Reassessment with Multiple Nominees

This section demonstrates how the eligibility and entitlement engine handles normal reassessment processing when more than one nominee is assigned to a rules objective. Note that only one nominee can be assigned to a rules objective at any point in time; however, multiple nominees can be assigned to the same rules objective over time. When there is more than one nominee assigned to the same rules objective over time, the eligibility and entitlement engine processes reassessment details for each nominee separately. This is to account for each nominee's delivery pattern.

The first part of reassessment processing is the creation of virtual financial components based on changes in circumstance. Virtual Financial component creation is done on a nominee by nominee basis and only for those nominees affected by the change in circumstance. The eligibility and entitlement engine then checks if reassessment needs to occur. If reassessment needs to occur, the eligibility and entitlement engine defines the reassessment period for each nominee affected by the change in circumstance.

The eligibility and entitlement engine determines the reassessment details for each nominee in line with the nominee's reassessment period. As part of determining the reassessment details for the nominee's reassessment period, the eligibility and entitlement engine retrieves all processed ILIs for this nominee during the reassessment period. In addition to retrieving the processed ILIs, the eligibility and entitlement engine creates in memory financial data for the nominee's virtual financial components. This financial data is the simulated creation of ILIs based on the change in circumstance.

The eligibility and entitlement engine then compares each actual amount to each financial data item within the same cover period for the nominee to determine if an over or underpayment exists. If an over or underpayment is found, the eligibility and entitlement engine records the over or underpayment details for the nominee and initiates over or underpayment processing. Note that this occurs for each nominee affected by the change in circumstance.

To demonstrate how the eligibility and entitlement engine processes a change in circumstance for cases with multiple nominees assigned to a single rules objective over time, this section uses the financial components created for James Smith and Linda Smith as outlined in Generate Financial Components for James Smith and Generate Financial Components for Linda Smith. Note, however, the financial components outlined in these subsections have been processed into actual financial transactions, i.e., ILIs. This section also uses the change in circumstance sample data from Reassessment Processing for a Benefit Case with the second nominee, Linda Smith. The following table outlines the change in circumstance sample data with the second case nominee: