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Insurance
Member Enrollment Business Process

Member Enrollment Business Process

After your organization has signed a contract for insurance services, you can enroll yourself and your family in medical, dental, and vision plans of your choice. We've created a simple process to show this can be done. Read on for details of how you can quickly enroll yourself.

Member Enrollment OmniScript Flow

You can find the member enrollment OmniScript in the Vlocity OmniScript Designer mode under:

  • Type - InsMember/enrollment
  • OmniScript name - Member Enrollment

The OmniScript uses Data Mappers to get account and member details. It then uses an Integration procedure to get the product information from the contract.

Next, the OmniScript displays member and dependent information for review. Additional dependents can be added at this stage.

The OmniScript uses a series of Data Mappers to extract the verified member information and then transform the data for medical, dental, and vision plans.

Next, the OmniScript gathers information about members to be included in medical plans.

Next, an Integration Procedure merges the list for selected members for medical plans. Now the MemberEnrollmentMedical1 OmniScript is called to enroll members into medical plans.

Now the OmniScript gathers information about members to be included in dental plans.

Next, an Integration Procedure merges the list for selected members for dental plans. Now the MemberEnrollmentDental1 OmniScript is called to enroll members into dental plans.

Now the OmniScript gathers information about members to be included in vision plans.

Next, an Integration Procedure merges the list for selected members for vision plans. Now the MemberEnrollmentVision1 OmniScript is called to enroll members into vision plans.

Now the MemberEnrollmentAdditional1 OmniScript is called to enroll the primary member in additional plans.

Now an Integration Procedure calls the InsEnrollmentService:enrollPlans service to enroll the user into the selected medical, dental, vision, and additional plans. Lastly, the OmniScript displays a confirmation of the selected plans and their details.

What's In the Member Enrollment OmniScript?

The member enrollment OmniScript calls other OmniScripts:

Component Name

Component Type

What It Does

What It Calls

FetchAccountDetails

Omnistudio Data Mapper Extract Action

Retrieves the account details and insured party specifications.

Ins_readAccountDetails_MemberEnrollmentOS

getCensusMembers

Data Mapper Extract Action

Retrieves census member information, contract ID, and producer details.

Ins_getCensusMemberDetails

getProductIdForConditionalView

Integration Procedure Action

Retrieves the product ID from the contract record.

Ins_ReadProductIdForConditionCheck_OS

memberDetails

Step

Displays the member's details as noted in the company's records.

None

SetErrors1

Set Errors

Displays an error if the user has not agreed to terms and conditions.

None

createContactsForMembers

Integration Procedure Action

Creates a contact record for the member and links the contact record to the census record.

ins_EnrollmentMemberCreateContact

setType

Set Values

Sets values of Medical, Dental, Vision, Term, and Additional to the insurance type.

None

setPrimaryMemberValuesforProducts

Set Values

Assigns the value of the primary member to the products.

None

medical

Step

Displays the form to select members to be enrolled for medical plans.

None

setCountM

Set Values

Sets the count for the medical plans depending on the user's choice.

None

SetMedical

Set Values

Sets cart value for the medical plan selected by the user.

None

dental

Step

Displays the form to select members to be enrolled for dental plans.

None

setCountD

Set Values

Sets the count for the dental plans depending on the user's choice.

None

SetMedcalDental

Set Values

Sets cart values for the medical and dental plans selected by the user.

None

vision

Step

Displays the form to select members to be enrolled for vision plans.

None

setCountV

Set Values

Sets the count for the vision plans depending on the user's choice.

None

setCartMedicalDentalVision

Set Values

Sets cart values for the medical, dental , and vision plans selected by the user.

None

term

Step

Displays the form to select term plans.

None

setCountT

Set Values

Sets the count for the term plans depending on the user's choice.

None

etCartMedicalDentalVisionTerm

Set Values

Sets cart values for the medical, dental , vision, and term plans selected by the user.

None

additional

Step

Displays the form to select additional plans.

None

setCountA

Set Values

Sets the count for the additional plans depending on the user's choice.

None

setCHAdditionalPlanDetails

Set Values

Sets cart value for the Critical Illness plan selected by the user.

None

setSIAdditionalPlanDetails

Set Values

Sets cart value for the Supplemental Health plan selected by the user.

None

setAdditionalPremiums

Set Values

Assigns values to additional premiums, if any.

None

setCartMedicalDentalVisionAdditional

Set Values

Sets cart values for the medical, dental , vision, term, and additional plans selected by the user.

None

ReviewDetailsCard

Step

Displays all the different plans selected by the user.

None

ReviewScreenSetError

Set Errors

Displays an error if the user does not accept terms and conditions.

None

enrollPlansForMedical

Integration Procedure Action

Uses the InsEnrollmentService service to enroll the member and any dependents in medical plans. It also generates a policy number.

EnrollPlanMedical

enrollPlansForDental

Integration Procedure Action

Uses the InsEnrollmentService service to enroll the member and any dependents in dental plans. It also generates a policy number.

EnrollPlanDental

enrollPlansForVision

Integration Procedure Action

Uses the InsEnrollmentService service to enroll the member and any dependents in vision plans. It also generates a policy number.

EnrollPlanVision

enrollPlansForTerm

Integration Procedure Action

Uses the InsEnrollmentService service to enroll the member and any dependents in term plans. It also generates a policy number.

InsEnrollmentTerm_EnrollPlan

enrollPlansForAdditional

Integration Procedure Action

Uses the InsEnrollmentService service to enroll the member and any dependents in additional plans. It also generates a policy number.

EnrollPlanAdditional

ConfirmationStep

Step

Displays the enrollment statement with details of all the plans the member has enrolled in.

None

NavigateAction1

Navigate Action

Navigates the user back to the policyholder Home page.

None

What's Next

Want to see the OmniScript in action? Read Member Enrollment Through the Policyholder Site.

 
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