# Patent

## Title
Benefits administration system and methods of use and doing business

## Abstract

An automated benefit administration system and methods of use and doing business. The full system includes a wide range of features including application of business rules to enrollment, eligibility, and maintenance data input, making of business decisions based on the specific data entered, and issuing of notices based on business rule discrepancies including notices to third parties when deemed appropriate. The full system also is secure while providing remote access, including through the Internet, limits access based on user hierarchy, allows user customization of various features including communications vehicles (e-mail, letter correspondence, or facsimile) and of the format of certain communications, provides automatic enrollment in Cobra without re-entry of beneficiary data, accomplishes various types of financial reconciliation, accommodates differing organizational structures and groupings of entities, provides business rule over-ride capability for certain users, and provides robust information about carriers and their services.

## Background
CROSS REFERENCE TO RELATED APPLICATIONS
This application claims priority through, and hereby incorporates by reference in its entirety, U.S. Provisional Patent Application Ser. No. 60/526,961, filed Dec. 5, 2003, entitled Benefit Administration System and Methods of Use and Doing Business.


The following document is a copyrighted text. All copyrights are reserved as allowed by law.
BACKGROUND
The present invention relates to benefits administration systems and methods of use and doing business. The present invention also relates to automated systems for administering benefits.
In business and industry, benefits plans are common. They often include health care, savings or retirement plan, insurance, and other funding or services for employees. Administration of benefits has long presented a substantial challenge for business and industry.
One prior art automated system designed for administration of benefits has been known as the “Phoenix” system. The Phoenix system automated certain benefits administration tasks and included features such as:

    
    
        a. enrollment of beneficiaries through a limited-access, private computer network such as an business's internal computer network;
        b. automated but limited application of certain basic business rules to inform the user, at the time of entry on-screen only, of certain limited missing information such as a beneficiary's address, birthdate dependents, or benefits plan choice;
        c. automated reconciliation of payments provided they exactly match the amount invoiced to the customer;
        d. limited automation of physical letter generation such as generation of a welcome letter to a new customer setting forth little more than the effective date of initiation of plan coverage for the customer;
        e. automated maintenance of certain limited carrier data, including certain carrier rates and rating areas;
        f. limited automation of Cobra enrollment by re-keying data for the Cobra enrollment into the system;
        g. limited automation of open enrollment and re-qualification by automated sending out of notices and issuance of failure to re-qualify reports, allowing manual entry of termination if desired by the administrator;
        h. automated termination and issuance of termination notice to the carrier upon first termination of a customer and thus well prior to conclusion of the re-instatement option period; and
        i. limited periodic reconciling of payments actually received in-house by receipt at the system administrator's mailroom, routing to the finance department for entry into the system; if the payments matched exactly the amount of their respective invoices, the finance department would initiate a program through that would reconcile the cash received against the invoice; non-matching payments would require substantial manual involvement in the reconciliation process
        j. The Phoenix system included numerous limitations and issues, however, including:
        k. limited carrier data such as not including data (only zip codes and rates);
        l. lack of automated creation of a Cobra record from information already in the system for a given beneficiary;
        m. with regard to issuance of notices for enrollment or re-qualification, lacked ability select sub-groups (e.g., groups under 5 employees) for issuance of notices only to them, and also lacked automatic termination of groups that do not re-qualify;
        n. providing notice of termination of a group to a carrier prior to expiration of a re-qualification period for the group including Cobra members of the group;
        o. lack of automatic changing of employee status upon change of employee coverage (e.g., by changing from employee-only coverage to employee and spouse coverage), along with lack of automated corrected billing as a result of the change;
        p. lack of automated reconciliation of cash upon closing of a batch of inputted premium checks, and automatic reconciling of premium notices with payments provided by multiple payments (e.g., multiple checks providing payment for a particular premium amount);
        q. limited application of business rules to ensure correct data entry and limiting of enrollment as allowed by the rules, and relatedly, no ability to issue notices other than on-screen notices of certain limited types of information that may be missing;
        r. limited ability to generate required notices, and limited or no ability to send notices through differing media (e-mail, mail, fax);
        s. no ability to allow system access through remote or separate networks, such as via the Internet;
        t. no ability to reconcile payments that do not exactly match invoice amounts, and no ability to issue notices based on matching discrepancies; and
        u. limited data handling capacity, requiring periodic purge data to run the system.
    
