MAINTAIN BENEFIT LINE DETAILS#

Benefit Lines are transaction records for coverage components. They indicate premiums, contributions, deductions, taxable benefits and calculated sales taxes, adjustments to the enrollment records and the remittance history.

Maintain Benefit Lines data is stored on the P2K_BE_BENEFIT_LINES and the P2K_BE_BENEFIT_LINE_DETAILS tables.

Plan

Plan is a user-defined code uniquely identifying the plan to the organization. Plan_Code is a mandatory 16-character alphanumeric field you must manually enter

Description

This is the user-defined description of the benefit plan. Description is an optional 50-character alphanumeric field you may manually enter.

Participation Rule

This field indicates whether participation in a benefit plan or coverage is mandatory or optional. The participation rule on the plan definition is used as a default entry to the benefit schedule. Only the participation rule from the benefit schedule is enforced. Participation_Rule is an optional fixed lexicon (X_PARTICIPATION_RULE).

Policy #

This field provides the insurance policy number assigned by the insurance carrier. Policy_Number is an optional 30-character alphanumeric field you may manually enter.

Last Remittance Date

This field displays the date this plan was last remitted to the insurance carrier (or reconciled for internal plans). Each time the remittance process is run, this date is updated by the system to reflect the latest date processed. When a user runs remittances for a time period, the system checks there are no missing remittance periods since the last run. Last_Remit_Date is an optional date field that is system updated, but it may be altered by you.

Coverage

Coverage is a user-defined code uniquely identifying the coverage to the organization. Coverage_Code is a mandatory 16-character alphanumeric field you must either manually enter or use the LOV (F9).

Coverage Step

Coverage Step code indicates the set of rates that apply to this enrollment. Codes may be numeric (e.g. 01, 02, 03...) or they may be alphanumeric (e.g. A, B, C, FS, MN, A1, B2...). Coverage_Step_Code is a mandatory 16-character alphanumeric field you must fill.

Processed

This field indicates the date for which the benefit calculation process was run. Processing_Date is a mandatory date field that is system maintained.

Benefit Line Status

This field indicates whether the benefit line has been updated to the enrollment form or the remittance history. Benefit_Line_Status is a mandatory fixed lexicon (X_BENEFIT_LINE_STATUS) that the system updates.

Description

This is the description of the benefit line. Description is a 50-character alphanumeric optional field you may manually enter.

Calendar Period

This field provides the year and period number to uniquely identify the calendar periods.

A monthly calendar for the calendar year Jan-Dec 1998 would have calendar periods 1998-01 through 1998-12. A weekly calendar for the fiscal year Apr1998-Mar1999 would have calendar periods 1999-01 through 1999-52 or 1999-53.

Calendar_Period is a mandatory 10-character number field you must either manually enter or use the LOV (F9).

Start Date

This is the start date of the calendar period. Calendar_Start_Date defaults in once the calendar period is selected.

End Date

This is the end date of the calendar period. Calendar_End_Date defaults in once the calendar period is selected.

State/Province

This field provides the standard abbreviation of the state or province where person resides. State_Province from P2K_CM_STATE_PROVINCES is a mandatory 16-character alphanumeric field you must either manually enter or use the LOV (F9).

Execution Status

This field shows the status of the execution log. Execution_Status is an optional fixed lexicon (X_EXECUTION_STATUS) that is system updated.

Benefit Source Module

This indicates the source application from which the benefit line originated. Benefit_Source_Module is an optional 100-character alphanumeric field that is system maintained.

Benefit Source Key

This is the key of the originating record. Benefit_Source_Key is an optional 100-character alphanumeric field that is system maintained.

Execution ID

This is the execution log ID of the benefit calculation. MEX_Id is an optional 10-digit numeric field that is system maintained.

Pay Line Status

This is the status of the pay line created. Pay_Line_Status is an optional fixed lexicon (X_PAY_LINE_STATUS) that is system updated.

Pay Line ID

This is the link to the pay transaction from where this benefit line may have originated or been updated from. PPL_Id is an optional 10-digit numeric field that is system maintained.

Remittance History

Remittance History is the link to the remittance amounts that have been reported/updated to the carrier. BRH_Id is an optional 10-digit numeric field that is system maintained.

BC

BC Code is a provided code that defines the benefits component. All BC codes begin with the letter “B” followed by a 4-digit number.

Definitions of each of the Benefits Components may be found in the list of Benefit Components.

BC_Code is a 16-character alphanumeric mandatory field you must either manually enter or use the LOV (F9).

Rule

BC Rule describes the possible options available for each benefits component. The rules shown are applicable to the highlighted benefits component in the BC Code field of the form. BC_Rule_Code from the P2K_BE_BC_RULES table is a provided 2-character numeric mandatory field.

Description

The line description is a brief explanation of the benefits component code highlighted. Description is a 50-character alphanumeric optional field that is either provided or that you may manually enter.

O/R Amount $

This is the value of the override amount. Amount_Override is an 18-digit numeric optional field you may manually enter.

Amount $

This is the value of the person's coverage component amount. Amount is an 18-digit numeric optional field that is system populated.

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Notes #

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