Health Products Overview
Health Products 

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arrowFlexible Reports
arrow Health Product Rating Flexibility
arrowClaims Handling and Repetitive Payments Processing

Unlike many software systems that use separate program components to support different lines of business, FIMMAS uses the same modules to process life, health, and annuity products. Some of the data elements required in the database may be different for different products, but they all use the same rate table structure, reserve factor tables, reporting capabilities, and processing logic for application entry, underwriting, billing, contract administration, etc.

The advantages to you are simplified training, reduced maintenance, and a consistent user interface across product lines, and, finally, better support for customers with multiple products. 

 
Short Term Disability
Long Term Care
Long Term Disability
Hospital Indemnity
Dental Products
Vision Products

 

Flexible Reports

Flexible reports help you analyze loss ratios by state and by products, number and size of claims, and other data sorted by line of business, state, geographic area, producer, and other variables.

Sample Disability Claims reports are shown below. Additional reports are easily created or customized for regularly scheduled reporting or ad hoc inquiry. All report detail can be printed or reviewed on-line.

Report
Description

Disability claims by status

User can select by status: pending, approved, payment in progress, suspended, or closed. User can sort by state, disability type, duration, benefit type, and group / individual.

Disability claims by approved to date

User can select by specific approved to date or by approved to dates a specified number of weeks / days in the future. User can sort by state, disability type, or group / individual.

Disability claim payments

User can select by total payments to date or by total payments for a specified time period (day, week, month, quarter, etc.). User can sort by insured, payee, state, disability type, and payment range.

Disability claim payee detail

User can select a single payee or multiple payees.

Explanation of benefits

User can select by payee and by individual payment.

1099 detail

User can select a single payee or multiple payees.

Reinsured disability claim payments

User can select reinsured claims by status: approved, payment in progress, or suspended. User can sort by reinsurer, state, disability type, duration, payment amount, or group / individual.


Health Product Rating Flexibility

FIMMAS maintains a detailed history of premium rates charged. This allows users to make back charges and credits across rate change periods. It also allows you to preschedule future rate changes, and have the new rates automatically included in calculations after the effective date.

FIMMAS provides extensive flexibility in factors affecting rate calculation. Rate tables may vary by state, geographical area, risk class, benefit series, date band, age, duration, volume band, sex, or other variables that you define for a particular plan or benefit. 

Undo / redo capabilities are available across anniversary date or multiple years. This streamlines error correction, and lets you rate contracts retroactively. For example, it may be time to bill a group while you're still negotiating the group rate. FIMMAS lets you bill the group, then enter the new rate and rebill, without further manual intervention.


Claims Handling and Repetitive Payments Processing

Click on Claims Handling and Repetitive Payments Processing for more information about support for disability and Long Term Care products.