    


BRIEF SUMMARY OF CERTAIN ASPECTS OF THE INVENTION
In summary, the present invention relates to an automated benefit administration system and methods of use and doing business. In certain embodiments, a full system includes a wide range of features including application of business rules to enrollment, eligibility, and maintenance data input, making of business decisions based on the specific data entered, and issuing of notices based on business rule discrepancies including notices to third parties when deemed appropriate. The full system also is secure while providing remote access, including through the Internet, limits access based on user hierarchy, allows user customization of various features including communications vehicles (e-mail, letter correspondence, or facsimile) and of the format of certain communications, provides automatic enrollment in COBRA without re-entry of beneficiary data, accomplishes various types of financial reconciliation, accommodates differing organizational structures and groupings of entities, provides business rule over-ride capability for certain users, and provides robust information about carriers and their services.
There are many other novel aspects and aspects of embodiments of the present invention. They will become apparent as the specification proceeds. In this regard, it is to be understood that the scope of the invention is not be determined by whether given subject matter addresses all or particular issues in the prior art noted above or provides all or particular features identified in this brief summary.



BRIEF DESCRIPTION OF THE DRAWINGS
FIGS. A-1 to A-3 are diagrams illustrating aspects of architectures in which embodiments of the present invention may be implemented.
FIGS. B-1 to B-3 illustrate example screens used to create a line of coverage in embodiments of the present invention.
FIGS. B-4 to B-6 illustrate example screens used to create a plan type in embodiments of the present invention.
FIGS. B-7 to B-9 illustrate example screens used to enter details of benefit levels in embodiments of the present invention.
FIGS. B-10 and B-11 illustrate example screens used to enter details about a carrier in embodiments of the present invention.
FIGS. B-12 to B-15 illustrate example screens used to search, view and edit information about available carriers in embodiments of the present invention.
FIGS. B-16 to B-19 illustrate example screens used to add information pertaining to a product and plan in embodiments of the present invention.
FIGS. B-20 to B-23 illustrate example screens used to view and edit/modify information in an existing plan name in embodiments of the present invention.
FIGS. B-24 to B-26 illustrate example screens used to create an admin fee in embodiments of the present invention.
FIGS. B-27 to B-33 illustrate example screens used to search, view and edit admin fee information in embodiments of the present invention.
FIGS. B-34 to B-36 illustrate example screens used to enter details about agent fees in embodiments of the present invention.
FIGS. B-37 to B-43 illustrate example screens used to search, view and edit agent fee information in embodiments of the present invention.
FIGS. B-44 to B-46 illustrate example screens used to enter details about additional fees in embodiments of the present invention.
FIGS. B-47 to B-53 illustrate example screens used to search, view and edit additional fee information in embodiments of the present invention.
FIGS. B-54 to B-56 illustrate example screens used to enter details about rate differentials in embodiments of the present invention.
FIGS. B-57 to B-63 illustrate example screens used to search, view and edit rate differential information in embodiments of the present invention.
FIGS. B-64 to B-67 illustrate example screens used to import zip code information in embodiments of the present invention.
FIGS. B-68 to B-70 illustrate example screens used to commit import IDs in embodiments of the present invention.
FIGS. B-71 to B-73 illustrate example screens used to import rate information in embodiments of the present invention.
FIGS. B-74 to B-78 illustrate example screens used to export rate information in embodiments of the present invention.
FIGS. B-79 to B-81 illustrate example screens used to export loaded rate files in embodiments of the present invention.
FIGS. B-82 to B-84 illustrate example screens used to import plan availability data in embodiments of the present invention.
FIGS. B-85 to B-88 illustrate example screens used to export plan availability data in embodiments of the present invention.
