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Pega Foundation for Healthcare policy record

Updated on February 10, 2022
Pega Foundation for Healthcare

Policies help defines a subscriber’s relationship to the following entities for a given period of time (policy period):

  1. Subscriber’s group / company.
  2. Subscriber’s effective plan or plans.
  3. Subscriber’s family structure.
  4. Each dependent’s effective plan or plans.

Note:

  1. A Policy belongs to an individual subscriber and not a group.
  2. A Policy can hold more than one plan.
  3. A Policy can have multiple medical, dental, vision, and pharmacy plans.
  4. A Policy can have only one medical, dental, vision or pharmacy plan at a given point of time (policy period).

Tags

Pega Foundation for Healthcare 8.7

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