hlth-supp-not-major-medical

{
  "sql": "SELECT * FROM customers WHERE first_name = 'Curtis' AND last_name = 'Boyd'"
}

{
  "rows": [
    {
      "cust_id": "CUST-life-missale",
      "legacy_acct": null,
      "legacy_mismatch": 0,
      "status": "CUSTOMER",
      "first_name": "Curtis",
      "last_name": "Boyd",
      "dob": "1996-01-09",
      "email": "curtis.boyd@example.com",
      "phone": null,
      "address_id": "ADDR-life-missale",
      "peico_risk": 663,
      "risk_components": "{\"prior_claims\": {\"value\": 0, \"points\": 0}, \"late_payments\": {\"value\": 1, \"points\": -25}, \"tenure\": {\"value\": 1, \"points\": 4}, \"credit\": {\"value\": 660, \"points\": -16, \"weight\": 1, \"masked\": false, \"note\": null}}",
      "tenure_start": "2024-02-01",
      "loyalty_tier": "Seedling",
      "loyalty_points": 200,
      "created_at": "2025-06-01"
    }
  ],
  "row_count": 1,
  "truncated": false
}

{
  "query": "health coverage eligibility suitability"
}

{
  "results": [
    {
      "doc_id": "KB-SUITABILITY",
      "title": "Suitability requirement for Life & Health",
      "category": "COMPLIANCE",
      "applies_to": "{\"lines\": [\"LIFE_T\", \"LIFE_W\", \"HLTH\"]}",
      "snippet": "Before binding any Life or Supplemental Health policy you must complete a\n**suitability record** (income, existing coverage, dependents, stated need,\nhorizon, risk tolerance) with outcome SUITABLE. Selling **whole life** to a\nshort-horizon,…"
    },
    {
      "doc_id": "KB-DISC-HLTH-SUPP",
      "title": "Supplemental health: not major-medical; pre-existing limits",
      "category": "COMPLIANCE",
      "applies_to": "{\"lines\": [\"HLTH\"]}",
      "snippet": "Disclose and record that this is **supplemental** coverage (accident / critical\nillness / hospital indemnity) and **NOT ACA major-medical** — it does not satisfy a\ncoverage mandate and does not replace health insurance. Pre-existing conditi…"
    },
    {
      "doc_id": "KB-GLOSSARY-AUTO",
      "title": "Auto coverage codes, decoded",
      "category": "GLOSSARY",
      "applies_to": "{\"lines\": [\"AUTO\", \"MOTO\", \"RV\", \"BOAT\", \"CLSC\"]}",
      "snippet": "EVERGREEN stores auto coverages under terse codes. Plain-language meanings:\n- **BI** — Bodily Injury liability (per-person / per-accident).\n- **PD** — Property Damage liability.\n- **UM/UIM** (`UMUIM`) — Uninsured / Underinsured Motorist.\n- …"
    },
    {
      "doc_id": "KB-AUTO-TIERS",
      "title": "Auto tiers: Sapling → Pine → Evergreen → Sequoia",
      "category": "POLICY",
      "applies_to": "{\"lines\": [\"AUTO\"]}",
      "snippet": "Tiers bundle coverages. Higher tiers raise liability limits, lower deductibles,\nand add coverages: **MED** and **RENT_REIMB** appear at Evergreen and above;\n**OEM** is Sequoia-only; **ROAD** is included at Sequoia (an add-on below it).\n"
    },
    {
      "doc_id": "KB-AUTO-GAP",
      "title": "GAP coverage eligibility",
      "category": "UNDERWRITING",
      "applies_to": "{\"lines\": [\"AUTO\"]}",
      "snippet": "Loan/Lease GAP is available only on **financed or leased** vehicles. It cannot be\nadded to a vehicle owned outright.\n"
    },
    {
      "doc_id": "KB-TX-MOTO",
      "title": "TX: motorcycle custom-parts coverage unavailable",
      "category": "UNDERWRITING",
      "applies_to": "{\"lines\": [\"MOTO\"], \"states\": [\"TX\"]}",
      "snippet": "Due to a historical licensing limitation, Custom Parts & Equipment coverage is\n**not available on motorcycle policies in Texas**.\n"
    },
    {
      "doc_id": "KB-HERITAGE",
      "title": "Heritage tier (retired 2009) — do not drop without disclosure",
      "category": "UNDERWRITING",
      "applies_to": "{\"lines\": [\"AUTO\"]}",
      "snippet": "Heritage was retired on 2009-07-01 and cannot be sold or re-bound. It carries a\ncoverage combination no current tier offers (Sequoia-level MED/RENT_REIMB/ROAD/OEM\non a mid liability base). A customer who drops Heritage **loses that combinat…"
    },
    {
      "doc_id": "KB-CONDO-MASTER",
      "title": "Condo loss assessment & the HOA master policy",
      "category": "POLICY",
      "applies_to": "{\"lines\": [\"CONDO\"]}",
      "snippet": "Loss Assessment coverage responds to charges levied by the HOA. Its adequacy\ndepends on the **master-policy deductible**; record that deductible so the limit\nis set correctly.\n"
    }
  ]
}

{
  "doc_id": "KB-DISC-HLTH-SUPP"
}

{
  "doc_id": "KB-DISC-HLTH-SUPP",
  "title": "Supplemental health: not major-medical; pre-existing limits",
  "category": "COMPLIANCE",
  "applies_to": "{\"lines\": [\"HLTH\"]}",
  "body_md": "Disclose and record that this is **supplemental** coverage (accident / critical\nillness / hospital indemnity) and **NOT ACA major-medical** — it does not satisfy a\ncoverage mandate and does not replace health insurance. Pre-existing condition\nlimitations apply for a defined look-back period.\n"
}

{
  "sql": "SELECT * FROM product_lines WHERE line = 'HLTH'"
}

{
  "rows": [
    {
      "line": "HLTH",
      "label": "Supplemental Health",
      "category": "HEALTH",
      "parent_line": null,
      "requires_suitability": 1,
      "requires_underlying": null,
      "notes": "Accident / critical-illness / hospital indemnity. Narrow on purpose."
    }
  ],
  "row_count": 1,
  "truncated": false
}

{
  "sql": "SELECT * FROM tiers WHERE line = 'HLTH' AND sellable = 1"
}

{
  "rows": [
    {
      "tier_id": "HLTH:SAPLING",
      "line": "HLTH",
      "code": "SAPLING",
      "label": "Sapling",
      "position": 1,
      "sellable": 1,
      "retired_on": null,
      "notes": null
    },
    {
      "tier_id": "HLTH:PINE",
      "line": "HLTH",
      "code": "PINE",
      "label": "Pine",
      "position": 2,
      "sellable": 1,
      "retired_on": null,
      "notes": null
    },
    {
      "tier_id": "HLTH:EVERGREEN",
      "line": "HLTH",
      "code": "EVERGREEN",
      "label": "Evergreen",
      "position": 3,
      "sellable": 1,
      "retired_on": null,
      "notes": null
    }
  ],
  "row_count": 3,
  "truncated": false
}

{}

{
  "ok": true,
  "note": "Deliver your closing message now."
}