Sample Health Product and Plan Inbound Message for Health Plan Setup
Using the below example, you can do the following:
-
Create the health plan for the product in the ORMB system through the health product and health plan inbound message.
Health Product Code | Health Plan Code | HiOS ID | Description | Start Date | Status |
---|---|---|---|---|---|
HPMP444 | HMCSP01 | HIOSHLPNMS001 | Health Plan Medicare Surplus | 2021-02-01 | ACTIVE |
HPMP444 | HMCDP01 | HIOSHLPNMD005 | Health Plan Medicare Dental | 2021-03-01 | ACTIVE |
<schema>
<bo>C1-HCProdHlthPlnInbound</bo>
<messageType>C1-HCPRODHLTHPLN-INB-MSG-TYPE</messageType>
<sourceSystem>NSC</sourceSystem>
<externalTransactionId>889977</externalTransactionId>
<externalBatchId>737373</externalBatchId>
<externalSourceId>373737</externalSourceId>
<healthPlanData>
<healthProductCode>HPMP444</healthProductCode>
<healthPlanCode>HMCSP01</healthPlanCode>
<hiosId>HIOSHLPNMS001</hiosId>
<description>HEALTH PLAN MEDICARE SURPLUS</description>
<charitablePlan>N</charitablePlan>
<standardPlan>Y</standardPlan>
<acaQhp>Y</acaQhp>
<grandFatherPlan>Y</grandFatherPlan>
<ancillaryBenefits>Y</ancillaryBenefits>
<riderBenefits>N</riderBenefits>
<addOnPlan>N</addOnPlan>
<startDate>2021-02-01</startDate>
<endDate>2021-11-30</endDate>
<status>ACTIVE</status>
<healthPlanCharacteristics>
<characteristicType>ZZ-BNBLA</characteristicType>
<characteristicValue>DRCT</characteristicValue>
<effectiveDate>2021-02-01</effectiveDate>
</healthPlanCharacteristics>
<healthPlanCharacteristics>
<characteristicType>ZZ-DISPA</characteristicType>
<characteristicValue>CRCB</characteristicValue>
<effectiveDate>2021-02-10</effectiveDate>
</healthPlanCharacteristics>
<healthPlanPricingRuleTypes>
<pricingRuleType>AGE_BASED</pricingRuleType>
</healthPlanPricingRuleTypes>
<healthPlanPricingRuleTypes>
<pricingRuleType>ANCILLARY</pricingRuleType>
</healthPlanPricingRuleTypes>
</healthPlanData>
<healthPlanData>
<healthProductCode>HPMP444</healthProductCode>
<healthPlanCode>HMCDP01</healthPlanCode>
<hiosId>HIOSHLPNMD005</hiosId>
<description>HEALTH PLAN MEDICARE DENTAL</description>
<charitablePlan>N</charitablePlan>
<standardPlan>N</standardPlan>
<acaQhp>Y</acaQhp>
<grandFatherPlan>N</grandFatherPlan>
<ancillaryBenefits>Y</ancillaryBenefits>
<riderBenefits>N</riderBenefits>
<addOnPlan>Y</addOnPlan>
<startDate>2021-02-01</startDate>
<endDate>2021-10-31</endDate>
<status>ACTIVE</status>
<healthPlanCharacteristics>
<characteristicType>ZZ-BNBLA</characteristicType>
<characteristicValue>DRCT</characteristicValue>
<effectiveDate>2021-02-01</effectiveDate>
</healthPlanCharacteristics>
<healthPlanCharacteristics>
<characteristicType>ZZ-DISPA</characteristicType>
<characteristicValue>CRCB</characteristicValue>
<effectiveDate>2021-02-10</effectiveDate>
</healthPlanCharacteristics>
<healthPlanPricingRuleTypes>
<pricingRuleType>AGE_BASED</pricingRuleType>
</healthPlanPricingRuleTypes>
<healthPlanPricingRuleTypes>
<pricingRuleType>DISCOUNT</pricingRuleType>
</healthPlanPricingRuleTypes>
</healthPlanData>
</schema>
Note: We have given the above sample to illustrate how the tags should
be nested while sending an inbound message from the external system.
However, you should not seamlessly use this sample in your environment
because the required pre-requisite data may not be available in your
environment. In such case, the system will give erroneous results.