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InsEnrollmentService:enrollPlans
Use this service to create policy (Asset or Insurance Policy) records for enrollee selected medical, dental, vision, and other plans.
Method: enrollPlans
How It Works for Insurance Policy Records
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. The service does the following:
-
The service takes the input JSON and looks for the information to create the policies (Insurance Policy).
defaultIsFSCOption
isFsc parameter
Policies Created
True
NA
Insurance Policy (
InsurancePolicy) recordsFalse
True
Insurance Policy (
InsurancePolicy) recordsFalse
False
Asset (
Asset) recordsNA
True
Insurance Policy (
InsurancePolicy) recordsNA
False
Asset (
Asset) records -
For Insurance Policy record, the member can be represented either as a Contact or a Person Account. When a member (primary or dependent) is represented as an account and contact both, the service uses the account representation.
-
Associates dependents to the policies as Insurance Policy Participants (
InsurancePolicyParticipants). It creates another Insurance Policy Participant (InsurancePolicyParticipant) for the primary member.The records for
InsurancePolicyParticipantsare populated according to these rules:You can create Person Accounts for the members in the given census. To support the Person Account flow:
-
If Primary Member is represented as a Person Account, then the member’s
Person Account Idis set as the policy’s Account. -
If Primary Member is represented as a Person Account, then Primary Participant Account Id of primary’s
InsurancePolicyParticipantrecord is Primary member’s person account Id and Primary Participant Contact Id ispersonAccount.personContactId. -
If Primary member of the dependent is represented as Person Account, then Primary Participant Account Id of dependent’s
InsurancePolicyParticipantrecord is Primary member’s person account Id. -
Primary Participant Contact Id of dependent’s
InsurancePolicyParticipantrecord is Primary member’spersonAccount.personContactId. -
If dependent is represented as a Person Account, then Related Participant Account Id of dependent’s
InsurancePolicyParticipantrecord is Related member’s person account Id. -
If dependent is represented as a Person Account, then Related Participant Contact Id of dependent’s
InsurancePolicyParticipantrecord is Related member’spersonAccount.personContactId.
-
If Primary Member is represented as a Contact, then the member’s
Account.Idis set as the policy’s Account. -
If Primary Member is represented as a Contact, then Primary Participant Contact Id of primary’s
InsurancePolicyParticipantrecord is Primary member’s Contact Id. -
If Primary member of the dependent is represented as Contact, Primary Participant Contact Id of
InsurancePolicyParticipantis Primary member’s contact ID. -
if dependent is represented as Contact, Related Participant Contact Id of
InsurancePolicyParticipantis Primary member’s contact ID.
-
-
Gets the
ProductIdfrom the plan and stampsInsurancePolicy.ProductId=plan.Product2Id. -
Creates these relationships:
Insurance Policy
InsurancePolicy.EffectiveDate=Contract.StartDateor the EffectiveStart in the input JSON.InsurancePolicy.ExpirationDate=Contract.EndDateor the EffectiveEnd in the input JSON.InsurancePolicy.ContractLineItemId__c=Plan.Id -
The service calculates
InsurancePolicy.PolicyTermbased onContract.ContractTerm:Insurance Policy
ContractTerm = 12, InsurancePolicy.PolicyTerm= Annual.
ContractTerm = 6, InsurancePolicy.PolicyTerm= Semi-Annual
ContractTerm = 1, InsurancePolicy.PolicyTerm= Monthly
ContractTerm = Any other value, InsurancePolicy.PolicyTerm= Custom.
-
Gets the
Pricekey from the input JSON and creates these relationships:Insurance Policy
InsurancePolicy.PremiumAmount= PriceInsurancePolicy.TermPremiumAmount= prorated price based on the effective dates specified in #5.InsurancePolicy.MonthlyPremium__c= Price/ContractTerm -
Creates Insurance Policy Coverages (
InsurancePolicyCoverages) for the coverage items.
How It Works for Assets
-
The service takes the input JSON and looks for the information to create the policies (assets).
defaultIsFSCOption
isFsc parameter
Policies Created
True
NA
Insurance Policy (
InsurancePolicy) recordsFalse
True
Insurance Policy (
InsurancePolicy) recordsFalse
False
Asset (
Asset) recordsNA
True
Insurance Policy (
InsurancePolicy) recordsNA
False
Asset (
Asset) records -
Associates the primary member’s
contactIdwith the policy as a Contact. -
Stamps the enrollment contract’s
accountIdas the policy’s Account. -
Takes the
RawPriceDatakey or theRateBandTierPriceDatakey from the input JSON and stamps it to theAsset.PricingLogData__cfield. -
Gets the
ProductIdfrom the plan and stampsAsset.Product2Id=plan.Product2Id__c. -
Creates the following relationships:
Assets
Asset.EffectiveDate__c=Contract.StartDateor the EffectiveStart in the input JSON.Asset.ExpirationDate__c=Contract.EndDateor the EffectiveEnd in the input JSON.Asset.BenefitPlanId__c=Plan.Id -
The service calculates
Asset.Term__cbased onContract.ContractTerm:Assets
ContractTerm = 12, Asset.Term__c = Annual.
ContractTerm = 6, Asset.Term__c = Semi-Annual
ContractTerm = 1, Asset.Term__c = Monthly
ContractTerm = Any other value, Asset.Term__c = Custom.
-
Gets the
Pricekey from the input JSON and creates these relationships:Assets
Asset.StandardPremium__c= PriceAsset.TotalPremiumTerm__c= prorated price based on the effective dates specified in #7Asset.AnnualPremium__c= Price/ContractTerm*12Asset.MonthlyPremium__c= Price/ContractTerm -
Associates dependents to the policies as Held Product Relationships (
AssetPartyRelationship__c). While creating asset party relationship for dependents, the partyId must be provided in the dependents node.
