Self-Funded Policy Activation

A self-funded policy can be activated manually from the user interface or through the Policy Periodic Monitor (C1-POLPR) batch. You can activate a self-funded policy by clicking the Activate button in the Policy screen. On clicking the Activate button, the system checks whether the To Do created for the Pending status is completed. If the To Do created for the Pending status is not completed, it completes the To Do and then changes the status of the self-funded policy from Pending to In Force/Active.

Note: The status of the policy is not changed from Pending to In Force/Active until the system date is later than or equal to the policy start date.

On executing the Policy Periodic Monitor (C1-POLPR) batch, the system does the following:

  • If the self-funded policy is in the Pending status and the policy start date - X days is earlier than or equal to the system date, it creates a To Do using the To Do type which is specified in the To Do Type for Pending Status parameter (of an algorithm created using the C1-ASOPOLMOA algorithm type).

  • If the start date of the self-funded policy is earlier than or equal to the system date and the To Do created using the To Do type specified in the To Do Type for Pending Status parameter is completed, it changes the status of the self-funded policy from Pending to In Force/Active.

You can define pricing rules using the pricing rule types of the following categories for a self-funded policy of a bill group which is in the Active status:

  • Claim

  • Specific Stop-Loss

  • Aggregate Stop-Loss

  • Retention Type Claim Based

  • Retention Type Enrollment Based

  • Ancillary

  • Flat Fees

  • Level Funded