Defining a Member Relationship and Subscription Tier Preference

Prerequisites

To define a member relationship and subscription tier preference, you should have:

  • Required characteristic types defined in the application

  • Values defined in the MAP_​ENTITY_​FLG lookup field

Procedure

To define a member relationship and subscription tier preference:

  1. Click the Admin link in the Application toolbar.
    A list appears.
  2. From the Admin menu, select F and then click Field Mapping.
    A sub-menu appears.
  3. Click the Add option from the Field Mapping sub-menu.

    The Select Business Object screen appears. It contains the following field:

    Field Name Field Description Mandatory (Yes or No)
    Field Mapping Business Object Used to indicate the business object using which you want to create the member relationship and subscription tier preference. The valid values are:

    • Field Mapping

    • Medicare Plan Benefit Package

    • Membership Status Reason Mapping

    		 Yes
    Note: Alternatively, you can access the Select Business Object screen by clicking the Add button in the Page Title area of the Field Mapping screen.
  4. Select the Field Mapping option from the Field Mapping Business Object list.
  5. Click OK.

    The Field Mapping screen appears. It contains the following sections:

    • Main - Used to specify basic details of the member relationship and subscription tier preference. It contains the following fields:

      Field Name Field Description Mandatory (Yes or No)
      Preference Used to specify the member relationship and subscription tier preference. Yes
      Description Used to specify the description for the member relationship and subscription tier preference. Yes
      Detailed Description Used to specify additional information about the member relationship and subscription tier preference. No
      Status Used to indicate the status of the member relationship and subscription tier preference. The valid values are:

      • Active

      • Inactive

      		 Yes

    • Preference Category - This section contains the following field:

      Field Name Field Description Mandatory (Yes or No)
      Preference Category Used to indicate the category to which the preference belongs. The valid values are:

      • Billing

      • Binder Payment

      • Geographic Rating Area

      • Individual Membership

      • Medicare

      • Medicare Plan Benefit

      • Member Reconciliation

      • Member Relationship and Subscription Tier

      • Membership Status Reason

      • Statement Construct

      		 Yes

    • Preference Settings - Used to set the attributes in the member relationship and subscription tier preference. It contains the following fields in a grid:

      Field Name Field Description Mandatory (Yes or No)
      Attribute Used to indicate the attribute which you want to set in the member relationship and subscription tier preference. The valid values are:

      • Age Calculation Date Basis Characteristic Type - Used when the system derives the member relationship for a member person and the subscription tier for a membership.

      • Max Age Limit for Max Dependent Count Characteristic Type - Used when the system derives the member relationship for a member person and the subscription tier for a membership.

      • Max Number of Dependents Order Priority Characteristic Type - Used when the system derives the member relationship for a member person and the subscription tier for a membership.

      • Member Relationship Characteristic Type - Used when the system stores the member relationship for a member person.

      • Maximum Number of Dependents Characteristic Type - Used when the system derives the member relationship for a member person and the subscription tier for a membership.

      • Member Relationship Derivation Date Characteristic Type - Used when the system derives the member relationship for a member person.

      • Member Relationship Structure Characteristic Type - Used when the system derives the member relationship for a member person.

      • New Born Gift Days Characteristic Type - Used when the system derives the member relationship for a member person and the subscription tier for a membership.

      • New Born Gift Days Applicability Characteristic Type - Used when the system derives the member relationship for a member person and the subscription tier for a membership.

      • Subscription Tier Structure Characteristic Type - Used when the system derives the subscription tier for a membership.

      • Subscription Tier Characteristic Type - Used when the system stores the subscription tier for a membership.

      • Young Adult Max Age Limit Characteristic Type - Used when the system derives the member relationship for a member person and the subscription tier for a membership.

      • Young Adult Max Age Limit Applicability Characteristic Type - Used when the system derives the member relationship for a member person and the subscription tier for a membership.

      		 Yes (Conditional)
      Note: This field is required while setting an attribute in the member relationship and subscription tier preference.
      Value Used to specify the attribute value. The attribute value that you can specify varies depending on the attribute you want to set in the member relationship and subscription tier preference:
      If the attribute is set to... Then, this field is...
      Age Calculation Date Basis Characteristic Type Used to specify the characteristic type that indicates how the member person's age should be calculated. The system supports the following characteristic values:

      • Member Enrollment Date

      • Member Enrollment Nearest Age

      • Plan Start Date

      • Policy Renewal/Start Date

      This type of characteristic can be defined for the following entities:

      • Policy Plan

      • Policy

      Here, you must specify a characteristic type where the characteristic entity is set to Policy Plan and Policy.

      Note: The C1-AGCAL characteristic type is shipped with the product.
      Max Age Limit for Max Dependent Count Characteristic Type Used to specify the characteristic type that indicates the maximum age limit for children which are eligible for premium calculation. This type of characteristic can be defined for the following entities:

      • Policy Plan

      • Policy

      Here, you must specify a characteristic type where the characteristic entity is set to Policy Plan and Policy.
      Max Number of Dependents Order Priority Characteristic Type Used to specify the characteristic type that indicates whether the system should first consider youngest or eldest children during premium calculation. The system supports the following two characteristic values - Youngest and Eldest. This type of characteristic can be defined for the following entities:

      • Policy Plan

      • Policy

      Here, you must specify a characteristic type where the characteristic entity is set to Policy Plan and Policy.

