Schedule Definitions

A schedule definition specifies the different dimensions (columns) in a premium schedule, add-on premium schedule, adjustment type, group adjustment type, surcharge type or fee schedule. A schedule definition has the following fields:

Field	Description
Code	The code of the schedule definition
Description	The description of the schedule definition
Type	The type of the schedule definition; the options are (1) Premium, (2) Policy Based Premium, (3) Add-on Premium, (4) Adjustment, (5) Group Adjustment, (6) Surcharge or (7) Fee (the type cannot be modified if the schedule definition is used by a premium schedule, add-on premium schedule, fee schedule, adjustment rule, group adjustment rule or surcharge rule)
Surcharge Rule Evaluation	The way the surcharge rules of a surcharge type are evaluated; the two options are (1) On Premium or (2) After Adjustment (must and may only be specified if the type is Surcharge)
Premium Scope	The premium scope of the adjustment; the options are (1) Product, (2) Add-on(s) or (3) Total (must and may only be specified if the type is Adjustment or Group Adjustment)
Scoped On Premium Schedule Type	The type of premium schedules that the adjustment is scoped on; if left unspecified the adjustment applies to premium schedules of all types. Can be set on Adjustments with a product premium scope and on Surcharges that evaluate on premium.
Scoped On Add-On	The specific add-on that the adjustment is scoped on; if left unspecified the adjustment applies to all add-ons (may only be specified if the premium scope is Add-on(s))
Distribute Indicator	Is the surcharge distributed across the applicable components (products, add-ons and adjustments)? (must and may only be specified if the type is Surcharge)
Schedule Condition	An optional dynamic logic condition that can be used to determine whether the premium schedule, adjustment or surcharge using the definition should be applied to a policy enrollment product during premium calculation (may only be specified if the type is Premium, Policy Based Premium, Adjustment, Group Adjustment or Surcharge)
Line/Rule Evaluation Condition	An optional dynamic logic condition that can be used to customize the evaluation for the rules, premium schedule lines, add-on premium schedule lines or fee schedule lines based on this definition
Enabled Indicator	Any rule, premium schedule, add-on premium schedule or fee schedule based on a disabled schedule definition is ignored during premium calculation or fee generation
In Scope (for) Percentage Commission Indicator	When set to Yes the schedule definition is considered as an input to compute the base amount on which the percentage commission is applied (may only be specified if the type is Adjustment, Group Adjustment or Surcharge)
Reference Date Field Name	The name (as in the object model) of a date field on the policy calculation period that is used as the reference date to determine the schedule value during premium calculation. This is only applicable for the premium calculation using policy calculation period.
Fatal If Line Not Found Indicator	Should a fatal message be raised if no line is found for the schedule during calculation?

A schedule definition consists out of zero, one or more schedule dimensions. Each dimension represents a column. A schedule dimension has the following fields:

Field	Description
Schedule Definition	The schedule definition to which this schedule dimension belongs
Field Name	Determines the unique name of this column within a schedule definition (used in dynamic logic)
Display Name	Determines the column header
Display Sequence	Determines the placement of the column (from left to right)
Display Length	Determines the width of the column in pixel
Type	Determines the kind of values that can be set in this column. The four options are (1) a cost share parameter (not allowed for schedule definitions of type Fee), (2) a dynamic field or (3) a generic free format character field
Datatype	Determines the datatype of the column; the four options are (1) Amount, (2) Char, (3) Date or (4) Number (this is a derived field for dimensions of type Parameter or Dynamic Field)
Parameter	If the type is parameter, this field determines which parameter alias is represented by the column (must be accompanied by a reference to a parameter alias)
Dynamic Field Usage	If the type is dynamic field, this field determines which dynamic field is represented by the column (must be accompanied by a reference to a dynamic field usage)
Usage	Determines if the cells in this column show (1) a single Value field or (2) two fields to capture a Range of values

Note that schedule dimensions for a schedule definition that has been used to create premium schedule lines, add-on premium schedule lines, fee schedule lines, adjustment rules, group adjustment rules or surcharge rules cannot be added, deleted or updated (except field name, display name, display sequence and display length).

For dimensions of the type dynamic field, the dynamic fields on the following records can be chosen:

• Enrollment Product (not allowed for schedule definitions of type Fee)

• Fee Definition (only allowed for schedule definitions of type Fee)

• Group Client

• Group Account

• Group Account Product (not allowed for schedule definitions of type Fee)

• Policy

• Collection Setting

• Policy Calculation Period

• Policy Enrollment

• Policy Enrollment Product (not allowed for schedule definitions of type Fee)

• Policyholder

• Relation

• Relation Address

• Insurable Object1…​10.
  Insurable Object1…​10 are the insurable object types configured in the system, e.g., 'Car', 'House'.

When a schedule dimension is configured as a range, "Display Name" From and "Display Name" To columns are available in the premium schedule line, add-on premium schedule line, adjustment rule, group adjustment rule, surcharge rule or fee schedule line setup.

Parameters

A parameter alias is the business name for a specific calculation parameter that is applied during claim adjudication. Examples are the 'Office visit copayment' and the 'Member Deductible'. These parameter names are also configured in OHI Enterprise Policy Administration because their value might be associated with e.g. an adjustment rule.

A schedule definition dimension of the type parameter has to refer to one of these parameter names. The same list of parameter names is available on an enrollment product in the context of a policy.

During the premium calculation, the parameter values listed in the rules, premium schedule lines and add-on premium schedule lines are compared to the values set on the person’s or object’s enrolled products in order to determine if the rule or line applies. More information on how the premium calculation works can be found in the implementation guide for premium calculation. The same applies for values listed in fee schedule lines during fee generation (see implementation guide for fee generation).

A parameter alias has the following fields:

Field	Description
Code	The code of the parameter alias
Display Name	The name of the parameter when displayed in the user interface
Display Sequence	The order in which parameter aliases are shown in the user interface
Type	The type of value (amount, number, percentage or service days)