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Insurance
InsEnrollmentService:getEligibleMemberProducts

InsEnrollmentService:getEligibleMemberProducts

Use this service to return eligible products for members of a census and groups them by type.

Class: InsEnrollmentService

Method: getEligibleMemberProducts

How It works

  1. This service takes a contractId and looks for information from the GroupCensus__c attached to it.

  2. Using the GroupCensus__c obtained from the contractId, the service retrieves all primary GroupCensusMembers__c and their dependents.

  3. The censusRatingFact is created using the GroupCensus__c Product Code and the AttributeSelectedValues__c.

  4. The contractId and categories options are used to retrieve the ContractLineItem__c (Plans) and associated metadata.

  5. The primary GroupCensusMembers__c uses the censusRatingFact and the AttributeSelectedValues__c of the primary member, and its dependents, to check the eligibility of a primary member.

  6. For each ContractLineItem__c  on the contract, its EligibilityCriteria__c  will be compared to the each of the primary member's inputs, from above.

    If a member has eligible products, the service will attach the primary member, sort it by category, then add it to the output JSON. Members with no eligible products will not be added to the output JSON.

Remote Options

Option

Description

contractId

Required.

Id of the contract.

category

Optional string.

Comma separated list of categories (Medical, Dental, Vision).

Will return plans only for specified categories.

Default = all categories.

onlyWhenMultiplePlansAvailable

Optional.

Boolean.

True returns options only when multiple plans are available.

Used to display members with their available options for each category, so user can make selections.

onlyWhenSinglePlansAvailable

Optional.

Boolean.

True returns options only when single plans are available.

Used for auto-enrollment when members have only a single plan option.

omitChildProducts

Boolean.

If true, only root products are returned.

Default = false.

Input JSON

This service does not use an input JSON.

Output JSON

The output JSON is a list of census members, with First Name, Last Name, Census Member Id, Categories of Products that they are eligible for.

