Policy Events and Mutations

The creation, modification and removal of a tracked entity (as described in Change Event Rules) leads to the creation of a policy event for change event rules of type Recalculation, Output, Fee or Message. Policy events of type Recalculation, Output or Fee lead to the creation of the more granular policy mutations or aggregate events. A policy event maps 1-to-1 to the triggering event (e.g. an event that indicates that product XYZ has changed). A policy mutation maps 1-to-1 to one of the affected policies.

A policy event has the following fields:

Field	Description
Event Level	The level of the policy event (Insurable Entity, Policy, Enrollment Product, Enrollment Product Type, Group Client, Group Account, Group Account Product, Premium Schedule or Adjustment/Surcharge Schedule Definition, Organization)
Type	The type of the event (Recalculation, Output, Fee or Message)
Insurable Entity	A reference to the insurable entity
Policy	A reference to the policy
Enrollment Product	A reference to the enrollment product
Enrollment Product Type	A reference to the enrollment product type
Group Client	A reference to the group client
Group Account	A reference to the group account
Premium Schedule	A reference to the premium schedule
Adjustment/Surcharge Schedule Definition	A reference to the adjustment/surcharge schedule definition
Event Level Id	The internal id of the event level subject (row id)
Output Definition	A reference to the output definition (only for type Output)
Fee Definition	A reference to the fee definition (only for type Fee)
Effective Date	The date from which onward the modification has effect
Cause	The cause of the event, being a combination of Trigger Action (C, U or D) - Subject of the change event rule setup (Alias of the entity) - Type (R, O, F or M). Examples of the format: Create Policy Enrollment Product (Recalculation) → C POEP R Update Policyholder (Output) → U POLH O Create Policy (Fee) → C POLI F
Change Log	Describes the cause of the event in detail by listing which entity/attributes were added, deleted or modified along with their old and new values. Applicable only for event type message

Field

Description

Event Level

The level of the policy event (Insurable Entity, Policy, Enrollment Product, Enrollment Product Type, Group Client, Group Account, Group Account Product, Premium Schedule or Adjustment/Surcharge Schedule Definition, Organization)

Type

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

Insurable Entity

A reference to the insurable entity

Policy

A reference to the policy

Enrollment Product

A reference to the enrollment product

Enrollment Product Type

A reference to the enrollment product type

Group Client

A reference to the group client

Group Account

A reference to the group account

Premium Schedule

A reference to the premium schedule

Adjustment/Surcharge Schedule Definition

A reference to the adjustment/surcharge schedule definition

Event Level Id

The internal id of the event level subject (row id)

Output Definition

A reference to the output definition (only for type Output)

Fee Definition

A reference to the fee definition (only for type Fee)

Effective Date

The date from which onward the modification has effect

Cause

The cause of the event, being a combination of Trigger Action (C, U or D) - Subject of the change event rule setup (Alias of the entity) - Type (R, O, F or M). Examples of the format:

Create Policy Enrollment Product (Recalculation) → C POEP R
Update Policyholder (Output) → U POLH O
Create Policy (Fee) → C POLI F

Change Log

Describes the cause of the event in detail by listing which entity/attributes were added, deleted or modified along with their old and new values. Applicable only for event type message

Each policy event holds a reference to the entity that triggered its creation or to its parent entity/entities. So, a change event rule on subject:

