Editing a Plan of a Fully-Insured Group Policy

Prerequisites

To edit a plan of a fully-insured group policy, you should have:

  • Price items defined in the application

Procedure

To edit a plan of a fully-insured group policy:

  1. Search for the fully-insured group policy in the Policy screen.
  2. In the Search Results section, click the link in the Policy Information column corresponding to the policy whose details you want to edit.
    The Policy screen appears.
  3. Click the Plan tab.
    The Plan tab appears.
  4. In the Plans zone, click the Edit (The Edit Icon) icon in the Edit column corresponding to the policy plan whose details you want to edit.

    The Policy Plan screen appears. It contains the following sections:

    • Main - Used to specify the basic details about the fully-insured group policy plan.

    • Pricing Rule Types - Used to associate the pricing rule types with the fully-insured group policy plan.

    • Proration Rules - Used to define the proration rules for the fully-insured group policy plan.

    • Characteristics - Used to define the characteristics for the fully-insured group policy plan.

    The Main section contains the following fields:

    Field Name Field Description Mandatory (Yes or No)
    Plan Information Displays information about the fully-insured group policy plan. Not applicable
    Policy Information Indicates the fully-insured group policy for which the policy plan is created. Not applicable
    Price Item Used to indicate the price item which you want to directly associate with the fully-insured group policy plan.
    Note:

    The Search (The Search Icon) icon appears corresponding to this field. On clicking the Search icon, the Price Item Search window appears.

    On specifying the price item, the description of the price item appears corresponding to the Price Item field.

    		 Yes (Conditional)
    Note: You must either specify the price item or associate at least one pricing rule type with the policy plan.
    Plan Number Used to specify the plan number. Yes
    Plan Name Used to specify the description for the fully-insured group policy plan. No
    Benefit Type Used to indicate the type of health insurance plan. The valid values are:

    • Commercial

    • Medicare Affiliated

    		 No
    Start Date Used to specify the date from when the fully-insured group policy plan is effective.
    Note:

    The fully-insured group policy plan start date cannot be earlier than the policy start date and later than the policy end date.

    The fully-insured group policy plan start date cannot be later than the policy plan end date.

    		 Yes
    End Date Used to specify the date till when the fully-insured group policy plan is effective.
    Note:

    The fully-insured group policy plan end date cannot be earlier than the policy start date and later than the policy end date.

    The fully-insured group policy plan end date cannot be earlier than the policy plan start date.

    		 No
    Tip: Alternatively, you can edit the details of a fully-insured group policy plan by clicking the Edit button in the Policy Plan zone of the Policy Plan screen.
  5. Modify the required details in the Main section.
  6. Associate the pricing rule types with the fully-insured group policy plan, if required.
    Note: You must associate at least one pricing rule type with the policy plan when the price item is not specified in the fully-insured group policy plan.
  7. Define, edit, or remove the proration rules of the fully-insured group policy plan, if required.
  8. Define, edit, or remove characteristics of the fully-insured group policy plan, if required.
  9. Click Save.
    The changes made to the fully-insured group policy plan are saved.

Related Topics

For more information on... See...
How to search for a fully-insured group policy Searching for a Policy
Policy screen Policy (Used for Viewing)
Plans zone Plans
Policy Plan screen Policy Plan (Used for Viewing)
Policy Plan zone Policy Plan
How to associate a pricing rule type with a fully-insured group policy plan Associating a Pricing Rule Type with a Fully-Insured Group Policy Plan
How to define a proration rule for a fully-insured group policy plan Defining a Proration Rule for a Fully-Insured Group Policy Plan
How to define a characteristic for a fully-insured group policy plan Defining a Characteristic for a Fully-Insured Group Policy Plan