C1-DETTERMDT

This algorithm calculates the termination effective date based on the termination date rule priority configuration set on the delinquency process type, and stores the termination effective date rule and termination date on the delinquency process for the subsequent processes, such as, letter extract, termination request event, etc.

The different termination date rules supported by this algorithm are:

  • X Days After Termination Request Event - The termination effective date is the Trigger Date of the Termination Request Event + (X) No. of Days

  • X Days After Grace End Date - The termination effective date is the Grace End Date + (X) No. of Days.

    Note: The X Days After Grace End Date is generally used for medium and small groups.

  • Latest Billed Coverage End Date - The termination effective date is the (X) No. of Days after the Maximum Coverage End Date that falls on or prior to the Grace End Date

  • Latest Due Coverage End Date - The termination effective date is the (X) No. of Days after the end of the coverage prior to the latest due date from the invoices on the delinquency process.

  • X Days After Paid Through Date - The termination effective date is the Paid Through Date + (X) No. of Days.

    Note: The X Days After Paid Through Date is commonly used for the Fully-Insured Plain Individual Plans.

  • X Months After Paid Through Date - The termination effective date is the End of Month (Paid Through Date + (X) No. of Months).

    Note: The X Months After Paid Through Date is commonly used for Fully-Insured Plain Individual Plans.

  • Month End of Termination Request Event - The termination effective date is the End of the Month of (Trigger Date of the Termination Request + Member Notification Days) + 1

    Note: The Month End of Termination Request Event is generally used for medicare and sometimes for group where the member notice is sent.

  • Month End of Grace Period Start - The termination effective date is the last day of the Grace Period Start Month.

  • Month End of Termination Letter Creation - The termination effective date is the Direct Billed Medicare Termination Date as the End of Month of the Termination Letter Creation Date.

Note: The C1-DETTERMDT algorithm type is shipped with the product. You must attach an algorithm created using the C1-DETTERMDT algorithm type to the Event Activation system event.