Individual Membership Termination

To terminate an individual membership, you need to change the status of the main subscriber to Inactive through a health care inbound message or membership repricing inbound web service. Along with the main subscriber status, you need to specify the status reason and end date for the main subscriber. If the end date is earlier than or equal to the inbound processing date, the system updates the status, status reason, and end date of the main subscriber and then changes the status of the individual membership to Terminated. The system determines the individual membership status reason using the membership status reason preference which is specified in the Status Reason Mapping option type of the C1-ASOBLLNG feature configuration.

Once the status of the individual membership is set to Terminated, the system automatically changes the status of the dependent persons to Inactive. Note that while inactivating the dependent persons, the system only considers the dependent persons who are in the Active status. The system determines the dependent person status reason using the membership status reason preference.

If the main subscriber end date is later than the inbound processing date, the system creates a record in the CI_​MEMBERSHIP_​PROCESS table with the Pending status. The system stores the following information in the record:

  • Membership ID

  • Member Person ID

  • Whether the member person is a main subscriber

  • Processing date (it is set to future dated end date of the member person)

  • Required action (is set to Terminate)

A new batch named C1-MEPRC is introduced in this release. On the C1-MEPRC batch execution, the system checks whether there are any records in the CI_​MEMBERSHIP_​PROCESS table with the Pending status. If so, the system checks whether the processing date of the record is earlier than or equal to the system date. If so, the system determines the required action to be taken for the individual membership from the record. If the MEMB_​PROCESS_​FLG column of the record is set to Terminate and the MAIN_​CUST_​SW column is set to N, the system changes the status of the dependent person to Inactive and updates the end date of the dependent person.

However, if the MEMB_​PROCESS_​FLG column of the record is set to Terminate and the MAIN_​CUST_​SW column is set to Y, the system updates the status and end date of the main subscriber and then changes the status of the individual membership to Terminated. Once the status of the individual membership is set to Terminated, the system automatically changes the status of the dependent persons to Inactive. The system also updates the end date of the individual membership and dependent persons.

The system enables you to configure whether the individual membership on the add-on health insurance plan should be automatically terminated when the primary individual membership is terminated. If the Cascade Associate Membership parameter in the C1-MEMSTSUP algorithm is set to Y, the system changes the status of the associated individual membership to Terminated. Once the status of the associated individual membership is set to Terminated, the system automatically changes the status of its main subscriber and dependent persons to Inactive. The system also updates the end date of the associated individual membership, its main subscriber and its dependent persons.

Once the required action is completed for the record in the CI_​MEMBERSHIP_​PROCESS table, the system changes the status of the record to Complete. However, if the system receives a reinstatement request for an individual membership before processing the termination request, the system changes the status of the record in the CI_​MEMBERSHIP_​PROCESS table to Canceled.