Salesforce Docs Portal

PlanBenefit

Represents the standard benefits available under a plan that the purchaser offers to their members.

Supported Calls

create(),  delete(),  describeLayout(),  describeSObjects(),  getDeleted(),  getUpdated(),  query(),  retrieve(),  search(),  undelete(),  update(),  upsert()

Fields

BenefitNotes

  • Type: textarea
  • Properties: Create, Nillable, Update
  • Description: Additional information about the benefits available to members under this plan’s coverage.

CoinsuranceNotes

  • Type: textarea
  • Properties: Create, Nillable, Update
  • Description: Information about the contribution a member makes towards treatment.

CopayNotes

  • Type: textarea
  • Properties: Create, Nillable, Update
  • Description: Additional information on the copayment amounts that members contribute.

DeductibleNotes

  • Type: textarea
  • Properties: Create, Nillable, Update
  • Description: Additional information about a member’s deductibles.

DocumentLocation

  • Type: url
  • Properties: Create, Nillable, Update
  • Description: Hyperlink to internal or external resources.

EffectiveDate

  • Type: date
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The date on which these benefits are communicated to plan members.

EffectiveFrom

  • Type: date
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The date on which these benefits become effective.

EffectiveTo

  • Type: date
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The date on which these benefits ceased to be effective.

EmergencyDepartmentCopay

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: Patient's portion of payment for using emergency department services.

FamilyInNetworkDeductible

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The amount a member pays for health care provided by the health plan’s preferred providers for all family members. When this amount is reached, the plan starts to contribute towards treatment.

FamilyInNetworkOutofPocket

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The most a member pays during a coverage year for health care provided by the health plan’s preferred providers for all family members. It includes deductibles, copayments, and coinsurance, but is in addition to premiums.

FamilyOutofNetworkDeductible

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The amount a member pay for health care provided by non-preferred providers for all family members before this plan starts to contribute towards treatment.

FamilyOutofNetworkOutofPocket

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The most a member pays during a coverage year for health care provided by non-preferred providers for all family members. It includes deductibles, copayments, and coinsurance, but is in addition to premiums.

FrequencyType

  • Type: picklist
  • Properties: Create, Filter, Group, Nillable, Restricted picklist, Sort, Update
  • Description: The frequency type of the plan benefit associated with the home healthcare visit.

    This field is available in API version 66.0 and later with the Home Health add-on license.

  • Possible values:
    • Daily
    • Fortnightly
    • Monthly
    • Quarterly
    • Weekly
    • Yearly

IndividualInNetworkDeductible

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The amount a member pays for health care provided by the health plan’s preferred providers to any one family member. When this amount is reached, the plan starts to contribute towards treatment.

IndividualInNetworkOutofPocket

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The most a member pays during a coverage year for health care provided by the health plan’s preferred providers for any one family member. It includes deductibles, copayments, and coinsurance, but excludes premiums.

IndividualOutofNetworkDeductible

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The amount a member pays for health care provided by non-preferred providers to any one family member before this plan starts to contribute towards treatment.

IndividualOutofNetworkOutofPocket

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The most a member pays during a coverage year for health care provided by non-preferred providers for any one family member. It includes deductibles, copayments, and coinsurance, but excludes premiums.

InNetworkCoinsuranceAmount

  • Type: double
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The amount a member contributes towards each treatment undertaken by the health plan’s preferred providers.

InNetworkCoinsurancePercentage

  • Type: double
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The percentage of treatment cost the member pays for each treatment undertaken by the health plan’s preferred providers.

InNetworkLifetimeMaximum

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The most a member pays during the lifetime membership on this plan for health care provided by the health plan’s preferred providers. It includes deductibles, copayments, and coinsurance, but excludes premiums.

LastReferencedDate

  • Type: datetime
  • Properties: Filter, Nillable, Sort
  • Description: The timestamp for when the current user last viewed a record related to this record.

LastViewedDate

  • Type: datetime
  • Properties: Filter, Nillable, Sort
  • Description: The timestamp for when the current user last viewed this record. If this value is null, it’s possible that this record was referenced (LastReferencedDate) and not viewed.

LifetimeMaximumNotes

  • Type: textarea
  • Properties: Create, Nillable, Update
  • Description: Additional information about a member’s maximum lifetime payments.

Name

  • Type: string
  • Properties: Create, Filter, Group, Sort, Update
  • Description: Name of these plan coverage benefits.

OutofNetworkCoinsuranceAmount

  • Type: double
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The amount a member contributes towards treatment undertaken by non-preferred providers.

OutofNetworkCoinsurancePercentage

  • Type: double
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The percentage of treatment cost the member pays for treatment undertaken by non-preferred providers.

OutofNetworkLifetimeMaximum

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The most a member pays during the lifetime membership on this plan for health care provided by non-preferred providers. It includes deductibles, copayments, and coinsurance, but excludes premiums.

OutofPocketNotes

  • Type: textarea
  • Properties: Create, Nillable, Update
  • Description: Additional information about the out-of-pocket payment a member makes.

OwnerId

  • Type: reference
  • Properties: Create, Defaulted on create, Filter, Group, Sort, Update
  • Description: The ID of the user who owns this record.

PrimaryCareCopay

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The amount a member contributes towards primary care treatment.

PurchaserPlanId

  • Type: reference
  • Properties: Create, Filter, Group, Sort
  • Description: The ID of the purchaser plan offering these benefits.

SourceSystem

  • Type: string
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The name of the system this benefits record came from.

SourceSystemIdentifier

  • Type: string
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The ID of this benefits record on its source system.

SourceSystemModified

  • Type: date
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The date on which these benefits were last changed on their source system.

SpecialistCopay

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The amount a member contributes towards specialist consultations.

Status

  • Type: picklist
  • Properties: Create, Filter, Group, Nillable, Sort, Update
  • Description: The status of these benefits. The default the picklist
  • Possible values:
    • Active
    • Inactive

TotalBenefitAmount

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The total amount of the plan benefit associated with the home healthcare visit.

    This field is available in API version 66.0 and later with the Home Health add-on license.

UrgentCareCopay

  • Type: currency
  • Properties: Create, Filter, Nillable, Sort, Update
  • Description: The amount a member contributes towards urgent care.

Associated Objects

This object has the following associated objects. Unless noted, they are available in the same API version as this object.

PlanBenefitChangeEvent (API version 60.0)
Change events are available for the object.
PlanBenefitFeed
Feed tracking is available for the object.
PlanBenefitHistory
History is available for tracked fields of the object.
PlanBenefitOwnerSharingRule
Sharing rules are available for the object.
PlanBenefitShare
Sharing is available for the object.