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Length Of Cover (Tenure) Limits (Doc ID 2731770.1)

Last updated on DECEMBER 04, 2020

Applies to:

Oracle Insurance Claims Administration Cloud Service - Version NA and later
Information in this document applies to any platform.

Goal

On : NA version, MICC Transfer to TSC

Length of Cover (Tenure) Limits

For some products the so called " Length of cover" limits apply. The maximum amount of some limits are dependent on the length of time the member has had coverage for that specific service that the limit applies to.
Although the length of time a member is enrolled can be derived from enrollment response information, it cannot be done at a service level.
 

Example:
Length of Cover Amount for Dental General restorative services
Up to 1 year $250
1 – 2 years $300
2 – 3 years $350
Over 3 years $400

These Length of cover limits could also be applicable for so called "combined limits", limits for a group of service option service codes.
 

Solution

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In this Document
Goal
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