--- title: "PolicyCoverage" url: "https://developers.zinnia.com/apis/policy-service-0-1-0/versions/8306e031-b41c-452a-a7ed-d73d65602086/schemas/PolicyCoverage" --- > Full API specification: https://developers.zinnia.com/apis/policy-service-0-1-0/versions/8306e031-b41c-452a-a7ed-d73d65602086.md # PolicyCoverage ## OpenAPI definition ```yaml openapi: 3.0.0 info: title: Policy Service version: 0.0.21 servers: - url: https://qa.api.zinnia.io components: schemas: CoverageLayer: type: object properties: coverageId: type: string description: The Coverage ID is a unique identifier assigned to a specific coverage type or benefit within an insurance policy. It helps insurance companies, agents, and policyholders track and differentiate multiple coverage components within a single policy example: Base_Coverage coverageType: $ref: "#/components/schemas/RiderType" coverageName: type: string description: The Coverage Name in a life insurance policy refers to the specific title or label assigned to a coverage type within the policy contract. It helps insurers, agents, and policyholders identify, classify, and manage different coverage components in a policy example: Base_Coverage productCode: type: string description: The Plan Code is a carrier-assigned alphanumeric identifier used to uniquely distinguish a specific insurance or annuity product, rate structure, version, and coverage layer within an insurer’s portfolio. It is essential for policy administration, pricing, underwriting, and claims processing example: EVGL1 coverageTerm: type: number format: int32 description: Coverage Term refers to the number of years that a life insurance policy or specific coverage component is intended to remain in force, providing protection to the insured. It defines the planned duration of insurance coverage, after which the coverage may expire, renew, or convert, depending on the product type example: 1 approvedCoverageAmount: type: number description: The Approved Coverage Amount refers to the specific amount of insurance coverage that has been approved by the insurer during the underwriting process. It represents the face amount (death benefit) the insurer has agreed to issue based on the applicant's risk profile, health, and other underwriting criteria example: 10000 format: double currentAmount: type: number format: double description: The Current Coverage Amount refers to the active or present death benefit or coverage value available under the policy at a specific point in time. It reflects any adjustments, policy changes, withdrawals, or loans that may have altered the original coverage amount example: 300000 originalCoverageAmount: type: number format: double description: The Original Coverage Amount refers to the initial face value or death benefit of a policy at the time of issuance before any policy modifications, withdrawals, loans, or benefit reductions. It represents the starting coverage amount agreed upon when the policy was first issued example: 300000 minimumCoverageAmount: type: number format: double description: The Minimum Coverage Amount at Each Coverage Level refers to the lowest permissible amount of insurance coverage allowed per policy layer, as set by the insurance carrier. It ensures policies remain financially viable and comply with regulatory and underwriting standards example: 10000 maximumCoverageAmount: type: number format: double description: The Maximum Coverage Amount at Each Coverage Level refers to the highest permissible amount of insurance coverage allowed per policy layer, as set by the insurance carrier example: 10000000 grossDeathBenefitAmount: type: number format: double description: The Gross Death Benefit per Coverage Layer refers to the total pre-deduction death benefit amount assigned to each specific coverage layer within a policy. It represents the sum of all base coverage amounts, riders, and enhancements before applying policy adjustments such as loans, withdrawals, or unpaid premiums example: 300000 coverageTargetPremium: type: number format: double description: Coverage Target Premium refers to the designated premium amount on a life insurance policy that:Qualifies for full target-level commissions in the first policy year, and Forms the basis for renewal commissions in subsequent policy years.Note - This is modal premium value example: 300000 lowDeathBenefitAmount: type: number format: double description: Low Death Benefit refers to the lowest possible death benefit guaranteed within each specific coverage component of a policy. This ensures that beneficiaries receive at least a minimum death benefit regardless of market performance, policy changes, or withdrawals example: 300000 coverageChangeAmount: type: number format: double description: The Coverage Change Amount refers to the specific increase or decrease in coverage that