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
Identify all the criteria combinations and their various claim limits.
Choose the claim variant to be further defined.
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.
Enter the criteria combination, for example; salary group and age group.
Enter the validity dates.
Enter the claim limit as either a flat amount or as a factor of base salary.
Enter the Dependent cover. This field is used in claim rule to assign dependent cover to plan.
Make enries in all the remaining fields.
Save your entries.
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.