the system should create plan-specific contracts for a price item on the accounts. Yes (Conditional)
    Note: This data is required when you want to enable the plan-specific contract creation feature for specific persons in the fully-insured group health plan business.
    Plan Based Contract Creation Eligibility Used to indicate whether the system should create plan-specific contract for a price item on the account. The valid value is Yes. Yes (Conditional)
    Note: This data is required when you want to enable the plan-specific contract creation feature for the fully-insured group health plan business.
    Plan Id Characteristic Type Used to specify the characteristic type where you want to store the plan for which the contract is created. During the fully-insured group policy plan contract creation, this characteristic is defined on the contract.
    Note: You must specify a characteristic type where the characteristic entity is set to Contract.
    		 Yes (Conditional)
    Note: This data is required when you want to enable the plan-specific contract creation feature for the fully-insured group health plan business.
    Policy Reinstatement Status Used to specify the status to which the policy must be transitioned when it is reinstated.
    Note: You must specify a status which is defined in the lifecycle of the C1-POLICY business object.
    		 Yes (Conditional)
    Note: This data is required while reinstating a fully-insured group policy.
    Policy Renewal Status Used to specify the status to which the policy must be transitioned when it is renewed.
    Note: You must specify a status which is defined in the lifecycle of the C1-POLICY business object.
    		 Yes (Conditional)
    Note: This data is required while renewing a fully-insured group policy.
    Policy Termination Status Used to specify the status to which the policy must be transitioned when it is terminated.
    Note: You must specify a status which is defined in the lifecycle of the C1-POLICY business object.
    		 Yes (Conditional)
    Note: This data is required while terminating a fully-insured group policy.
    Pricing Arrangement Parameter Used to specify the parameter in which you want to store the pricing arrangement. This parameter can then be used while defining an ancillary pricing rule type.
    Note: You must specify an adhoc parameter where the source entity is set to Transaction and the parameter usage is set to Price Item.
    		 Yes (Conditional)
    Note: This data is required while defining an ancillary pricing rule type.
    Pricing Group Rule Parameter Used to specify the parameter in which you want to store the pricing group rule. The system stamps this parameter on the price assignment which is created through a pricing rule using a pricing group. It indicates that the price assignment is created using the respective rule in the pricing group.
    Note: You must specify an adhoc parameter where the source entity is set to Transaction and the parameter usage is set to Price Item.
    		 Yes (Conditional)
    Note: This data is required while defining a claim, specific stop-loss, aggregate stop-loss, retention type claim based, or retention type enrollment based pricing rule for a bill group using a pricing group.
    Pricing Rule ID Characteristic for Inbound Log Used to specify the characteristic type where you want to store the pricing rule ID. This characteristic type is used while creating a log entry for a health care inbound message. The log entry then indicates the pricing rule which is created through the health care inbound message.
    Note:

    The C1PRLOG characteristic type is shipped with the product.

    By default, the value is set to C1PRLOG. You can change the value, if required. However, note that you must specify a foreign key characteristic type where the characteristic entity is set to Inbound Message Log.

    		 Yes (Conditional)
    Note: This data is required while creating a pricing rule through a health care inbound message.
    Pricing Rule Type Category Characteristic Used to specify the characteristic type which indicates the pricing rule type category. This characteristic type is defined for a billable charge line type. The system uses this characteristic to lists the billable charge line types which are valid while defining a pricing rule type or pricing rule of a particular category.
    Note:

    The C1PRTCAT characteristic type is shipped with the product.

    By default, the value is set to C1PRTCAT. You can change the value, if required. However, note that you must specify a foreign key characteristic type where the characteristic entity is set to Billable Charge Line Type.

    		 Yes
    Proration Distributed SQI Used to specify the SQI where you want to store the distributed premium amount for the non-skip billing period. The system uses this SQI while creating the SQI based billable charge for the group membership premium.
    Note: You must specify an SQI which is already defined in the system.
    		 es (Conditional)
    Note: This data is required when the 9/10 Billing (Skip Months) feature is enabled for an account.
    Proration SQI Used to specify the SQI where you want to store the pre-calculated or calculated premium amount. The system uses this SQI while creating the SQI based billable charge for the group or individual membership premium.
    Note: You must specify an SQI which is already defined in the system.
    		 Yes (Conditional)
    Note: This data is required while billing fully-insured group and individual health plans.
    Rate Component Base Fee Characteristic Used to specify the characteristic type which indicates whether the rate component is a base fee rate component. This characteristic type is defined for the rate component.
    Note:

    The C1RCBFMA characteristic type is shipped with the product.

    By default, the value is set to C1RCBFMA.

    		 Yes
    Rate Option Extendable Lookup Business Object Used to specify the rate option extendable lookup business object. The system displays the values of the specified extendable lookup in the Rate Option list while defining, editing, or copying a pricing rule type.
    Note:

    The C1-ExtLookRetTypeRateOpt extendable lookup for rate option is shipped with the product.

    By default, the value is set to C1-ExtLookRetTypeRateOpt. You can change the value, if required.