FIGS. C-1 to C-6 illustrate example screens used to enter association details in embodiments of the present invention FIGS. C-7 to C-14 illustrate example screens used to modify the contents of an existing association in embodiments of the present invention.
FIGS. C-15 to C-28 illustrate example screens used to enter group details for a small employer group in embodiments of the present invention.
FIGS. C-29 to C-42 illustrate example screens used to enter group details for an alternate group/individual member in embodiments of the present invention.
FIGS. C-43 to C-58 illustrate example screens used to save or edit group details for an alternate group/individual member in embodiments of the present invention.
FIGS. C-59 to C-69 illustrate example screens used to save or edit group details for a small employer group in embodiments of the present invention.
FIGS. C-70 to C-87 illustrate example screens used to modify employee details, activate or inactivate an employee, or enter or modify employee dependent details in embodiments of the present invention.
FIGS. C-88 to C-105 illustrate example screens used to modify member details, activate or inactivate a member, or enter or modify member dependent details in embodiments of the present invention.
FIGS. C-106 to C-111 and C-113 to C-140 illustrate example screens used in COBRA functions in embodiments of the present invention.
FIGS. C-141 to C-160 illustrate example screens used in termination functions in embodiments of the present invention.
FIGS. C-161 to C-178 illustrate example screens used reinstatement functions in embodiments of the present invention.
FIGS. C-179 to C-191 illustrate example screens used in appeals and grievance functions in embodiments of the present invention.
FIGS. C-192 to C-204 illustrate example screens used to raise issues with carriers in embodiments of the present invention.
FIGS. C-205 to C-233 illustrate example screens used to add or modify details for employees or dependents, in embodiments of the present invention.
FIGS. C-234 to C-248 illustrate example screens used to export data in embodiments of the present invention.
FIGS. C-249 to C-323 illustrate example screens used to change group and member information in embodiments of the present invention.
FIGS. C-324 to C-384 illustrate example screens used in requalification and open enrollment functions in embodiments of the present invention.
FIGS. C-385 to C-399 illustrate example screens used to view group, employee or dependent details in embodiments of the present invention.
FIGS. D-1 to D-13 illustrate example screens used in billing functions in embodiments of the present invention.
FIGS. D-14 to D-20 illustrate example screens used in cash receipts functions in embodiments of the present invention.
FIGS. D-21 to D-28 illustrate example screens used in cash reconciliation functions in embodiments of the present invention.
FIGS. D-29 to D-35 illustrate example screens used in cash disbursement functions in embodiments of the present invention.
FIGS. D-36 to D-62 illustrate example screens used in finance operation functions in embodiments of the present invention.
FIGS. E-1 to E-26 illustrate example screens used in search zip, call tracking, mail merge and report generation in embodiments of the present invention.
FIGS. F-1 to F-6 illustrate example screens used in supply request functions in embodiments of the present invention.
FIGS. F-7 to F-20 illustrate example screens used in work group functions in embodiments of the present invention.
FIGS. F-21 to F-39 illustrate example screens used in associates and campaign functions in embodiments of the present invention.
FIGS. F-40 to F-94 illustrate example screens used in sales master functions in embodiments of the present invention.
FIGS. F-95 to F-106 illustrate example screens used in quotes functions in embodiments of the present invention.
FIGS. G-1 to G-8 illustrate example screens used in module master functions in embodiments of the present invention.
FIGS. G-9 to G-18 illustrate example screens used in application master functions in embodiments of the present invention.
FIGS. G-19 to G-27 illustrate example screens used in resource master functions in embodiments of the present invention.
FIGS. G-28 to G-35 illustrate example screens used in group master functions in embodiments of the present invention.
FIGS. G-36 to G-43 illustrate example screens used in user master functions in embodiments of the present invention.
FIGS. G-44 to G-51 illustrate example screens used in user role master functions in embodiments of the present invention.
