Data Model

This page describes the data model of the group client and group account.

Group Account Product Add-on Override

A group account product add-on override stores the overriding premium for add-on in the context of a group account product and group account time period.

Field Description

Add-on Premium Schedule Line

The reference to the add-on premium schedule line

Amount

The amount by which the base premium is increased

Currency

The currency of the add-on amount (it will automatically be set to the premium currency that is specified on the enrollment product)

Percentage

The percentage by which the premium is increased

Function

The dynamic logic function used to calculate the add-on amount

Group Account Time Period

Reference to the group account time period

Group Account Product

Reference to the group account product

Group Client

Field Description

Code

The code of the group client

Description

The description of the group client

Display Name

The display name of the group client

Status

The status of the group client

Group Client

The parent group client this group client is part of

Employer Organization

The organization to which the group account belongs to

Bill to Organization

The organization to which the premium invoices can be billed

Amount Distribution

The way an amount is divided over calculation periods: on a daily basis or evenly

Partial Period Resolution

Charge for a partial period (per day, no charge, full period or enrolled days threshold)

Enrolled Days Threshold

The enrolled days threshold for the partial period resolution

Contact Relation

The contact relation for the group client

Group Representative

The group’s representative

Termination Date

The date the group client was terminated

Object Last Update By

Reference to the user who last updated the group client entity or updated an entity within context of the group client

Object Last Update Date

Date of the last update to the group client entity or to an entity within context of the group client

Constraints:

  • The enrolled days threshold must and may only be specified if the partial period resolution is set to enrolled days threshold

Group Client Collection Setting

A group client collection setting specifies how often the premium is collected. Group client collection settings also control the generation of policy specific calculation periods.

A group client can have one or more collection settings.

Field Description

Group Client

The group client that has the collection setting

Span Reference Date

The date to determine the start of a span of calculation periods

Advance Length

Length of a span of calculation periods

Advance UoM

Unit of measure for a span of calculation periods (Days / Months / Years)

Policy Calculation Periods?

Indicator that defines whether policy specific calculation periods are used for this group client

Policy Calculation Period Length*

Length of the generated policy calculation periods

Policy Calculation Period UoM*

Unit of measure for the generated policy calculation periods (Days / Months / Years)

Start Date**

The start date of the collection setting

End Date

The end date of the collection setting

^* When unspecified for a collection setting with the indicator policy calculation period set to 'Yes', ^^the system considers policy calculation period length and UoM as 1 Month.

Modifying the collection setting after policy calculation period generation may result in inconsistency, it is recommended that periods are re-generated if the collection setting is modified.

^** With negative calculation date offsets - ^^The collection setting must start on or before the span reference date + calculation date offset. This is to ensure that system finds a valid collection setting to generate periods when the calculation date is set to be before the period start date.^

Constraints:

  • It is not allowed to have an overlap in time validity for group client collection settings with the same group client

  • Both Advance Length and Advance UoM (unit of measure) have to be set or both have to be unspecified

  • Both Policy Calculation Period Length and Policy Calculation Period UoM (unit of measure) have to be set or both have to be unspecified

Group Client Billing Account

A group client can have one or more group client billing accounts. A group client billing account is an account that is used for billing purposes on a group client. Note that the allocation of a bill to a group client billing account is configured within the premium bill allocations and bill receivers setup (described in the Premium Bill Allocation section).

Field Description

Group Client

The group client that has the billing account

Code

The code of the group client billing account (unique across billing accounts)

Description

The description of the group client billing account

Contact Relation

The contact relation for the group client billing account. The values of contacts associated with the particular group client or group account are visible.

Default?

Is this the default billing account for the group client? (if set to Yes, this billing account will be the default bill receiver if not specified otherwise on the Premium Bill Allocations and Bill Receivers)

Constraints:

  • There can be only one default billing account for a group client

Group Client Broker Agent

Brokers and agents are described in the Brokers and Agents section of the Policy data model. A group client has a single group client broker and/or agent at any point in time, but the group client can be transferred from one broker and/or agent to another.