occurs within a life insurance policy due to policyholder requests, automatic adjustments, or insurer-initiated changes. This amount reflects the difference between the original or prior coverage amount and the new coverage amount after the change takes effect example: 3000000 coverageEffectiveDate: type: string format: date description: The Coverage Effective Date refers to the date when an increase in coverage or a new coverage component officially takes effect in a life insurance policy. It marks the beginning of the insured’s eligibility for the new or increased benefits example: 2023-01-01 coverageChangeEffectiveDate: type: string format: date description: The Coverage Change Effective Date (for a decrease in coverage) refers to the date when the reduced coverage amount officially takes effect in a life insurance policy. It marks the point from which the new lower coverage amount applies example: 2023-01-01 coverageTerminationDate: type: string format: date description: The Coverage Termination Date refers to the date when a policy’s coverage officially ends, meaning the insured is no longer protected under the contract. After this date, no benefits or claims can be paid unless reinstatement is an option example: 2023-01-01 unitOfCoverage: type: number format: double description: The Unit of Coverage refers to the measurement standard used to define the amount of coverage provided under a life insurance policy. It helps insurers calculate premiums, determine benefit payouts, and structure policies consistently.In life insurance, the unit of coverage is typically measured per $1,000 of face amount. example: 300 valuePerUnitOfCoverage: type: number format: double description: The Value per Unit of Coverage refers to the monetary worth of each unit of coverage in a life insurance policy, which is used for premium calculations, benefit payouts, and policy adjustments. This value helps insurers standardize pricing and policy structures.In life insurance, the value per unit represents the cost per $1,000 of coverage or payout per unit of death benefit.In annuities, it determines the payout per annuity unit or per $1,000 of account value example: 1000 annualPremium: type: number format: double description: The annual premium is the total amount you would pay for a full year of life insurance or annuity if you made just one payment per year example: 1000 modalPremium: type: number format: double description: Modal Premium refers to the actual premium amount a policyholder pays based on the selected billing frequency (mode)—such as monthly, quarterly, semiannual, or annual. It represents the current periodic payment due for the base coverage and any attached riders under a life or annuity insurance policy example: 1000 cumulativeModalPremium: type: number format: double description: Cumulative Modal Premium refers to the sum of actual premium amount a policyholder pays based on the selected billing frequency (mode)—such as monthly, quarterly, semiannual, or annual. It represents the sum of current periodic payment due for the base coverage and any attached riders under a life or annuity insurance policy. example: 1000 guidelineSinglePremium: type: number format: double description: The Guideline Single Premium (GSP) is the maximum single premium payment that can be made into a life insurance policy without causing it to lose its tax-advantaged status as life insurance under IRS guidelines. It is determined based on IRS regulations and ensures that the policy remains compliant with Section 7702 of the Internal Revenue Code example: 65068.27 guidelineLevelPremium: type: number format: double description: The Guideline Level Premium (GLP) is the maximum total premium that can be paid over time into a life insurance policy without violating IRS regulations under Section 7702. It ensures that a policy retains its tax-advantaged status as life insurance and does not become classified as a Modified Endowment Contract (MEC) example: 4695.39 sevenPayPremium: type: number format: double description: The 7-Pay Premium refers to the maximum cumulative premium that can be paid into a life insurance policy during the first seven years without causing the policy to become a Modified Endowment Contract (MEC). It is part of the 7-Pay Test, which ensures that life insurance policies do not become overfunded and lose their tax advantages example: 19807.51 coverageParticipants: type: array items: $ref: "#/components/schemas/CoverageParticipants" overdueModalPremium: type: number format: double description: refers to a scheduled premium payment that was not received or applied by its due date, based on the policy’s modal frequency (e.g., monthly, quarterly, semi-annual, or annual). It represents a missed payment obligation that remains outstanding and may trigger administrative