Single Contract Creation Across Fully-Insured Group Policies and Plans

The system automatically creates a contract for a fully-insured group policy plan on the parent customer and/or bill group accounts. The system creates or updates contracts of a policy plan when you do either of the following:

  • Create or Edit a Policy Plan from the User Interface or through an Inbound Message - The system creates a contract in either of the following ways:

    • If a price item is associated with the policy plan, it creates a contract using the contract type which is associated with the price item.

    • If a pricing rule type is associated with the policy plan and the pricing rule type contains one or more price items, it creates one contract using each contract type which may be associated with one or more price items. Let us assume that a pricing rule type named PRT1 is associated with the policy plan and it contains three price items - PI1, PI2, and PI3. Now, if the PI1 is associated with the CT1 contract type, PI2 is associated with the CT2 contract type, and PI3 is associated with the CT3 contract type, the system will create three contracts - C1 using CT1, C2 using CT2, and C3 using CT3. However, if the PI1 and PI3 are associated with the CT1 contract type and PI2 is associated with the CT2 contract type, the system will create two contracts - C1 using CT1 and C2 using CT2.

      If a policy has two or more plans, multiple pricing rule types are associated with each policy plan and each pricing rule type contains multiple price items, it creates one contract using each contract type which may be associated with one or more price items. Let us assume that P1 has two plans - PP1 and PP2, PRT1 is associated with PP1, PRT2 is associated with PP2, PRT1 contains three price items - PI1, PI2, and PI3, and PRT2 contains three price items - PI1, PI4, and PI5. Now, if the PI1 is associated with the CT1 contract type, PI2 is associated with the CT2 contract type, PI3 is associated with the CT3 contract type, PI4 is associated with the CT4 contract type, and PI5 is associated with the CT5 contract type, the system will create five contracts - C1 using CT1, C2 using CT2, C3 using CT3, C4 using CT4, and C5 using CT5. However, if PI1, PI2, and PI5 are associated with the CT1 contract type and PI3 and PI4 are associated with the CT2 contract type, the system will create two contracts - C1 using CT1 and C2 using CT2.

    The status of each contract is set to Active. The contract start date is set to the start date of the respective plan. If the same contract type is associated with different price items, and if these price items are added on different pricing rule types, and if these pricing rule types are associated with different plans, the contract start date is set to the start date of the earliest plan. The default rate schedule specified on the respective contract type is added to the contract in the rate information and its effective date is set to the contract start date.

    Example 1 - Contract Creation for a Parent Customer

    If a policy plan belongs to a policy of the parent customer (where a bill group is not associated), the system will create one contract using each contract type on each account of the parent customer and bill groups. Let us assume that…

    • PC1 has two bill groups - BG1 and BG2

    • PC1 has A1 account, BG1 has A2 account, and BG2 has A3 and A4 accounts

    • A policy named P1 with two plans - PP1 and PP2 - is created for PC1 (where none of the bill groups are associated)

    • PP1 (with the start date as 01-01-2019) is associated with PRT1 and PRT2

    • PP2 (with the start date as 03-01-2019) is associated with PRT2 and PRT3

    • PRT1 contains two price items - PI1 and PI2

    • PRT2 contains three price items - PI1, PI3, and PI4

    • PRT3 contains three price items - PI4, PI5, and PI6

    • PI1 is associated with the CT1 contract type, PI2 is associated with the CT2 contract type, PI3 is associated with the CT3 contract type, PI4 and PI5 are associated with the CT4 contract type, and PI6 is associated with the CT6 contract type

