Identifying and
status information on the account of Customer and their relationship with
service providers.
CustNo string PRIMARY KEY identifier of Customer’s account
with consulting firm
CustName string FK
à Contact(ContactName) personal and/or business full
name of Customer
Broker string FK à
Contact(ContactName) personal
and/or business full name of insurance broker
Executive string FK à
Contact(ContactName) personal
and/or business full name of Customer contact
Carrier string FK à
Contact(ContactName) personal
and/or business full name of insurance provider
CarrierDate date when
Customer started relationship with insurance provider
EnrollDate date when
Customer started relationship with consulting firm
Enrolled integer approximate
number of enrollees to be covered in benefit plan
Industry integer FK à
Industry(Code) indicates occupational classification of enrollees
ZipIn integer In-network
zip code (first 3 digits) – used in rate calculation
ZipOut integer Out-of-network
zip code (first 3 digits) – used in rate calculation
Assigns
descriptions to the codes used for classifying enrollees by occupation.
Code integer PRIMARY KEY classification ID
Description string classification
description
Maintains
contact information for all business entities in database.
ContactName string PRIMARY KEY personal and/or business full name of entity
Addr1 string first
line of postal address and/or location
Addr2 string second
line of postal address and/or location
City string city
of entity’s operation and/or location
State string state
of entity’s operation and/or location
Zip integer 5-digit
postal code base
Zip4 integer 4-digit
postal code extension
AreaCode integer 3-digit
telephone area code
Phone integer 7-digit
telephone number
Email string primary
business email address
Base quantities
and factors– apply to all calculated rate values of a specific model version.
CustNo string PRIMARY KEY, FKàAccount identifier
of Customer’s account with consulting firm
ModelType integer PRIMARY KEY, FKàModelType identifies the specific plan
version for this Customer
AnnMaxIn decimal In-network
maximum annual benefit payment per enrollee
AnnMaxOut decimal Out-of-network
maximum annual benefit payment per enrollee
CommBrok decimal broker’s
commission percentage on premium
CommGA decimal another
commission percentage
EmpContrib decimal enrollee’s
premium contribution percentage
PctEnrolled decimal estimated
benefit-covered percentage of Customer’s payroll
DualChoice Boolean relates
to employer’s benefit spectrum
OrthoMax decimal lifetime
maximum Orthodontic benefit per enrollee
ModelCfg string FK à
ModelConfig(CfgCode) designates
a combination of flexible benefit assignments
Parameterized
quantities used for rate calculations – several parameters apply to each
distinct model version.
CustNo string PRIMARY KEY, FKàAccount identifier
of Customer’s account with consulting firm
ModelType integer PRIMARY KEY, FKàModelType identifies the specific plan
version for this Customer
Parameter string PRIMARY KEY identifies the parameter being quantified
NetworkOut Boolean PRIMARY KEY each parameter is really two: In-network &
Out-of-network
Level1 decimal the
parameter value for basic cleaning & exams
Level2 decimal the
parameter value for fillings and extractions
Level3 decimal the
parameter value for crown, bridge, and surgery
Level4 decimal the
parameter value for orthodontics
Designates a
combination of flexible benefit assignments.
CfgCode string PRIMARY KEY identifies the combination
Description string provides
a longer text description of the combination
Ortho Boolean determines
whether Orthodontic coverage is include in calculation
Perio integer parameterized
Level# assigned to Periodontic services
Endo integer parameterized
Level# assigned to Endodontic services
Surg integer parameterized
Level# assigned to Surgical services
ModelType
table
Identifies the
specific plan version for a Customer.
TypeCode integer PRIMARY KEY identifies the ModelType
Description string text
description of ModelType