FIGS. G-52 to G-66 illustrate example screens used in mapping functions, user role group mapping functions, group access rights functions, user access rights functions, and password configuration functions in embodiments of the present invention.
FIG. H-1 is a flowchart illustrating an example process of creating a master record for a carrier, FIGS. H-2 to H-9 illustrate example screens used in carrier record functions in embodiments of the present invention, and FIG. H-10 shows an associated screen flow.
FIG. H-11 is a flowchart illustrating an example process of creating a plan, FIGS. H-12 to H-14 illustrate example screens used in plan creation functions in embodiments of the present invention, and FIG. H-15 shows an associated screen flow.
FIGS. H-16 to H-19 are flowcharts illustrating example processes for admin fee, agent fee, additional fee and rate differential, FIGS. H-20 to H-31 illustrate example screens used in fee and rate functions in embodiments of the present invention, and FIG. H-32 shows an associated screen flow.
FIG. H-33 is a flowchart illustrating example zip processes, FIGS. H-34 to H-35 illustrate example screens used in zip functions in embodiments of the present invention, and FIG. H-36 shows an associated screen flow.
FIGS. I-1 and I-2 are flowcharts illustrating example COBRA processes, FIGS. I-3 to I-11 illustrate example screens used in COBRA functions in embodiments of the present invention, and FIG. I-12 shows an associated screen flow.
FIGS. I-13 to I-23 show screen flows for screens used in change management in embodiments of the present invention.
FIG. I-24 is a flowchart illustrating example requalification and open enrollment processes, FIGS. I-25 to I-30 illustrate example screens used in requalification and open enrollment functions in embodiments of the present invention, and FIGS. I-31 to I-33 show associated screen flows.
FIG. I-34 is a flowchart illustrating example termination processes, FIGS. I-35 to I-59 illustrate example screens used in termination and reinstatement functions in embodiments of the present invention, and FIG. I-60 show an associated screen flow.
FIGS. I-61 to I-64 illustrate example screens used in appeals and grievances functions in embodiments of the present invention, and FIG. I-65 show an associated screen flow.
FIGS. I-66 to I-71 illustrate example screens used in association masters functions in embodiments of the present invention, and FIG. I-72 show an associated screen flow.
FIGS. I-73 to I-76 illustrate example screens used in carrier issues functions in embodiments of the present invention, and FIG. I-77 show an associated screen flow.
FIGS. J-1 to J-8 illustrate example screens used in billing, cash receipt, cash reconciliation and risk adjustment functions in embodiments of the present invention.
FIG. K-1 is a diagram illustrating an example mail merge process, and FIG. K-2 is an example screen for mail merge functions in embodiments of the present invention.
FIGS. L-1 and L-2 illustrate example screens used in report functions in embodiments of the present invention, and FIG. L-3 show an associated menu outline.
FIG. M-1 is a flowchart illustrating example marketing campaign processes, FIGS. M-2 to M-8 illustrate example screens used in marketing campaign functions in embodiments of the present invention, and FIG. M-9 show an associated screen flow.
FIG. M-10 is a flowchart illustrating example sales masters processes, FIGS. M-11 to M-38 illustrate example screens used in sales masters functions in embodiments of the present invention.
FIGS. M-39 to M-44 illustrate example screens used in agent profiles functions in embodiments of the present invention.
FIGS. M-45 to M-53 illustrate example screens used in quote creation functions in embodiments of the present invention.
FIGS. N-1 and N-8 are flowcharts illustrating example supply request processes, and FIGS. N-2, N-3, N-9 and N-10 illustrate example screens used in supply request functions in embodiments of the present invention.
FIG. N-4 is a flowchart illustrating example work group processes, and FIGS. N-5 to N-7 illustrate example screens used in work group functions in embodiments of the present invention.
FIGS. N-11 to N-13 illustrate example screens used in associates and call tracking functions in embodiments of the present invention.
FIGS. P-1 to P-12 are flowcharts illustrating example security mechanism processes, and FIGS. P-13 to P-38 illustrate example screens used in security mechanism functions in embodiments of the present invention.