    The following table indicates the distinct contracts that would be created across policy plans on the A1, A2, A3, and A4 accounts in the above stated scenario:
    Account Plan Pricing Rule Type Price Item Contract Type Contract Plans for which the contract is created… Contract Start Date (i.e. Earliest Plan Date)
    A1 PP1 PRTI PI1 CT1 A1C1 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI2 CT2 A1C2 PP1 (01-01-2019) 01-01-2019
    PRT2 PI1 CT1 A1C1 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI3 CT3 A1C3 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI4 CT4 A1C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PP2 PRT2 PI1 CT1 A1C1 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI3 CT3 A1C3 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI4 CT4 A1C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PRT3 PI4 CT4 A1C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI5 CT4 A1C4 PP2 (03-01-2019) 01-01-2019 (because PI4 and PI5 are associated with the same contract type (i.e. CT4)
    PI6 CT6 A1C6 PP2 (03-01-2019) 03-01-2019
    A2 PP1 PRTI PI1 CT1 A2C1 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI2 CT2 A2C2 PP1 (01-01-2019) 01-01-2019
    PRT2 PI1 CT1 A2C1 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI3 CT3 A2C3 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI4 CT4 A2C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PP2 PRT2 PI1 CT1 A2C1 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI3 CT3 A2C3 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI4 CT4 A2C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PRT3 PI4 CT4 A2C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI5 CT4 A2C4 PP2 (03-01-2019) 01-01-2019 (because PI4 and PI5 are associated with the same contract type (i.e. CT4)
    PI6 CT6 A2C6 PP2 (03-01-2019) 03-01-2019
    A3 PP1 PRTI PI1 CT1 A3C1 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI2 CT2 A3C2 PP1 (01-01-2019) 01-01-2019
    PRT2 PI1 CT1 A3C1 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI3 CT3 A3C3 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI4 CT4 A3C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PP2 PRT2 PI1 CT1 A3C1 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI3 CT3 A3C3 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI4 CT4 A3C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PRT3 PI4 CT4 A3C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI5 CT4 A3C4 PP2 (03-01-2019) 01-01-2019 (because PI4 and PI5 are associated with the same contract type (i.e. CT4)
    PI6 CT6 A3C6 PP2 (03-01-2019) 03-01-2019
    A4 PP1 PRTI PI1 CT1 A4C1 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI2 CT2 A4C2 PP1 (01-01-2019) 01-01-2019
    PRT2 PI1 CT1 A4C1 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI3 CT3 A4C3 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI4 CT4 A4C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PP2 PRT2 PI1 CT1 A4C1 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI3 CT3 A4C3 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI4 CT4 A4C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PRT3 PI4 CT4 A4C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI5 CT4 A4C4 PP2 (03-01-2019) 01-01-2019 (because PI4 and PI5 are associated with the same contract type (i.e. CT4)
    PI6 CT6 A4C6 PP2 (03-01-2019) 03-01-2019

    The following figure graphically illustrates the example 1:


    The figure illustrates how the contracts are created across the fully-insured group policies and plans for all accounts of a parent customer.

    Example 2 - Contract Creation for a Bill Group

    If a policy plan belongs to a policy of a bill group (where the parent customer is the policy holder), the system will create one contract using each contract type on each account of the parent customer and the bill group. Let us assume that…

    • PC1 has two bill groups - BG1 and BG2

    • PC1 has A1 account, BG1 has A2 account, and BG2 has A3 and A4 accounts

    • A policy named P1 with three plans - PP1, PP2, and PP3 - is created for BG1 (where PC1 is the policy holder)

    • PP1 (with the start date as 01-01-2019) is associated with PRT1 and PRT2

    • PP2 (with the start date as 03-01-2019) is associated with PRT2 and PRT3

    • PP3 (with the start date as 06-01-2019) is associated with PRT1

    • PRT1 contains two price items - PI1 and PI2

    • PRT2 contains three price items - PI1, PI3, and PI4

    • PRT3 contains three price items - PI4, PI5, and PI6

    • PI1 is associated with the CT1 contract type, PI2 is associated with the CT2 contract type, PI3 is associated with the CT3 contract type, PI4 and PI5 are associated with the CT4 contract type, and PI6 is associated with the CT6 contract type

