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Employee
Basic Data |
This includes the following information:
- Name/Address
- SS#
- DOB
- Date of Hire
- Dependent Name, DOB, SS#, Status
- Job Description
- Annual Compensation
- General Payroll Data
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Clients (Coverage) |
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The
Customers (Clients) screen contains all of the pertinent
information for a case record, including the records’ status,
coverage information, and receivables’ data. It also contains
further information breakdowns on employees and dependents at
the case level. |
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Employee Eligibility |
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The
Employee Eligibility screen is accessed from the "employees"
button of the case screen. This contains information about
specific coverages, dependents, and beneficiaries for the given
employee. |
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Employee Coverage |
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This
screen is accessed from the "coverages" button on the Employee
Eligibility Screen. This contains further breakdowns of the
coverage information for the given employee. |
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Dependents Information |
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This
screen is accessed from the "dependents" button on the Employee
Eligibility Screen. This contains necessary dependent
eligibility information for the given employee. |
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Personal |
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This
screen is accessed from the "personal" button on the Employee
Eligibility Screen. This contains the employee’s background
information. |
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Provider |
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This
screen is accessed from the "provider" button on the Employee
Eligibility Screen. This contains necessary provider information
for the given employee. |
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Volume |
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This
screen is accessed from the "volume" button on the Employee
Eligibility Screen. This contains volume rates and date
information for a variety of coverages for the given employee. |
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Employee Beneficiaries |
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This
screen is accessed from the "beneficiaries" button on the
Employee Eligibility Screen. This contains beneficiary
information, including their percentages of the coverage as a
whole, for the given employee. |
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Client
Company Basic Data |
This includes the following information:
- Name of business
- Address
- Description of business
- Number of employees
- Basic payroll data
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Clients (Coverage) |
|
 |
The
Customers (Clients) screen contains all of the pertinent
information for a case record, including the records’ status,
coverage information, and receivables’ data. It also contains
further information breakdowns on employees and dependents at
the case level. |
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Medical
Plan Basic Data |
This includes the following information:
- Schedule(s) of benefits
- Cost of plan(s)
- Employer contributions (if any)
- Employee contributions (if any)
- Eligibility requirements
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Plan Master |
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The
Plan Master screen contains a variety of data for given plans in
the system. This information is broken down into different plan
types, including short-term disability (STD), long-term
disability (LTD), and basic plan types including medical,
dental, life, and vision. |
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Plan Master - Medical Tab |
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The
Medical tab contains pertinent information relating to the
medical plans for a given case and coverage. This information
includes deductible, co-pay, prescription, and network rates. |
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Insurance
Company Basic Plan Data |
This includes the following information:
- Eligible participants (including
dependents)
- Benefits incurred and paid
- Networks used in providing benefits
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Case Coverage Processing |
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This
screen contains the coverage information for a given plan of a
given case. This includes information on the coverage’s
duration, broker information, and even provides further
breakdowns by history, commissions, and other criteria for a
given coverage. |
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Medical Benefits |
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The
Medical Plans screen is displayed when the "benefits" button is
clicked for a given medical record. This screen contains
information including deductible, co-pay, prescription, and
network rates for the given coverage. |
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Coverage Eligibility |
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This
screen is displayed by clicking the "eligibility rules" button
for a given coverage. This contains information about wait
periods, coverage duration, and various policies in terms of
billing and termination. |