      Note: The DEPORPRI characteristic type is shipped with the product.
      Member Relationship Characteristic Type Used to specify the characteristic type where you can store the member relationship for a member person. This type of characteristic is defined for the member person. Here, you must specify a characteristic type where the characteristic entity is set to Membership Person.
      Note: The C1-MEMRL characteristic type is shipped with the product.
      Maximum Number of Dependents Characteristic Type Used to specify the characteristic type that indicates the maximum number of dependent persons which are eligible for premium calculation. This type of characteristic can be defined for the following entities:

      • Policy Plan

      • Policy

      Here, you must specify a characteristic type where the characteristic entity is set to Policy Plan and Policy.
      Member Relationship Derivation Date Characteristic Type Used to specify the characteristic type that indicates whether the member relationship should be derived for a member person using its date of birth or enrollment date. The system supports the following two characteristic values - Date of Birth and Enrollment Date. This type of characteristic can be defined for the following entities:

      • Policy Plan

      • Policy

      Here, you must specify a characteristic type where the characteristic entity is set to Policy Plan and Policy.

      Note: The C1-MRDDB characteristic type is shipped with the product.
      Member Relationship Structure Characteristic Type Used to specify the characteristic type that indicates the member relationship structure which should be considered while deriving the member relationship for a member person. This type of characteristic can be defined for the following entities:

      • Policy Plan

      • Policy

      Here, you must specify a characteristic type where the characteristic entity is set to Policy Plan and Policy.

      Note: The C1-MRLST characteristic type is shipped with the product.
      New Born Gift Days Characteristic Type Used to specify the characteristic type that indicates the number of days you want to offer as gift days from the new born child's birth date. This type of characteristic can be defined for the following entities:

      • Policy Plan

      • Policy

      Here, you must specify a characteristic type where the characteristic entity is set to Policy Plan and Policy.

      Note: The NOOFGIFT characteristic type is shipped with the product. Here, you must define the required predefined characteristic values.
      New Born Gift Days Applicability Characteristic Type Used to specify the characteristic type that indicates whether you want to offer gift days in case of a new born. The system supports the following two characteristic values - Y and N. This type of characteristic can be defined for the following entities:

      • Policy Plan

      • Policy

      Here, you must specify a characteristic type where the characteristic entity is set to Policy Plan and Policy.

      Note: The NEWBORNA characteristic type is shipped with the product.
      Subscription Tier Structure Characteristic Type Used to specify the characteristic type that indicates the subscription tier structure which should be considered while deriving the subscription tier for a membership. This type of characteristic can be defined for the following entities:

      • Policy Plan

      • Policy

      Here, you must specify a characteristic type where the characteristic entity is set to Policy Plan and Policy.

      Note: The C1-STRST characteristic type is shipped with the product.
      Subscription Tier Characteristic Type Used to specify the characteristic type where you can store the subscription tier for a membership. This type of characteristic is defined for the membership. Here, you must specify a characteristic type where the characteristic entity is set to Membership.
      Note: The C1-SUBST characteristic type is shipped with the product.
      Young Adult Max Age Limit Characteristic Type Used to specify the characteristic type that indicates the maximum age limit for young adults which are eligible for premium calculation. This type of characteristic can be defined for the following entities:

      • Policy Plan

      • Policy

      Here, you must specify a characteristic type where the characteristic entity is set to Policy Plan and Policy.

      Note: The YADULTAG characteristic type is shipped with the product. Here, you must define the required predefined characteristic values.
      Young Adult Max Age Limit Applicability Characteristic Type Used to specify the characteristic type that indicates whether you want to consider the young adults during the premium calculation. The system supports the following two characteristic values - Y and N. This type of characteristic can be defined for the following entities:

      • Policy Plan

      • Policy

      Here, you must specify a characteristic type where the characteristic entity is set to Policy Plan and Policy.
      		Yes (Conditional)
      Note: This field is required while setting an attribute in the member relationship and subscription tier preference.
      Entity Type Used to indicate the type of entity for which the attribute is applicable. The valid values are:

      • Account

      • Billable Charge

      Note: At present, this data is stored for informational purposes only and is not considered in the business logic. If required, you can add more entity types to the MAP_​ENTITY_​FLG lookup field.
      		 No
      Note: While defining a member relationship and subscription tier preference, you must set at least one attribute in the member relationship and subscription tier preference.
  6. Select the Member Relationship and Subscription Tier Preferences option from the Preference Category list.
  7. Enter the required details in the Main section.
  8. Select the required attribute and value from the respective fields.
  9. If you want to set more than one attribute in the member relationship and subscription tier preference, click the Add (The Add Icon) icon and then repeat step 8.
    Note: However, if you want to remove an attribute from the member relationship and subscription tier preference, click the Delete (The Delete Icon) icon corresponding to the attribute.
  10. Click Save.
    The member relationship and subscription tier preference is defined.

Related Topics

For more information on... See...
Field Mapping screen Field Mapping