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Configuring the healthcare insurance plan

Suggest edit Updated on September 10, 2021

You configure a healthcare plan for a specific customer or to meet a particular mandated requirement. When you configure a plan, for example, if you have a small number of core products that can result in hundreds of plans for large accounts and thousands of plans for small groups and individuals, use a product to facilitate the efficient building of plans. By using a product to build a plan, the plan inherits the values that are defined in the product.

A healthcare plan is the most specific level of information that contains networks, benefits, and cost shares. Health insurance organizations sell plans to groups or individuals.

For this tutorial, you are configuring a plan by using a product. The plan includes a five-step wizard to guide you during configuration:

Step 1: Entering details for the plan
Step 2: Configuring cost shares for the plan
Step 3: Modifying the network cost shares for the plan
Step 4: Configuring benefits for the plan
Step 5: Changing benefit categories and setting the default benefit

Before you begin

Ensure that you have configured all the product steps. See Configuring a new product for the plan.

What to do next

Enter the details for the plan. See Step 1: Entering details for the plan.

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