Financial Component Processing

This section demonstrates how the eligibility and entitlement engine creates financial components at the highest level. Financial components are created from case decision objectives. To create case decisions, the eligibility and entitlement engine uses a list of dates. This is either provided to the eligibility and entitlement engine (event date list) or compiled by the eligibility and entitlement engine (pattern date list). The eligibility and entitlement engine then creates decisions by calling the rules engine for each one of these dates. All identical decisions are rolled up into one decision covering the necessary time period. The eligibility and entitlement engine creates a case event and stores each case decision, each case decision objective, and each case decision objective tag. The eligibility and entitlement engine generates the financial components from the case decision objectives using the case decision period and the nominee delivery frequency. The following table outlines the sample data used to demonstrate this processing:

Table 1. Sample Data for Financial Component Processing
Sample Data	Description
Primary Client	James Smith is a registered person who is the primary client of the demonstration case.
Product Type	The product used in this demonstration is the Sample Benefit product.
Product Rerate Frequency	The rerate frequency for the Sample Benefit product is set up to recur every week on a Wednesday.
Case Certification Period	The case certification period is April 1st, 2004 to April 30th, 2004.
Case Start Date and Creation Date	The case start date and creation date is April 1st, 2004.
Case Expected End Date	The case expected end date is April 30th, 2004.
Case Nominee Delivery Pattern	There is only one nominee on this case, James Smith. The case nominee delivery pattern is weekly in advance on a Friday. If for any reason delivery cannot be made on a Friday, the delivery must be made on the nearest possible Friday in advance.
Rules Objective	James Smith, the primary client, is eligible for the Max Personal rules objective.
Daily Rate	The daily rate is $10 until April 5th, 2004, when legislation increases the value of the daily rate to $11.
Weekly Rate	The weekly rate is $70 until April 5th, 2004, when legislation increases the value of the weekly rate to $77.

Changing Case Start and Expected End Dates: A case start date can be modified manually until the case is approved. After approval, the case start date is fixed. For the Sample Benefit product, the case start and expected end dates can be changed, even after case approval, by resetting the certification period. Functionality has been added to the Sample Benefit product where the system sets the case start date to the earliest certification from date provided that the certification from date is before the case start date. The case expected end date is set to the latest certification to date.