Individual Products

Actuarial Support

FIMMAS provides extensive user flexibility in defining, maintaining, and applying rules for rating and valuation calculations. Product rules and ratebook information are designed to be maintained by non-technical personnel using standard input screens or importing data from outside sources.  Rate tables may be imported into FIMMAS from external files or spreadsheets. Programming is required only when there are special, non-standard output formats or calculations.

Details

Agency Administration

FIMMAS allows each policy to be associated with multiple writing agents, with up to ten agent splits. Writing agents can be in a reporting hierarchy of up to nine levels. The number of levels can be easily modified to accommodate your requirements. FIMMAS supports commission processing for all product lines. The commission master files include agent master information, hierarchy information, agent financial information and statements, commission rate files, and commission history files. Agent validation takes place during application submission based on rules defined in easily-maintainable tables using the information in the license and appointment records for the Agent or Agents.

Commission rates can vary by plan, marketing organization, age, duration, agent level, face amount band, date range, substandard rating, premium type, agent situations, and group. FIMMAS prepares an agent statement for each agent, listing all commission transactions including totals on premiums and commissions for the statement period, year-to-date totals, debit balances, etc. FIMMAS readily interfaces with an existing check writing or Accounts Payable system to produce checks. FIMMAS captures information needed for 1099 reporting and to produce W2s.

Details

Billing Administration

FIMMAS Billing Administration creates billing extracts, prints notices, and updates master files, based on user-maintained rules for billing. Billing rules include the number of notices per billing cycle, the timing of notices, the header information for notices, and whether or not payment is required to keep the policy inforce. Bills and notices can be printed for one, several, or all policies; and can be run on an ad hoc basis, upon user request, or as part of regularly scheduled processing. FIMMAS billing features include:

  • Multiple billing types: direct bill, list bill, true group, self billing, credit card, and ebilling
  • Multiple non-standard frequencies, including 9, 10, 11, 13, and zero times per year, in addition to all the normal modes
  • User-defined billing parameters and rules
  • User-defined wording and messages on bills
  • Balance carry forward and automatic application
  • Billing for outstanding periods
  • Multiple remittance options: check, lockbox, EFT
  • Ability to review the bill before sending a notice
  • Ability to change billing information and recalculate
  • Ability to change billing status
  • Ability to rebill
  • Ability to suspend billing for user-defined reason
  • Manual or auto reconciliation for group billing
  • Group change activities through reconciliation screens
  • Group level over/short tolerances
  • Multiple user-defined billing formats
  • Administration Fee billing for ASO groups
Details

Claims Handling

Claims handling in FIMMAS consists of four elements:

  1. Claims entry and determination of eligibility
  2. Claims adjudication (calculation of payment)
  3. Disbursement processing
  4. Claims tracking, inquiry and reporting (including tax reporting)

FIMMAS handles all four of these elements. FIMMAS also provides an interface to specialized systems for claims adjudication for health products if required. In other words, FIMMAS manages claims for all types of products. It creates the claim record, checks eligibility, and  calculates the payment amount.  The payment information is used to create a disbursement record, allocates the disbursement to appropriate General Ledger accounts, and updates the client database to reflect the payment. The FIMMAS database then retains all transaction detail for tracking of claims history and payment history. All detail is available for inquiry and reporting. Detail records are retained online until you decide to archive or delete them.

 

Details

New Business

FIMMAS  New Business processing provides functions for streamlined entry of information about new applications, validation of new data, preparation of issue documents, commission advances, correspondence, and placing the coverage in force. Highlights include:

  • Online application entry
  • Optional automatic assignment of policy number
  • Calculation of all items for policy specifications and cost disclosure pages, including issue age, premiums, dividends, and paid-up insurance
  • Support for redo/reprocessing, reprinting, recalculation, and reissue without reentry of application data
  • Automated requirements ordering and tracking
  • Tracking and aging of applications
  • Commission calculation
  • Compliance verification
  • Handling of cash with application
  • Real-time update of all information, immediately available for online inquiry and reporting
  • Entry/inquiry access for authorized field personnel
  • Optional electronic transfer of application data from external files. Whatever the source, all application data is subject to the same integrity edits. (This supports "E" applications through the Web.)
  • Support for Jet Issue processing.
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Policy Administration

Policy Administration includes those functions that enable customer service personnel to provide assistance to a company's policy owners, agents, and beneficiaries.

Details

Reinsurance

Reinsurance tracking is part of the FIMMAS base system. FIMMAS determines the total amount of insurance inforce by insured Social Security number. The amount of existing coverage plus the amount applied for can be compared to the company's retention limit, to check for the need to reinsure a case. FIMMAS easily calculates the amount of insurance and reinsurance inforce on existing policies. FIMMAS also provides an optional module for the administration of reinsured contracts. The reinsurance module includes net reinsured amount, age, substandard ratings, risk class, sex code, and other variables to compute the reinsurance premium. The module also calculates allowances. Each benefit, rider, or supplemental coverage can be reinsured with one or more carriers under multiple treaties. FIMMAS can also interface with an external reinsurance system.

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Reporting/Correspondence

FIMMAS has an inherent reporting module or you can generate reports using any ODBC-compliant third-party reporting tool. The FIMMAS Correspondence Link provides an interface to the full-function capabilities of standard word processing and document creation packages. Data from FIMMAS can be integrated with user-defined templates to create custom correspondence.  FIMMAS has complete ad hoc and automatic correspondence capabilities.  Through the use of event triggers, you can link any correspondence template to an event trigger and generate correspondence automatically to as many individuals as necessary.  Both automatic and ad hoc letters can have variable paragraphs or variable languages based on user-defined rules.  FIMMAS also supports email distribution of correspondence and reports.

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Underwriting

 The FIMMAS  Underwriter Worksheet provides streamlined access to underwriting tasks:

  • Automatic determination of which new applications require underwriter reviews versus those available for speedy issue
  • Automatic determination of underwriting requirements based on plan, age, amount, and other user-defined variables
  • Application status tracking
  • Checking of approvals and licensing
  • Automatic follow ups and reminders on pended items
  • Underwriting instructions and referrals to support staff
  • Underwriting notes and comments
  • Underwriting analysis reports
  • Automatic generation of forms and letters
  • System calculation of premiums
  • Interface with MIB and other vendor support systems
  • Security for personal health information
  • Online access to reinsurance database
Details

Since 1982, Management Data, Inc. has specialized in insurance administration software solutions.

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