Rules Engine for Eligibility & Enrollment maintains the rules repository for calculation of premiums and for eligibility determination and enrollment. It allows processing of individual & household information through the rules repository to come up with premium amounts and eligibility results.

Salient Features:

• Maintain standardized rate sheets with effective dates
• Maintain rules for eligibility determination for state programs, exchange plans and subsidies
• Maintain rules for verification of information provided for eligibility and enrollment
• Premium calculation and verifications of individual/household information and eligibility determination