    The following table indicates the distinct contracts that would be created across policy plans on the A1 and A2 accounts in the above stated scenario:
    Account Plan Pricing Rule Type Price Item Contract Type Contract Plans for which the contract is created… Contract Start Date (i.e. Earliest Plan Date)
    A1 PP1 PRT1 PI1 CT1 A1C1 PP1 (01-01-2019), PP2 (03-01-2019), and PP3 (06-01-2019) 01-01-2019
    PI2 CT2 A1C2 PP1 (01-01-2019) and PP3 (06-01-2019) 01-01-2019
    PRT2 PI1 CT1 A1C1 PP1 (01-01-2019), PP2 (03-01-2019), and PP3 (06-01-2019) 01-01-2019
    PI3 CT3 A1C3 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI4 CT4 A1C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PP2 PRT2 PI1 CT1 A1C1 PP1 (01-01-2019), PP2 (03-01-2019), and PP3 (06-01-2019) 01-01-2019
    PI3 CT3 A1C3 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI4 CT4 A1C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PRT3 PI4 CT4 A1C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI5 CT4 A1C4 PP2 (03-01-2019) 01-01-2019 (because PI4 and PI5 are associated with the same contract type (i.e. CT4)
    PI6 CT6 A1C6 PP2 (03-01-2019) 03-01-2019
    PP3 PRT1 PI1 CT1 A1C1 PP1 (01-01-2019), PP2 (03-01-2019), and PP3 (06-01-2019) 01-01-2019
    PI2 CT2 A1C2 PP1 (01-01-2019) and PP3 (06-01-2019) 01-01-2019
    A2 PP1 PRT1 PI1 CT1 A2C1 PP1 (01-01-2019), PP2 (03-01-2019), and PP3 (06-01-2019) 01-01-2019
    PI2 CT2 A2C2 PP1 (01-01-2019) and PP3 (06-01-2019) 01-01-2019
    PRT2 PI1 CT1 A2C1 PP1 (01-01-2019), PP2 (03-01-2019), and PP3 (06-01-2019) 01-01-2019
    PI3 CT3 A2C3 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI4 CT4 A2C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PP2 PRT2 PI1 CT1 A2C1 PP1 (01-01-2019), PP2 (03-01-2019), and PP3 (06-01-2019) 01-01-2019
    PI3 CT3 A2C3 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI4 CT4 A2C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PRT3 PI4 CT4 A2C4 PP1 (01-01-2019) and PP2 (03-01-2019) 01-01-2019
    PI5 CT4 A2C4 PP2 (03-01-2019) 01-01-2019 (because PI4 and PI5 are associated with the same contract type (i.e. CT4)
    PI6 CT6 A2C6 PP2 (03-01-2019) 03-01-2019
    PP3 PRT1 PI1 CT1 A2C1 PP1 (01-01-2019), PP2 (03-01-2019), and PP3 (06-01-2019) 01-01-2019
    PI2 CT2 A2C2 PP1 (01-01-2019) and PP3 (06-01-2019) 01-01-2019

    The following figure graphically illustrates the example 2:


    The figure illustrates how the contracts are created across the fully-insured group policies and plans for all accounts of a bill group.

    Note:

    The system creates a contract using a contract type for an account only when the division to which the account and contract type belongs is same.

    If a contract of a contract type is already present on the account, the system will not create a new contract. Instead, it will update the start date of the existing contract, if required.

  • Create or Edit an Account from the User Interface or through an Inbound Message - The system creates a contract when either of the following condition is met:

    • The main customer of the account is a parent customer and holds a policy (where a bill group is not associated) which is created using the policy type where the policy category is set to Fully-Insured Group.

    • The main customer of the account is a parent customer and holds a policy (where a bill group is associated) which is created using the policy type where the policy category is set to Fully-Insured Group.

    • The main customer of the account is a bill group and holds a policy (where the parent customer is the policy holder) which is created using the policy type where the policy category is set to Fully-Insured Group.

    The system creates a contract in either of the following ways:

    • If a price item is associated with the policy plan, it creates a contract using the contract type which is associated with the price item.

    • If a pricing rule type is associated with the policy plan and the pricing rule type contains one or more price items, it creates one contract using each contract type which may be associated with one or more price items. Let us assume that a pricing rule type named PRT1 is associated with the policy plan and it contains three price items - PI1, PI2, and PI3. Now, if the PI1 is associated with the CT1 contract type, PI2 is associated with the CT2 contract type, and PI3 is associated with the CT3 contract type, the system will create three contracts - C1 using CT1, C2 using CT2, and C3 using CT3. However, if the PI1 and PI3 are associated with the CT1 contract type and PI2 is associated with the CT2 contract type, the system will create two contracts - C1 using CT1 and C2 using CT2.

      If a policy has two or more plans, multiple pricing rule types are associated with each policy plan and each pricing rule type contains multiple price items, it creates one contract using each contract type which may be associated with one or more price items. Let us assume that P1 has two plans - PP1 and PP2, PRT1 is associated with PP1, PRT2 is associated with PP2, PRT1 contains three price items - PI1, PI2, and PI3, and PRT2 contains three price items - PI1, PI4, and PI5. Now, if the PI1 is associated with the CT1 contract type, PI2 is associated with the CT2 contract type, PI3 is associated with the CT3 contract type, PI4 is associated with the CT4 contract type, and PI5 is associated with the CT5 contract type, the system will create five contracts - C1 using CT1, C2 using CT2, C3 using CT3, C4 using CT4, and C5 using CT5. However, if PI1, PI2, and PI5 are associated with the CT1 contract type and PI3 and PI4 are associated with the CT2 contract type, the system will create two contracts - C1 using CT1 and C2 using CT2.