Field Description

Group Client

The group client that the group client broker agent is intermediary for

Enrollment Product Category

The category of the enrollment products that the group client broker agent is intermediary for

Broker

The broker that serves as intermediary

Agent

The agent that serves as intermediary

Start Date

The start date of the group client broker agent

End Date

The end date of the group client broker agent

Constraints:

  • At least one of broker and agent must be specified

  • It is not allowed to have an overlap in time validity for group client brokers agents with the same group client and enrollment product category

Group Client Premium Schedule

Group client premium schedules specify which premium schedules are assigned to a group client.

Field Description

Group Client

The group client that has the group client premium schedule

Enrollment Product

The enrollment product that the premium schedule is assigned to in the context of the group client

Enrollment Product Category

The enrollment product category that the premium schedule is assigned to in the context of the group client

Premium Schedule

The premium schedule (unique in combination with the group client, enrollment product and enrollment product category)

Start Date

The start date of the assignment of the premium schedule

End Date

The end date of the assignment of the premium schedule

Constraints:

  • Only one of enrollment product or enrollment product category can be specified

  • The amount interpretations of the premium schedules of a group client must be the same for an enrollment product or an enrollment product category (all Calculation Period or all Calendar Year)

  • The schedule definition types of the premium schedules of a group client must be the same for an enrollment product or an enrollment product category (all Premium or all Policy Based Premium)

  • It is not allowed to have an overlap in time validity for group client premium schedules with the same group client, enrollment product category, enrollment product and premium schedule

Group Client Adjustment

Group client adjustments specify which adjustments are assigned to a group client. The adjustments are calculated in the ascending order of the sequence. This is especially relevant for the adjustments that are based on a percentage. The adjustment types having the same sequence, say N, take the same base amount for the percentage based adjustment calculations and it is premium +/- all the adjustments up to and including (N-1) sequence. More information on how adjustment amounts are evaluated can be found in the implementation guide for premium calculation.

Field Description

Group Client

The group client that has the group client adjustment

Enrollment Product

The enrollment product that the adjustment is assigned to in the context of the group client

Enrollment Product Category

The enrollment product category that the adjustment is assigned to in the context of the group client

Adjustment Type

The schedule definition of the type group adjustment

Sequence

The sequence specifies the order in which adjustments get applied

Start Date

The start date of the assignment of the adjustment

End Date

The end date of the assignment of the adjustment

Constraints:

  • The schedule definition must be of type group adjustment

  • It is not allowed to have an overlap in time validity for group client adjustments with the same group client, enrollment product category, enrollment product and adjustment type (schedule definition)

  • Only one of enrollment product or enrollment product category can be specified

Group Client Event

Group client event history holds the history of changes that were applied to the group client.

Field Description

Group Client

The group client for which the event was raised

Description

The description of the event

Event Datetime

The date and time the event happened

Policy

The policy for which the event was raised

Activity

The acivity in whcih the event was raised

Group Account

The group account for which the event was raised

Constraints:

  • The policy, group account and activity hold only the value of the code resp. the id; not a real link to the object.

Policy Message / Group Client Message

A policy message or group client message is the message that is stored during processing of the policy or validation o the group client

Field Description

Policy

The policy for which the message was raised

Group Client

The group client for which the message was raised

Message

The message that was raised

Process Step

The process step in which the message was raised

Value0 .. Value9

The value for the message placeholder 0 .. 9

Policy messages and group client messages are both stored under the name policy messages. A message will have a reference either to the policy or to the group client.

Group Account

The group account defines the level that assembles the enrollment products in an offering. It represents an organization and the benefits offerings. Group accounts facilitate the mechanism to offer selected enrollment products with a defined set of parameters, add-ons, premium-adjustments and premium bill allocations to a group of people who are grouped by some characteristics for example group of people belonging to a common organization or part of an organization (as employees of a company or a department of a company). The group accounts make it possible to offer benefits coverage and premium-adjustments that are uniform in nature, that is, offering the same benefits and premium-adjustments to all the members of the group for a given enrollment product.