DETAILED DESCRIPTION
Certain embodiments of the benefits administration system may (i) apply rules to enrollment, eligibility, and/or group maintenance data input, preferably all such input, and (ii) make business rule decisions based on the specific data entered, preferably including automatic actions related to correct business rules as well as issuance of notices for business rule discrepancies. These capabilities can, in certain embodiments, include business rule over-rides based on user authority level.
For example, in the insurance industry, an enrollment application is required for enrollment into any insurance plan. Enrollment rules may pertain to the input of data from this application into the benefits administration system. An example of an enrollment rule may include inputting a Social Security number (SSN) that has been assigned to another member previously. In certain embodiments, the benefits administration system can produce a notification of a duplicate SSN and may not allow the completion of the member's enrollment utilizing the duplicate SSN.
Another example of an enrollment business rule is the entry of information for a new member who requests family health coverage but does not list any dependents on the new member's enrollment application in the system. In certain embodiments, the business rules within and automatically applied by benefits administration system can require the data entry of one spouse and at least one child in order to comply with family coverage. Without this dependent information, the system may refrain from allowing finalization of the enrollment. In certain embodiments, the system can then automatically designate the member's application as pending and generate one or more notices (such as letters) advising of the need for, or requesting, the missing information.
Eligibility rules may pertain to the specific business rules set up by the insurance companies. For example, to be eligible for a certain type of insurance, an employer group may require at least two employees; or in order for an employee to be eligible, the employee may have to work at least thirty hours per week. In certain embodiments, the benefits administration system may implement these types of specific rules.
For example, if a user seeks to enter an employer group with only one employee, in certain embodiments the system can thus refuse to finalize the enrollment unless another employee's information is entered. As another example, if user enters hours-work-per week for an employee less than the business rule of 30 hours, in certain embodiments, the system will not allow finalization of the enrollment. In certain embodiments, the system may accommodate exceptions such as when a user with a pre-determined authority level, such as a manager, desires to over-ride the eligibility business rule. In certain embodiments, the system can allow the exception based on pre-arranged authority levels within the system.
Group maintenance may pertain to enrollment/eligibility activities that occur after the finalization of a group's enrollment. One example may be the addition a newly hired employee to the employer group's plan. In certain embodiments, once the new employee application is received and data is entered, the system may apply one or more business rules for the waiting period for the new hire within the group within which the new hire is hired. Based on this comparison, the system may either assign a correct effective date or deny the enrollment because the employee has not properly satisfied the waiting period. In additional embodiments, if the employee is enrolled, the system may automatically issue an enrollment letter; or if denied, the system may automatically issue a denial letter.
Yet another group maintenance example may be the receipt of monthly insurance premium payments. In certain embodiments, the system may automatically issue an invoice outlining activity affecting the premium for a given period of time, such as the past month. Such activity may include adding a newly hired employee or dis-enrolling a terminated employee. In certain embodiments, the system may implement business rules to provide automatic reconciliation of the premium to the amount of an invoice.
In certain embodiments, the system may also be flexible enough to take into consideration activity that occurred after the creation of the invoice in reconciling the premium. For example, the monthly invoice to a given customer may total a particular amount. By the due date of the invoice, the employer may have sent notification of an employee disenrollment. The employer may have only sent a payment that deducts the premium for the disenrolled employee. In certain embodiments, the system can automatically reconcile the received payment against the invoice amount and the termination credit for the disenrolled employee.
In certain embodiments, the benefits administration system may implement varying authority levels for data entry and system operation. For example, the system may provide that (i) a data entry position may have authority to enter data but not to finalize enrollment even if all business rules are met; (ii) yet another position may have authority to finalize enrollment if all business rules have been satisfied; (iii) a supervisor may have authority to finalize enrollment with, as possible examples, minor premium shortages or non-eligibility-related missing enrollment information; (iv) managers may have authority to finalize enrollments with significant premium shortages or non-eligibility issues; and (v) a system administrator may have authority to over-ride any business rule.
