Membership

The Membership zone displays the details of the membership. It contains the following sections:

Main - Displays basic information about the membership. It contains the following fields:

Field Name

Field Description

Membership Information

Displays information about the membership.

Health Plan

Displays the health plan for which the main subscriber has enrolled.

Note:

It has a link. On clicking the link, the Health Plan 360° Information screen appears where you can view the details of the respective health plan.

This field appears only when a membership is created using the Individual Membership (C1-IndividualMembership) business object.

Policy Information

Displays information about the policy.

Note: It has a link. On clicking the link, the Policy screen appears where you can view the details of the respective policy.

Plan Information

Displays the policy plan for which the membership is defined.

Note: It has a link. On clicking the link, the Policy Plan screen appears where you can view the details of the respective policy plan.

Status

Indicates the status of the membership. The valid values are:

Active
Canceled
Draft
Pending Effectuation
Terminated

Start Date

Displays the date from when the membership is effective.

End Date

Displays the date till when the membership is effective.

Membership Type

Indicates the type of membership. The valid values are:

COBRA
Medicare
Retiree

External Membership ID

Displays the corresponding membership ID which is maintained in the external source system.

Paid Through Date

Indicates the term end date of the last fully or partially paid term. The system considers the term to be fully paid when the threshold limit is met.

Note:

This field appears when the paid through date is calculated at the membership level.

The paid through date is calculated while freezing or canceling a payment or adjustment depending on whether the required algorithm is attached to the respective system event:

Entity	System Event	Algorithm
Customer Class	Payment Freeze	C1-PSPTDCAL
Customer Class	Payment Cancellation	C1-PXPTDCAL
Adjustment Type	Adjustment Freeze	C1-ADPTDCAL
Adjustment Type	Adjustment Cancellation	C1-AXPTDCAL

The following table indicates when the paid through date is calculated at the policy and/or membership level:

If the Paid Through Date Calculation Level parameter is set to…	If the following characteristics are defined for the bill charge or adjustment…	Then…
P	C1-POLID	Paid through date is calculated at the policy level
P	C1-MPID	Paid through date is calculated at the policy level
P	C1-POLID and C1-MPID	Paid through date is calculated at the policy level
M	C1-POLID	Paid through date is not calculated at the membership level
M	C1-MPID	Paid through date is calculated at the membership level
M	C1-POLID and C1-MPID	Paid through date is calculated at the membership level
P, M	C1-POLID	Paid through date is calculated at the policy level
P, M	C1-MPID	Paid through date is calculated at both the policy and membership levels
P, M	C1-POLID and C1-MPID	Paid through date is calculated at both the policy and membership levels

Automatic Renewal

Indicates whether the individual membership should be automatically renewed or not.