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            InsEnrollmentServiceStd:enrollNewHires

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            InsEnrollmentServiceStd:enrollNewHires

            Enroll new census members into their selected plans in the middle of a contract term.

            Class: InsEnrollmentServiceStd

            Method: enrollNewHires

            Scenario

            groupCensusID contractID groupCensusMemberIds primaryRoleName dependentRoleName
            groupCensusID1 ctrlD1 censusMemberPrimary1 PolicyHolder  
            censusMemberDependent1   Member
            censusMemberDependent2   Member
            policyID coverage PolicyParticipant policyParticipant.role
            policyID101 coverage1, coverage2 censusMemberPrimary1 self
            censusMemberDependent1 spouse
            censusMemberDependent2 child

            How It Works

            1. The service searches for Group Census Members:
              1. Either all members for a given groupCensusId or
              2. Only those members specified in the groupCensusMemberIds list.
            2. Each primary groupCensusMemberIds of the group census should have the PolicyStartDate field mapped. The PolicyStartDate should fall in between the Contract Start Date and Contract End Date.
              1. If any of the primary groupCensusMemberIds doesn't have the PolicyStartDate populated the service throws an error with a list of groupCensusMemberIds and a message: "Specify a valid date for PolicyStartDate."
              2. If any of the primary groupCensusMemberIds has a PolicyStartDate that doesn't fall between the Contract Start Date and Contract End Date the service throws an error with a list of groupCensusMemberIds and a message: '"Specify a PolicyStartDate that's within the ContractStartDate and ContractEndDate."
            3. Once the service verifies all primary census members have the PolicyStartDate information it searches for the pre-enrolled plans linked to each member in the GroupCensusMemberPlan.
            4. The plan's products for each member are returned.
            5. If the product is eligible (it's a part of a Contract and ContractGroupPlans), an Insurance Policy is created.
            6. Insurance Policy Coverages (InsurancePolicyCoverages) are created for the coverage items specified in the plan.
            7. Person accounts can be created for the group census members in the group census. To support the Person Account flow, this service goes through group census members to do below things:
              1. If AccountIds (retrieved from the GroupCensusMember) are available the service uses AccountId as InsurancePolicy.NameInsured and creates InsurancePolicyParticipants' PrimaryParticipantAccountId and RelatedParticipantAccountId.
              2. If AccountId is null, the service uses the groupAccountId as InsurancePolicy.NameInsured and contactId as InsurancePolicyParticipants' PrimaryParticipantContactId and RelatedParticipantContactId.
            8. An Insurance Policy is created only for a primary member, not their dependent. The dependent details in the Insurance Policies are stored as:
              1. The dependent information is created in a separate object called InsurancePolicyParticipants. A record is also created for the primary member. The service associates these records to the Insurance Policies.
              2. Insurance Policy Participant's (InsurancePolicyParticipant) primaryParticipantAccountId and relatedParticipantAccountId fields are also populated using the AccountId field of the group census member and Contact fields when AccountId is null.
            9. The Insurance Policy's effective date will be same as the PolicyStartDate of the primary member.
            10. The Insurance Premium will be prorated based on the number of days the member is enrolled for within the contract term. For example: the total premium from the rating :16.00. Contract duration: 365 days (Start date: 10-jan-2023 to End date: 9-jan-2024)Member's policy start date : 28-Feb-2023Total days for the new hire in the contract: 316Prorated premium: 16* (316/365) = 13.85
            11. Insurance Policy Coverages:
              1. If a family member enrolls for an optional coverage during member enrollment, a separate InsurancePolicyCoverage record corresponds to each and every enrolled optional coverage. Each InsurancePolicyCoverage record corresponding to optional coverages stores the enrolled Insurance Policy Participant in the vlocity_ins_fsc__InsurancePolicyParticipantId__c field on the InsurancePolicyCoverage object.
              2. There's a single InsurancePolicyCoverage record for mandatory coverages for a family per product.
            12. Insurance Policy Premium: If saveMemberPremium is set to true, the InsurancePolicyParticipant records contain the StandardPremiumAmount value of the policy. This amount is prorated (and is calculated the same way as the Insurance Premium in step 10).
              Note
              Note Configure the expression set or calculation procedure to set the member level premium amount to a memberPremium field the Include in Calculation output option set to true.

            Configure the rating procedure to pass the effective dates as options into the expression set or calculation procedure.

            • Key for the expression set or calculation procedure remote option : effectiveDate
            • Value for the expression set or calculation procedure remote option: %options:effectiveDate%
            • What it does: This value is passed in as an option to the InsProductService:getRatedProduct service by this Integration Procedure. This data is used to pull the correct versions of the expression set or calculation procedure and matrices the Integration Procedure uses for rating.

            Remote Options

            Option Description
            contractId

            Required.

            The ID of the contract that the members belong to and the plans that they will be enrolled in contractId.
            dependentRoleName

            Optional.

            Default value is Member.

            The Role field in InsurancePolicyParticipant will follow this value for dependents. The RelationshipToInsured field will be Spouse, Child, Parent, etc based on what is passed from the GroupCensusMember
            groupCensusId

            Required if not using groupCensusMembersIds.

            The ID of the census that contains all census members for enrollment.
            groupCensusMemberIds

            Required if not using groupCensusId.

            A list of IDs of specific census members for enrollment, separated by commas.
            isBatchMode

            Optional.

            Default value is true.

            Creates policies asynchronously.
            primaryRoleName

            Optional.

            Default value is PolicyHolder. The Role field in InsurancePolicyParticipant follows this value for primary members. The RelationshipToInsured field is Self for this case.
            saveMemberPremium

            Optional.

            Default Value is false.

            The value indicates the policy premium amount to be set for all InsurancePolicyParticipant records.

            If the value is true, the policy member premium is stored in the TotalStandardAmount field of the InsurancePolicyParticipant object for all the associated Insurance Policy Participants of a policy.

            Input JSON

            Here's the sample input JSON:

            {
   "Input": {
    "groupCensusId": "0rfRO00000005OUYAY",
    "contractId": "800RO000000WG4mYAG"
  },
  "Options":{
    "isBatchMode":false
  }
 }

            Output JSON

            Here's the sample output JSON:

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