HP Policy Maintenance
Contents
Overview of HC100UPD
The HC Policy Maintenance Screen allows you to either edit an existing policy or add a new policy.
Adding a New Policy
If you clicked New from the HC Policy Inquiry screen, the HC Policy Maintenance screen will launch in data entry mode. You can also access this screen from the Account Entry screen by clicking Create and selecting New HC Policy:
There are three tabs on this screen:
Policy Maint Tab
The first tab is the Policy Maintenance tab, and will look like this:
The following fields are available on this screen:
| Field | Description |
|---|---|
| Policy # | This is a read only field. The policy number is automatically assigned by the system |
| Name/Address Block | Displays the name and address of the Owner, once the Owner PIN has been established |
| Owned by | Click the drop down to select the ownership type of this policy |
| Owner PIN | Enter the PIN number of the owner of the policy. You can also click the search icon to launch Name/Address Inquiry or click the Add button to launch Name/Address Entry |
| Calculate Premium | When checked, the policy’s premiums should be calculated when a new primary insured is added, an insured’s coverage has changed or someone runs the Premium Update application |
| Plan | Type the plan number or click the list icon to select from a list of available plans |
| Premium type | The Premium type field automatically populates based on the plan number, and is a read only field |
| Administrator | The Administrator field automatically populates based on the plan number, and is a read only field |
| Premium state | The Premium state automatically populates based on the Owner PIN |
| State factor | Displays the current State factor based on the Owner State and year |
| Region | If applicable, displays the HC Region code |
| Policy start date | Enter the date that the policy is effective. You can type the date in mm/dd/yyyy format or click the calendar to select the date |
| Policy termination date | If the policy has been terminated, enter the date that the policy was terminated. You can type the date in mm/dd/yyyy format or click the calendar to select the date |
| Reason for termination | If the policy is terminated, click the drop down arrow to select the reason for termination from a list of active termination codes configured within the system |
| Day due | The day of the month that the premium payments are due for this policy. This will default to the day due configured on the HC Settings Maintenance screen but you can override and enter a different day of the month for this policy |
| Monthly premium | Example |
| Monthly assistance | Example |
| Monthly due amount | Example |
When you have finished entering the Policy information, click Save to retain your changes. You can now add Insured to the Policy.
When on the Policy Maint tab, if you click the Actions menu on the toolbar, you will see these options:
Enter Assistance
Selecting this menu option will launch the HC Assistance screen
Recalculate Policy
Selecting this menu option will launch the Recalculate Policy process
Insureds Tab
When you click the Insureds tab, you will see this screen:
To add an insured to the policy, click the New button on the toolbar. The fields will activate for data entry:
The following fields are available on this screen:
| Field | Description |
|---|---|
| Policy # | The policy number is automatically populated from the Policy Maint tab, and is a read only field |
| Active on | Date that the policy is active on. This is a read only field that populates from the Policy Maint tab |
| PIN | Enter the PIN of the individual you are adding as an insured. You can type the PIN, click the search icon to launch Name/Address Inquiry, or click the Add button to launch Name/Address Entry |
| Name/Address | Populates with the Name/Address information of the insured PIN |
| Insured Type | Click the drop down arrow to select the type of insured record you are adding |
| Primary | This box automatically selects if you choose the Insured Type of Primary. If you select this box, it will automatically set the Insured Type to Primary |
| Coverage | Click the drop down to select the type of coverage for this policy. The available options are based on the selections configured for the plan in HC Plan Maintenance |
| Start date | Enter the date that the policy begins. You can type the date in mm/dd/yyyy format or click the calendar icon to select the date |
| Termination date | If the policy is terminated, enter the date of termination here. You can type the date in mm/dd/yyyy format or click the calendar icon to select the date |
| Reason | If the policy is terminated, click the drop down arrow to select the reason for termination |
| PPO network | If this policy is a member of a PPO network, enter the network name or ID here for tracking |
| Health Care ID | Enter the insured's health care ID |
| Prescription ID | Enter the insured's prescription ID |
| Premium | The premium will be updated based on the plan premium and other factors configured within HC Plan Maintenance |
When you have finished entering the information, click Save to retain your changes.
Remitters Tab
When you click the Remitters tab, you will see this screen:
Each individual or agency that will be paying on a policy, including the policy owner, will have to be entered in the remitter maintenance screen.
To add a new remitter to the policy, click the New button on the toolbar. The fields will activate for data entry:
The following fields are available on this screen:
| Field | Description |
|---|---|
| Policy # | This is a display only field that shows the policy number you are currently working with |
| Active on | A read only field that displays the date that the policy became active |
| Policy paid by | Enter the PIN of the remitter you are adding to this policy. You can also click the search icon to launch Name/Address Inquiry or click the New button to launch Name/Address Entry |
| Name/Address | Once a Remitter PIN has been entered, the name/address information for that remitter will appear in this box |
| Send remittances for this remitter | Option that determines whether Generate Remittances for HC (HC821) produces a remittance for the selected remitter on this policy. If selected, a remittance will be sent for this remitter |
| Specific amount | Indicates that the remitter will pay a specific amount of the premium. If selected, a field appears that allows you to enter the amount being paid |
| Percent | If selected, indicates that the remitter will pay a specified percentage of the premium. If this selection is chosen, a field activates that allows you to specify the percentage to be paid by this remitter |
| Remaining amount | If selected, this remitter will pay the amount of premium remaining after other remitter payments are applied |
| Start date | The date the remitter will begin paying on the policy. You can type the date in mm/dd/yyyy format or click the calender icon to select the date |
| End date | The date when the remitter will stop paying on the policy. Any payment falling within the start and end date range is the responsibility of the remitter, regardless of whether the date range includes the entire month being paid. You can enter the date in mm/dd/yyyy format or click the calendar icon to select the date. Leave this field blank if there is no end date for the remitter payments |
| Premium balance | Current over or under payment for remitter. Negative value means the policy is that much short of being fully paid through the paid-through date. Positive means that amount has been paid beyond the current paid-through date. A zero balance indicates that the premium is current |
| Next pmt dt | The date when the next payment is due. Can initially be set up when creating a remitter or changed later. Type the date in mm/dd/yyyy format or click the calendar icon to select the date |
| Paid thru | A display-only field that indicates the month and year that this policy is paid through |
| Premium paid ttd | Total premium paid on the health care policy to date (display only) |
| Discount earned ttd | Total discount earned on the health care policy to date (display only) |
When you have finished entering the information for the remitter, click Save to retain your changes. You can now continue to add remitters if desired.
If you click the Actions menu on the toolbar when viewing the Remitters tab, you will see that there is an option to enter a refund:
The refund entry window is used to enter refund information for a specific health care policy. (Typically, a refund would only be issued when a policy is being cancelled and the dues have been paid in advance.)
If you click the View button, you will see two options:
Edit History screen
Selecting Edit History will launch the Edit History screen for this remitter
Transactions screen
Selecting Transactions will launch the Health Care Transaction Inquiry screen for this remitter
