Tuesday Feb 10, 2015

Transform Your Enterprise through Core Systems Consolidation

The life insurance industry is facing decreasing revenues. Written premiums have been flat or even decreasing since 2012, and coupled with interest rates that have been falling, we are now at historic lows – making it harder for life carriers to grow the business. As regulations, industry, competitors, and consumer needs change, life insurance and annuity carriers must continue to adapt their product portfolios and introduce new products faster to market to gain competitive advantage and sustain growth.

Dave Shively, Oracle's Senior Director of Life and Annuity Policy Administration, discusses how insurers can approach consolidation of core systems:

Unfortunately for many carriers, their aging, legacy policy administration systems prevent or inhibit rapid changes to products or processes. Many carriers are struggling with policy administration systems that are over 30 years old. These aging systems impede carriers from capitalizing on growth opportunities or reacting to competitive pressures. These systems also require significant maintenance, thus reducing profits. However, insurers can overcome these challenges by consolidating distributed and aging policy administration systems into a modern, flexible system that can improve business agility.

There are many benefits that carriers can gain by replacing their old systems with a modern system such as Oracle Insurance Policy Administration for Life and Annuity. Our customers have achieved benefits such as faster time-to-market for new products, enhanced customer service, increased flexibility on product configuration, improved management and distribution by taking advantage of a modern system that is scalable and high-performance to support growth in the business.

In fact, one large multi-national carrier with tens of millions of active policies in several business units is currently implementing Oracle Insurance Policy Administration. They do business in more than 15 countries and wanted to standardize their solution into one modern policy administration system. The challenge facing the company was the urgent need for new modern systems to replace multiple aging policy admin platforms across the group. The carrier recognized that none of these legacy platforms met the requirements necessary to fulfill the strategy put forward, and they decided to standardize using the Oracle Insurance Policy Administration solution.

To learn more about how this company is achieving transformational results from policy modernization and is overcoming challenges by consolidating distributed policy administration systems, we invite you to watch the recent webcast hosted by LOMA and sponsored by Oracle.

Join Us for Oracle Industry Connect in Washington, DC, March 25-26, 2015

The impact of digital disruption is being felt in the financial services industry. Join us for open and provocative discussions during Oracle Industry Connect, an exclusive event taking place March 25–26, 2015 in Washington DC. The Financial Services and Insurance program brings together top business and IT executives from leading financial institutions including insurers, healthcare payers, and banks. Join your industry peers for in-depth conversations on trends, challenges and opportunities facing insurers today.

Don’t forget to keep up with Oracle Insurance year-round via social media.

Thursday Jan 08, 2015

Core Technology Platform for Health System of the Future

With healthcare costs rising annually over last decade, health reform is at the forefront of many developed and emerging market countries. In many developing nations, the focus of reform is around business models that have more involvement from private sector, while the focus of the reform in the United States is on business models that incent providers to cut costs while improving quality.

However health reform is in its infancy globally, and there is constant change expected over next several years as governments experiment with various business models. Under those circumstances, there is need for a new genre of technology options to cater to the health system of the future. Current inflexible platforms, and even the newer flexible platforms that require health plans to rip-and-replace entire core operational systems, aren’t going to work for emerging health plan needs. Health insurers need to consider “progressive transformation” approach where there is a phased approach to overall end-to-end core systems transformation.  Additionally, insures need to look at options that provide value-based payment support and that work in parallel with their current core processing systems.

Oracle Health Insurance (OHI) business unit within Oracle is dedicated to address the needs of the global health insurance market. The OHI Claims solution was first introduced in 1994 in the Netherlands to cater to the needs of the Dutch market. Today, over 50% of the health insurers in Netherlands run their core operations on Oracle Health Insurance solutions, with many achieving over 98% auto adjudication on claims processing. Furthermore, OHI applications have now been successfully deployed in the United States and other international markets.

The OHI team has spent the last couple of years on developing a technology platform for the newer and emerging health insurance business models.  As a team, we are working with governmental institutions and private companies to understand and help these organizations with their transformation projects. Given our origin in Netherlands, we routinely host health officials and delegations from the emerging market countries considering health transformation to study the Dutch system.

Based on those leanings, we are starting blog series to explore different aspects of the health reform as it impacts health insurance organizations.  We will present business transformation imperatives one at a time and explore technology options to support this. We encourage you to start by downloading our new white paper Building the Healthcare System of the Future. It lays the groundwork for some of the topics we’ll be discussing in the blog series, such as:

  • Driving Transparency with Benefit Adjudication
  • End of Fee for Service? Gaining Popularity of Shared Saving Plans
  • Engaging with Health Providers in Future
  • Real-time Claims Adjudication to Enhance Member and Provider Service
  • Technology Platform for Health Insurance Exchanges
  • Administering Government Programs in a Cost-effective Way

At the end of the series, we will summarize all of the imperatives ahnd present a holistic platform for the health system of future.

