T7XAS8

Claim rule for Plan | #other | Component: Claims Processing (Asia)
Column Name Description
MANDT FK Client
BAREA FK Benefit area
BPLAN FK Benefit plan
CLMFM FK Claim variant for Plan
SALGR FK Benefit salary group
AGEGR FK Benefit age group
LOSGR FK Benefit seniority group
CLMGR FK Claim grouping for plan
GENDR Gender data for calculating claims limit Show values
ENDDA End Date
Column Name Description
💲 Benefit Currency Key (T5UD3.CURRE):
AMOUT Claim Limit Amount
CLMAX Maximum amount per claim
DCLMX Maximum amount per claim for dependents
MXAMT Maximum amount for each day
CPAMT Co-payment amount
CADEP Co-payment amount for family(dependents)
DPAMT Claim limit amount for dependents
Column Name Description
Column Name Description
ENDDA End Date
BEGDA Start Date
Column Name Description
GENDR Gender data for calculating claims limit Show values
APPRL Processing rule for claim limit amount and percentage Show values
PRRUL Processing rule for amout and percentage Show values
CPPRL Processing rule for co-pay amount and percentage for EE Show values
CDPRL Processing rule for co-pay amount and percentage for family Show values
ELGTY Dependent eligibility type Show values
Column Name Description Domain name
PRCNT Claim limit expressed as a percentage DEC3_2
NUMCL Number of claims DEC3
MXPER Claim limit expressed as a percentage DEC3_2
CLMNO No. of units DEC3
UNFLG Claim limit is applicable for all (Employee and Family) CHAR1
NDAYS Duration in no. of days NUMC4
CPPER Co-payment percentage DEC3_2
CPDEP Co-payment percentage for family(dependents) DEC3_2
WRDTY Claims ward type CLM_WRDTY
ELPER Dependent eligibility percentage DEC3_2
Master Data Relations Join Conditions
Benefit age group
  • Benefit area
  • ?
  • Benefit age group
  • T7XAS8.MANDT == T5UBL.MANDT
  • T7XAS8.BAREA == T5UBL.BAREA
  • T7XAS8.[column in domain "BEN_CRGRP"] == T5UBL.CRGRP
  • T7XAS8.AGEGR == T5UBL.AGEGR
Benefit area
  • Benefit area
  • Client
  • T7XAS8.BAREA == T5UB3.BAREA
  • T7XAS8.MANDT == T5UB3.MANDT
Benefit plan
  • Benefit plan
  • Benefit area
  • Client
  • ?
  • T7XAS8.BPLAN == T5UBA.BPLAN
  • T7XAS8.BAREA == T5UBA.BAREA
  • T7XAS8.MANDT == T5UBA.MANDT
  • T7XAS8.[column in domain "ENDDA"] == T5UBA.ENDDA
Dependent Coverage for Claims
  • Benefit area
  • Dependent Coverage for Claims
Claim variant for Plan
  • Benefit area
  • Claim variant for Plan
  • Client
  • Benefit plan
Claim grouping for plan
  • Claim grouping for plan
  • Benefit area
  • Client
Claims units for no. of claims
  • T7XAS8.MANDT == T549R.MANDT
  • T7XAS8.CLMUN == T549R.PERMO
Benefit seniority group
  • Benefit area
  • ?
  • Benefit seniority group
  • T7XAS8.MANDT == T5UBM.MANDT
  • T7XAS8.BAREA == T5UBM.BAREA
  • T7XAS8.[column in domain "BEN_CRGRP"] == T5UBM.CRGRP
  • T7XAS8.LOSGR == T5UBM.LOSGR
Client T7XAS8.MANDT == T000.MANDT
Benefit salary group
  • Benefit area
  • ?
  • Benefit salary group
  • Client
  • T7XAS8.BAREA == T5UBK.BAREA
  • T7XAS8.[column in domain "BEN_CRGRP"] == T5UBK.CRGRP
  • T7XAS8.SALGR == T5UBK.SALGR
  • T7XAS8.MANDT == T5UBK.MANDT