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SECTION I – GENERAL INFORMATION
MOVEMENT OF INFORMATION
A group insurance contract is the result of an agreement between a taker (enterprise) and an insurer. In order to realize this contract, an advisor will make sure to gather the pertinent information on the enterprise, to recommend the proper benefits to the enterprise and then “go to market” in order to offer the risk.
Historically, the exchange of information between the various parties was carried out manually. Not only did the data have to be entered manually (an average of 7 times and a minimum of 3 times if only one insurer was invited to tender), which represents significant costs for marketing and activating the contract, this redundancy significantly increased the risk of errors. Also, processing diverse information received from the insurers can represent intensive manual labour. Thanks to the ALLEGROUPE software, managing each step is simplified and the information can be distributed electronically to all parties.
To fully grasp its power, let us take the time to examine each necessary step to produce a contract.
Enterprise
During the exchange between enterprise and advisor, the managers must enter all the pertinent data on the enterprise including, but not limited to, all conditions relating to:
§ Physical co-ordinates of the enterprise. The province registered will have a significant impact on taxation.
§ Logical structure of the enterprise. Each division (branch, department, etc.) must be clearly identified; all classes of employees must also be identified (management, manual workers, white-collar, etc.)
§ Employer contributions. It is important to define the contribution level, the number of periods in which to continue contributions and the administration fees applicable to a TPA (Third Party Administrator), a union or other.
§ Modules (optional). If the insurance plan is offered on a modular basis, each module must then be defined.
§ Participating advisors (optional).
§ Available resource persons (optional). For each division/class, the manager of the resource persons ensures access to all pertinent information.
Benefits
The advisor must, in accordance with the needs expressed and analysed with the enterprise manager define the applicable benefits (1 to 15) according to the chosen plan (divisions/classes, modular or flexible). It is important to define all the applicable benefits for each category. For example, if a enterprise has 5 divisions and 32 classes, the advisor must define 32 groups of benefits reflecting the required models. Considering the number of benefits (15) and the number of classes (32) time the number of divisions (5), the work could be enormous. With the ALLEGROUPE software, MDI can simplify the process by creating a bank of benefits (C), applying a guaranty to a class according to the selection from the bank, copying a guaranty already in place, etc.
Employees
Summary information on each employee is required so insurers can evaluate the risk and the volume of applicable premiums. This information can be entered manually by using the MDI “express” module or, even better, it could be entered electronically by transferring information obtainable from the enterprise. This information can be extracted from a payroll system, from a competitive system such as Baag, Fast or others, from Excel or Word files or even downloaded from an insurer.
The claim history could also be registered so as to be able to transmit a complete file. Presently, no claim management mechanism is in place.
Project request
By assembling the data, the advisor is now in a position to transfer information (request for proposal) to insurers well positioned to help the enterprise.
Project transmission can be carried out through hard copy to be entered manually by the insurer's rating department or, even better, it can be electronically sent directly to insurer's rating system. In this second case, the time saved, the execution speed and the related costs can represent a significant advantage.
In each case, the MDI request for proposals management module ensures professional follow-up.
Project analysis
Insurers invited to tender should complete their analysis work and establish the precise term offers including coverage limitations or extended coverage (benefits), the rates and all criteria judged to be pertinent. This offer will in time be sent as a hard copy but, thanks to the ALLEGROUPE software, it could ideally be sent electronically to the advisor.
Upon reception, the information must be entered and analysed to identify the bidders who best respond to the expectation of the taker (enterprise).
In all this, the ALLEGROUPE software becomes a valuable asset to automatically carry out comparative analysis of rates and conditions. In short, this comparative tool selects the parties and the projects to be compared. Before, this analysis work was very time-consuming, especially if the advisor had to present the (ever more demanding) taker various alternatives or options.
Contract issuance
In collaboration with the purchaser, the advisor asks the insurer to proceed with the issuance of the contract. Thanks to the ALLEGROUPE software functions, the advisor has only to convert the selected insurer's project into a contract and can continue to assist his client for the duration of the contract in accordance with the service agreements concluded between the parties.
Once the taker and the supplier have concluded an agreement and the taker (enterprise) has chosen to ensure electronic control of the movements of personnel and self administration, it will be necessary for the manager to have the management system installed at the enterprise.
Installation of the ALLEGROUPE software at the enterprise (Virtual, Virtual +, Self administration or management of personnel movement version) is highly automated.
Information on the enterprise as well as the contract conditions can be transferred electronically from the advisor's or insurer’s system.
The list of employees can be taken electronically from the insurer and refined or updated from the payroll system.
The manager can then complete the complementary information, specific to each employee, and necessary to activate the contract and finally ensure continuous management.
Some elements will require initialisation to ensure that the information will be properly processed, fully respecting the agreements concluded with the insurer and in accordance with the wishes of the enterprise. Some elements to initialize:
§ Manual or automatic activation of the admissibility;
§ How to process movements, that is initialization of electronic processing of event parameters;
§ Activation of self administration when applicable. WARNING: The activation of self administration will have a direct impact on the processing of events (current, non processed or their history). Printed reports will always reflect the current elements;
§ Review of employer contributions and maintenance of payments according to each benefit;
§ Review of processing fees for the union or the TPA;
§ Creation of a new adhesion for each employee and entry of any pertinent complementary information;
§ Validation of incomplete files. MDI has a pre-processing validation option which gives a list of files to review. This is to simplify the control process. As an example, it will be necessary to indicate a home province for each employee since this information is vital for taxation purposes.
Transmission of movement
Thanks to MDI technology, the manager can ensure easy management of employee movement while the ALLEGROUPE software will ensure conservation of the history of employee activities or the changes to the benefits and the rates.
ALLEGROUPE will also ensure automatic tax management by optimizing employer contributions in accordance with the initialisation parameters. Changes to the contracts could be electronically transmitted to update the enterprise's system. In this case, the enterprise cannot modify the terms and conditions of the benefits. Finally, ALLEGROUPE will ensure integrity of premiums paid retroactively or proactively even if a transaction is carried out on a different date.
The enterprise will be able to produce all necessary reports from the information stored in the database. Examples:
§ Management of enterprise bills for each insurer , this can comprise:
- Detailed report of bills (insurers);
- Summary report of bills (insurers);
- Detailed report of bills (clients);
- Summary report of bills (clients);
- Movement report;
- Movement report (messages).
§ Generic contract for each class, including the available benefits;
§ Specific contract for an employee;
§ Hypothetical analysis of changes requested by an employee;
§ Project requests, this can comprise:
- Summary contract report;
- Project request report;
- Project analysis report.
§ Employee statement;
§ Report of payroll deduction per employee or for the enterprise;
§ Etc.
Enterprise billing information and pertinent information on the Health Insurance Card can also be electronically transmitted to the insurer.
