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Setup/Maintain Fully Insured Individual Customer – Gap (Doc ID 2472986.1)

Last updated on MARCH 12, 2019

Applies to:

Oracle Financial Services Revenue Management and Billing - Version and later
Information in this document applies to any platform.


New customer interface/s and related algorithm/s are required to support fully insured individual customer setup and maintenance. Unlike fully insured groups (where the customer and contract details are processed separately from eligibility/membership), the setup of the individual billing structure can be done as part of the enrollment message/s.

The fully insured individual customer structure setup must also be able to support tracking and systematic application of binder payments, i.e.
1. Identify and apply binder payment received in advance on initial enrollment of the individual.
2. Identify when binder payment has not been received or when individual is a returning member previously terminated due to non-payment with prior unpaid balance and move enrollment into a "waiting for payment" status.



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