Learn More at Oracle Industry Connect in Washington, DC, March 25-26, 2015

Oracle Industry Connect is a premier conference designed to promote innovation and transformation through open and provocative discussion within the Financial Services and Insurance communities. The event brings together top business and IT executives from leading financial institutions including healthcare payers, insurers and banks. Join your industry peers for in-depth discussions on trends, challenges and opportunities facing healthcare payers and insurers today.

Check Back for New Posts

We hope to create a lively discussion throughout this blog series.  Please participate with your comments and thoughts as it will enrich the experience as we embark on this transformational journey of Healthcare Reform.

Please check back soon for our next post. In the meantime, you can keep up with Oracle Insurance year-round via social media.

Wednesday Jan 07, 2015

Live Webcast with INN: Grow Business by Streamlining the Entire Opportunity-To-Quote-To-Application Process

The economic realities of today’s insurance market make it harder than ever to achieve profitable growth. There is a need for insurers to reduce costs while growing their business. The web has changed the landscape, and customers now expect products and services to be configured to meet their needs, as well as fast and accurate price quotes and fulfillment. Have you aligned your sales process with the way customers are now buying?

One of the key ways that insurers can grow their business is by optimizing the conversion of sales opportunities into revenue. Insurers can transform their business process by combining their configure, price and quote system with an enterprise rating solution. The result allows insurers to streamline the entire opportunity-to-quote-to-application process including product selection, configuration, pricing, quoting, application, and approval workflows. Learn how to:

  • Increase ease-of-use to dramatically reduce the rate creation and revision process
  • Enhance pricing discipline
  • Improve sales cycles and margins

Join Oracle and Insurance Networking News for this webcast to learn how today’s technology solutions can help insurers achieve profitable growth.

  • January 20, 2015
  • 2:00pm Eastern / 11:00am Pacific
  • Register Now

For more information on how Oracle’s solutions for insurers and healthcare payers can be used to support your business, visit oracle.com/insurance.

Wednesday Dec 10, 2014

Impact Analysis to Help Insurers Sustain Profitable Growth

Anton Wiryawan, Insurance Product Strategy Director, discusses the topic below:

The economy is showing some signs of life, company balance sheets are stabilizing, and consumer and manufacturers’ confidence indices are trending toward the positive. All of these bode well for Insurance companies. In fact, according to Insurance Information Institute, Insurers’ profitability is at its highest level in the post-crisis era in 2013 as sharply lower catastrophe losses, modestly higher premium growth, improved realized investment gains and favorable prior-year reserve loss development push the industry’s return on average surplus to 10.3 percent, up from 6.1 percent in 2012 and just 3.5 percent in 2011.

However, on a more fundamental level, insurers have bigger challenges on their hands. In both personal and commercial lines, insurers are struggling to adapt to evolving customer demands and higher service expectations with more information sought and transactions conducted over the Web. It will be hard pressed for insurers to achieve more consistent and higher rates of growth going forward without system upgrades to improve efficiency, reduce operating costs, and shore up their financial results.

Faced with uncertain growth prospects, many carriers have looked at the use of predictive analytics (modeling) to help optimize products and prices to meet corporate goals such as profitability, retention, and premium growth. Rating/underwriting and actuarial/predictive analytics are at the center of many of these initiatives. Unfortunately, in many cases, in-place rating systems are not able to do some of the “what if” analysis requirements well.

Carriers need a modern rating system that provides the ”what if” analysis out of the box. Oracle Insurance Insbridge Enterprise Rating system is built from the ground up to handle carriers’ complex rating requirements. It provides an Impact Analysis module that enables carriers to test the impact of “what if” scenarios on their book of business before it’s launched in the production environment. It allows carriers to fine tune their product and pricing and optimize their revenues. Such a valuable tool is needed to sustain carriers’ growth in the market.

To learn more about how your business can benefit from Oracle Insurance Insbridge Enterprise Rating and its Impact Analysis module, visit oracle.com/insurance.

Don’t forget to keep up with us year-round:

Monday Dec 08, 2014

Group Billing Made Easy With Oracle Insurance Policy Administration for Life and Annuity

For many insurers, billing is no longer just a process of generating bills, but an important part of communication between the carriers and their customers. A majority of insurance carriers find themselves constrained by aging and inflexible legacy billing systems, which limit their ability to improve operational efficiency. Also, cumbersome or inaccurate billing has led to customer dissatisfaction, creating difficulty in selling additional insurance products to existing customers/accounts.

In order to address this problem, insurance carriers may be considering modern billing systems to be integrated with the policy administration systems. However, the addition of these systems creates complexities and limitations – in addition to increased investment for an external billing system – and also makes maintenance and further enhancements painful.

