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Insurance
InsEnrollmentService:enrollMembers

InsEnrollmentService:enrollMembers

Use this service to enroll census members into their selected plans.

Important
Important From Winter '23 onward, we have InsEnrollmentServiceStd:enrollMembers service enabled to work with Salesforce Standard Data Model for Financial Services Cloud and Health Cloud. Existing customers can continue to use this service, but no further enhancements will be provided in the Insurance Managed Package.
Note
Note

Enrollment services can either write to the Insurance Policy and related objects (Harmonized policy data model) or Asset objects (Vlocity model), depending on the isFsc parameter, and the custom setting for defaultIsFSCOption.

From the Vlocity Health and Insurance Summer '21 release onward, the service also supports the Person Account flow.

If you're using Vlocity Package Data Model, we don't support enrollment for products that are inactive or that have a future date set as the effective date.

Class: InsEnrollmentService

Method: enrollMembers

How It Works

  1. The service first queries for Group Census Members either a) via all members for a given censusId or b) via only those members specified in the censusMembersIds list.  

  2. It then searches for pre-enrolled plans linked to each member by the Group Census Member Plan (GroupCensusMemberPlan__c). 

  3. The plans products for each member are returned. 

  4. If the product is part of the contract, then a policy record (Insurance Policy or Asset) is created. The type of policy that gets created, depends on the isFsc parameter, and the custom setting for defaultIsFSCOption as is described in this table.

    Custom Settings > Insurance Configuration Setup>defaultIsFSCOption

    IsFsc Parameter

    Policies Created

    True

    NA

    InsurancePolicy

    False

    True

    InsurancePolicy

    False

    False

    Asset

    NA

    True

    InsurancePolicy

    NA

    False

    Asset

  5. You can create Person Accounts for the members in the given census. To support the Person Account flow:

    This flow goes through census members.

    If accountId is not null, the service uses accountId as Policy.NameInsured and creates InsurancePolicyParticipants’ PrimaryParticipantAccountId and RelatedParticipantAccountId.

    If accountId is null, the service uses groupAccountId as NameInsured and contactId as InsurancePolicyParticipants’ PrimaryParticipantContactId and RelatedParticipantContactId.

    Note
    Note

    The Person Account is only enabled for Insurance Policy objects, not for Asset.

  6. Insurance Policy or Asset is created only for primary member and not its dependent. In order to specify the dependent details in the policies:

    1. For Insurance Policy: The dependent information is created in a separate object called InsurancePolicyParticipants. A record is created for the Primary member as well.

    2. For Assets: Dependents who are enrolled into the Asset are maintained in the AssetPartyRelationship__c. No record is created for Primary member in AssetPartyRelationship__c.

  7. For coverage items:

    1. Insurance Policy: Service creates Insurance Policy Coverages (InsurancePolicyCoverages).

    2. Asset: Service creates Policy Coverages (AssetCoverage__c).

Remote Options

Option

Description

isFsc

Determines whether to create the policies as Asset records or as InsurancePolicy records. The value of the parameter is honored:

  • If the Custom Settings > Insurance Configuration Setup has the defaultIsFSCOption set to false.

  • Or, if there’s no defaultIsFSCOption, the value of this parameter is taken.

censusMemberIds

Required if censusId isn’t used.

Id of the specific census members to be enrolled.

censusId

Required if censusMemberIds isn’t used.

Id of the census containing all census members to be enrolled.

contractId

Required.

Id of the contract that the members belong to and the plans that they’ll be enrolled in.

dependentRoleName

This option is only applicable to FSC policies. The default value is Member. The Role field in InsurancePolicyParticipant sets with this value, for all dependents.

primaryRoleName

This option is only applicable to FSC policies.

The default value is Policyholder.

The Role field in InsurancePolicyParticipant follows this value for primary members.

spousalRelationshipName

This option is only applicable to FSC policies.

The default value is Dependent.

The RelationshipToInsured field in InsurancePolicyParticipant follows this value for dependents who are tagged as spouses.

memberPlanIntegrationProcedure

Initiates a custom integration procedure based on the user configuration. When you use this option, it passes all options of the service to the custom integration procedure and all policy Ids as input to integrate with the object, for example the insurance policy object with the member plan.

Output JSON

The list of policies created by the service.

assetIds

InsurancePolicy record IDs if the service is creating FSC records, otherwise, these are Asset record IDs

policyIds

InsurancePolicy record IDs. This option doesn’t appear in Non-FSC records.

{
   "assetIds":[
      {
         "assetId":"0036F00002Q4wlSQAR"
      },
      {
         "assetId":"0036F00002Q4wlSQAQ"
      }
   ],
   "policyIds":[
      "0036F00002Q4wlSQAR",
      "0036F00002Q4wlSQAQ"
   ]
}
 
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