eBusiness Insurance Model (EIM). Value proposition: Developed and integrated defined contribution data model and services that unifies multiple distribution systems into a single Internet-based, real-time rating engine for agents, brokers, employer groups, consumers and alternate distribution channels. It enables channel members to generate quotes, make plan comparisons and create proposals based on a variety of self-selected attributes. EIM significantly improves product distribution activities by improving quote accuracy, minimizing cycle time and reducing administrative costs:
- More consistent premium rate quotes and benefit cost comparisons
- Faster, more timely response
- More accurate quoting and comparison information.
Backed by a multi-million dollar investment, extensive research and market analysis, insurance specific experience, successful Internet strategies, proven implementation and a highly developed business model with integrated processes, eBusiness Insurance Model (EIM) delivers the following benefits:
- Improved competitiveness and profitability
- Increased productivity
- Reduced workflow and process inefficiencies
- Detailed sales activity and critical marketing information
EIM is a knowledge-based application built upon a highly developed data warehouse / data mart with automated reporting tools and instant information. The modules include: plan details and coverage information, needs analysis, programmable scoring system, interactive Question & Answer session, real-time price configurator linked to an instant quote engine, integrated application forms and extensive office tools and resources incorporating on-line help guides, vocabulary and glossary terms. All information is displayed in an easy-to-read format and built for fast navigation.
Total Outcomes Management Solution (TOMS) – design, development and implementation of proprietary data mart, data warehousing, and Ad-hoc & executive reporting solution (Total Outcomes Management Solution – “TOMS”) with outcomes focused measurement, benchmarking and vendor performance and assessment capabilities. This non-intrusive, low-cost solution has a built-in processing engine that integrates information across lines of insurance, business units, data elements and geographical areas. This application design has been deployed by insurance carriers, third party administrators, medical management entities, bill review processors, corporations, brokers, industry consultants and state funds. TOMS is also available under a Private Label Program.
TOMS is a multi-faceted data warehouse delivering integrated information across:
- Lines of insurance (e.g. workers’ compensation, STD, LTD and general liability)
- Vendors (e.g. carriers, TPAs, case management, bill review, provider networks)
- Data elements (e.g. reporting, claim processing, file notes, financials, medical management, bill review and risk management)
- Geographical areas (e.g. states, distinct jurisdictional areas and different countries).
- TOMS integrates all information, helps reduce costs and effectively measures performance.
Complete integration and data integrity – TOMS integrates data, both from internal and external vendor sources, to provide a true normalized database of information with complete data purification, ensuring information integrity and consistency.
Performance management – TOMS enables intelligent analysis and evaluation of vendors and their services: claims handling, medical case management, return to work activity, provider profiling, network coverage and overall risk reporting. TOMS also enables forecasting “what-if” scenarios across business entities and customers to help continuously enhance overall performance: profitability by client, geographical area, business unit and even employee.
Outcomes Measurement and Benchmarking – by measuring and benchmarking results against industry standards (NCCI, WCRI, PRDP, URAC), competitive or “best in class” performance, opportunities for operational efficiencies to improve risk programs and decision-making can be identified throughout the organization.
Independence – since all data is delivered into the warehouse, information independence is maintained including complete vendor flexibility without data conversion or data integrity concerns.
Proactive services – Customizing the edits within TOMS processing engine to specific requirements help identify potential trouble areas before they occur. Both vendors and customers can be proactively managed and internal resources shifted accordingly.
Non-intrusive ASP Delivery – working from standard EDI transaction sets and proprietary feeds, TOMS does not disrupt or force changes to systems or established workflows. The low-cost ASP delivery minimizes the typical expenses for hardware, software, communication lines, technical infrastructure and on-going support.
Universal sharing of information – by reducing the need for investment in new or additional tools, TOMS accessibility of data promotes the sharing of information across the entire organization at minimal cost with maximum insight.