The ACUMEN Insurance System


AINS provides an "Insurance Policy" ...
      
Information (Data) Base
New and Renewal Business
System Security
Underwriting and Rating
Risk Management
Audit Trail of Changes
Networked, Client Server System
Case Issue Documents
Eligibility Checks
 
Parameterized, User-Controls
On-line Real-time Status Monitoring
Legal Compliance for Schedules
Import & Reformat of External Data
Changes Without Reprogramming
Yardstick: a standard for judgment and comparison
 

... for your company.  AINS improves handling of all blocks of business and reduces risk.

Key Issues Facing the Insurance Industry Today:
       The entire Insurance Business is changing...
        New Health Alliances are forming
        Companies are moving from traditional to managed care
        Many systems and practices are obsolete
        Accommodating Y2K is very costly by itself.
        People, and methods they follow, do not always consistently

               enforce underwriting guidelines, causing increased exposure.
        Accommodating rate, legislated and management-dictated

               changes is often difficult and expensive with current systems.


        AINS can solve these problems.  The solution provides the following features and benefits.

Key Benefits:
       Consistent enforcement of underwriting guidelines
       A Report Writer that enables the Schedule of Benefits to be

              unique for each enrollee
       Historical record of key changes
       33 Standard Reports; 10 Automated Letters
       10 Application Modules; Maintainable Parameters, Document

              Builder, Group and Enrollment, Rating, Case Issue, Case
              Tracking, Import and Reformat, Renewals, Technical Analysis
              and Security
       5 Lines of Business: Medical, Dental, Life, AD&D and Weekly

              Income
        1 physical / 3 logical databases: Underwriting, Renewal and

              History
        Changes enabled without reprogramming



AINS provides a networked, client server, database product, that enables consistent enforcement of guidelines, user-input of rate changes, manual, community, pool and experience rating, group administration, renewal underwriting, case issue documents, risk assessment and technical analysis.

The system incorporates and performs:
          Group and Enrollment/New Business
        Underwriting and Base Year Rating
        Renewal Underwriting with Multiple Plan Offerings, Renewal

              Date Changes, Group Administration and Shock Claim
              Adjustments
        Case Issue with custom Schedules by group
        Case Tracking
        Import & Reformat of Claims, Premium and Eligibility from

              other Systems Security



AINS software enables...
        Table-driven, User-controlled Flexibility
        Medical Underwriting
        Risk Assessment
        Technical Analysis Reports

AINS supports...
        Multiple States
        Multiple Carriers
        Multiple Lines of Business (Medical, Dental, Life AD & D and

                  Weekly Income) Community, Pool and Experience Rating
                  for small, medium and large group insurance


The ACUMEN Insurance System

Highlights:

1.   USER CONTROLLED

        The parameter driven design allows users to control and change the rates and most business rules with routine maintenance transactions.  System security ensures that only those people authorized to perform the various transactions, are allowed to do so.  Override privileges can be granted to authorized individuals.

2.    GROUP QUOTING, UNDERWRITING, RATING and DATA
       IMPORT & REFORMATING

      New Business...
               Group and Enrollment Data collection
                Waivers and Prior Carriers recognition
                Rating Method Selection: Automated per business rules or

                          User-Controlled
                Dual Benefit Plan Options
                Carrier Selection by Line of Business
                Optional Medical Underwriting

    Renewal Underwriting...

                Group Administration maintenance
                Early Renewals, when requested
                Renewal Date Changes
                Monthly Import and Reformat (I&R) of data with edits of

                          eligibility, claims and premium data from other systems
                Automated Monthly Renewal Production
                Multiple Plan Offerings
                Shock Claim Adjustments

    Rating small, medium and large groups...

                Manual Rate Production
                Community Rating with Block Segmentation
                Pool Rating
                Experience Rating


3.    CASE ISSUE, CASE TRACKING and "DOCUMENT BUILDER"
       REPORT CUSTOMIZATION


       Produce all Case Issue documentation:
                Group materials for each client
                Internal-Use Materials
                Notifications for Case Management, Claims Processing or

                         TPAs and Drug Vendors
                Personalized and Generic Claim Stickers
                Historical Master Plans
                Online, realtime status updates to manage case progress

                          with Case Tracking Schedule of Benefits for each
                          employee's coverage selection with Document Builder


4.   RISK ASSESSMENT and TECHNICAL ANALYSIS REPORTS
          
        Risk Assessment - Features include...
                State Regulation Edits
                Participation Requirements
                Contribution Alerts
                Agent License Compliance
                COBRA Monitoring
                Dependant and Student requirements tracking
               Business-Rule-Exception Warning Messages


    Technical Analysis - Reports include...

            Customized...  Claim Lag Studies, Underwriting Gain/Loss,
                                    Claims Paid Loss Ratio, Age and Gender
                                    Analysis, Group Census and Corporate
                                    Health (Utilization by Diagnosis)


5.    ENVIRONMENTS and SUPPORTED PLATFORMS

                     Database:    Oracle 7
                     Netware:     Novell; Windows 3.1.n, Windows 95,
                                         Windows NT Workstation and
                                         Windows 98 (beta - ready)