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Step 5: Setting or changing the default benefit and changing benefit categories

Updated on September 10, 2021

When you create a plan, you set a default benefit for each benefit category according to your business needs. You set a default benefit to best represent the cost share for the benefit category. The cost share, such as copay or coinsurance, on the benefit category displays in a Summary of Benefits and Coverage (SBC) document.

When you create a plan, you can change the benefit category assignments. For example, you might change the benefit category for the Office visit benefit from Inpatient services as defined during benefit creation to Outpatient services.

For this tutorial, you change the default benefit.

Before you begin

Ensure that you configured the benefits for the plan. See Step 4: Configuring benefits for the plan.

Procedure

  1. In the Configure benefit categories step of the wizard, in the Benefit category column, click the Urgent Services tab to expand it.
  2. At the right of the FAC-Urgent Care benefit, click the Gear icon.
  3. Click Set as default display benefit.
    Setting the default benefit
  4. Click Save and then click Finish.
  5. Because you have manager credentials, approve the plan entity by following these steps:
    1. Click Actions > Approve and hold at the top right.
      By clicking Approve and hold instead of Approve, the entity remains in the current stage, but is available for use in other tasks. To advance the entity to the next stage, click Approve.
    2. In the Approve section, click Submit.

What to do next

You have completed the plan. As an option, you can configure a plan bundle. See Configuring a plan bundle.

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