This document summarizes the openIMIS features provided by the Policies module.
...
in the default enrollment:
Expiry date = Start date + Product Duration
Effective date is calculated based on the last installment (policy fully paid)
...
For free enrolment: Start Date = Enrolment Date + Administration Period, Effective Date = Max( Start Date, date of full payment of contributions), Expiry Date=Start Date + Insurance Period
For Fixed enrolment: Start Date = the nearest start of the fixed cycle (Nearest Cycle) provided the full payment of contributions occurs within the Grace Period Payment,, Effective Date = Max(Nearest Cycle, date of fullpayment of contributions), Expiry Date = Start Date +Insurance Period. I don’t go into details with determination of Nearest Cycle-Grace Period Enrolment/Renewal play the role in it.
You see that the rules shows compatibility between free enrolment and fixed enrolment.
Business rationale for the rules is that if an insuree pays later his/her effective duration of coverage shortens. It reduces potential of a moral hazard on the side of the insuree who may speculate and sign his/her policy and pay just before he/she needs health care. He/she still can do it but he/she will penalized by shotening of the coverage (for the full contribution).
There is no coverage in the interval <Start Date, Effective Date|) of course. Potential claims will be rejected. It is the actual consequence of the rules.
Access Rights
There is no straight link between a Policy and a Location. However, a Policy is linked to a Family, which in turn is attached to a location. Besides role-based feature access control (cf. Actors and Roles here below), all policy management actions (querying, entering, ...) are limited by user’s location(s) scope: users can only access/manage policies of families listed for his registered health facilities.
...
there are filters on the location… but a policy is not linked to a specific location. So we assume the location criteria are on policies' families (… which can be down to ‘village’).
when double clicking on a policy from the list, the legacy app opens the family overview (!), we’ll replace this by the default behavior (open the entity itself - in this case the policy, but add a ‘open family’ button in the rows to access the family overview from the policies (i.e. as we did for the insurees)
Note about the ‘historical’ checkbox:
The search in ‘historical’ values makes the assumption that archiving is performed “in live table”. This mechanism is under review (for performance reasons). This criteria may not be available anymore (depending on the new archiving mechanism chosen).
...