Multiple Reassessment Processing

This section demonstrates how the eligibility and entitlement engine handles multiple reassessments within the same reassessment period. To handle multiple reassessments, the eligibility and entitlement engine first processes the new reassessment details. The eligibility and entitlement engine performs the same steps described in Reassessment Processing for a Benefit Case to create virtual financial components, check if reassessment needs to occur, and to determine the reassessment period. As part of determining the reassessment details for the reassessment period, the eligibility and entitlement engine retrieves the processed ILIs during the reassessment period, creates in memory the financial data from the virtual financial components, and compares the financial data to the processed ILIs to determine any over or underpayments.

Once the eligibility and entitlement engine processes the new reassessment details, it must then determine if any previous reassessments exists for the same period of time. If a previous reassessment does exist for the same period of time, the eligibility and entitlement engine must take into consideration any previous over or underpayments when calculating the value of the new over or underpayments. The eligibility and entitlement engine adjusts the value of the new over or underpayment according to the value of the existing over or underpayment.

To demonstrate how the eligibility and entitlement engine handles multiple reassessments, the change in circumstance data used in Reassessment Processing for a Benefit Case is also used in this section. This sample data represents the first change in circumstance which triggers reassessment. The first change in circumstance is a change in the certification period. An overpayment with a value of 5 resulted from the change in certification. A second change in circumstance is applied to this sample data which triggers reassessment within the same period for a second time. Note that the second change in circumstance does not occur until after the first reassessment. The second change in circumstance is a change in evidence such that James Smith is eligible for the Max Personal component with a daily rate of $9 as of the case start date and a weekly rate of $63. The following table describes how this second change in circumstance compares to the original data and the sample data after the first change:

Table 1. Second Change in Circumstance to Sample Data

Sample Data

Sample Data before any Change

Sample Data after 1st Change

Sample Data after 2nd Change

Primary Client

James Smith.

Same.

Same.

Product Type

Sample Benefit product.

Same.

Same.

Product Rerate Frequency

Every week on a Wednesday.

Same.

Same.

Case Certification Period

Certification period from April 1st - April 30th, 2004.

Certification period from March 15th - April 15th, 2004.

Same. Certification period from March 15th - April 15th, 2004.

Case Start Date

April 1st, 2004

March 15th, 2004.

Same. March 15th, 2004.

Case Expected End Date

April 30th, 2004.

April 15th, 2004.

Same. April 15th, 2004.

Case Nominee Delivery Pattern

Weekly in advance on a Friday.

Same.

Same.

Rules Objective

James Smith is eligible for the Max Personal rules objective. The daily rate for this rules objective is $10 until April 5th, 2004, when legislation increases the value of the daily rate to $11. The weekly rate is $70 until April 5th, 2004, when legislation increases the value of the weekly rate to $77.

Same.

James Smith is eligible for the Max Personal rules objective. The daily rate for this rules objective is $9. The weekly rate is $63.

Date up to which benefit has already been covered.

No ILIs have been created for the benefit, thus there is no date up to which the benefit has already been covered.

April 30th. This means that all FCs on or before April 30th have been realized into actual financial transactions, i.e., ILIs.

No new ILIs have been created for the benefit since April 30th.