Managing Customers

A Customer can represent a group or an individual that purchases one or more policies. Some examples of customers include Commercial Groups, Medicare Groups (for example, when Employers offer Medicare benefits to Employees or Retirees), Government Agencies, and Individuals. Often, customers exist in a hierarchy, in which a master customer has multiple locations or subsidiaries.

The Customer record itself typically only contains basic demographic information about the customer, such as their name and business type. Details about their policy are stored in the Customer Policy record, while details about ownership are stored in the Producer Ownership Details.

Key fields on the customer record are:

Customer ID: The unique identifier for the customer. This field is sometimes called the group or contract ID. This number typically originates in the customer’s policy administrator system.

Name: The name of the customer. For an individual business, this is the policy holder’s name. For a group health insurance customer, this would contain the company name.

Customer Type: Identifier to help categorize the Customer for reporting purposes, Such as Group or Individual. This field indicates the current customer type since the Customer record is not date banded.

Business Type: Another identifier that categorizes the customer for reporting purposes. Examples of Business Types include Medicare Advantage, Health, or Marketplace. This field also indicates the current business type since the Customer record is not date banded.

The diagram above shows how the primary tables are associated with the Customer table. The CustPolicy table stores any policies that customer holds, while the BrokerCustomer and BrokerHierarchy tables are joined with the customer via the CustomerMatch table.