Field Description

Group Client

The reference to the group client

Code

The code of the group account

Description

The description of the group account

Display Name

The display name of the group account

Start Date

The start date of the group account for benefits limit evaluation purposes

Amount Distribution

The way an amount is divided over calculation periods: on a daily basis or evenly

Partial Period Resolution

Charge for a partial period (per day, no charge, full period or enrolled days threshold)

Enrolled Days Threshold

The enrolled days threshold for the partial period resolution

Data Access Group

The reference to the data access group

Contact Relation

The contact relation for the group account

Constraints:

  • The enrolled days threshold must and may only be specified if the partial period resolution is set to enrolled days threshold

Group Account Time Period

This is a time period that is used in the context of the group account. The group account time period has the following attributes

Field Description

Display Name

The name ofthe group account time period (unique in combination with the group account)

Start Date

The start date for the group account time period

End Date

The end date for the group account time period

Group Account

The group account

Constraints:

  • It is not allowed to have overlapping time periods

Group Account Insurable Class

The group account insurable class defines the insurable classes that are available in a group account.

Field Description

Group Account

The group account

Insurable Class

The insurable class

Insurable Class

The insurable class

Field Description

Code

The code of the insurable class

Description

The description of the insurable class

Display Name

The display name of the insurable class

Group Account Collection Setting

A group account collection setting specifies how often the premium is collected. Group account collection settings also control the generation of policy specific calculation periods.

A group account can have one or more collection settings.

Field Description

Group Account

The group account that has the collection setting

Span Reference Date

The date to determine the start of a span of calculation periods

Advance Length

Length of a span of calculation periods

Advance UoM

Unit of measure for a span of calculation periods (Days / Months / Years)

Policy Calculation Period?

Indicator that defines whether policy specific calculation periods are used for this group account

Policy Calculation Period Length*

Length of the generated calculation periods

Policy Calculation Period UoM*

Unit of measure for the generated calculation periods (Days / Months / Years)

Start Date**

The start date of the collection setting

End Date

The end date of the collection setting

^* When unspecified for a collection setting with the indicator policy calculation period set to 'Yes', ^^the system considers policy calculation period length and UoM as 1 Month.

Note - Modifying the collection setting after policy calculation period generation may result in inconsistency, it is recommended that periods are re-generated if the collection setting is modified.^

^** With negative calculation date offsets - ^^ The collection setting must start on or before the span reference date + calculation date offset. This is to ensure that system finds a valid collection setting to generate periods when the calculation date is set to be before the period start date.^

Constraints:

  • It is not allowed to have an overlap in time validity for group client collection settings with the same group client

  • Both Advance Length and Advance UoM (unit of measure) have to be set or both have to be unspecified

  • Both Policy Calculation Period Length and Policy Calculation Period UoM (unit of measure) have to be set or both have to be unspecified

Group Account Broker Agent

Brokers and agents are described in the Brokers and Agents section of the Policy data model. A group account has a single group account broker and/or agent at any point in time, but the group account can be transferred from one broker and/or agent to another.

Field Description

Group Account

The group account that the group account broker agent is intermediary for

Enrollment Product Category

The category of the enrollment products that the group client broker agent is intermediary for

Broker

The broker that serves as intermediary

Agent

The agent that serves as intermediary

Start Date

The start date of the group account broker agent

End Date

The end date of the group account broker agent

Constraints:

  • At least one of broker and agent must be specified

  • It is not allowed to have an overlap in time validity for group account brokers agents with the same group account and enrollment product category

Broker Agent Switch Rule

Broker agent switch rules specify how the commission is distributed when the applicable assigned broker agent for a policy changes in the middle of the group account time period.

