Patent ID: 8145500
Filing Date: 2012-03-27
Classification: G06Q,G16H

Abstract:
1. A computer implemented method for periodically determining a policyholder's discounted premium for a next succeeding period of a medical insurance plan comprising the steps of: inputting into at least one computer data pertaining to (i) a medical insurance plan whereby policyholders in the plan pay periodically premiums for each succeeding period of the plan in consideration of their medical insurance claims for insured loss under the insurance plan will be paid according to the terms and conditions of the plan and the rules imposed by the plan, and (ii) a list of participating 3 selecting, from data inputted into said at least one computer, at least one data pertaining to at least one policyholder, said data selected from the group consisting of: personal and family data, premiums paid in a current period and preceding periods, medical insurance claims made, goods and services of 3 calculating, using said at least one computer, premiums that a policyholder shall pay for each next succeeding period of each policyholder's medical insurance plan, based on the premium of the current period, by first determining a notional premium for the current period with no discount applied, and then, adjusting for any plan or option changes in personal and family data, and storing in memory of said at least one computer a first output indicative thereof; calculating, using said at least one computer, for each policyholder (i) medical insurance claims paid during the current period, (ii) medical insurance claims filed and in process of resolution, and (iii) medical insurance claims filed but not yet in process of resolution, and applying plan rules inputted into said at least one computer to medical insurance claims in process of resolution and medical insurance claims not yet in process of resolution, and adjusting the policyholder's medical insurance claims for medical insurance claims deemed likely to comply with plan rules and be paid, to obtain an adjusted total of medical insurance claims, and storing in memory of said at least one computer a second output indicative thereof; calculating, using said at least one computer, the status level of each policyholder based on the points accumulated by the policyholder, and storing in memory of said at least one computer a third output indicative thereof; calculating, using said at least one computer, based upon the first, second and third outputs to the processor, a discounted premium to be applied to each policyholder's premium for the next succeeding period, and storing in memory of said at least one computer a fourth output indicative thereof; and transforming from memory in said at least one computer to human visible form, said fourth output, by one of displaying on a display or printing.