    The status of each contract is set to Active. The contract start date is set to the start date of the respective plan. If the same contract type is associated with different price items, and if these price items are added on different pricing rule types, and if these pricing rule types are associated with different plans, the contract start date is set to the start date of the earliest plan. The default rate schedule specified on the respective contract type is added to the contract in the rate information and its effective date is set to the contract start date.

    Example 3 - Contract Creation for an Account of a Parent Customer

    If you create an account for a parent customer who holds polices (where a bill group may or may not be associated), the system will create one contract using each contract type for all parent customer's policies on the account. Let us assume…

    • PC1 has two bill groups - BG1 and BG2

    • PC1 has two policies - a policy named P1 (where a bill group is not associated) and a policy named P2 (where BG1 is associated)

    • BG1 has one policy named P2 where PC1 is the policy holder

    • An account named A1 is added for PC1

    • P1 has two plans - PP1 and PP2

    • P2 has two plans - PP11 and PP12

    • PP1 (with the start date as 01-01-2019) is associated with PRT1 and PRT2

    • PP2 (with the start date as 06-01-2019) is associated with PRT2, PRT3, and PRT4

    • PP11 (with the start date as 05-01-2019) is associated with PRT111 and PRT112

    • PP12 (with the start date as 09-01-2019) is associated with PRT113 and PRT114

    • PRT1 contains two price items - PI1 and PI2

    • PRT2 contains two price items - PI3 and PI4

    • PRT3 contains two price items - PI1 and PI5

    • PRT4 contains two price items - PI6 and PI7

    • PRT111 contains two price items - PI11 and PI12

    • PRT112 contains two price items - PI1 and PI5

    • PRT113 contains two price items - PI13 and PI14

    • PRT114 contains two price items - PI7 and PI15

    • PI1 is associated with the CT1 contract type, PI2 and PI3 are associated with the CT2 contract type, PI4 is associated with the CT4 contract type, PI5 is associated with the CT5 contract type, PI6 is associated with the CT6 contract type, PI7 is associated with the CT7 contract type, PI11 is associated with the CT11 contract type, PI12 is associated with the CT12 contract type, PI13 is associated with the CT13 contract type, PI14 is associated with the CT14 contract type, and PI15 is associated with the CT15 contract type

    The following table indicates the distinct contracts that would be created across policy plans on the A1 account in the above stated scenario:
    Account Policy Plan Pricing Rule Type Price Item Contract Type Contract Plans for which the contract is created… Contract Start Date (i.e. Earliest Plan Date)
    A1 P1 PP1 PRT1 PI1 CT1 A1C1 PP1 (01-01-2019), PP2 (06-01-2019), and PP11 (05-01-2019) 01-01-2019
    PI2 CT2 A1C2 PP1 (01-01-2019) 01-01-2019
    PRT2 PI3 CT2 A1C2 PP1 (01-01-2019) and PP2 (06-01-2019) 01-01-2019
    PI4 CT4 A1C4 PP1 (01-01-2019) and PP2 (06-01-2019) 01-01-2019
    PP2 PRT2 PI3 CT2 A1C2 PP1 (01-01-2019) and PP2 (06-01-2019) 01-01-2019
    PI4 CT4 A1C4 PP1 (01-01-2019) and PP2 (06-01-2019) 01-01-2019
    PRT3 PI1 CT1 A1C1 PP1 (01-01-2019), PP2 (06-01-2019), and PP11 (05-01-2019) 01-01-2019
    PI5 CT5 A1C5 PP2 (06-01-2019) and PP11 (05-01-2019) 05-01-2019
    PRT4 PI6 CT6 A1C6 PP2 (06-01-2019) 06-01-2019
    PI7 CT7 A1C7 PP2 (06-01-2019) and PP12 (09-01-2019) 06-01-2019
    P2 PP11 PRT111 PI11 CT11 A1C11 PP11 (05-01-2019) 05-01-2019
    PI12 CT12 A1C12 PP11 (05-01-2019) 05-01-2019
    PRT112 PI1 CT1 A1C1 PP1 (01-01-2019), PP2 (06-01-2019), and PP11 (05-01-2019) 01-01-2019
    PI5 CT5 A1C5 PP2 (06-01-2019) and PP11 (05-01-2019) 05-01-2019
    PP12 PRT113 PI13 CT13 A1C13 PP12 (09-01-2019) 09-01-2019
    PI14 CT14 A1C14 PP12 (09-01-2019) 09-01-2019
    PRT114 PI7 CT7 A1C7 PP2 (06-01-2019) and PP12 (09-01-2019) 06-01-2019
    PI15 CT15 A1C15 PP12 (09-01-2019) 09-01-2019

    The following figure graphically illustrates the example 3:


    The figure illustrates how the contracts are created across the fully-insured group policies and plans for an account of a parent customer.