Field Description

Group Account

The group account that has the broker agent switch rule

Commission Existing Enrollment

The commission for the policy enrollment product enrolled before the broker agent switch is paid to 1) the broker agent that enrolled the member to the product (old broker agent [1]), or to 2) the broker agent that is currently active (new broker agent) or to 3) the third party.

Possible values:

  • New Broker Agent

  • Old Broker Agent

  • Third Party


1. For group account renewal scenario when the policy^^ enrollment product start date is before the group account time period start date, the broker agent that is applicable on the start date of the group account time period is considered as the 'Old Broker Agent'

Commission New Enrollment

The commission for the policy enrollment product enrolled after the broker agent switch is paid to 1) the broker agent that is currently active (new broker agent) or to 2) the third party.

Possible values:

  • New Broker Agent

  • Third Party

Third Party

Relation to which the commission is payed when a switch rule specifies 'Third Party' for existing enrollments or new enrollments or both

Start Date

The start date of the broker agent switch rule

End Date

The end date of the broker agent switch rule

Constraints:

  • Third party must be specified if the setting commission existing enrollment or commission new enrollment or both are selected as 'Third Party'

  • It is not allowed to have an overlap in time validity for broker agent switch over rules in context of a group account

Group Account Premium Schedule

Group account premium schedules specify which premium schedules are assigned to a group account.

Field Description

Group Account

The group account that has the group account premium schedule

Enrollment Product Category

The enrollment product category that the premium schedule is assigned to in the context of the group account

Premium Schedule

The premium schedule (unique in combination with the group account and enrollment product category)

Start Date

The start date of the assignment of the premium schedule

End Date

The end date of the assignment of the premium schedule

Constraints:

  • The amount interpretations of the premium schedules of a group account must be the same for an enrollment product category (all Calculation Period or all Calendar Year)

  • The schedule definition types of the premium schedules of a group account must be Premium Policy, Based Premium or a combination of these types for an enrollment product category

  • It is not allowed to have an overlap in time validity for group account premium schedules with the same group account, enrollment product category and premium schedule

Group Account Adjustment

Group account adjustments specify which adjustments are assigned to a group account.

Field Description

Group Account

The group account that has the group account adjustment

Enrollment Product Category

The enrollment product category that the adjustment is assigned to in the context of the group account

Adjustment Type

The schedule definition of the type group adjustment

Sequence

The sequence specifies the order in which adjustments get applied

Start Date

The start date of the assignment of the adjustment

End Date

The end date of the assignment of the adjustment

Constraints:

  • The schedule definition must be of type group adjustment

  • It is not allowed to have an overlap in time validity for group account adjustments with the same group account, enrollment product category and adjustment type (schedule definition)

Group Account Product

The group account products define which enrollment products are offered by the group account.

Field Description

Group Account

The group account

Enrollment Product

The enrollment product (unique in combination with the group account)

Display Name

The display name for the group account product

Display Sequence

The display sequence for the enrollment product within the group account

Amount Distribution

The way an amount is divided over calculation periods: on a daily basis or evenly

Partial Period Resolution

Charge for a partial period (per day, no charge, full period or enrolled days threshold)

Enrolled Days Threshold

The enrolled days threshold for the partial period resolution

Constraints:

  • The enrolled days threshold must and may only be specified if the partial period resolution is set to enrolled days threshold

Group Account Product Premium Schedule

Group account product premium schedules specify which premium schedules are assigned to a group account product.

Field Description

Group Account Product

The group account product that has the group account product premium schedule

Premium Schedule

The premium schedule (unique in combination with the group account product)

Start Date

The start date of the assignment of the premium schedule

End Date

The end date of the assignment of the premium schedule

Constraints:

  • The amount interpretations of the premium schedules of a group account product must be the same (all Calculation Period or all Calendar Year)

  • The schedule definition types of the premium schedules of a group account product must be the same (all Premium or all Policy Based Premium)

  • It is not allowed to have an overlap in time validity for group account product premium schedules with the same group account product and premium schedule

Group Account Product Adjustment

Group account product adjustments specify which adjustments are assigned to a group account product.

