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- Group Insurance Admin
- Data model
The tables behind Group Insurance Admin
Group Insurance Admin ships with 16 tables, grouped here by the feature that uses them. Every record your team works with lives in one of them, and you can add fields and tables in Proto.
- Tables
- 16
- Features
- 6, plus shared settings
- Change it
- Add fields and tables in Proto
How the model is organised
Organizations and people
Organizations, Policyholders, team members and Users identify the serviced group and accountable participants.
Policy and cover
Policies hold the lifecycle and premium; policy coverages and policy endorsements hold dated terms and changes.
Eligibility and review
Group eligibility records the submitted extension; review decisions retains the independent decision.
Claims and money
Claims link to the policy; claim decisions, claim payments and premium receipts preserve distinct decisions and financial events.
Evidence and reconciliation
Record attachments and operation receipts keep supporting material and guarded result state. Exchange rates holds effective currency rates.
Every table, by feature
- Group policies6
- Employer eligibility5
- Coverage and endorsements4
- Claims and decisions5
- Premiums and payments6
- Review and evidence6
- Shared and settings2
- Policies
Group insurance policies with lifecycle, premium and carrier issuance state.
Linked to Organizations, Team members, Policyholders - Organizations
Employer and broker organizations serviced by the group insurance operation.
- Policyholders
Policyholder groups with contact and eligibility context.
Linked to Organizations - Team members
Internal team members with their organization membership and role scope.
Linked to Organizations, Users - Review decisions
Independent reviewer decisions recorded against a policy revision.
Linked to Policies, Team members - Operation receipts
Idempotent receipts for guarded operations with result state and effects.
Linked to Policies
- Group eligibility
Employer group eligibility extensions raised against a policy.
Linked to Policies, Organizations - Policies
Group insurance policies with lifecycle, premium and carrier issuance state.
Linked to Organizations, Team members, Policyholders - Organizations
Employer and broker organizations serviced by the group insurance operation.
- Review decisions
Independent reviewer decisions recorded against a policy revision.
Linked to Policies, Team members - Operation receipts
Idempotent receipts for guarded operations with result state and effects.
Linked to Policies
- Policy coverages
Coverage lines belonging to a policy with limits, deductibles and exclusions.
Linked to Policies - Policy endorsements
Endorsements preserving prior coverage revisions with carrier receipts.
Linked to Policies - Policies
Group insurance policies with lifecycle, premium and carrier issuance state.
Linked to Organizations, Team members, Policyholders - Claims
Claims reported against a policy with loss and reported evidence.
Linked to Policies
- Claims
Claims reported against a policy with loss and reported evidence.
Linked to Policies - Policies
Group insurance policies with lifecycle, premium and carrier issuance state.
Linked to Organizations, Team members, Policyholders - Policy coverages
Coverage lines belonging to a policy with limits, deductibles and exclusions.
Linked to Policies - Claim decisions
Authorized insurer claim decisions with approved benefit amounts.
Linked to Claims - Claim payments
Verified claim payments recorded against an approved decision.
Linked to Claims, Claim decisions
- Review decisions
Independent reviewer decisions recorded against a policy revision.
Linked to Policies, Team members - Record attachments
Evidence files attached to a policy with uploader and visibility scope.
Linked to Policies, Team members - Operation receipts
Idempotent receipts for guarded operations with result state and effects.
Linked to Policies - Policies
Group insurance policies with lifecycle, premium and carrier issuance state.
Linked to Organizations, Team members, Policyholders - Group eligibility
Employer group eligibility extensions raised against a policy.
Linked to Policies, Organizations - Team members
Internal team members with their organization membership and role scope.
Linked to Organizations, Users
Keys and references
Use the policy record number for operating lookup, while record references bind each child to its parent. A claim points to one policy and each claim payment points to both the claim and its decision. Review decisions point to the parent policy and source revision. Provider event identities and operation keys allow teams to spot repeated effects. Keep effective and loss dates when moving historical data.
Migration order
- Load Organizations, Users and team members, then Policyholders.
- Load Policies with organization, owner and policyholder references.
- Load policy coverages, policy endorsements and group eligibility against their policies.
- Load Claims and claim decisions, then claim payments and premium receipts.
- Load review decisions, record attachments, operation receipts and exchange rates; reconcile references and dates.
Set up Group Insurance Admin your way.
Start free, then use Proto to change fields, steps and approvals before your team goes live.