The Oracle Insurance Policy Administration 10.1 release introduces unified Group Billing functionality to better align the solution’s capabilities with market needs and trends.  This new functionality provides an excellent billing solution that can significantly impact an insurer’s processing expenses, improve cash flow, and increase customer satisfaction, especially in case of Group Billing where reconciliation becomes overwhelming. This solution also supports efficient and effective batch processing capabilities, eliminating the need for any external billing solution.

Group Billing in Oracle Insurance Policy Administration has been designed and developed with wide range of capabilities:

The solution uses a two-stage process in generating a bill, which allows it to capture granular details and makes Group Billing configurable.

  • Generate Bill Details

    This is a rule attached to a transaction that generates the bill details as various entity levels – usually at the Policy, Client or Coverage level.

    These bill details hold the most detailed information pertaining to any policy, client and coverage that can further be grouped together to generate Group Bills as required.

  • Generate Group Bill

    This is an attached rule configured to find mapped bill details to a Group Customer in order to generate a single Group Bill.

    The system allows the ability to define a billing group, which can be a company, government agency or other organization that handles billing for individual annuity or life insurance policies held by their employees or members. This billing group will be the recipient of the Group Bill.

    It is also possible to aggregate bill details to a Group Bill, based on bill details generated over a period of time, or based on set levels of bill due amounts. Search capabilities are available and can be performed at various levels. The Group Bill can be searched and accessed, so all bill details associated with the Group Bill can be viewed.

    The system can be setup to automatically generate a Group Bill on a given billing date and can be configured to support multiple client billing cycles (e.g. weekly, bi-weekly, semi-monthly, monthly, quarterly, semi-annual, annual or any other client defined frequency). The system is also capable of defining a configurable or system status with the Group Bill (for example Pending, Active, Released, Deleted). The status is changed as billing activities are processed for a specific Group Bill.

Group Bill Reconciliation

Once a Group Bill is generated for an entity (such as a Group Customer) and payments are received from the payer, these are adjusted against the individual Bill Detail entries and reconciled. The Billing Reconciliation enhancement introduces new screens, business rules and other functionalities needed to process the reconciliation and generate the required policy level activities to ensure the payments are adjusted to the policy.

User-friendly screens allow the billing/payment representative to easily find a bill and reconcile it manually and provide the ability to do adjustments anytime in future.

The system allows the addition or removal of a policy for a member that has already been generated, and reconciliation handles the associated adjustments needed.

The system has the ability to produce periodic discrepancy reports at the participant level, providing insight to into which employer-billed premium payments need to be resolved (e.g. may be missed deduction or underpayment) and to produce a periodic past due report, based on remittance frequency, to communicate the receivables that are not paid and past due.

Oracle Insurance Policy Administration’s Group Billing functionality can also identify and track unallocated cash (through suspense) and support retroactive enrollment, retroactive termination, and reinstatements. It also allows reallocation of payments or adjustments to individual receivables within system.

After reconciliation of the amount received, the bill can be released and the status changed. The system will automatically generate individual remittance activities for the policies included in the list bill for the amount received (reconciled amount). If there is an amount that is not reconciled, it can be applied to the appropriate level of suspense at the lowest level known, which can be at Group Customer, invoice, billing class or policy level.  The system also allows reversal of reconciliation in cases of erroneous payments (over payments, under payments or incorrect allocations).

Batch Processing using Data Intake

Oracle Insurance Policy Administration can receive an electronic format file from the employer or payroll provider for employee payroll deductions at participant (member/dependent) level – within a benefit by employer selected schedule (by pay period, weekly, monthly or any client-defined frequency) – and batch process it to generate scheduled Group Bills.

The system has the ability to support tracking, research and follow-up of unallocated payments (i.e., a batch of suspense items where all of the money was not applied as premium to contracts in the group, the unapplied suspense detail would be available). It is capable of receiving payments by means of lockbox, EFT, payroll deduct or manual check.

The system also supports search capabilities for missing or improperly applied payments in order to provide corrective processing to address improperly applied payments located in search. This includes the ability to remove payment, apply to another account or reopen suspense.

Learn more

Oracle Insurance Policy Administration provides a highly configurable and flexible platform that enables the carriers to innovate to keep pace with changing demands, simplify their IT environments and transform the business into an agile, cost-effective enterprise. The addition of Group Billing functionality offers an excellent billing solution that can significantly impact an insurer’s processing expenses, improve cash flow, and increase customer satisfaction

To learn more about Oracle Insurance Policy Administration for Life and Annuity and how Oracle’s solutions can be used to support your business, visit oracle.com/insurance.

Don’t forget to keep up with us year-round:

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Oracle's flexible solutions can help insurers navigate the change necessary to meet today’s challenges and have the business agility to be prepared for the future.

For mor information, visit oracle.com/insurance.

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