| Dimensional Warehouse Model Data Model |
| Description | An agreement (individual agreement or group agreement) between a healthcare insurer and a member based on a health plan product. The agreement specifies the obligation of the healthcare insurer to pay benefits and of the premium payer to pay premiums. |
| Primary Key | |
Insurance Policy Dimension PK |
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| Attribute Details |
Agreement Status Cd
| Description | Indicates the Insurance Policy's current status. For Example: Active Cancelled Expired Final In Force In Process Initial Lapsed Not taken up Offered Rejected Suspended Terminated Under Negotiation |
| 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 |
Agreement Status Code Descr
| Description | Indicates the Insurance Policy's current status. For Example: Active Cancelled Expired Final In Force In Process Initial Lapsed Not taken up Offered Rejected Suspended Terminated Under Negotiation |
| Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Agreement Status Code Sk
| Description | Indicates the Insurance Policy's current status. For Example: Active Cancelled Expired Final In Force In Process Initial Lapsed Not taken up Offered Rejected Suspended Terminated Under Negotiation |
| 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 |
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 |
Bound Dt
| Description | The date upon which the Insurance Policy is considered legally binding, or in force. Depending on the legislation the bound date can be the date when the Insurance Policy is signed by both parties and/or when the first premium has been paid. Derived from the status related information. |
| 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 |
Coverage Out-of-Network Pct
| Description | Percent of charges payable under the contract, for covered medical services or products delivered by and out-of-network provider, under this insurance policy. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Coverage Pct
| Description | Percent of charges payable under the contract, for in-network benefits where applicable. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| 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 |
Discount Category Cd
| Description | Indicates a discount category that determines the reductions in premium or price from the standard rating structure based on the presence of factors that reduce the risk or increase profitability. For example: No claim No Discount Percentage of Usual and Customary Fee |
| 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 |
Discount Category Code Descr
| Description | Indicates a discount category that determines the reductions in premium or price from the standard rating structure based on the presence of factors that reduce the risk or increase profitability. For example: No claim No Discount Percentage of Usual and Customary Fee |
| Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Discount Category Code Sk
| Description | Indicates a discount category that determines the reductions in premium or price from the standard rating structure based on the presence of factors that reduce the risk or increase profitability. For example: No claim No Discount Percentage of Usual and Customary Fee |
| 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 |
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 |
Entry Cd
| Description | Identifies whether the insurance policy was entered by an external party or by a party within the modeled organization. For example: Agency entered Branch entered |
| 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 |
Entry Code Descr
| Description | Identifies whether the insurance policy was entered by an external party or by a party within the modeled organization. For example: Agency entered Branch entered |
| Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Entry Code Sk
| Description | Identifies whether the insurance policy was entered by an external party or by a party within the modeled organization. For example: Agency entered Branch entered |
| 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 |
Insurance Policy Descr
| Description | Textual description of the Insurance Policy. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Insurance Policy Dimension Bk
| Description | Concatenated values of a set of business attributes that uniquely identify the row. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Business Key [VARCHAR(255)] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| 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 | true |
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 |
Insurance Policy End Dt
| Description | The date upon which the Insurance Policy actually terminates. This may pre- or post-date the Planned End Date. For example, early termination of a contract due to poor performance. The termination date of the Insurance Policy is also represented in the status date for the terminated status. |
| 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 Start Dt
| Description | The date on which the Insurance Policy first starts. For renewable Insurance Policy, this date represents the date of the original Insurance Policy before any renewal. Derived from the status related information. |
| 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 Status Reason Cd
| Description | Indicates the motivation or cause for changing the agreement status of the Insurance Policy. For example: Not eligible (if agreement rejected) Not taken up (if agreement rejected) |
| 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 |
Insurance Policy Status Reason Code Descr
| Description | Indicates the motivation or cause for changing the agreement status of the Insurance Policy. For example: Not eligible (if agreement rejected) Not taken up (if agreement rejected) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Insurance Policy Status Reason Code Sk
| Description | Indicates the motivation or cause for changing the agreement status of the Insurance Policy. For example: Not eligible (if agreement rejected) Not taken up (if agreement rejected) |
| 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 |
Line Of Business Cd
| Description | Indicates the nature of commercial enterprise of the modeled organization. |
| 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 |
Line Of Business Code Descr
| Description | Indicates the nature of commercial enterprise of the modeled organization. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Line Of Business Code Sk
| Description | Indicates the nature of commercial enterprise of the modeled organization. |
| 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 Card Ind
