New Born Business Rules

Oracle Revenue Management and Billing enables you to define business rules for new born pricing. A new category named New Born Business Rule is introduced in this release. The premium calculation process for an individual membership is described as follows:

• If you want to calculate the premium for an individual membership using an age based pricing rule, the system derives the rate for each eligible member person. Once the rate is derived, the system identifies members that are eligible for premium calculation using the new born business rules. On creating or editing an individual membership through a health care inbound message or membership repricing inbound web service, the system determines the new born business rules which are applicable for the individual membership. If an individual membership meets the criteria of the new born business rule, the system then stamps the new born business rule corresponding to the individual membership.

• If you want to calculate the premium for an individual membership using a tier based pricing rule, the system derives the subscription tier using the new born business rules. Once the premium is calculated for an individual membership, the system creates a billable charge for the premium. If the account is defined for the individual membership using the characteristic types specified in the Account Identifier Type Char Type and Account Identifier Value Char Type option types of the C1-ASOBLLNG feature configuration, the system uses the account to bill the charge for the premium. However, if these characteristics are not defined for the individual membership, the system considers the account of the financially responsible member person to the charge for the premium.

  Note: While deriving a business rule of the New Born Business Rule category, the system considers the respective business rules which are effective on the audit event's effective date.

You can define, edit, and delete a new born business rule through the Business Rule screen. While defining a new born business rule, you need to set its category to Fully-Insured Pricing Business Rule. The new born business rule enables you to define the following parameters:

• Gift Days Applicability - Used to indicate whether you want to offer gift days in case of a new born child.

• New Born Gift Days - Used to specify the number of days you want to offer as gift days from the new born child's birth date.

You can view the new born business rules through the Business Rule screen.

Parent topic: Business Rules