or policy-level actions example: 1000 required: - coverageTerm RiderType: type: string enum: - BASE - RIDER - BASEINCREASE - INTEGRATEDRIDER - RIDERINCREASE - BENEFIT - DISCOUNT - OTHER - UNKNOWN CoverageParticipants: type: object properties: partyId: type: string description: The Insured(s) ID is a unique identifier assigned to the insured individual(s) covered under a life insurance policy. It is used by insurance companies to track, process, and manage policyholder records efficiently example: Party_PI_1 issueAge: type: integer format: int32 description: Note-Use coverage.coverageLayers.coverageParticipants.partyAgeAtIssue field instead of issueAge example: 43 partyAgeAtIssue: type: number format: int32 description: The Party Age at Issue refers to the age of any party associated with a life insurance or annuity policy at the time the contract is issued example: 43 riskClass: $ref: "#/components/schemas/RiskClass" substandardRating: $ref: "#/components/schemas/SubStandardRating" flatExtra: type: array items: $ref: "#/components/schemas/FlatExtra" RiskClass: type: string enum: - ULTRANONTOBACCO - ELITENONTOBACCO - PREFERREDNONTOBACCO - STANDARDNONTOBACCO - STANDARDTOBACCO - STANDARDAGGREGATE - SUBSTANDARDNONTOBACCO - SUBSTANDARDTOBACCO - STANDARDPLUSNONTOBACCO - PREFERREDTOBACCO - STANDARDCONVERSIONTOBACCO - STANDARDCONVERSIONNONTOBACCO SubStandardRating: type: string enum: - TABLEA - TABLEB - TABLEC - TABLED - TABLEE - TABLEF - TABLEG - TABLEH - TABLEI - TABLEJ - TABLEK - TABLEL - TABLEM - TABLEN - TABLEO - TABLEP - NONETABLE FlatExtra: type: object properties: flatExtraType: type: string enum: - TEMPORARY - PERMANENT description: A Flat Extra is an additional dollar amount added to the base premium for a life insurance policy due to increased risk factors. Insurers apply Flat Extras on top of standard risk classifications (e.g., Preferred, Standard, or Substandard ratings).Flat Extras can be classified into two types "Temporary Flat Extra" and "Permanent Flat Extra" flatExtraDuration: type: number description: The Flat Extra Duration refers to the length of time a Flat Extra premium charge is applied to a life insurance policy. This duration depends on whether the Flat Extra is temporary or permanent, and it is determined by the insurer based on the risk factor associated with the insured format: int32 example: 0 flatExtraAmount: type: number description: The Flat Extra Amount refers to an additional charge per $1,000 of coverage that an insurer applies to a life insurance policy due to an increased risk factor. This extra cost is added on top of the standard premium and can be temporary or permanent, depending on the nature of the risk format: double example: 0 flatExtraStartDate: type: string description: The Flat Extra Start Date refers to the date when an additional, fixed premium charge (Flat Extra) begins on a life insurance policy. This charge is typically applied due to an increased underwriting risk, such as hazardous occupations, high-risk hobbies, or medical conditions format: date example: 2023-01-01 PolicyCoverage: type: object properties: totalCoverageAmount: type: number description: The Total Coverage Amount refers to the maximum benefit or sum insured that a policyholder or beneficiary is entitled to receive under a life insurance contract. It represents the total financial protection provided by the policy example: 300000 format: double cumulativeGrossDeathBenefitAmount: type: number description: The Cumulative Gross Death Benefit refers to the total amount payable to a beneficiary upon the insured or annuitant death, before any deductions such as loans, outstanding premiums, or surrender charges. It represents the gross value of the death benefit provided under a life insurance or annuity contract. It is cumulative gross death benefit of all the layers of base coverage (not including riders ). example: 300000 format: double netDeathBenefit: type: number description: The Net Death Benefit refers to the actual amount paid to the beneficiary upon the insured or annuitant death, after deductions such as policy loans, unpaid premiums, withdrawals, or other charges example: 300000 format: double remainingDeathBenefitAmount: type: number description: The Remaining Death Benefit Amount refers to the portion of the death benefit that is still available as of date for benefit payment to beneficiaries after a partial claim has been taken example: 300000 format: double minimumCoverageAmount: type: number description: The Minimum Coverage Amount refers to the lowest amount of death benefit or policy coverage that an insurance company allows for a life insurance contract. It is the smallest sum insured that can be purchased under a specific product type example: 10000 format: double maximumCoverageAmount: type: number description: The Maximum