SAP ABAP IMG Activity CLM_00_CL_155 (Define Claim Rule for Plan)
Hierarchy
SAP_HRRXX (Software Component) Sub component SAP_HRRXX of SAP_HR
   PA-BN-CL (Application Component) Claims Processing (Asia)
     PCLM (Package) Claims processing :Asia
IMG Activity
ID CLM_00_CL_155 Define Claim Rule for Plan  
Transaction Code S_AHR_61012734   (empty) 
Created on 19990308    
Customizing Attributes CLM_00_CL_155   Define Claim Rule for Plan 
Customizing Activity CLM_00_CL_155   Define claim rule for plan 
Document
Document Class SIMG   Hypertext: Object Class - Class to which a document belongs.
Document Name CLM_00_CL_155    

In this step, you define the actual claim limit for each plan.

Firstly, you consider every variation of criteria that you have
already defined in the claim rule variant. Then, you enter the
actual claim limit for these employees, for each possible combination
of these criteria within the variant.

Example

Plan Amount No. of Claims/ Dependent Cover Co-payment
Frequencies Employee Famliy
----------------------------------------------------------------------
DENT $200 - Spouse - -
GP01 $500 - All 20 30
OPD1 $500 - All 20 20
SPEC $1000 5/7 months - 20 -

Activities

  1. Identify all the criteria combinations and their various claim
    limits.
  2. Choose the claim variant to be further defined.
  3. Select the "New entries" function.

    To help you, the system will only allow you to make entries for the
    criteria that you have already defined as relevant in the claim
    variant.
  4. Enter the criteria combination, for example; salary group and age
    group.
  5. Enter the validity dates.
  6. Enter the claim limit as either a flat amount or as a factor of base
    salary.
  7. Enter the Dependent cover.
    This field is used in claim rule to assign dependent cover to plan.
  8. Make enries in all the remaining fields.
  9. Save your entries.
  10. Repeat steps 1 to 9 for each claim rule, within each variant.

Further notes

The salary that is referenced within claim limit as percentage of base
salary. It is calculated automatically by the system, as required.

Business Attributes
ASAP Roadmap ID 203   Establish Master Data 
Mandatory / Optional 1   Mandatory activity 
Critical / Non-Critical 1   Critical 
Country-Dependency I   Valid for countries specified 
Customizing Attributes Country Key Country Name
CLM_00_CL_155 HK Hong Kong
CLM_00_CL_155 ID Indonesia
CLM_00_CL_155 MY Malaysia
CLM_00_CL_155 PH Philippines
CLM_00_CL_155 SG Singapore
CLM_00_CL_155 TH Thailand
CLM_00_CL_155 TW Taiwan
Assigned Application Components
Documentation Object Class Documentation Object Name Current line number Application Component Application Component Name
SIMG CLM_00_CL_155 0 AHR0000574 Claims Processing (Asia) 
Maintenance Objects
Maintenance object type C   Customizing Object 
Assigned objects
Customizing Object Object Type Transaction Code Sub-object Do not Summarize Skip Subset Dialog Box Description for multiple selections
V_T7XAS8 V - View HRCLM0010 0000000000 Define claim rule for plan 
History
Last changed by/on SAP  20000128 
SAP Release Created in