Field Description

Group Account Product

The group account product that has the group account product adjustment

Adjustment Type

The schedule definition of the type group adjustment

Sequence

The sequence specifies the order in which adjustments get applied

Start Date

The start date of the assignment of the adjustment

End Date

The end date of the assignment of the adjustment

Constraints:

  • The schedule definition must be of type group adjustment

  • It is not allowed to have an overlap in time validity for group account product adjustments with the same group account product and adjustment type (schedule definition)

Group Account Product Adjustment Value

The group product adjustment value is a value for the adjustment rule used in the context of the group account, that is, it overrides the default adjustment value. This is only possible for a schedule definition of type group account adjustment.

Field Description

Amount

The adjustment amount (negative means that the premium is lowered)

Currency

The currency of the adjustment amount

Percentage

The adjustment percentage (negative means that the premium is lowered)

Amount Function

Reference to a function dynamic logic function with signature 'Adjustment' that determines the adjustment amount

Adjustment Rule

The reference to an adjustment rule (unique in combination with the group account time period and the group account product)

Group Account Time Period

The group account time period to which this value belongs to

Let us revisit the Example 3 Co-payment value discount from the chapter Adjustment Rules in the Premium Configuration guide for understanding how the column values and adjustment values - default and override are applied when multiple time periods are involved.

The example mentioned has one time period "Calendar year 2015". This is extended to two default time periods.

The following default time periods are defined

Display Name Start Date End Date

Calendar year 2015

1/1/2015

31/12/2015

Calendar year 2016

1/1/2016

31/12/2016

The adjustment rules for Calendar year 2015 are:

Adjustment Rules

OV Co-pay

Adjustment

10.00 USD

0.00 USD

20.00 USD

-5.00 USD

30.00 USD

-10.00 USD

The adjustment values, if not zero, have a negative sign because they are a discount.

The column values for OV Copay are changed for the next year and the adjustment rules for Calendar year 2016 are set up as:

Adjustment Rules

OV Co-pay

Adjustment

12.00 USD

0.00 USD

22.00 USD

-5.00 USD

32.00 USD

-10.00 USD

In the example mentioned, the Co-payment value adjustment is configured for the enrollment product COPAY PLAN in the group account ORCL. Here we will try to understand how the different adjustment rules will apply within the context of the group account time period.

Consider that group account time periods are defined as:

Display Name Start Date End Date

ORCL Plan 2015-1

1/6/2015

31/12/2015

ORCL Plan 2016-1

1/1/2016

30/6/2016

ORCLPan 2016 -2

1/7/2016

31/12/2016

The adjustment rule consists of two things: the column value and the adjustment value. The column values applicable to the adjustment rules are the values defined for the applicable default time period. The adjustment value is either the default adjustment value or the group account product specific adjustment value.

How is a group account time period mapped to a default time period?

The application looks at the start date of the selected group account time period and determines the default time period to which the start date belongs to. Hence for theORCLPlan 2015-1, the applicable default time period is Calendar year 2015.

The group account product adjustment and adjustment rules for product COPAY PLAN within group account time periodORCLPlan 2015-1 without overriding values are shown below.

Group Account Product Adjustment

Seq.

Code

Start Date

End Date

1

DC_COP

Adjustment Rules

OV Co-pay

Adjustment

10.00 USD

0.00 USD

20.00 USD

-5.00 USD

30.00 USD

-10.00 USD

For the group account time periodORCLPlan 2016-1, the corresponding default time period changes to Calendar year 2016. The group account product adjustment specified above does not have an end date so it also applies in Calendar year 2016. The adjustment rules for COPAY PLAN within group account time periodORCLPlan 2016-1 with adjustment values modified at group account product level look like:

Adjustment Rules

OV Co-pay

Adjustment

12.00 USD

-2.00 USD

22.00 USD

-6.00 USD

32.00 USD

-11.00 USD

For the group account time periodORCLplan 2016-2 the applicable default time period is still Calendar year 2016, so the column values continue to be the same as they were forORCLplan 2016-1, however the overriding adjustment values can be different.

Adjustment Type

Seq.

Code

Override Value

1

DC_COP

Yes

Adjustment Rules

OV Co-pay

Adjustment

12.00 USD

-2.00 USD

22.00 USD

-6.00 USD

32.00 USD

-10.00 USD

Here the adjustment value for OV Co-pay 32.00 is reduced to -10.00 in ORCL plan 2016-2.

Group Account Product Provider Group

Group account product provider groups specify which provider groups are assigned to a group account product.

Field Description

Group Account Product

The group account product that has the group account product provider group

Provider Group

The provider group that is assigned to the group account product

Assigned Provider Group Label

The qualifying label for the assignment of a provider group to a group account product (assigned provider group labels are configured separately; they have a code and a display name)

Start Date

The start date of the assignment of the provider group

End Date

The end date of the assignment of the provider group

Constraints:

  • It is not allowed to have an overlap in time validity for group account product provider groups with the same group account product, assigned provider group label and provider group

Group Account Add-on

The group account add-ons define which add-ons are offered by the group account.

Field Description

Group Account

The group account

Add-on

The add-on (unique in combination with the group account)

Display Name

The display name for the group account add on

Display Sequence

The display sequence for the add on within the group account

Group Account Available Product

The group account available product defines which group account products are available for a group account in a group account period. The availability can be defined per a specific insurable class or for all insurable classes within a group account.

Field Description

Group Account Product

The group account product

Group Account Time Period

The group account time period

Insurable Class

The insurable class

Group Account Available Product Add-on

The group account available product add on defines which group account add-ons are available for a group account product in a group account time period.

Field Description

Group Account Available Product

The group account available product

Group Account Add-on

The group account add-on

Insurable Class

The insurable class

Parameter Domain and Domain Value

A parameter domain defines per enrollment product/group account product and parameter alias combination if a non discrete value is applicable or that the parameter domain holds a list of predefined values.

Parameter Domain

A parameter domain has the following attributes:

Field Description

Parameter Alias

The parameter alias

Enrollment Product

The enrollment product to which the parameter domain applies

Group Account Product

The group account product to which the parameter domain applies

Discrete

Indicates whether the parameter domain is a list of predefined discrete values or a single non-discrete value.

Amount

The default value (amount) of a non discrete parameter domain (only for parameter aliases of type Amount)

Currency

The currency of the amount (only for parameter aliases of type Amount; it will automatically be set to the parameter currency that is specified on the enrollment product)

Percentage

The default value (percentage) of a non discrete parameter domain (only for parameter aliases of type Percentage)

Number of Units

The default value (number of units) of a non discrete parameter domain (only for parameter aliases of type Number of Units)

Service Days

The default value (service days) of a non discrete parameter domain (only for parameter aliases of type Service Days)

Constraints:

  • Either the enrollment product or the group account product must be specified

Parameter Domain Value

Parameter domain values are allowed values for a parameter alias in a policy enrollment product. Parameter domain values can only be defined for discrete parameter domains.

A parameter domain value has the following attributes:

Field Description

Parameter Domain

The parameter domain

Amount

The value (amount) of the parameter (only for parameter aliases of type Amount)

Currency

The currency of the amount (only for parameter aliases of type Amount; it will automatically be set to the parameter currency that is specified on the enrollment product)

Percentage

The value (percentage) of the parameter (only for parameter aliases of type Percentage)

Number of Units

The value (number of units) of the parameter (only for parameter aliases of type Number)

Service Days

The value (service days) of the parameter (only for parameter aliases of type Service Days)

Default

Indicates whether the value is the default value for the parameter domain

Condition

Reference to a condition dynamic logic function with signature 'Parameter Value' that determines if the domain value is applicable for a person or object for an enrollment product in a policy Note : This condition is applicable only for ADF UI

Start Date

The start date of the parameter domain value.

End Date

The end date of the parameter domain value.

Constraints:

  • The value (amount, number of units, percentage or service days) that matches the type (amount, number, percentage or service days) of the parameter alias is required and the other values are not allowed

  • Only 1 domain value can be the default value within a parameter domain

  • A condition can only be set for a domain value that is not the default value

  • The start date of the parameter domain value is mandatory.

Premium Bill Allocation

Premium bill allocations define how the premium bill is allocated to bill receivers in the context of a group client based on the applicable group account, schedule definition, premium schedule type, insurable class, enrollment product, enrollment product category and add-on. The start date of the parameter domain value is mandatory.

Allocation

A premium bill allocation stores the specification on how to allocate the premium bill.

Field Description

Group Client

The group client that has the premium bill allocation

Group Account

The group account for which the premium bill allocation is defined

Insurable Class

The insurable class for which the premium bill allocation is defined

Schedule Definition

The schedule definition for which the premium bill allocation is defined

Premium Schedule Type

The type of premium schedules for which the premium bill allocation is defined

Enrollment Product

The enrollment product for which the premium bill allocation is defined

Enrollment Product Category

The enrollment product category for which the premium bill alloca tion is defined

Add-on

The add-on for which the premium bill allocation is defined

Start Date

The start date of the premium bill allocation

End Date

The end date of the premium bill allocation

Active

Is the premium bill allocation currently active?

Constraints:

  • It is not allowed to have an overlap in time validity for premium bill allocations with the same group client, group account, insurable class, schedule definition, premium schedule type, enrollment product, enrollment product category and add-on

  • The group account (if specified) must be part of the group client

  • Only one of enrollment product or enrollment product category can be specified

  • Only one of schedule definition, premium schedule type or add-on can be specified

Receiver

A premium bill allocation can have one or more bill receivers. The bill receiver defines who pays what percentage of the policy premium.

Field Description

Premium Bill Allocation

The premium bill allocation that applies

Function

Dynamic logic function that retrieves the bill receiver

Group Client Billing Account

The group client billing account that is the bill receiver

Percentage

The percentage of the premium that this bill receiver has to pay

Constraints:

  • A dynamic logic function or a group client billing account (only one) must be specified

Group Commission Rate

Group commission rate defines the commission rate (% or amount) that is paid out for the policy enrollment product in the context of a group client based on the applicable group account, enrollment product, enrollment product category, broker and agent.

Field Description

Group Client

The group client that has the commission rate

Group Account

The group account for which the commission rate is defined

Enrollment Product

The enrollment product for which the commission rate is defined

Enrollment Product Category

The enrollment product category for which the commission rate is defined

Broker

The broker for which the commission rate is defined

Agent

The agent for which the commission rate is defined

Percentage

The commission is calculated as specified percentage of applicable premiums, adjustments and surcharges

The adjustment type and surcharge type is applicable for commission when indicator 'In Scope % Commission' on the schedule definition is set to Y(es). Similarly, the premium schedule is considered as applicable for % commission when the indicator 'In Scope % Commission' on the premium schedule is set to Y(es).

Amount Interpretation

The way amounts are interpreted (per Calendar Year, per Calculation Period or Specific (number of days))

No. of Days

Number of days for which the commission is specified when Amount Interpretation Specific is chosen (must and may only be specified if the amount interpretation is Specific)

Amount

The commission amount per calculation period for the policy enrollment product

Amount Currency

The currency of the commission amount

Start Date

The start date of the commission rate

End Date

The end date of the commission rate

Constraints:

  • It is not allowed to have an overlap in time validity for group commission rates with the same group client, group account, enrollment product, enrollment product category, broker and agent

  • The group account (if specified) must be part of the group client

  • Only one of enrollment product or enrollment product category can be specified

  • Exactly one of amount or percentage must be specified

  • Commission amount and currency must both be specified or must both be empty