Person, Person Address, Person Assigned Provider or Object leads to a policy event of level 'Insurable Entity' with a reference to the insurable entity (i.e. the person or object)
Policy Enrollment, Policy Group Account, Policy Enrollment Product, Policy Add-on, Policy, Policy Enrollment Insurable Class, Policy Premium Bill Allocation, Policy Bill Receiver, Policy Contract Period, Policyholder, Policy Calculation Period or Parameter Value leads to a policy event of level 'Policy' with a reference to the policy (note that this means in logical terms a combination of the policy code and the version)
- If the change event rule has a reference to an Output Definition or Fee Definition of level 'Enrollment', modifications to Policy Enrollments, Policy Enrollment Products, Policy Add-ons and Parameter Values, lead to a policy event of level 'Policy' with a reference to the policy and the applicable person or object
Collection Setting
- In the context of a policy leads to a policy event of level 'Policy' with a reference to the policy (note that this means in logical terms a combination of the policy code and the version)
- In the context of a group account leads to a policy event of level 'Group Account' with a reference to the group account
- In the context of a group client leads to a policy event of level 'Group Client' with a reference to the group client
Assigned Broker Agent
- In the context of a policy leads to a policy event of level 'Policy' with a reference to the policy (note that this means in logical terms a combination of the policy code and the version)
- In the context of a group account leads to a policy event of level 'Group Account' with a reference to the group account
- In the context of a group client leads to a policy event of level 'Group Client' with a reference to the group client
Enrollment Product leads to a policy event of level 'Enrollment Product' with a reference to the enrollment product
Premium Schedule or Premium Schedule Line leads to a policy event of level 'Premium Schedule' with a reference to the premium schedule
Add-on Premium Schedule Line leads to a policy event of level 'Enrollment Product' with a reference to the enrollment product
Schedule Definition leads to a policy event of level 'Adjustment/Surcharge Schedule Definition' with a reference to the adjustment/surcharge schedule definition
Assigned Premium Schedule
- In the context of an enrollment product leads to a policy event of level 'Enrollment Product' with a reference to the enrollment product
- In the context of a group account product leads to a policy event of level 'Group Account Product' with a reference to the group account and the enrollment product
- In the context of a group account leads to a policy event of level 'Group Account' with a reference to the group account
- In the context of a group client leads to a policy event of level 'Group Client' with a reference to the group client
Assigned Adjustment
- In the context of an enrollment product leads to a policy event of level 'Enrollment Product' with a reference to the enrollment product
- In the context of a group account product leads to a policy event of level 'Group Account Product' with a reference to the group account and the enrollment product
- In the context of a group account leads to a policy event of level 'Group Account' with a reference to the group account
- In the context of a group client leads to a policy event of level 'Group Client' with a reference to the group client
Adjustment Value
- In the context of an enrollment product (for adjustment rules) leads to a policy event of level 'Enrollment Product' with a reference to the enrollment product
- In the context of a group account product (for group adjustment rules) leads to a policy event of level 'Group Account Product' with a reference to the group account and enrollment product
- In the context of default values (for adjustment rules, group adjustment rules and surcharge rules) leads to a policy event of level 'Adjustment/Surcharge Schedule Definition' with a reference to the adjustment/surcharge schedule definition
Schedule Dimension Value
- In the context of a premium schedule line leads to a policy event of level 'Premium Schedule' with a reference to the premium schedule
- In the context of an add-on premium schedule line leads to a policy event of level 'Enrollment Product' with a reference to the enrollment product
- In the context of an adjustment rule, group adjustment rule or surcharge rule leads to a policy event of level 'Adjustment/Surcharge Schedule Definition' with a reference to the adjustment/surcharge schedule definition
Group Client or Group Client Event leads to a policy event of level 'Group Client' with a reference to the group client
Group Account or Broker Agent Switch Rule leads to a policy event of level 'Group Account' with a reference to the group account
Premium Bill Allocation or Bill Receiver
- In the context of a group client leads to a policy event of level 'Group Client' with a reference to the group client.
- In the context of a group account leads to a policy event of level 'Group Account' with a reference to the group account
Group Commission Rate
- In the context of a group client leads to a policy event of level 'Group Client' with a reference to the group client.
- In the context of a group account leads to a policy event of level 'Group Account' with a reference to the group account
Billing Account
- In the context of a policy leads to a policy event of level 'Policy' with a reference to the policy (note that this means in logical terms a combination of the policy code and the version)
- In the context of a group client leads to a policy event of level 'Group Client' with a reference to the group client
Group Account Product, Group Account Product Add-on Override and Group Account Product Provider Group leads to a policy event of level 'Group Account Product' with a reference to the group account and enrollment product
Enrollment Product Type or Reinsurance Setting leads to a policy event of level 'Enrollment Product Type' with a reference to the enrollment product type

Not all policy events explicitly refer to a policy or insurable entity, e.g., the event may have been triggered by a configuration change, indirectly affecting a large number of policies. In order for the application to detect which policies or which insurable entities are affected, this link is first made explicit by creating policy mutations.

The application includes a separate activity that makes explicit which policies or insurable entities are affected by a policy event, in the form of policy mutations. Note that once the policy mutations for an event have been generated, the policy event record itself is removed.

A policy mutation record consists of the following fields:

Field	Description
Gid	The global unique identifier of the policy (always stored)
Insurable Entity	A reference to the insurable entity (stored for mutations related to an Output Definition or Fee Definition of level Enrollment)
Type	The type of the mutation (Recalculation, Output or Fee)
Output Definition	A reference to the output definition (only for type Output)
Fee Definition	A reference to the fee definition (only for type Fee)
Effective Date	The date from which onward the modification has effect (transferred from the effective date of the event)
Cause	The cause of the mutation (transferred from the cause of the event)

Field

Description

Gid

The global unique identifier of the policy (always stored)

Insurable Entity

A reference to the insurable entity (stored for mutations related to an Output Definition or Fee Definition of level Enrollment)

Type

The type of the mutation (Recalculation, Output or Fee)

Output Definition

A reference to the output definition (only for type Output)

Fee Definition

A reference to the fee definition (only for type Fee)

Effective Date

The date from which onward the modification has effect (transferred from the effective date of the event)

Cause

The cause of the mutation (transferred from the cause of the event)

The global activity type 'Generate Policy Mutations' takes policy events and turns them into a number of policy mutations, based on the level of the event.