{
  "contractId": "8006F0000014asaQAA",
  "ContextId": "",
  "timeStamp": "2019-08-30T08:34:43.150Z",
  "userId": "0056F0000077bTYQAY",
  "userName": "john@company.com",
  "userProfile": "System Administrator",
  "userTimeZone": -420,
  "userCurrencyCode": "EUR",
  "sfdcIFrameOrigin": "https://company.com",
  "sfdcIFrameHost": "web",
  "layout": "lightning",
  "isdtp": "p1",
  "id": "a1e6F000004RxxkQAC",
  "vlcPersistentComponent": {},
  "totalSize": 0,
  "records": [
    {
      "displaySequence": -1,
      "Id": "a386F000001ao9xQAA",
      "FirstName": "Lynn",
      "LastName": "Robbins",
      "Medical": {
        "totalSize": 1,
        "records": [
          {
            "displaySequence": -1,
            "Id": "01t6F00000AyW3ZQAV",
            "planId": "a1u6F000005ipRCQAY",
            "productName": "Acupuncture Office Professional",
            "Type": "Medical",
            "Description": "Anthem",
            "ProductCode": "AcupOffiProf",
            "MarketSegment": "Large Group",
            "LineOfBusiness": "Group Health",
            "attributeCategories": {
              "totalSize": 2,
              "records": [
                {
                  "productAttributes": {
                    "records": [
                      {
                        "attributeGroupType": "In-Network",
                        "userValues": null,
                        "values": [
                          {
                            "disabled": false,
                            "readonly": false
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 1,
                        "label": "Covered at",
                        "attributeId": "a1R6F00000Km1XLUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "number",
                        "dataType": "percentage",
                        "code": "INN_covered"
                      },
                      {
                        "attributeGroupType": "In-Network",
                        "userValues": null,
                        "values": [
                          {
                            "value": "yes",
                            "disabled": false,
                            "readonly": false,
                            "label": "Yes",
                            "id": "0"
                          },
                          {
                            "value": "no",
                            "disabled": false,
                            "readonly": false,
                            "label": "No",
                            "id": "1"
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 2,
                        "label": "Deductible",
                        "attributeId": "a1R6F00000Km1XMUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "dropdown",
                        "dataType": "text",
                        "code": "INN_deductible"
                      },
                      {
                        "attributeGroupType": "In-Network",
                        "userValues": null,
                        "values": [
                          {
                            "disabled": false,
                            "readonly": false
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 3,
                        "label": "Copay",
                        "attributeId": "a1R6F00000Km1XNUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "number",
                        "dataType": "currency",
                        "code": "INN_copay"
                      },
                      {
                        "attributeGroupType": "In-Network",
                        "userValues": null,
                        "values": [
                          {
                            "disabled": false,
                            "readonly": false
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 5,
                        "label": "IN covered",
                        "attributeId": "a1R6F00000Km1XKUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "checkbox",
                        "dataType": "text",
                        "code": "INNetwork_covered"
                      }
                    ],
                    "totalSize": 4
                  },
                  "id": "a1Q6F00000FR6uJUAT",
                  "Name": "In-Network",
                  "Code__c": "Vlocity_INN",
                  "displaySequence": 210
                },
                {
                  "productAttributes": {
                    "records": [
                      {
                        "attributeGroupType": "Out-Of-Network",
                        "userValues": null,
                        "values": [
                          {
                            "disabled": false,
                            "readonly": false
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 1,
                        "label": "Covered at",
                        "attributeId": "a1R6F00000Km1ZGUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "number",
                        "dataType": "percentage",
                        "code": "OON_covered"
                      },
                      {
                        "attributeGroupType": "Out-Of-Network",
                        "userValues": null,
                        "values": [
                          {
                            "value": "yes",
                            "disabled": false,
                            "readonly": false,
                            "label": "Yes",
                            "id": "0"
                          },
                          {
                            "value": "no",
                            "disabled": false,
                            "readonly": false,
                            "label": "No",
                            "id": "1"
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 2,
                        "label": "Deductible",
                        "attributeId": "a1R6F00000Km1ZHUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "radio",
                        "dataType": "text",
                        "code": "OON_deductible"
                      },
                      {
                        "attributeGroupType": "Out-Of-Network",
                        "userValues": null,
                        "values": [
                          {
                            "disabled": false,
                            "readonly": false
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 3,
                        "label": "Copay",
                        "attributeId": "a1R6F00000Km1ZIUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "number",
                        "dataType": "currency",
                        "code": "OON_copay"
                      },
                      {
                        "attributeGroupType": "Out-Of-Network",
                        "userValues": null,
                        "values": [
                          {
                            "disabled": false,
                            "readonly": false
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 4,
                        "label": "ON Covered",
                        "attributeId": "a1R6F00000Km1ZFUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "checkbox",
                        "dataType": "text",
                        "code": "OutNetwork_covered"
                      }
                    ],
                    "totalSize": 4
                  },
                  "id": "a1Q6F00000FR6vIUAT",
                  "Name": "Out-Of-Network",
                  "Code__c": "ANTM_OON",
                  "displaySequence": 220
                }
              ]
            }
          }
        ]
      },
      "Dental": {
        "totalSize": 1,
        "records": [
          {
            "displaySequence": -1,
            "Id": "01t6F000007sPVlQAM",
            "planId": "a1u6F000005j7AlQAI",
            "productName": "Dental 2",
            "Type": "Dental",
            "ProductCode": "DENTAL2",
            "attributeCategories": {
              "totalSize": 1,
              "records": [
