Support Open Ended Policies, Plans, Pricing Rules, and Memberships

Oracle Revenue Management and Billing enables you to maintain open-ended policies, policy or health plans, pricing rules, and group and individual memberships wherein you can specify far-fetched end dates for them. To support the open-ended group and individual memberships, the following changes are made to the system:

• All the group and individual memberships would be auto renewed by the system based on the given renewal period.

• Two new option types are added in the C1-ASOBLLNG feature configuration:

  • Number of months in advance for Open-Ended Renewal - Used to indicate the number of months in advance you want to automatically renew the group and individual memberships. You must specify a positive value for this option type.

  • Renewal period for Open-Ended Membership – Used to indicate the period (i.e. number of months) for which you want to automatically renew the group and individual memberships. You must specify a positive value for this option type. The system will then set the end date of the group memberships to the policy start date + renewal period – number of months in advance for open-ended renewal. Similarly, the system will then set the end date of the individual memberships to the membership start date + renewal period – number of months in advance for open-ended renewal.

• A new column named ENRL_​END_​DT is introduced in the CI_​MEMBERSHIP, CI_​MEMBERSHIP_​PER, and C1_​BENEFITS tables.

• A new column named OPEN_​ENDED_​SW is introduced in the CI_​MEMBERSHIP_​PROCESS table.

• The enrlEndDate tag is added for membership and membership person in the C1-Membership business object schema.

• The autoRenew and contractPeriod tags are added for membership in the C1-Membership business object schema.

• The enrlEndDate tag is added for membership and membership person in the C1-IndMembership business object schema.

• The enrlEndDate tag is added for benefit in the C1-Benefits business object schema.

• A new parameter named Open Ended Membership is added in the C1-MEPRC batch. It is optional. It is used when you want to process only open-ended memberships and automatically renew them for the given renewal period.

From now onwards, the end date of the group or individual membership received from the source system through an inbound message will be stored in the ENRL_​END_​DT column. The system will stamp the auto renewal end date in the END_​DT column and will use it for the membership premium calculation. The system will display the date from the ENRL_​END_​DT column for the membership and membership person in the Membership screen.

Now, when a group or individual membership is created through a health care inbound message, the system checks whether the renewal period for open-ended membership (specified in the C1-ASOBLLNG feature configuration) is less than the membership period. If so, the system does the following:

• Sets the end date of the membership and membership person to policy start date or individual membership start date + renewal period – number of months in advance for open-ended renewal.

• Sets the enrolment end date to the date specified in the endDate tag of the inbound message.

• Sets the AUTO_​RENEW_​SW field to Y and the CONTRACT_​PERIOD field to the renewal period.

• Sets the PROCESS_​DT column of the CI_​MEMBERSHIP_​PROCESS table to the end date of the membership.

• Sets the OPEN_​ENDED_​SW column of the CI_​MEMBERSHIP_​PROCESS table to Y.

On executing the C1-MEPRC batch, the system considers the membership records whose the OPEN_​ENDED_​SW column is set to Y and whose the processing date is earlier than the batch business date. It then recalculates the end date of the membership and membership person and accordingly updates the processing date of the corresponding record in the CI_​MEMBERSHIP_​PROCESS table.

However, if the renewal period for open-ended membership (specified in the C1-ASOBLLNG feature configuration) is equal to or greater than the membership period, the system sets the end date of the membership and membership person to the enrolment end date.