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Scenario Overview

Health Coverage Assistance through the Department of Health and Welfare provides health coverage or assistance in paying for health coverage for people who meet certain criteria.

This example shows how to set up a Decision Table to evaluate if a person is entitled to Health coverage or Assistance under the requirements laid down by the US State of Idaho.

Requirements shown below.


To be eligible you must fit into one of the following categories:

Category 1:

Be a child under 19 years old
Category 2:

Be a pregnant woman
Category 3:

Be an adult with a child under the age of 19
Category 4:

Be aged 65 or older
Category 5:

Be blind or disabled according to the Social Security Administration criteria

If you match one of the above categories then you must also meet the below criteria:

Rule 1: 

You must be a Citizen of, or legal immigrant to, the USA.
Rule 2:

You must be a resident of the State of Idaho
Rule 3:

Your household income must be less then the program income limits for your household size.
Rule 4:

Your resource limits must not exceed the program resource limits

In this example the Account entity has been renamed to Household  and modified accordingly.
Contacts have been renamed as Household Residents that live in the that Household


Household Resident

N52 Formula Manager Solution

The Formula Manager solution works like this:

  • A formula of type Save – Perform Action is created on the Household Resident entity
  • The Source Properties are set to Employment Status, Current Savings, Monthly IncomeDisability Status, Pregnant and Immigration Status
  • The Event is set to Create & Update
  • Exit this Decision Table on First Match is turned On on all Decision Tables
  • Exit All Decision Tables on First Match is turned Off on all Decision Tables

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