Wiki: IBPT

DEFINE BENEFIT PLAN#

Benefit Plan Types define the major categories of plans for which the organization has specific coverage. benefit plan types are usually broad categories like 'Health', 'Dental' and 'Life Insurance'.

Benefit Plan Types data is stored in the P2K_BE_BENEFIT_PLAN_TYPES and P2K_BE_BENEFIT_COMPONENTS tables.

Plan Type: This field holds High Line defined plan type codes that uniquely identify the plan type. Plan_Type_Code is a mandatory 16-character alphanumeric field provided by High Line.

Recipient Type: This field determines the recipient eligible in the Benefit Plan. e.g Children, Spouse/Others, Not Applicable, Beneficiary. Recipient_Type is a fixed lexicon (X_PLAN_RECIPIENT_TYPE)

Plan Type

Description: This is a description of the benefit plan type. Description is an optional 50-character alphanumeric field provided by High Line.

Sequence: The Calculation Sequence field determines the order in which this plan type will be processed. Calculation_Sequence is a 5-digit numeric field provided by High Line but may be user altered.

Benefit Components Usage #

BC Code: The BC Code is the unique identifier for the benefit component. BC_Code is a mandatory 16-character alphanumeric field provided by High Line.

Sequence: Sequence determines the order in which the benefit plan calculation process will process this benefit component. Component_Sequence is a mandatory 5-character numeric field provided by High Line.

Description: This field describes the purpose of the benefit component. Description is an optional 50-character alphanumeric field provided by High Line but may be user altered.

BC Action: BC Action indicates the use of a benefit component. BC_Action is a mandatory fixed lexicon (X_BC_Action) you may use to look up the value.

Plan Definitions#

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

Description: This is the description of the plan(s) associated with this benefit plan type. Description is an optional 50-character alphanumeric field you may manually enter.

Participation: The participation rule 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 holds 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: The Last Remit Date field shows 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 may be user altered.