Using the Social Benefits Playbook Eligibility Rules Engine (PaCE)
Summarize
Summary of Using the Social Benefits Playbook Eligibility Rules Engine (PaCE)
The Social Benefits Playbook Eligibility Rules Engine (PaCE) is designed to define and manage eligibility rules for social benefit programs. It utilizes pre-defined policies to assess whether applicants qualify for various benefits offered by your agency. This engine helps to streamline the application process by filtering out ineligible applications based on set criteria, ensuring compliance with current regulations.
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Key Features
- Policy Management: Create, update, review, and execute policies related to eligibility.
- Auto-Calculation: Provides auto-calculated eligibility recommendations based on the policies when a case is evaluated.
- Version Control: Allows for the creation of new policy versions by copying and modifying existing ones.
- Activity Tracking: Review execution history and activity for policies and versions.
- Efficient Organization: Utilize tags and categories to manage policies effectively.
Key Outcomes
By implementing the Eligibility Rules Engine, organizations can:
- Design an eligibility system that adapts to changes in laws and regulations.
- Reduce manual processing efforts by leveraging automated recommendations.
- Ensure consistent and accurate decisions regarding benefit eligibility.
If an applicant meets all eligibility criteria, they can proceed with their application. If not, their request will be marked as "not eligible," thus preventing unnecessary processing for ineligible cases.
Define and manage rules to determine eligibility and calculate benefits.
The Social Benefits Playbook uses an Eligibility Rules Engine, a series of pre-defined policies that are associated to a specific benefit, to determine whether they are eligible to apply for one or more social benefit programs that your agency offers. These policies are a set of pre-defined rules and logic that determines whether a constituent will receive benefits or not. Using a set eligibility rules criteria for Social Benefits Playbook may aid in deflecting applications for which the applicant is not eligible for a specific social benefit program. These policies can be updated as rules and regulations surrounding these social benefit programs change. The policies in Social Benefits Playbook Eligibility Rules Engine are powered by Policy as Code Engine (PaCE).
A PaCE policy is a set of pre-defined rules and logic that determines the desired behavior of an application or a service. When invoked, the rules in the policy are applied on the provided input, and a decision is reached. In PSDS, a PaCE policy represents a set of eligibility criteria that must be satisfied for a constituent to receive benefits. When invoked, the rules in the policy are applied to the case, and an auto-calculated eligibility recommendation is provided to the agent. For more information on understanding PaCE within the Social Benefits Playbook, see Understanding Policy as Code Engine (PaCE) and the Social Benefits Playbook.
You can use the eligibility rules engine to manage the life cycle of a policy and create, update, review, and execute policies. With the eligibility rules engine, you can:
- Evaluate any changes to ensure they meet your organization's policy management requirements.
- Create a policy, modify policy information, or copy a policy and its version to a new policy.
- Create a new policy version by copying an existing policy version and modifying it.
- View and define mapping information for any policy.
- Review executed policy activity and execution history for policies and policy versions.
- Use tags and categories to manage your policies more efficiently.
If the applicant fulfills all the criteria set forth by the eligibility rules engine policies, then the applicant can proceed with their application, or the agent can proceed in creating a case for the applicant. Case information must satisfy the conditions of each pre-defined policy for a constituent’s request to be deemed ‘eligible.’ If the information from the case is found to be non-compliant with one or more policies, and the applicant does not fulfill at least one of the eligibility criteria, neither an agent nor an applicant can proceed in creating a case for the social benefit program, and their request will be labeled as "not eligible."
- Allows governments to design an eligibility system and institute updates as laws and regulations change
- Reduces manual effort from agents by providing auto-calculated eligibility recommendations
- Allows governments to render consistent and accurate benefit decisions