Explain the benefits behind each insurance package
A policy name alone cannot explain the member’s selected benefit packages or annual limits. Model medical, dental and vision access as separate entitlements, while policy administration and claims systems determine actual coverage, eligibility and claim outcomes.
Explore the exampleAccess rights
- Medical benefits
- Included
- Source: Medical plan, version 1
- Dental benefits
- Not included
- Source: Not included in Medical plan
- Vision benefits
- Not included
- Source: Not included in Medical plan
- Digital member card
- Included
- Source: Medical plan, version 1
Illustrative benefit-package access. Policy administration and claims systems determine eligibility, coverage details and claim outcomes.
Explore insurance examples
Combine medical, dental and vision benefits
Priya holds a medical plan and wants dental and vision benefits. Compare keeping the medical package alone with adding a compatible benefits package, and inspect the source of each entitlement.
Step 1 of 4: Read the member’s benefits
The medical package is active. Dental and vision benefits are not included in the current plan.
DevelopmentTestDevelopment is a test environment: test money and sample customers only.
Access rights
- Medical benefits
- Included
- Source: Medical plan, version 1
- Dental benefits
- Not included
- Source: Not included in Medical plan
- Vision benefits
- Not included
- Source: Not included in Medical plan
- Digital member card
- Included
- Source: Medical plan, version 1
Illustrative benefit-package access. Policy administration and claims systems determine eligibility, coverage details and claim outcomes.
Benefit access and benefit balances are separate
Medical, dental and vision access can have different plan or add-on sources. Annual benefit balances track approved usage separately.
| Feature | Type | Plan value |
|---|---|---|
| Medical benefits | On or off | Included. Medical plan, version 1 |
| Dental benefits | On or off | Not included. Not included in Medical plan |
| Vision benefits | On or off | Not included. Not included in Medical plan |
| Digital member card | On or off | Included. Medical plan, version 1 |
More situations your team can handle
A member holds several benefit packages
The portal needs to explain which package supplies medical, dental or vision access. Read each entitlement’s sources alongside the coverage details held in policy administration.
A new benefits package is released
Existing members hold agreed package terms. Preserve the relevant cohort’s version or choose when its members receive the new package.
Explore reviewing member terms
Questions about insurance
More solutions
Explore all solutions, organised by team, company size, industry and use case.
Try your plans in Entitler
Start with sample plans and customers. Then try a change you expect to make, such as a new tier, a usage allowance or an exception for an early customer. Request an invite to try it with your team.