Policy Event of level 'Policy'

The policy’s status determines what happens:

For an approved policy: a new policy mutation is created (the policy event is removed)
For a canceled policy: no policy mutation is created (the policy event is removed)
For a pended, edit or in process policy: no policy mutation is created (the policy event remains untouched)

Policy Event of level 'Insurable Entity'

The system retrieves the latest approved version of every policy that has a policy enrollment for the specified insurable entity with at least one policy enrollment product that does not have an end date before the policy event’s effective date. The system creates a policy mutation for each policy retrieved in this way.

If any of these policies is not in an approved state, the system creates a new policy event of level 'policy' instead of a policy mutation. This ensures that the change to the insurable entity leads to recalculation as soon as the policy is approved, rather than on the most recent approved version of the policy.

Policy Event of level 'Enrollment Product'

The system retrieves* the latest approved version of every policy that has at least one policy enrollment product that refers to the specified enrollment product (directly or through a group account product) and that does not have an end date before the policy event’s effective date.

Policy Event of level 'Enrollment Product Type'

The system retrieves the latest approved version of every policy that has at least one policy enrollment product that refers to an enrollment product (directly or through a group account product) of the specified enrollment product type and that does not have an end date before the policy event’s effective date.

Policy Event of level 'Group Client'

The system retrieves the latest approved version of every policy that has at least one policy enrollment product that refers to the specified group client (through a group account product and its group account) and that does not have an end date before the policy event’s effective date.

Policy Event of level 'Group Account'

The system retrieves* the latest approved version of every policy that has at least one policy enrollment product that refers to the specified group account (through a group account product) and that does not have an end date before the policy event’s effective date.

Policy Event of level 'Group Account Product'

The system retrieves* the latest approved version of every policy that has at least one policy enrollment product that refers to the specified group account and enrollment product (through a group account product) and that does not have an end date before the policy event’s effective date.

Policy Event of level 'Premium Schedule'

The system retrieves* the latest approved version of every policy that has at least one policy enrollment product that does not have an end date before the policy event’s effective date and that refers to one or more of the following:

An enrollment product (directly or through a group account product) that is linked to the specified premium schedule (through an assigned premium schedule that does not have an end date before the policy event’s effective date)
A group account product that is linked to the specified premium schedule (through an assigned premium schedule that does not have an end date before the policy event’s effective date)
A group account (through a group account product) that is linked to the specified premium schedule (through an assigned premium schedule that does not have an end date before the policy event’s effective date)
A group client (through a group account product and its group account) that is linked to the specified premium schedule (through an assigned premium schedule that does not have an end date before the policy event’s effective date)

Policy Event of level 'Adjustment/Surcharge Schedule Definition'

The evaluation of the policy event depends on the type of the specified schedule definition on the policy event:

For schedule definitions of type surcharge, the system retrieves* the latest approved version of every policy that has at least one policy enrollment product that does not have an end date before the policy event’s effective date.
For schedule definitions of type adjustment, the system retrieves* the latest approved version of every policy that has at least one policy enrollment product that refers to an enrollment product (directly or through a group account product) that is linked to the specified schedule definition (through an assigned adjustment that does not have an end date before the policy event’s effective date) and that does not have an end date before the policy event’s effective date.
For schedule definitions of type group adjustment, the system retrieves* the latest approved version of every policy that has at least one policy enrollment product that does not have an end date before the policy event’s effective date and that refers to one or more of the following:
- A group account product that is linked to the specified schedule definition (through an assigned adjustment that does not have an end date before the policy event’s effective date
- A group account (through a group account product) that is linked to the specified schedule definition (through an assigned adjustment that does not have an end date before the policy event’s effective date)
- A group client (through a group account product and its group account) that is linked to the specified schedule definition (through an assigned adjustment that does not have an end date before the policy event’s effective date)

^[1]

1. The system creates a policy mutation for each policy retrieved as specified per specific event level. Note that for policy events related to an Output Definition or Fee Definition of level Enrollment, a policy mutation (with a reference to the applicable insurable entity) is created for every policy enrollment on the returned policies that meets the conditions as specified per specific event level.