Healthcare IT Whitepaper - WebInsure Consumer

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hCentive's WebInsure Consumer is the perfect solution for insurers looking for a proactive approach towards web based insurance solutions. WebInsure Consumer simplifies the implementation of the complex health reforms and offers a cost-effective and highly tailored solution for insurers looking to leverage retail-focussed opportunities arising in the industry.

Overview

Features

2.1. FUNCTIONAL MODULES

The system is divided into 3 portals directed at three dierent class of users:

Consumer Portal (C) – directed at end consumer buyers
Broker Portal (B)– directed at brokers selling to end buyers
Administration Portal (A)– directed at internal carrier team
Each portal then provides specic functionality as described below. The functionality described is available today except when specically mentioned:

Feature

Details

Quoting and Rating

Landing Pages. Intake consumer information and use it to provide a quote for all products the customer is eligible for
Quote View. Dynamically modify viewed products in a tabular format with options to sort and lter the product list on a variety of customizable criteria including price, deductible, co-pay, co-insurance or any other product benet or meta-data\
Discounts. Provide discounts based on family size or other attributes of the census information.
Save Quote. Consumer can save the quotes and revisit them later.
Product Search. Ability for customer to nd products based on selected parameters (benet / coverage options, limits etc)

Cross-sell / Up-sell

Ability to recommend one or more products based on incoming campaign or inferred demographic

Product Details

Product Page. Dynamically generated pages to show high-level and detailed information about each product sold
Product Benets. Dynamically display list of benets available with the product
Product Comparison. Support product comparison functionality that allows consumers to compare multiple products across multiple product attributes.
PDF Download. Ability to download the documents attached to the product in PDF format

Online Application Presentation

eApp Creation. Present an electronic version of the Premera application form as published for that market.
Intuitive online application with dynamic medical questions with drill-down questions.
Support for state-specific applications
Pre-fill certain information if known about the applicant (mostly valid for renewals)
Validate that the information submitted is complete
Validate information for format errors (e.g. phone numbers, SSN etc)
Mask sensitive information

Online Application Save

eApp Save. Ability to gather and store all the data elements in the application
eApp Restore. Save an unfinished eApp in a secure environment and ability to continue it later (possible after a few days)
eApp Download. Ability to download a finished or unfinished application in a PDF format with all the filled information preserved.

Online Application Submission

Assign a unique identifier to each application for tracking
Submit application to the backend underwriting system
Attach a time of submission with each application

Payment Processing

Ability to process payment from ACH, Credit Card and Paypal.
Separate payment options for initial and ongoing payments
Ability to change payment preferences

Electronic Signatures

Meet the requirements of electronic signature laws for signature creation, storage and retrival

Application Status

Track the current status of application by end-consumer, broker and CSR.
Ability to generate standard and customized messages (accepted, declined, need more info etc)
Real-time status

Notifications

Notify application status and changes to consumers and brokers including acceptance and rejection
Support periodic reminders to consumers on brokers for renewals, application drop-off etc
Notify broker on specific events like opening of broker proposal, start of eapp etc
Customize and configure the list of notification for each broker
Support multiple channels including text messages and email.

Broker Quoting

See complex quotes quickly
Filter and sort through the quotes
Create a proposal from the quotes displayed and send it to a consumer
Rate-up or Rate-down a quote

Broker CRM

Add and manage list of clients of the broker
Attach a client to a lead source
Store client information for reuse
Send emails to the client
Send proposals to the client
Track client status
Collaborate with clients to help them submit the application

Broker Proposal Management

Ability for brokers to send out a proposal to their customers
Ability to track the status of the proposal
Auto-attach specific documents to the proposal
Get notifications on when proposals are opened, viewed and applications started
View applications submitted against the proposal

Account Management

Login and Logout
Profile Management
Change Password

Policy Renewals

Renew a policy on a yearly basis
Send notification for renewals

Policy Updates (coming in next 120 days)

Ability for the end consumer to update policy due to changes in life status
Adding another member to the policy
Removing a member from the policy
Change Address
Change benefits

Policy Documents

Download policy documents from the portal including card

Bill Presentation (coming in next 180 days)

Integration with Billing system to showcase the latest bill to the end user
Collect premiums on the amount shown in the bill
Ability to reach out to support or report any errors in the bill
Change payment preference including mode of payment, frequency and address.