NoteAnother Insurance Policy Participant (
InsurancePolicyParticipant) is created for the primary member, but no record is created for the primary member in Held Product Relationship (AssetPartyRelationship__c). -
Creates Policy Coverages (
AssetCoverage__c) for the coverage items.
Remote Options
Option |
Description |
|---|---|
|
Required. The key to a pre-transformed JSON structure that contains information the service needs. |
|
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. |
Input JSON
The service takes the input JSON specified by the inputKey. In
this example, inputKey = enrollmentJson.
The service requires:
-
contractId: <value> -
Dependents: <list of maps for contactId and relationshipType of the dependents>.NoteWhile using enrollPlans service to generate Asset and AssetPartyRelationship, if dependents are passed in enrollmentJson, then corresponding partyId must be provided.
-
Product JSON Structure Model including attributes and child products
This input JSON can have either a list of objects or a map, because the service supports creating either one policy or multiple policies.
To support Person Account Id, primaryMemberId is a new node added
to the enrollmentJson. It supports both Person Account Id and
ContactId for backward compatibility. Based on the Id type
of primaryMemberId, the services work as described in service
description.
Similarly, for dependents, memberId node is added. It supports
both Person Account Id and contact Id for backward compatibility. Based on the Id
type of memberId, the services work as described in service
description.
In this example, the JSON includes three policies.
{
"enrollmentJson":[
{
"primaryMemberContactId":"0035w00003HjCFcAAN",
"primaryMemberId" : "0015e00000DvQ89AAF"
"contractId":"8005w000001mT4MAAU",
"dependents":{
"IsSpouse":false,
"contactId":"0035w00003HhfXPAAZ",
"memberId": "0015e00000RvO24IAJ"
"LastName":"Jones",
"FirstName":"Jean",
"relationshipType":"Child"
},
"Id":"01t5w00000EZUtMAAX",
"Name":"HMO 500",
"Family":"Other",
"ProductCode":"SG-HMO-500",
"Type__c":"Medical",
"SubType__c":"HMO",
"RecordTypeName__c":"Product",
"IsConfigurable__c":false,
"PricingFormula__c":"GroupPremium",
"productId":"01t5w00000EZUtMAAX",
"currencyCode":"USD",
"currencySymbol":"$",
"Price":300,
"planId":"a2S5w0000034B2cEAE",
"planRateType":"Age",
"attributeCategories":{
"totalSize":1,
"records":[
{
"Code__c":"SG_Medical",
"Name":"SG Medical",
"id":"a085w00000uA9v6AAC",
"productAttributes":{
"totalSize":1,
"records":[
{
"rulesCode":"SG-HMO-500.SG_annualDed_INN",
"productCode":"SG-HMO-500",
"code":"SG_annualDed_INN",
"dataType":"text",
"inputType":"text",
"multiselect":false,
"required":false,
"readonly":true,
"disabled":true,
"filterable":true,
"attributeId":"a095w000010zIYkAAM",
"label":"Deductible",
"hasRules":false,
"hidden":false,
"cloneable":true,
"isNotTranslatable":false,
"values":[
{
"readonly":true,
"disabled":true
}
],
"userValues":"$500 / $1,000",
"attributeGroupType":"In-Network"
}
]
}
}
]
},
"childProducts":{
"totalSize":1,
"records":[
{
"Id":"01t5w00000EZUA7AAP",
"Name":"Emergency Services",
"ProductCode":"SG_Emerg_Serv",
"Type__c":"Medical",
"IsRecommended__c":false,
"RecordTypeName__c":"CoverageSpec",
"IsConfigurable__c":true,
"productId":"01t5w00000EZUA7AAP",
"pciId":"a3A5w000000Ib6fEAC",
"isOptional":false,
"isSelected":true,
"attributeCategories":{
"totalSize":1,
"records":[
{
"Code__c":"SG_Medical",
"Name":"SG Medical",
"id":"a085w00000uA9v6AAC",
"productAttributes":{
"totalSize":1,
"records":[
{
"code":"SG_urgentCareFacility_OON",
"dataType":"text",
"inputType":"dropdown",
"multiselect":false,
"required":false,
"readonly":false,
"disabled":false,
"filterable":true,
"attributeId":"a095w000010zIZRAA2",
"label":"Urgent Care Facility",
"hasRules":false,
"hidden":false,
"cloneable":true,
"isNotTranslatable":false,
"values":[
{
"id":"0",
"label":"Not Covered",
"readonly":false,
"disabled":false,
"value":"Not Covered"
},
{
"id":"1",
"label":"40% Coins After Ded",
"readonly":false,
"disabled":false,
"value":"40% Coins After Ded"
},
{
"id":"2",
"label":"50% Coins After Ded",
"readonly":false,
"disabled":false,
"value":"50% Coins After Ded"
},
{
"id":"3",
"label":"30% Coins After Ded",
"readonly":false,
"disabled":false,
"value":"30% Coins After Ded"
}
],
"userValues":"Not Covered",
"attributeGroupType":"Out-Of-Network"
}
]
}
}
]
}
}
]
}
}
]
}Output JSON
The list of policies created by the service.
assetIds |
InsurancePolicy record IDs for Insurance Policy records. Asset record IDs for Assets records. |
|---|---|
policyIds |
InsurancePolicy record IDs. Generated only for Insurance Policy records. |
{
"assetIds":[
{
"assetId":"0036F00002Q4wlSQAR"
},
{
"assetId":"0036F00002Q4wlSQAQ"
}
],
"policyIds":[
"0036F00002Q4wlSQAR",
"0036F00002Q4wlSQAQ"
]
}