| Dimensional Warehouse Model Data Model |
| Description | An association between Insurance Policy Dimension and Plan Member Dimension. |
| Relationship | |
Insurance Policy / Plan Member Bridge_Plan Member Dimension_FK |
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Insurance Policy / Plan Member Bridge_Insurance Policy Dimension_FK |
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| Primary Key | |
Insurance Policy / Plan Member Bridge PK |
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| Dependencies | |
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| Reverse Dependencies | |
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| Attribute Details |
AWM Load Info Sk
| Description | The surrogate key of the load information entry describing the details regarding the loading of the row in the atomic data warehouse. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Current Ind
| Description | Set to 'Y' if this is the most recent row of a group having the same Surrogate Key. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Boolean Indicator [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
DWM Load Info Sk
| Description | The surrogate key of the load information entry describing the details regarding the loading of the row. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Effective From Dt
| Description | Establishes a period where a set of attributes are true according to the business. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Date [DATE] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Effective To Dt
| Description | Ends a period of effectivity. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Date [DATE] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Insurance Policy Dimension Dk
| Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Insurance Policy Dimension Sk
| Description | A numeric surrogate key used to uniquely identify entities in the atomic model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Late Enrollment Ind
| Description | Indicates whether the member is considered to have been continuously enrolled in a plan for a specified period or has switched plans during the criteria period, since their enrollment date or notification date, whichever is later. 1 enrolled late 0 not late |
| Data Type | Standards - Data Domains.ddm/Data Domains/Boolean Indicator [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Membership End Dt
| Description | The date upon which the membership of the policy ended. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Date [DATE] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Membership Lifetime Benefit Accumulator
| Description | The total benefits ever paid to date for this member for the agreement. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Membership Notification Dt
| Description | The date upon which the organization became aware of a membership. This may occur prospectively, i.e. before the enrollment date or retrospectively, i.e. after the enrollment date has passed. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Date [DATE] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Membership Start Dt
| Description | The date upon which the membership of the policy commenced. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Date [DATE] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Membership Status Cd
| Description | Indicates the current status of the membership. For example, if Mary separates from her husband, she may no longer elect to include spouse coverage on her individual policy, so while her policy and resulting membership will remain active her husbands will be terminated. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Membership Status Code Sk
| Description | Indicates the current status of the membership. For example, if Mary separates from her husband, she may no longer elect to include spouse coverage on her individual policy, so while her policy and resulting membership will remain active her husbands will be terminated. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Membership Status Reason Cd
| Description | Indicates the reason for the current membership status or why it has changed. For example: Divorced Employment Opted out Overage Dependent Retired Terminated |
| Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Membership Status Reason Code Sk
| Description | Indicates the reason for the current membership status or why it has changed. For example: Divorced Employment Opted out Overage Dependent Retired Terminated |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Membership Year To Date Benefit Accumulator
| Description | The total benefits paid year-to-date for this agreement for this member for the given agreement. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Membership Year To Date Deductible Accumulator
| Description | Amount of deductible on the agreement already paid by the member during the current contract year. Applies to benefits in-network, where applicable. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Membership Year To Date Deductible Accumulator Out-of-Network
| Description | Amount of deductible on the agreement already paid by the member during the current contract year for benefits received out-of-network. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Membership Year To Date Out-of-Pocket Accumulator
| Description | Amount of deductibles and co-payments on the agreement already paid by the member during the current contract year. Applies to benefits in-network, where applicable. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Membership Year To Date Out-of-Pocket Accumulator Out-of-Network
| Description | Amount of deductibles and co-payments on the agreement already paid by the member during the current contract year. Applies to benefits out-of-network. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Plan Member Dk
| Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Plan Member Sk
| Description | A numeric surrogate key used to uniquely identify entities in the atomic model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Pre-existing Condition Waiver
| Description | Indicates whether enrolment occurred without consideration for pre-existing conditions. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Boolean Indicator [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Relationship Type Cd
| Description | The code that corresponds to the Relationship Type Code Sk. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Relationship Type Code Sk
| Description | The code identifying the actual type of the relationship as defined in the business data model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Source Code Sk
| Description | The origin of the data identifying the actual load source, vendor, manual key entry, or context of the data in a specific row in the database. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Tenant Sk
| Description | The surrogate key of the entry identifying the legal owner of the data. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Type of Membership Cd
| Description | Indicates the type of membership under which benefits are paid. For example: Consolidated Omnibus Budget Reconciliation Act (COBRA) Standard Surviving Insured Tax Equity and Fiscal Responsibility Act (TEFRA) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Tenant Common Code [VARCHAR(80)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Type of Membership Code Sk
| Description | Indicates the type of membership under which benefits are paid. For example: Consolidated Omnibus Budget Reconciliation Act (COBRA) Standard Surviving Insured Tax Equity and Fiscal Responsibility Act (TEFRA) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Valid From Ts
| Description | Establishes a period where a set of attributes are true in the source system. This would be populated with the transaction timestamp and would be used for the snapshot date. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Timestamp [TIMESTAMP] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Valid To Ts
| Description | Ends a period of validity. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Timestamp [TIMESTAMP] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
| Relationship Details |
Insurance Policy / Plan Member Bridge_Plan Member Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Insurance Policy / Plan Member Bridge |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Plan Member Dimension |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Insurance Policy / Plan Member Bridge_Insurance Policy Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Insurance Policy / Plan Member Bridge |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Insurance Policy Dimension |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
| Primary Key Details |
Insurance Policy / Plan Member Bridge PK
| Key Attribute | Insurance Policy Dimension Dk |
| Key Attribute | Plan Member Dk |
| Key Attribute | Relationship Type Code Sk |
| Key Attribute | Valid From Ts |
| Dimensional Warehouse Model Data Model |