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How values are populated in Pega Product Composer for Healthcare entity fields

A key feature of the Pega Product Composer for Healthcare application is its inheritance patterns. Inheritance describes how values for certain properties are shared within and across various entities.

The application uses inheritance in entity creation and updates. For example, when you change a value for a parent entity, Product A, PCS automatically updates the value for the child entities, Plan A, Plan B, and so on, unless you have overridden the original value in the plan (the child entities), and therefore have broken the inheritance.

Although Pega Product Composer for Healthcare uses three different inheritance patterns, there are some exceptions throughout the processes. Some of the entity fields receive copied data instead of inherited data. The topics in this section describe when data is copied to fields versus when fields inherit data. Other sections describe the three inheritance patterns.

You can override inherited values. However, keeping the automatic inherited values saves you time when you have many updates, such as during portfolio renewal.

The following table shows the PCS items and the category that applies to each item:
Copy Inheritance pattern 1 Inheritance pattern 2

(Item is configured at the network level)

Inheritance pattern 3

(Item is configured at the benefit level)

Product template values X
Metadata X
Required and covered fields X
Benefit categories X
Copayment X
Coinsurance X
Authorization X
Lifetime maximum X X
Out-of-pocket maximum X X
Annual maximum X X
Deductible X X
Limits X X