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FAQ: How do I manage specific billing groups at the employee level within BEM?

  • 1.  FAQ: How do I manage specific billing groups at the employee level within BEM?

    Posted 07-26-2023 11:33

    This is how to utilize the BEM Standard to manage accounts at the employee level specifically for billing groups.

    • Within the Employee node, is the Coverage node. 
    • Within the Coverage node is a "BillGroupIdentifier" element. 
      • This element is specifically designed to allow multiple billing groups per employer.

    <xsd:element minOccurs="0" name="BillGroupIdentifier" type="xsd:string">

    			<Coverage>
    				<CoverageID>2397070</CoverageID>
    				<GroupPolicyNumber>P123344</GroupPolicyNumber>
    				<ProductTypeCode>Life</ProductTypeCode>
    				<BenefitPlanIdentifier>W34D</BenefitPlanIdentifier>
    				<BenefitClassIdentifier>01</BenefitClassIdentifier>
    				<BenefitSubClassIdentifier>003</BenefitSubClassIdentifier>
    				<BillGroupIdentifier>BGWH01</BillGroupIdentifier>
    				<OriginalCoverageEffectiveDate>2019-09-01</OriginalCoverageEffectiveDate>
    				<CoverageEffectiveDate>2019-09-01</CoverageEffectiveDate>
    				<CoverageTierCode>SpouseOnly</CoverageTierCode>
    				<BenefitCalculationMethodCode>FlatAmount</BenefitCalculationMethodCode>
    				<BenefitAmount>20000</BenefitAmount>
    				<EmployeeContributionCode>EmployeePaid</EmployeeContributionCode>
    				<EmployeePremiumContributionAmount>3.31</EmployeePremiumContributionAmount>
    				<EmployerPremiumContributionAmount>0</EmployerPremiumContributionAmount>
    				<TotalPlanPremiumAmount>3.31</TotalPlanPremiumAmount>
    				<PaymentMethodCode>PayrollDeduction</PaymentMethodCode>
    				<PremiumModeQuantity>26</PremiumModeQuantity>
    				<PreTaxCode>PostTax</PreTaxCode>
    				<TobaccoUseIndicator>1</TobaccoUseIndicator>
    				<TakeOverCoverageIndicator>1</TakeOverCoverageIndicator>
    				<BeneficiaryGroupID>UC0014</BeneficiaryGroupID>
    				<CarrierID>1234</CarrierID>
    				<ElectedCoverage>
    					<ElectedBenefitCalculationMethodCode>FlatAmount</ElectedBenefitCalculationMethodCode>
    					<ElectedEmployeeContributionCode>EmployeePaid</ElectedEmployeeContributionCode>
    					<ElectedTotalPlanPremiumAmount>3.31</ElectedTotalPlanPremiumAmount>
    					<ElectedCoverageInsured>
    						<InsuredPartyID>45</InsuredPartyID>
    						<PrimaryInsuredIndicator>1</PrimaryInsuredIndicator>
    						<InsuredCoverageEffectiveDate>2019-09-01</InsuredCoverageEffectiveDate>
    					</ElectedCoverageInsured>
    				</ElectedCoverage>
    				<CoverageInsured>
    					<InsuredPartyID>45</InsuredPartyID>
    					<PrimaryInsuredIndicator>1</PrimaryInsuredIndicator>
    					<TobaccoUseIndicator>0</TobaccoUseIndicator>
    					<InsuredCoverageEffectiveDate>2019-09-01</InsuredCoverageEffectiveDate>
    				</CoverageInsured>
    				<CoverageEventID>NHEVT1234</CoverageEventID>
    			</Coverage>
    

    #LDEx-General
    #LDEx-API
    #LDEx-BEM
    #LDEx-Implementation
    #LDEx-XML

    ------------------------------
    Michael J Grudgings
    Business Architect, Data Standards | LL Global, Inc.
    300 Day Hill Road, Windsor, CT, 06095
    t: (860) 298-3850 | mgrudgings@limra.com
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