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In order to use openimis beyond health, the Product must be more generic, justification/use case could be found here : openIMIS beyond health features needs

Proposed Model

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Instantiation of the Benefit program for an household / Beneficiary : Benefit package:

create a benefit package that could group:

• benefit consumptions (Benefit consumption module / Enquire ), replacement/extension of the insureeInsuree

• invoice (Invoices (and bills) )

• beneficiary

• policyHolder ( beneficiacy or policyholder model)

upon the activation of the Benefit package the “benefit consumptions” will be filled

• just the policy

other benefit consumption limits will be created with the first consumption related to the limit

Prioritization of benefit consumption in claims:

1- if the claim specify a benefit plan, use this on first

2- if not benefitplan specified OR does not provide coverage, take the benefit with the higher priority

3- if there is several benefit with the same priority, use the most favorable for the beneficiary

Model

Main model

• Generic Product that should be based on the HistoryBusinessModel

  • date_valid_from* (old date_from)

  • date_valid_to* old date_to)

  • replacement_uuid* (tbc old conversion_product)

  • is_deleted**

  • json_ext**

  • date_created**

  • date_updated**

  • user_created** (old audit_user_id)

  • user_updated**(old audit_user_id)

  • version**

  • history**

  • code: str

  • name : str

  • location : key to geo location, zone where the Benefit plan is available, nullable

  • acc_code_premiums

  • acc_code_remuneration

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