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Step 5: Configuring network cost shares for your product template

Updated on September 10, 2021

You can view the summary of all the network cost shares and guardrails that you defined in the product template and modify coverage at the network level. For example, you might want to increase the minimum coinsurance in the low range to 30% to accommodate out-of-network services.

The Guardrail summary in the bottom section of the page displays the cost share boundary rules that you previously defined.

Before you begin

Ensure that you configured your cost shares and accumulators. For additional information, see Step 4: Configuring cost shares and accumulators for your product template.

Procedure

  1. On the Configure networks page, in the Networks section, click the PPO Out-of-network link to update coverage at the network level.
  2. On the Configure network details page, click Edit.
  3. In the Configure or modify coverage dialog box, select Coinsurance and click OK.
    Coverage modification
  4. In the Low column, enter 30.
    This means that for services that are out-of-network, the minimum coinsurance for the low range is 30%.
  5. Click Submit.
  6. On the Configure networks page, in the PPO Out-of-network row, click the icon in the Cost share inheritance column. The dialog box shows that coinsurance is no longer inheriting the values from the product template (PT).
    Inheritance
  7. Click OK.
  8. Click Mark all as complete.
  9. Click Continue.

What to do next

Configure your benefits for the product template. See Step 6: Configuring benefits for your product template.

  • Previous topic Step 4: Configuring cost shares and accumulators for your product template
  • Next topic Step 6: Configuring benefits for your product template

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