Product: Qualified Plan Distribution Analysis
Company: Advanced Impact
Web site: www.advancedimpact.com

Pacific Life Insurance has had a relationship with softwaredeveloper Advanced Impact for five years, and one of the keys tothe relationship has been Advanced Impacts regular updates of itsofferings for the life insurance and financial services industry,according to Alyce Peterson, vice president marketing services withPacific Life.

Advanced Impact, located in Charlotte, N.C., has released a newversion of its three-year-old product Qualified Plan DistributionAnalysis. Each of the tools is unique, but largely they helpclients plan their assets, says Peterson. This is done by examiningimpacts on planning objectives, tax implications, and estate taximplications. It gives us a tool to do what-if scenarios for ourclients, she says.

The Advanced Impact software works on the desktop as aback-office tool, generating reports that can be used in front ofclients. Usually, the producer who uses this software will gothrough a fact-finding process, and the nice thing about the Impactsoftware is it comes with a fact finder you can print off and workwith in a client meeting, says Peterson.

Pacific Life, which is based in Newport Beach, Calif., likes thesoftware because it removes some of the complications from thedifficult processes in the life insurance market. If you are tryingto take a distribution from a qualified plan, there are a lot ofdifferent calculations involved, whether it is a minimumdistribution or you are taking the maximum, Peterson says. Thereare a lot of calculations involved that [with the software] theydon't have to do by hand."

Pricing for Qualified Plan Distribution Analysis is based on anannual subscription basis.

Product: CLEAR (Clear Logic Edit and Rules)
Company: CGI Group, Inc.
Web site: www.cgi.com

CGI, an information technology services firm based in Montreal,has teamed up with one of its insurance partners, the RegenceGroup, to develop CLEAR (Clear Logic Edit and Rules), a claimsvalidation system with an open-knowledge base that shares claimsedit rules with providers to help them manage claims submissionsmore effectively.

Regence is an affiliation of four Blue Cross and/or Blue Shieldcompanies in the Northwest and mountain states. It serves more thanthree million members in Washington, Oregon, Idaho, and Utah andgenerates $5 billion in revenue with 23,000 providerrelationships.

Regence and CGI have had a working relationship for over fiveyears, according to Robert Haskey, M.D., a medical director forRegence. Two years ago, both sides met to discuss claims processingand code adjudication. A small team of professionals was puttogether to start working on what has evolved into the CLEARproduct, says Haskey. It was designed specifically to put forth therule set we feel is applicable to coding in this country at thistime.

Haskey felt there was a business perspective to this, he says,and Regence wanted to partner with CGI through a licensingagreement. The system was not designed to be proprietary forRegence. We felt perhaps there would be others who might beinterested in a similar concept, he says.

Rob Rolf, a principal at CGI, says from his companys perspectivethere already was a great working relationship with Regence, andCGI had more than a decade of experience in claims auditing anddeveloping claims edits. The [CLEAR] system really matches ourbelief, says Rolf. Lets have an open set of rules for everyone tosee, and lets enforce those rules.

Rolf says individual companies still have the opportunity to usespecific rules that apply to an individual plan, even if theydiffer from national standards. Insurers have the opportunity toimplement those, but our approach has always been that [the rules]are out there in either the provider-reimbursement policyguidelines or in their contract.

Regence and CGI did not create new rules for coding, Haskeynotes. They were already out there, he says. We reviewed all thedocuments and worked them into a format that would be applicable toa claims processing system.

Portions of the CLEAR system are intellectual property, Rolfsays, but the overall product is part of our joint desire to seethis become more of a standards marketplace approach. It can beused by any payer on any platform. Using proprietary edits createsan administrative burden for both the provider and the payer. Theprovider doesnt know what rules are being held to, and the payerhas to deal with numerous provider inquiries on those rules, Rolfexplains.

Haskey believes if everyone knows a rules set, regardless ofwhat the application is, both parties will be able to navigate thesystem in a more efficient manner: If we in health care can helpreduce the paper chase, it will save the entire [health care]system a tremendous amount of money and also make it easier tonavigate the system.

