Change Event Rules

Changes to operational data, especially retro-active changes, may have relevant operational consequences. Such changes may require:

  • A recalculation of the applicable premium amounts

  • A new collateral document, such as new member ID card

  • A one time fee towards the member

  • A web service message towards other contingent applications

This application uses configurable business rules to detect these changes and act upon those changes. These rules are called change event rules.

Each change event rule has a trigger. The trigger is a specific data manipulation for a specific entity, such as the creation of a new person record, or the update of a enrollment product description. If the specified manipulation occurs, then the rule applies its effect.

  • This effect can be a system event. For example, a flag that tells the application that the affected policy must be recalculated upon the next calculation run.

  • This effect can be immediate. For example, the function event type can set default values upon the creation of a new group client.

The following list specifies the entities that can be monitored and serve as a trigger for change event rules. The list is restricted to entities that represent operational data:

  • Person

    • Person titles, marital statuses, bank account numbers and contract alignments are seen as part of a person

    • Available types: recalculation, output, fee, message and function

  • Address

    • Person and Organization Address

    • Available types: recalculation, output, fee and message

  • Person Assigned Provider

    • Available types: recalculation, output and fee

  • Object(s)

    • Available types: recalculation, output and fee

  • Organization

    • Available types: message

  • Policy Enrollment

    • Available types: recalculation, output, fee and message

  • Policy Enrollment Product

    • Available types: recalculation, output, fee and message

  • Policy Add-on

    • Available types: recalculation, output, fee and message

  • Policy

    • Available types: recalculation, output, fee and message

  • Policy Contract Period

    • Available types: recalculation, output, fee and message

  • Collection Setting

    • Available types: recalculation, output, fee and message

  • Policy Calculation Period

    • Available types: recalculation, output, fee, message and function

  • Policy Enrollment Insurable Class

  • Available types: recalculation, output, fee and message

  • Policy Premium Bill Allocation

    • Available types: recalculation, output, fee and message

  • Policy Bill Receiver

    • Available types: recalculation, output, fee and message

  • Assigned Broker Agent

    • Available types: recalculation, output, fee and message

  • Policy Group Account

  • Available types: recalculation, output, fee and message

  • Policyholder

    • Available types: recalculation, output, fee and message

  • Attached Policy Data

    • Available types: message

  • Enrollment Product

    • Available types: recalculation, output, fee, message and function

  • Enrollment Product Type

    • Available types: recalculation, output, fee and message

  • Reinsurance Setting

    • Reinsurance exclusions are seen as part of a reinsurance setting

    • Available types: recalculation, output and fee

  • Add-on Premium Schedule Line

    • Available types: recalculation, output and fee

  • Group Account Product Add-on Override

    • Available types: recalculation, output and fee

  • Group Account Product Provider Group

    • Available types: recalculation, output and fee

  • Parameter Value

    • Available types: recalculation, output, fee and message

  • Premium Schedule

    • Available types: recalculation, output and fee

  • Premium Schedule Line

    • Available types: recalculation, output and fee

  • Schedule Definition

    • Only for definition types Adjustment, Group Adjustment and Surcharge

    • Available types: recalculation, output and fee

  • Schedule Dimension Value

    • Only in the context of premium schedule lines, add-on premium schedule lines and adjustment/surcharge rules

    • Available types: recalculation, output and fee

  • Assigned Premium Schedule

    • Available types: recalculation, output, fee and message

  • Assigned Adjustment

    • Available types: recalculation, output, fee and message

  • Adjustment Value

    • Also applicable for values of surcharges

    • Available types: recalculation, output, fee and message

  • Group Account

    • Available types: recalculation, output, fee, message and function

  • Group Account Product

    • Available types: recalculation, output, fee, message and function

  • Premium Bill Allocation

    • Available types: recalculation, output, fee and message

  • Bill Receiver

    • Available types: recalculation, output, fee, function and message

  • Group Client

    • Available types: recalculation, output, fee, message and function

  • Billing Account

    • Available types: recalculation, output, fee and message

  • Broker Agent Switch Rule

    • Available types: recalculation, output, fee and message

  • Group Commission Rate

    • Available types: recalculation, output, fee and message

  • Group Client Event

    • Available types: message

Person and Person Assigned Provider are only in the list if an insurable person type is configured in the system. Object(s) are only in the list if one or more insurable object types are configured in the system. Values in the list for persons or objects display the singular display names of the insurable entity type. For example, when an insurable person type with display name 'Member' and two insurable objects with the display names 'Car' and 'Truck' have been configured, then the top part of the list shows:

  • Member

  • Member Address

  • Member Assigned Provider

  • Car

  • Truck

  • ..

The monitored data manipulation is specified by the entity, the action and, in case of an update, the list of fields:

  • Action: Create, Update or Delete

    • Note that updates on person details through the Relation integration point are handled as replacements of the existing details by the details specified in the request, so if updates on subjects address or assigned provider are to be tracked it is advisable to create a change event rule for the Update trigger action as well as a change event rule for the Create trigger action.

    • The action cannot be 'delete' if the subject is Enrollment Product, Organization, Person, Policy, Group Account, Group Client and type is 'Message'

  • Field List: for an update, it is important to provide a list of all the fields (fixed and dynamic) on the entity that are worth monitoring. When this list is not provided, all the field are monitored for an update

The change event rule’s effect can be a recalculation, output generation, fee generation, message creation or function execution. The chosen subject entity determines which effects are available.

If it is output generation, then a reference is made to one of the configured output definitions like a summary plan description or an ID card. If it is fee generation, then a reference is made to one of the configured fee definitions like a new policy fee. Note that separate change event rules are necessary if different triggers are needed, e.g. one for recalculation and one for ID card regeneration.

Last, for types Recalculation, Output and Fee it is necessary to define from which date onward the modification has effect. For a time valid record like a policy enrollment product this is likely to be the start date of the record. And if the modification is on the start date itself, then it is likely to be the earliest of the old and the new value for the start date. Because variations are possible, this is made configurable through function dynamic logic with signature Change Event Rule (Effective Date).

For type Function it is necessary to define a function dynamic logic with signature Change Event Rule (Function) that for example sets default values.

Refer to the Functions section in the Dynamic Logic guide for a detailed description of these signatures.

Summing up, a change event rule has the following fields:

Field Description

Code

The code of the change event rule

Subject

The subject of the modification

(Trigger) Action

The change action that needs to trigger an event

Field List

The list of fields that trigger an event on update (may only be specified if the action is Update). When not specified, all the field are monitored for an update.

Type

The type of the event (Recalculation, Output, Fee, Message or Function)

Output Definition

A reference to a configured output definition (must and may only be specified for type Output)

Fee Definition

A reference to a configured fee definition (must and may only be specified for type Fee)

Function

A reference to the function dynamic logic that is used:

  • To generate the effective date of the policy event for types Recalculation, Output and Fee

  • To execute a function for type Function

What automatically happens on a modification of one of the subjects, is that all the change event rules on the subject are evaluated, taken into account the trigger action and the field list. If all conditions are met, then:

  • For types Recalculation, Output and Fee a policy event is stored (described in Events and Mutations)

  • For type Message a message event is stored (described in Events and Mutations

  • For type Function the dynamic logic function is executed (note that no policy event is stored for this type)