                {
                  "productAttributes": {
                    "records": [
                      {
                        "userValues": null,
                        "values": [
                          {
                            "disabled": true,
                            "readonly": true
                          }
                        ],
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 1,
                        "label": "Office Visits & Exams",
                        "attributeId": "a1R6F00000K0X4sUAF",
                        "filterable": true,
                        "disabled": false,
                        "readonly": true,
                        "required": false,
                        "inputType": "number",
                        "dataType": "currency",
                        "code": "ILLNESS"
                      },
                      {
                        "userValues": null,
                        "values": [
                          {
                            "disabled": true,
                            "readonly": true
                          }
                        ],
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 2,
                        "label": "Unexpected Illness",
                        "attributeId": "a1R6F00000K0X4tUAF",
                        "filterable": true,
                        "disabled": false,
                        "readonly": true,
                        "required": false,
                        "inputType": "number",
                        "dataType": "currency",
                        "code": "ILL-UNEXPECTED"
                      }
                    ],
                    "totalSize": 2
                  },
                  "id": "a1Q6F000009NzKhUAK",
                  "Name": "Benefit",
                  "Code__c": "BENEFIT",
                  "displaySequence": 483
                }
              ]
            }
          }
        ]
      }
    },
    {
      "displaySequence": -1,
      "Id": "a386F000001aoA0QAI",
      "FirstName": "Mara",
      "LastName": "Robbins",
      "Medical": {
        "totalSize": 1,
        "records": [
          {
            "displaySequence": -1,
            "Id": "01t6F00000AyW3ZQAV",
            "planId": "a1u6F000005ipRCQAY",
            "productName": "Acupuncture Office Professional",
            "Type": "Medical",
            "Description": "Anthem",
            "ProductCode": "AcupOffiProf",
            "MarketSegment": "Large Group",
            "LineOfBusiness": "Group Health",
            "attributeCategories": {
              "totalSize": 2,
              "records": [
                {
                  "productAttributes": {
                    "records": [
                      {
                        "attributeGroupType": "In-Network",
                        "userValues": null,
                        "values": [
                          {
                            "disabled": false,
                            "readonly": false
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 1,
                        "label": "Covered at",
                        "attributeId": "a1R6F00000Km1XLUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "number",
                        "dataType": "percentage",
                        "code": "INN_covered"
                      },
                      {
                        "attributeGroupType": "In-Network",
                        "userValues": null,
                        "values": [
                          {
                            "value": "yes",
                            "disabled": false,
                            "readonly": false,
                            "label": "Yes",
                            "id": "0"
                          },
                          {
                            "value": "no",
                            "disabled": false,
                            "readonly": false,
                            "label": "No",
                            "id": "1"
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 2,
                        "label": "Deductible",
                        "attributeId": "a1R6F00000Km1XMUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "dropdown",
                        "dataType": "text",
                        "code": "INN_deductible"
                      },
                      {
                        "attributeGroupType": "In-Network",
                        "userValues": null,
                        "values": [
                          {
                            "disabled": false,
                            "readonly": false
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 3,
                        "label": "Copay",
                        "attributeId": "a1R6F00000Km1XNUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "number",
                        "dataType": "currency",
                        "code": "INN_copay"
                      },
                      {
                        "attributeGroupType": "In-Network",
                        "userValues": null,
                        "values": [
                          {
                            "disabled": false,
                            "readonly": false
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 5,
                        "label": "IN covered",
                        "attributeId": "a1R6F00000Km1XKUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "checkbox",
                        "dataType": "text",
                        "code": "INNetwork_covered"
                      }
                    ],
                    "totalSize": 4
                  },
                  "id": "a1Q6F00000FR6uJUAT",
                  "Name": "In-Network",
                  "Code__c": "Vlocity_INN",
                  "displaySequence": 210
                },
                {
                  "productAttributes": {
                    "records": [
                      {
                        "attributeGroupType": "Out-Of-Network",
                        "userValues": null,
                        "values": [
                          {
                            "disabled": false,
                            "readonly": false
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 1,
                        "label": "Covered at",
                        "attributeId": "a1R6F00000Km1ZGUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "number",
                        "dataType": "percentage",
                        "code": "OON_covered"
                      },
                      {
                        "attributeGroupType": "Out-Of-Network",
                        "userValues": null,
                        "values": [
                          {
                            "value": "yes",
                            "disabled": false,
                            "readonly": false,
                            "label": "Yes",
                            "id": "0"
                          },
                          {
                            "value": "no",
                            "disabled": false,
                            "readonly": false,
                            "label": "No",
                            "id": "1"
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 2,
                        "label": "Deductible",
                        "attributeId": "a1R6F00000Km1ZHUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "radio",
                        "dataType": "text",
                        "code": "OON_deductible"
                      },
                      {
                        "attributeGroupType": "Out-Of-Network",
                        "userValues": null,
                        "values": [
                          {
                            "disabled": false,
                            "readonly": false
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 3,
                        "label": "Copay",