Customer Support

Live Chat. Ability for customers to talk to chat representative
Click-to-call. Ability for the customers to call a customer representative from the browser
Call-back. Ability for the customers to ask for call back on a provided number.
Tracking. CSRs can view the page URL the customers are on.

Plan and Benefit Updates

Ability for business users to update benefit information of plan
Ability to update rating information and other plan documents
Preview changes made
Assign an “effective date” for each update

User Management

Add and manage administrative users and assign roles and permissions to them
Add and manage brokers and assign geography and hierarchy to them
Add and manage CSR representatives.

CSR UI

CSR can go and enter a new application (useful for processing application on phone)
Shift management for CSR

Web Analytics

Send information to web marketing and generic marketing tools
Link web activity with specific campaigns

Campaign Management Support

Create trackable links for specific campaigns.
Post links to social media websites
Create banners and links for google ads and other such initiatives

Reporting

Reports on system usage including users, application, submissions, rejections and status updates
Reports on broker logins and activity
Reports on changes done by administrative users
Alerts on spikes or decrease in volumes

2.2. BROWSER COMPATIBILITY

Following browsers and operating system configurations are supported by the product:

Internet Explorer
(version 7.0 +)

Firefox
(version 3.5 +)

Chrome
(version 10+)

Apple Safari
(version 4.0+)

Windows XP

✔

Windows Vista

✔

Windows7

✔

Mac OSX 10.5 (“Leopard”)

✔

Mac OSX 10.6 (“Snow Leopard”)

✔

Mac OSX 10.7 (“Lion”)

✔

2.3. INTEGRATION ENDPOINTS

hCentive will provide integration with following systems of Premera:

Underwriting System: Application Submission and Status Updates
Broker Management System: Broker Management
Archiving: Long term storage of submitted apps and other data
Billing: Bill Presentation and Update of payments

Technology

3.1. ARCHITECTURE

Our solution is based on best design principles, keeping in mind the scalability, extensibility and interoperability of the application. Following are some of the key design principles used in our product:

Service Oriented
Event Driven
Loosely Coupled
Able to support assembly and integration
Able to leverage existing applications and infrastructure

3.2. TECHNOLOGY STACK

Component

Software Used

Operating System

Linux (Ubuntu, Amazon Linux)

JDK

Sun JDK 1.6

Web Server

Apache 2.2.14

Application Server

Tomcat 6.0.29

Database

MySql 5.1.41

DI/AOP

Spring Framework

ORM

Hibernate

Caching

EhCache

Rules Engine

Drools

Web Framework

Struts2, SpringMVC

Messaging Services

MuleESB

Security

Spring Security

Scheduler

Quartz

SCM

Subversion

Build

Maven

Development IDE

Eclipse

Reporting

Crystal Reports or COGNOS

3.3 HOSTING

The system will be hosted on Amazon Web Service (AWS) infrastructure. The system will be completely isolated from any other system managed by hCentive, Inc. and will not share any resources (except the outer firewall and load balancer) residing in its own Virtual Private Cloud (VPC) with its own access policies. These resources will include application servers, database servers, load balancers, monitoring servers, queuing services, mailing services and storage volumes. Database servers will be replicated across multiple availability zones. Disk volumes of these database servers are encrypted to secure data in storage. To secure data over-the-wire, SSL Tunnels are established between application & database servers.

Our uptime commitment is 99.9%, with minimal scheduled maintenance. Our hosting includes management of all upgrades, hardware, and third-party software on your behalf, as well as 24/7 monitoring of the application.

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