    Example 4 - Contract Creation for an Account of a Bill Group

    If you create an account for a bill group who holds policies and its parent customer holds policies (where a bill group may or may not be associated), the system will create one contract using each contract type for the bill group's polices and parent customer's polices (where a bill group is not associated) on the account. Let us assume…

    • PC1 has two bill groups - BG1 and BG2

    • PC1 has two policies - a policy named P2 (where a bill group is not associated) and a policy named P1 (where BG2 is associated)

    • BG2 has one policy named P1 where PC1 is the policy holder

    • An account named A1 is added for BG2

    • P1 has two plans - PP11 and PP12

    • P2 has two plans - PP1 and PP2

    • PP1 (with the start date as 01-01-2019) is associated with PRT1 and PRT2

    • PP2 (with the start date as 04-01-2019) is associated with PRT3 and PRT4

    • PP11 (with the start date as 07-01-2019) is associated with PRT11 and PRT12

    • PP12 (with the start date as 11-01-2019) is associated with PRT13 and PRT14

    • PRT1 contains two price items - PI1 and PI2

    • PRT2 contains two price items - PI3 and PI2

    • PRT3 contains two price items - PI3 and PI4

    • PRT4 contains two price items - PI5 and PI6

    • PRT11 contains two price items - PI111 and PI112

    • PRT12 contains two price items - PI1 and PI6

    • PRT13 contains two price items - PI113 and PI114

    • PRT14 contains two price items - PI115 and PI5

    • PI1 is associated with the CT1 contract type, PI2 and PI3 are associated with the CT2 contract type, PI4 is associated with the CT4 contract type, PI5 is associated with the CT5 contract type, PI6 is associated with the CT6 contract type, PI111 is associated with the CT111 contract type, PI112 is associated with the CT112 contract type, PI113 is associated with the CT113 contract type, and PI114 and PI115 is associated with the CT114 contract type

    The following table indicates the distinct contracts that would be created across policy plans on the A1 account in the above stated scenario:
    Account Policy Plan Pricing Rule Type Price Item Contract Type Contract Plans for which the contract is created… Contract Start Date (i.e. Earliest Plan Date)
    A1 P1 PP11 PRT11 PI111 CT111 A1C111 PP11 (07-01-2019) 07-01-2019
    PI112 CT112 A1C112 PP11 (07-01-2019) 07-01-2019
    PRT12 PI1 CT1 A1C1 PP1 (01-01-2019) and PP11 (07-01-2019) 01-01-2019
    PI6 CT6 A1C6 PP2 (04-01-2019) and PP11 (07-01-2019) 04-01-2019
    PP12 PRT13 PI113 CT113 A1C113 PP12 (11-01-2019) 11-01-2019
    PI114 CT114 A1C114 PP12 (11-01-2019) 11-01-2019
    PRT14 PI115 CT114 A1C114 PP12 (11-01-2019) 11-01-2019
    PI5 CT5 A1C5 PP2 (04-01-2019) and PP12 (11-01-2019) 04-01-2019
    P2 PP1 PRT1 PI1 CT1 A1C1 PP1 (01-01-2019) and PP11 (07-01-2019) 01-01-2019
    PI2 CT2 A1C2 PP1 (01-01-2019) 01-01-2019
    PRT2 PI2 CT2 A1C2 PP1 (01-01-2019) 01-01-2019
    PI3 CT2 A1C2 PP1 (01-01-2019) and PP2 (04-01-2019) 01-01-2019
    PP2 PRT3 PI3 CT2 A1C2 PP1 (01-01-2019) and PP2 (04-01-2019) 01-01-2019
    PI4 CT4 A1C4 PP2 (04-01-2019) 04-01-2019
    PRT4 PI5 CT5 A1C5 PP2 (04-01-2019) and PP12 (11-01-2019) 04-01-2019
    PI6 CT6 A1C6 PP2 (04-01-2019) and PP11 (07-01-2019) 04-01-2019

    The following figure graphically illustrates the example 4:


    The figure illustrates how the contracts are created across the fully-insured group policies and plans for an account of a bill group.

    Note:

    The system creates a contract using a contract type for an account only when the division to which the account and contract type belongs is same.

    If a contract of a contract type is already present on the account, the system will not create a new contract. Instead, it will update the start date of the existing contract, if required.