    		 Yes
    Rating Area Field Mapping for Group Used to specify a geographic rating area preference. The system considers the various attributes of the geographic rating area preference while deriving the geographic rating area for a group membership.
    Note: You must specify a geographic rating area preference which is already defined in the system.
    		 Yes (Conditional)
    Note: This data is required while deriving the geographic rating area for a group membership.
    Rating Area Field Mapping for Individual Used to specify a geographic rating area preference. The system considers the various attributes of the geographic rating area preference while deriving the geographic rating area for an individual membership.
    Note: You must specify a geographic rating area preference which is already defined in the system.
    		 Yes (Conditional)
    Note: This data is required while deriving the geographic rating area for an individual membership.
    Reinsurer Person Relationship Type Used to indicate the relationship type using which the reinsurer person should be associated with the parent customer.
    Note: You must specify a reinsurer person relationship type which is already defined in the system.
    		 Yes (Conditional)
    Note: This data is required while associating the reinsurer person with the parent customer.
    Relation Structure Code Field Mapping Used to specify a member relationship and subscription tier preference. The system considers the various attributes of the member relationship and subscription tier preference while deriving the member relationship for a member person and the subscription tier for a group or individual membership.
    Note: You must specify a member relationship and subscription tier preference which is already defined in the system.
    		 Yes (Conditional)
    Note: This data is required while deriving the member relationship for a member person and the subscription tier for a group or individual membership.
    Sponsored Switch Characteristic for Billable Charge Used to specify the characteristic type which indicates whether the billable charge is a reverse charge for a membership benefit. This characteristic type is defined while creating the reverse charge for a membership benefit.
    Note: You must specify a characteristic type where the characteristic entity is set to Billable Charge.
    		 Yes (Conditional)
    Note: This data is required while creating the reverse charge for a benefit.
    State of Issue Characteristic Type Used to specify the characteristic type where you store the state for which the group or individual membership, policy plan, or policy is issued. This characteristic type can be defined for the group or individual membership, policy plan, or policy. This characteristic is used while identifying a list of eligible children in a group or individual membership for premium calculation.
    Note: You must specify a characteristic type where the characteristic entity is set to Membership, Policy Plan, and Policy.
    		Yes (Conditional)
    Note: This data is required while identifying a list of eligible children for premium calculation.
    Statement Construct Char for Inbound Log Used to specify the characteristic type where you want to store the statement construct ID. This characteristic type is used while creating a log entry for a health care inbound message. The log entry then indicates the statement construct which is created through the health care inbound message.
    Note: You must specify a characteristic type where the characteristic entity is set to Statement Construct for Inbound Log.
    		 Yes (Conditional)
    Note: This data is required while creating a log entry for a health care inbound message.
    Status Reason Mapping Used to specify a membership status reason preference. The system considers the various attributes of the membership status reason preference while deriving the individual membership or member person status reason.
    Note: You must specify a membership status reason preference which is already defined in the system.
    		 Yes (Conditional)
    Note: This data is required while maintaining an individual membership.
    To Do Role Characteristic Type Used to specify the characteristic type where you want to store the To Do role. This characteristic type is defined for the parent customer. The system uses this characteristic to determine the users to whom the To Dos created using the C1-REPC1, C1-REPC2, and C1-FIBCR To Do types should be assigned.
    Note:

    A To Do is created using the C1-REPC1 To Do type when an error occurs while creating a repricing request. A To Do is created using the C1-REPC2 To Do type when an error occurs while calculating group or individual membership premium. A To Do is created using the C1-FIBCR To Do type when an error occurs while creating a billable charge for a group and individual membership.

    You must specify an adhoc characteristic type where the characteristic entity is set to Person.

    		 Yes (Conditional)
    Note: This data is required while billing fully-insured group and individual health plans.
    TPA Account Relationship Type Used to indicate how a third party administrator (TPA) person should be related to its account. The system uses this account relationship type while creating a TPA account for a TPA person through a health care inbound message.
    Note: You must specify an account relationship type which is already defined in the system.
    		 Yes (Conditional)
    Note: This data is required while creating a TPA account through a health care inbound message.
    TPA Person Relationship Type Used to indicate how a third party administrator (TPA) person should be related to its parent customer. The system uses this person relationship type while creating a TPA person for a parent customer through a health care inbound message.
    Note: You must specify a person relationship type which is already defined in the system.
    		 Yes (Conditional)
    Note: This data is required while creating a TPA person through a health care inbound message.
    TPA Policy Person Role Used to specify the policy person role using which a third party administrator (TPA) person should be associated with a fully-insured group policy when the policy information is given for the TPA person in a health care inbound message.
    Note: You must specify a policy person role which is already defined in the system.
    		 Yes (Conditional)
    Note: This data is required while associating a TPA person with a fully-insured group policy through a health care inbound message.
  7. Enter the values for the required option types in the Feature Configuration screen.
  8. Click the Save button in the Page Title area.
    The changes made to the feature configuration are saved.

Related Topics

For more information on... See...
Customer 360° Information screen Customer 360° Information
Health Care Inbound Message Health Care Inbound Message