Discount Charge Pricing for Retiree Membership
Oracle Revenue Management and Billing enables you to maintain a flat or percentage based contribution of employer or sponsor for a retiree membership through a discount charge pricing rule. A new pricing rule type category named Discount Charge and the new business objects named Discount Charge Pricing Rule Type (C1-PrcRuleTypeDisChg) and Discount Charge Pricing Rule (C1-PricingRuleDiscount) are introduced in this release. This enables you to create the discount charge pricing rules where you can define different base and modifier fees based on the following pricing parameters:
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Membership attributes
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Member person attributes
For the fully-insured group and individual businesses, you can create or edit a flat or percentage based discount charge pricing rule through a health care inbound message. You can define a discount charge pricing rule at the policy plan, policy, or parent customer level. The following table describes the information that you need to provide in a health care inbound message while defining or editing a discount charge pricing rule on a policy plan, policy, or parent customer:
| Entity Type | Entity Identifiers |
|---|---|
| Policy Plan | Policy, Plan, and Source System |
| Policy | Policy and Source System |
| Parent Customer | Person Identifier Type and Person Identifier Value |
For the fully-insured individual business, you can create or edit a flat or percentage based discount charge pricing rule through a health product and plan inbound message. You can define a discount charge pricing rule at the health plan level. The following table describes the information that you need to provide in a health product and plan inbound message while defining or editing a discount charge pricing rule on a health plan:
| Entity Type | Entity Identifiers |
|---|---|
| Health Plan | Health Plan |
You can view a discount charge pricing rule defined for the fully-insured group business through the Customer 360° View screen. However, at present, you cannot view a discount charge pricing rule defined for the fully-insured individual business from the user interface.
You can create a discount charge pricing rule using a discount charge pricing rule type. You can create a discount charge pricing rule type from the user interface and not through an inbound message. While creating a discount charge pricing rule type, you must the select the Discount Charge Pricing Rule Type business object and set the pricing rule type category to Discount Charge. The discount is always charged per subscriber and not per member, and therefore you must set the pricing rule type sub category to Per Subscriber. Here, you must specify the algorithms for the following system events:
| System Event | Algorithm |
|---|---|
| Account and Price Item Derivation | C1_ACCPRIMEM |
| Account and Price Item Derivation Post-Processing | C1-BILLPDRV |
| Account and Price Item Derivation Post-Processing | C1-BILLRPCR |
| Billable Charge Creation Post-Processing | C1-FICRETBC |
| Bill Group Derivation | C1_MEMBGDRV |
| Premium Calculation | C1_TIERPREM |
In addition, you must specify the price items for which you can create discount charge pricing rules using the discount charge pricing rule type. A discount charge pricing rule type is not a primary pricing rule type. You must include a discount charge pricing rule type as a related pricing rule type in the age-based or tier based pricing rule types which are used for calculating the retiree membership premium. This is because the discount is offered on the retiree membership premium.
If the pricing type in the discount charge pricing rule is set to Flat, the system offers a flat discount on the retiree membership. But, if pricing type in the discount charge pricing rule is set to Percent, the system calculates and offers the percentage based discount on the retiree membership premium.