Self-Funded Policy Contract Creation
The system automatically creates contracts when a self-funded policy is created either from the user interface or through a health care inbound message. It creates a contract for a self-funded policy on each account of the bill group. It creates a contract using the contract type which is specified in the Contract Type parameter of an algorithm which is created using the C1-ASOBOPOSP algorithm type. Let us assume that the Contract Type parameter in the C1-ASOBOPOSP algorithm is set to CT1. Now, when you create the self-funded policies named P1 and P2 for BG1 and P11, P12, and P13 for BG2 through a health care inbound message, the system will create a set of contracts on the respective accounts as mentioned below.
| Bill Group | Account | Contract |
|---|---|---|
| BG1 | A1 | C1 (for P1 using the CT1 contract type) |
| C2 (for P2 using the CT1 contract type) | ||
| A2 | C3 (for P1 using the CT1 contract type) | |
| C4 (for P2 using the CT1 contract type) | ||
| BG2 | A4 | C11 (for P11 using the CT1 contract type) |
| C12 (for P12 using the CT1 contract type) | ||
| C13 (for P13 using the CT1 contract type) | ||
| A5 | C14 (for P11 using the CT1 contract type) | |
| C15 (for P12 using the CT1 contract type) | ||
| C16 (for P13 using the CT1 contract type) | ||
| A6 | C17 (for P11 using the CT1 contract type) | |
| C18 (for P12 using the CT1 contract type) | ||
| C19 (for P13 using the CT1 contract type) |
The following figure graphically represents the above example:
You can also specify comma-separated values for the Contract Type parameter. The system will then create a contract using each contract type for each self-funded policy on each account of the bill group. Let us assume that the Contract Type parameter in the C1-ASOBOPOSP algorithm is set to CT1, CT2. Now, when you create the self-funded policies named P1 and P2 for BG1 and P11 and P12 for BG2 through a health care inbound message, the system will create a set of contracts on the respective accounts as mentioned below.
| Bill Group | Account | Contract |
|---|---|---|
| BG1 | A1 | C1 (for P1 using the CT1 contract type) |
| C2 (for P1 using the CT2 contract type) | ||
| C3 (for P2 using the CT1 contract type) | ||
| C4 (for P2 using the CT2 contract type) | ||
| A2 | C5 (for P1 using the CT1 contract type) | |
| C6 (for P1 using the CT2 contract type) | ||
| C7 (for P2 using the CT1 contract type) | ||
| C8 (for P2 using the CT2 contract type) | ||
| BG2 | A11 | C11 (for P11 using the CT1 contract type) |
| C12 (for P11 using the CT2 contract type) | ||
| C13 (for P12 using the CT1 contract type) | ||
| C14 (for P12 using the CT2 contract type) | ||
| A12 | C15 (for P11 using the CT1 contract type) | |
| C16 (for P11 using the CT2 contract type) | ||
| C18 (for P12 using the CT1 contract type) | ||
| C19 (for P12 using the CT2 contract type) |
The following figure graphically represents the above example:
