Premium Schedules
Premium Schedules
A premium schedule is a re-usable look-up table for premium amounts. It consists of a header (the premium schedule) and one or more premium schedule lines. A premium schedule line consists of fields (columns) that represent conditions and a premium amount field (including the currency). This is the premium amount that applies if all the conditions on the line are met.
The image below shows a premium schedule with the name 'Basic Plan' where the premium amount is based on the condition 'Smoking?'.
The premium schedule always refers to a schedule definition. The schedule definition specifies which columns are available in the premium schedule. In addition to the columns specified in the schedule definition, each premium schedule has a premium amount (including the currency) or a dynamic logic function that calculates the premium amount.
The premium schedule header has the following fields:
- Code
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The functional identifier of the premium schedule
- Schedule Definition
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The schedule definition on which the premium schedule is based on.
- Type
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The Premium Schedule Types of the premium schedule.
- Amount Interpretation
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The way amounts are interpreted. Possible choices are per Calendar Year, per Calculation Period, or Specific. Specific means for a specified number of days.
- Number of Days
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Number of days for which the premium is specified when Amount Interpretation Specific is chosen. This value must and may only be specified if Amount Interpretation is Specific (POL-RULE-VAL-001).
- Premium Currency
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The currency of the premium amounts in the premium schedule. All premium schedule lines in the premium schedule have the same premium currency.
- In Scope (for) Percentage Commission?
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When set to Yes, the premium schedule is applicable for commission calculation.
- Extensibility
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Premium schedules can be extended with single value dynamic fields.
Premium Schedule Lines
A premium schedule line has at the following fields:
- Time Period
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The default time period to which this premium schedule line belongs to.
- Premium Tier
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The premium tier for which the premium applies. This reference is only available for premium schedules with a schedule definition type of Policy Based Premium (POL-PREL-002).
- Premium
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The premium amount that applies if all the conditions on this line are met.
Either the premium or the function must be specified (POL-PREL-001). - Function
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The dynamic logic function to calculate the premium amount if all the conditions on this line are met.
Either the premium or the function must be specified (POL-PREL-001). - Currency
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The currency of the premium amount. This field is automatically set to the premium currency specified on the premium schedule. It is only available when the user chooses to enter an amount on the premium schedule line.
- Dimensions
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All dimensions specified by the premium schedule’s schedule definition.
Premium Schedule Types
Premium schedule types can be used to scope adjustments on premium schedules of specific types or to configure premium splits for premium schedules of specific types. Some examples for premium schedule types are 'Inpatient', 'Outpatient' or 'Pharmacy'. A premium schedule type has the following fields:
- Code
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The functional identifier of the premium schedule type
- Description
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The description of the premium schedule type
- Extensibility
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Premium schedule types can be extended with single value dynamic fields.