Coverage Amount refers to the highest amount of death benefit or policy coverage that an insurance company will issue under a life insurance contract. It represents the largest sum insured that an applicant can qualify for based on underwriting and financial eligibility example: 10000000 format: double coverageChangeEffectiveDate: type: string description: The Earliest Coverage Change Date refers to the first possible date when a modification to an insurance policy can take effect. It defines the earliest point at which a policyholder can adjust coverage levels, add or remove riders, or make other contractual changes based on policy terms and conditions example: 2023-01-01 coverageBand: type: string enum: - BAND1 - BAND2 - BAND3 - BAND4 - BAND5 - BAND6 - BAND7 description: In life insurance, a band refers to a coverage range or tier that affects premium rates, underwriting guidelines, or policy benefits. Insurance companies use coverage bands to determine pricing structures, offering lower per-unit costs for higher coverage amounts maximumAnnualCoverageChangeAllowedPerPolicy: type: integer description: The Maximum Annual Coverage Change Allowed per Policy refers to the largest increase or decrease in coverage amount permitted within a single policy year, as defined by the insurance carrier. This limit is set to maintain policy stability, prevent excessive risk exposure, and ensure compliance with underwriting and policy guidelines example: 1 format: int32 minimumCoverageDecreaseAmount: type: number description: The Minimum Coverage Amount Decrease refers to the smallest reduction in coverage that a policyholder is allowed to make per policy year, as defined by the insurance carrier. This ensures that policies remain viable and do not fall below the required minimum coverage limits example: 10000 format: double maximumCoverageDecreaseAmount: type: number description: The Maximum Coverage Amount Decrease refers to the largest reduction in coverage that a policyholder is allowed to make per policy year, as defined by the insurance carrier. This ensures that policyholders can lower coverage if needed while maintaining a minimum required coverage amount example: 290000 format: double maximumAgeNumberCoverageAmountDecrease: type: integer description: The Maximum Age of No Coverage Amount Decrease refers to the age at which a policyholder can no longer reduce their coverage amount. This limit is set by the insurance carrier to maintain policy integrity and ensure sufficient death benefit protection, particularly for older policyholders example: 80 format: int32 coverageAmountDecreaseAllowed: type: integer description: The Number of Coverage Amount Decrease Allowed Per Policy Year refers to the maximum number of times a policyholder is permitted to reduce their coverage amount within a single policy year. This limit is set by the insurance carrier to maintain policy stability and prevent excessive policy modifications example: 120 format: int32 minimumCoverageIncreaseAmount: type: number description: The Minimum Coverage Amount Increase refers to the smallest increment by which a policyholder can raise their coverage amount within a policy year. This minimum threshold is set by the insurance carrier to ensure that coverage increases are financially viable and align with underwriting guidelines example: 10000 format: double maximumCoverageIncreaseAmount: type: number description: The Maximum Coverage Amount Increase refers to the highest amount by which a policyholder can raise their coverage within a single policy year, as defined by the insurance carrier. This limit ensures that coverage increases remain manageable and are aligned with underwriting and financial justification example: 9700000 format: double maximumAgeNumberCoverageAmountIncrease: type: integer description: The Maximum Age of No Coverage Amount Increase refers to the oldest age at which a policyholder can request an increase in coverage. After reaching this age, the policyholder is no longer eligible to increase their coverage amount, as determined by the insurance carrier example: 80 format: int32 coverageAmountIncreaseAllowed: type: integer description: The Number of Coverage Amount Increases Allowed Per Policy Year refers to the maximum number of times a policyholder can request an increase in coverage within a single policy year, as defined by the insurance carrier. This limit helps insurers manage risk exposure and maintain policy stability example: 10 format: int32 coverageLayers: type: array items: $ref: "#/components/schemas/CoverageLayer" deathBenefitAmountDistributed: type: number description: The amount of the death benefit that has been paid out. This should be the difference between of Cumulative Gross Death Benefit and Remaining Death Benefit Amount example: 250000 format: double ```