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Policy overview tab

Updated on February 10, 2022

The policy overview tab wizard allows a user to configure the policy effective dates along with the insurance type.

Pega Foundation for Healthcare

Field NameDescriptionMandatory
Policy IDA Policy ID is auto assigned. If need be clients can choose to load the policies with their own unique ID’s.Yes

Insurance type

Type pf policy:

  • GP – Group Policy
  • IP – Individual Policy
  • MC – Medicaid
  • MP – Medicare Primary
  • WC – Workers Compensation

Based on the policy or insurance type, the group contracts are filtered. For example. a Group policy would show group contracts and individual policy would show the individual contracts.

Yes
Policy Coverage type

Type of coverage which would be allowed under this policy:

  • Employee Only
  • Employee and Spouse
  • Employee and Children
  • Employee and Family

For example, if a policy coverage type is employee only, members with coverage type “employee and family” should not be enrolled in the policy.

Yes
Policy effective dateEffective start date of the policy.Yes
Policy term dateTerm date of the policy.Yes
Policy elected amountPolicy elected amountNo
Policy used amountPolicy used amountNo
Policy remaining amountPolicy remaining amountNo
VIP indicatorCheck of the subscriber is a VIP.No

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