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