Entity Intermediary Agreement

DescriptionAn agreement defining the way in which an intermediary can act on behalf of a healthcare insurer.

For example:
Broker agreement between Broker ABC and Acme Insurance Company.

Attributes
Commission EarnedCommission Earned
Commission Rate SacrificedCommission Rate Sacrificed
Commission WithheldCommission Withheld
Number Of Payments MadeNumber Of Payments Made
Pre-issue Commission IndPre-issue Commission Ind

Relationship
Intermediary Agreement_Health Plan Product_FKIntermediary Agreement_Health Plan Product_FK

Generalization
Intermediary Agreement_Agreement_GenIntermediary Agreement_Agreement_Gen

Dependencies
 NONE

Reverse Dependencies
 

Attribute Details

 Commission Earned
DescriptionSum of commission earned under the terms of the agreement.
Data TypeStandards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 Commission Rate Sacrificed
DescriptionRate representing the portion of commission given up by the sales entity to enhance the terms for their client.
Data TypeStandards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 Commission Withheld
DescriptionSum of that part of the commissions which are not paid out to the sales entity, but kept as compensation for contracts which are prematurely terminated.
Data TypeStandards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 Number Of Payments Made
DescriptionThe number of commission payments made.
Data TypeStandards - Data Domains.ddm/Data Domains/Small Counter [SHORT]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse



 Pre-issue Commission Ind
DescriptionIndicates whether (1) or not (0) the pre-issue of commission applies to the agreement. Under this process, commission is paid to the intermediary's or sales rep's current account because he issued a new application for insurance. The pre-issue commission will be reversed when the commission for the new business comes on the books. When the new policy does not come on the books, the pre-issue commission will be recovered. This usually happens at a set point in time. The reason for allocating pre-issue commission is that it may take several weeks before the underwriting process (especially medical underwriting) can be completed. Without pre-issue commission, the intermediary would have to wait all this time before they receive the commission. Pre-issue commission is optional, as the health plan may or may not want to do this process.

For example:
0 = Pre-Issue Commission Does Not Apply
1 = Pre-Issue Commission Applies
Data TypeStandards - Data Domains.ddm/Data Domains/Boolean Indicator [INTEGER]
Is Part Of PrimaryKeyfalse
Is Requiredfalse
Is Derivedfalse
Is Surrogate Keyfalse

Relationship Details

 Intermediary Agreement_Health Plan Product_FK
Is Identifying Relationshipfalse
Child TableIntermediary Agreement
Child MultiplicityZERO_TO_MANY
Child Referential Integrity: On DeleteNONE
Child Referential Integrity: On InsertNONE
Child Referential Integrity: On UpdateNONE
Parent TableHealth Plan Product
Parent MultiplicityZERO_TO_MANY
Parent Referential Integrity: On DeleteNONE
Parent Referential Integrity: On InsertNONE
Parent Referential Integrity: On UpdateNONE

Generalization Details

 Intermediary Agreement_Agreement_Gen
SupertypeAgreement
SubtypeIntermediary Agreement
Transform AsTABLE