| Description | Indicates whether membership cards are to be issued to members under the policy. For example: Not required. To be issued. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Alphanumeric Small [VARCHAR(6)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Membership Eligibility Cd
| Description | Indicates the qualification conditions for membership to an insurance policy. For example: Full Time Employees Full Time Employees Only Subscriber and Dependents Subscriber and Spouse Subscriber Only |
| 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 Eligibility Code Descr
| Description | Indicates the qualification conditions for membership to an insurance policy. For example: Full Time Employees Full Time Employees Only Subscriber and Dependents Subscriber and Spouse Subscriber Only |
| Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Membership Eligibility Code Sk
| Description | Indicates the qualification conditions for membership to an insurance policy. For example: Full Time Employees Full Time Employees Only Subscriber and Dependents Subscriber and Spouse Subscriber Only |
| 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 |
Next Renewal Dt
| Description | The next date at which the enforce status of the Insurance Policy must be re-evaluated or re-conducted. |
| 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 |
Next Review Dt
| Description | The date upon which a review of the Insurance Policy is planned. |
| 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 |
Planned End Dt
| Description | The date upon which the end of the Insurance Policy is planned. |
| 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 |
Policy Id
| Description | Identifies an instance of an Insurance Policy. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Identifier [VARCHAR(80)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Policy Identifier Type Cd
| Description | Describes the kind or nature of the Insurance Policy Identifier. |
| 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 |
Policy Identifier Type Code Descr
| Description | Describes the kind or nature of the Insurance Policy Identifier. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
| Is Part Of PrimaryKey | false |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Policy Identifier Type Code Sk
| Description | Describes the kind or nature of the Insurance Policy Identifier. |
| 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 |
Policy Type Cd
| Description | Identifies the type of the Insurance Policy. |
| 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 |
Policy Type Code Descr
| Description | Identifies the type of the Insurance Policy. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Policy Type Code Sk
| Description | Identifies the type of the Insurance Policy. |
| 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 |
Premium Payment Frequency Cd
| Description | Indicates the frequency with which the payment of the premium will occur. For example: Annually |
| 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 |
Premium Payment Frequency Code Descr
| Description | Indicates the frequency with which the payment of the premium will occur. For example: Annually |
| Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Premium Payment Frequency Code Sk
| Description | Indicates the frequency with which the payment of the premium will occur. For example: Annually |
| 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 |
Premium Payment Method Cd
| Description | Indicates the payment method that will be used to pay the premiums for the policy. For example: Check Direct debit mandate Electronic funds transfer |
| 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 |
Premium Payment Method Code Descr
| Description | Indicates the payment method that will be used to pay the premiums for the policy. For example: Check Direct debit mandate Electronic funds transfer |
| Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Premium Payment Method Code Sk
| Description | Indicates the payment method that will be used to pay the premiums for the policy. For example: Check Direct debit mandate Electronic funds transfer |
| 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 |
Rate Class Cd
| Description | Indicates the category that determines premium rates or rating structures for the insurance policy. For example: Single Male Principal Operator Age 20-25 |
| 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 |
Rate Class Code Descr
| Description | Indicates the category that determines premium rates or rating structures for the insurance policy. For example: Single Male Principal Operator Age 20-25 |
| Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Rate Class Code Sk
| Description | Indicates the category that determines premium rates or rating structures for the insurance policy. For example: Single Male Principal Operator Age 20-25 |
| 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 |
Renewal Ind
| Description | Indicates whether or not the insurance policy is a renewal. If not, it indicates that the insurance policy is in its first renewal period. |
| 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 |
Risk Type Cd
| Description | Indicates the types of risk or financial exposure to the health plan. |
| 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 |
Risk Type Code Descr
| Description | Indicates the types of risk or financial exposure to the health plan. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Risk Type Code Sk
| Description | Indicates the types of risk or financial exposure to the health plan. |
| 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 |
Selected Currency Cd
| Description | Indicates the currency as selected by the customer to be used on any monetary information provided to the customer. |
| 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 |
Selected Currency Code Descr
| Description | Indicates the currency as selected by the customer to be used on any monetary information provided to the customer. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Selected Currency Code Sk
| Description | Indicates the currency as selected by the customer to be used on any monetary information provided to the customer. |
| 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 |
Source Cd
| Description | The code that corresponds to the Source 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 |
Source Code Descr
| Description | The description that corresponds to the Source Type Cd. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Description [VARCHAR(250)] |
| Is Part Of PrimaryKey | false |
| 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 |
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 | false |
| 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 |
| Primary Key Details |
Insurance Policy Dimension PK
| Key Attribute | Insurance Policy Dimension Dk |
| Dimensional Warehouse Model Data Model |