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ACUMEN
Insurance System
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
& REFORMATTING
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,
real-time 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 (also known
as
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)
Contact ACUMEN: E-MAIL