CLEAR has been rolled out in Idaho, Haskey says, and the otherthree plans will get the system in 2003. Its working well, heclaims. Whenever you enter into a new venture you never know. Hesays only minimal issues have cropped up and adds the business sideof Regence has been satisfied with what has been accomplished.

Shopping Cart
Product: MIB Web Services
Company: MIB Group, Inc.
Web site: www.mib.com

Web services designed to extend in-house IT solutions to clientsby providing software functionality via the Web are now availablefrom the MIB Group, the Westwood, Mass., facilitator of electronicinsurance commerce via dedicated networks and Internet-basedsystems. Included in the Web services are MIBs Security AlertEntity Look-up Utility and Security Alert ID Look-up Utility, bothpart of MIBs Security Alert Services, a compliance solution for theUSA Patriot Act and Canadas OSFI regulations.

The MIB Web services use a representational state transfer(REST) architectural style that utilizes standard Internettechnologies such as XML, URI, and HTTP to improve integration witha customers existing business systems.

Product: Genelco Reinsurance+
Company: Genelco Software Solutions
Web site: www.genelco.com

Genelco Software Solutions, St. Louis, a division of LibertyInsurance Services Corp., recently released version 3.0 of itsGenelco Reinsurance+. Genelco vice president of client reinsuranceservices Craig Carothers says features of the new version includerisk pooling, unlimited joint policies, and the ability to scheduleinterface files with the system as frequently as every minute,which simulates real-time interface to connected applications.

The product automates the processing of ceded life insurance, hesays. Using a client/server application, the system supports fulllife-cycle administration of reinsured benefits from new businessto termination. The system, Carothers says, can receive data fromany life administration system, automatically analyze it for therequirements of reinsurance, and process reinsurancetransactions.

Product: Acquire
Company: Superior Access Internet Software, Inc.
Web site: www.sais.com

A new e-business solution designed to enable property/casualtyinsurance carriers to acquire new business has been introduced bySuperior Access Internet Software (SAIS). Called Acquire, thesolution brings SAIS components into a seamless processing solutionthat serves carriers and producers. Acquire automates rate quotingand underwriting while integrating with the carriers legacy ratingengines and issuance systems to achieve end-to-end processing ofP&C policies. Mike Mayo, president of the Irvine, Calif.-basedSAIS, says Acquire will create new revenue capabilities, reduceproduction costs, and enhance organizational efficiencies.

Product: Bladeworks
Company: Infoglide Software Corp.
Web site: www.infoglidesoftware.com

Another tool in the battle against fraud has been introduced byInfoglide Software of Austin, Tex., a provider of enterprisesolutions for classifying, analyzing, and investigating data storedin multiple, disparate, remote databases. Called Bladeworks, theproduct is a fully integrated design process solution for real-timerisk assessment, decision automation, and relationship discovery.The systems remote search capability creates a virtual datawarehouse for its different databases. Privacy issues are addressedas well, says Michael Schultz, president and CEO of Infoglide.Bladeworks can return risk assessment scores without returning theassociated data. Todays environment of protecting informationprivacy while assessing risk demands a solution like Bladeworks,says Schultz.

Product: Agora Interchange
Company: AgoraINS
Web site: www.agorains.com

AgoraINS has released Agora Inter-change, a reinsuranceadministration clearinghouse service for direct writers andreinsurers. Carol Sullivan, vice president operations of theChicago-based solutions firm, says, Agora Interchange provides anexpress route to fast and easy communication between businesspartners. Agora Interchange accepts reinsurance administrationtransaction information from direct writers in any record typetape,CD, or paperand converts it into each reinsurers preferred recordformat. Custom formats or ACORD XML formats can be used. Reinsurersno longer have to keep up with the format requirements of theirtransaction partners to send compatible information, says PaulBuckley, vice president of technology for AgoraINS.