                        "attributeId": "a1R6F00000Km1ZIUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "number",
                        "dataType": "currency",
                        "code": "OON_copay"
                      },
                      {
                        "attributeGroupType": "Out-Of-Network",
                        "userValues": null,
                        "values": [
                          {
                            "disabled": false,
                            "readonly": false
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 4,
                        "label": "ON Covered",
                        "attributeId": "a1R6F00000Km1ZFUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "checkbox",
                        "dataType": "text",
                        "code": "OutNetwork_covered"
                      }
                    ],
                    "totalSize": 4
                  },
                  "id": "a1Q6F00000FR6vIUAT",
                  "Name": "Out-Of-Network",
                  "Code__c": "ANTM_OON",
                  "displaySequence": 220
                }
              ]
            }
          }
        ]
      },
      "Dental": {
        "totalSize": 1,
        "records": [
          {
            "displaySequence": -1,
            "Id": "01t6F000007sPVlQAM",
            "planId": "a1u6F000005j7AlQAI",
            "productName": "Dental 2",
            "Type": "Dental",
            "ProductCode": "DENTAL2",
            "attributeCategories": {
              "totalSize": 1,
              "records": [
                {
                  "productAttributes": {
                    "records": [
                      {
                        "userValues": null,
                        "values": [
                          {
                            "disabled": true,
                            "readonly": true
                          }
                        ],
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 1,
                        "label": "Office Visits & Exams",
                        "attributeId": "a1R6F00000K0X4sUAF",
                        "filterable": true,
                        "disabled": false,
                        "readonly": true,
                        "required": false,
                        "inputType": "number",
                        "dataType": "currency",
                        "code": "ILLNESS"
                      },
                      {
                        "userValues": null,
                        "values": [
                          {
                            "disabled": true,
                            "readonly": true
                          }
                        ],
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 2,
                        "label": "Unexpected Illness",
                        "attributeId": "a1R6F00000K0X4tUAF",
                        "filterable": true,
                        "disabled": false,
                        "readonly": true,
                        "required": false,
                        "inputType": "number",
                        "dataType": "currency",
                        "code": "ILL-UNEXPECTED"
                      }
                    ],
                    "totalSize": 2
                  },
                  "id": "a1Q6F000009NzKhUAK",
                  "Name": "Benefit",
                  "Code__c": "BENEFIT",
                  "displaySequence": 483
                }
              ]
            }
          }
        ]
      }
    },
    {
      "displaySequence": -1,
      "Id": "a386F000001ao9yQAA",
      "FirstName": "Bill",
      "LastName": "William",
      "Medical": {
        "totalSize": 1,
        "records": [
          {
            "displaySequence": -1,
            "Id": "01t6F00000AyW3ZQAV",
            "planId": "a1u6F000005ipRCQAY",
            "productName": "Acupuncture Office Professional",
            "Type": "Medical",
            "Description": "Anthem",
            "ProductCode": "AcupOffiProf",
            "MarketSegment": "Large Group",
            "LineOfBusiness": "Group Health",
            "attributeCategories": {
              "totalSize": 2,
              "records": [
                {
                  "productAttributes": {
                    "records": [
                      {
                        "attributeGroupType": "In-Network",
                        "userValues": null,
                        "values": [
                          {
                            "disabled": false,
                            "readonly": false
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 1,
                        "label": "Covered at",
                        "attributeId": "a1R6F00000Km1XLUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "number",
                        "dataType": "percentage",
                        "code": "INN_covered"
                      },
                      {
                        "attributeGroupType": "In-Network",
                        "userValues": null,
                        "values": [
                          {
                            "value": "yes",
                            "disabled": false,
                            "readonly": false,
                            "label": "Yes",
                            "id": "0"
                          },
                          {
                            "value": "no",
                            "disabled": false,
                            "readonly": false,
                            "label": "No",
                            "id": "1"
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 2,
                        "label": "Deductible",
                        "attributeId": "a1R6F00000Km1XMUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "dropdown",
                        "dataType": "text",
                        "code": "INN_deductible"
                      },
                      {
                        "attributeGroupType": "In-Network",
                        "userValues": null,
                        "values": [
                          {
                            "disabled": false,
                            "readonly": false
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 3,
                        "label": "Copay",
                        "attributeId": "a1R6F00000Km1XNUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "number",
                        "dataType": "currency",
                        "code": "INN_copay"
                      },
                      {
                        "attributeGroupType": "In-Network",
                        "userValues": null,
                        "values": [
                          {
                            "disabled": false,
                            "readonly": false
                          }
                        ],
                        "isNotTranslatable": false,
                        "cloneable": true,
                        "hidden": false,
                        "hasRules": false,
                        "displaySequence": 5,
                        "label": "IN covered",
                        "attributeId": "a1R6F00000Km1XKUAZ",
                        "filterable": true,
                        "disabled": false,
                        "readonly": false,
                        "required": false,
                        "multiselect": false,
                        "inputType": "checkbox",
                        "dataType": "text",
                        "code": "INNetwork_covered"
                      }
                    ],
                    "totalSize": 4
                  },
                  "id": "a1Q6F00000FR6uJUAT",
                  "Name": "In-Network",
                  "Code__c": "Vlocity_INN",
                  "displaySequence": 210
                },
                {
                  "productAttributes": {
                    "records": [
                      {
                        "attributeGroupType": "Out-Of-Network",
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