Certain embodiments may also provide remote access through disparate networks, such as, for example, through the Internet, for enrollment, eligibility, or group maintenance data input. In certain embodiments, the system may then make business rule decisions based on the specific data entered. In certain embodiments, the system also may automatically perform actions related to the business rules. In certain embodiments, the system also may automatically issue notices, including on-line notice in certain embodiments, for business rule discrepancies. In certain embodiments, the system may include business rule over-rides based on the authority level of user.
In certain embodiments, the system can allow an external business customer to process enrollment, eligibility, or group maintenance via the Internet. For example, in the insurance industry, an enrollment application typically is required for enrollment into an insurance plan. In certain embodiments, the benefits administration system may allow this application to be entered remotely through a, preferably secure, Web site.
For example, an employer may request enrollment in a health insurance plan. In certain embodiments, the employer then may access the Web site provided by the system and enter the employer's current employees' demographic and health carrier information. The employer also may pay the first month's premium on-line through the Web site.
Preferably, the system prompts the on-line user for information. While the data is being entertained, in certain embodiments the system may compare the data to the business rules associated with each field. Once the input is completed properly, in certain embodiments the system may present an enrollment summary sheet summarizing enrollment information for the on-line user. For example, in certain embodiments implementing the a wage and tax form requirement for new group enrollments, the system may present the on-line user with the completed form and instructions to return the form to, for example, the insurance company for further processing. In certain embodiments, once the insurer approves enrollment, the system may automatically e-mail or otherwise forward an enrollment acceptance form to the user.
In certain embodiments, business rules remain identical whether for in-network or remote on-line transactions such as, for example, through the Internet.
Group maintenance may involve enrollment/eligibility activity occurring after the finalization of a group's enrollment. For example, if an employer or designated contact person is attempting to enroll a newly hired employee on-line, the employee is hired to work twenty hours per week, and the business rule set up for this particular group is that all employee's must work forty hours per week, in certain embodiments the system may dis-allow the finalization of the enrollment. In certain embodiments, the system may automatically issue a notice informing the group of the non-enrollment and, preferably, the reason(s) for the non-enrollment.
Another group maintenance activity can be employee or dependent disenrollments. In certain embodiments, the employer or designated person may access the appropriate group information on-line and enter the requested termination date. If the requested termination date complies with the business rule, in certain embodiments the system may immediately process the termination, preferably including the sending of a termination notice and COBRA information to the disenrolled employee, adjusting the applicable premium invoice, and notifying the appropriate insurance carrier. If the requested termination date is not within the pertinent business rules, in certain embodiments the system may calculate the termination date and display the date to the on-line user. If the user were to accept this date, in certain embodiments the system may complete the termination and, preferably, issue a notification to the user, such as by e-mail. If the user were to decline the system's proposed termination date, in certain embodiments the system may place the requested employee termination on hold and, preferably automatically, issue a notice of the situation to an appropriate representative.
In certain embodiments, the system may limit the capability to over-ride business rules to in-house personnel (e.g., the personnel of the entity that administers the system).
In certain embodiments, the system can provide a security application or process in order to control access to the system. In certain embodiments, the security framework includes a security information database as well as an administrator login capability. In certain embodiments, the system can allow the administrator to create users, modules, groups, applications, and assign user roles and access control lists (ACLs), etc. Preferably, the system significantly restricts access to the core administrative system.
In certain embodiments, the system generates an ACL for each user at the time the user logs into the system. Access to any resource in the core administrative system may be determined by the ACL, and the determination may be stored in, e.g., a user profile object, which may be stored into the session. A user can include a person working in any of the departments in a company, Internet users, or persons accessing an in-house system from an external location. In certain embodiments, individual user permissions take precedence over group permissions. In certain embodiments, even if the group permission is less restrictive than the user permission, the user permission overrides the group permission.
For example, the agent/broker of a large association group may want to allow the members of the association to enroll through the Internet but to also provide for agent/broker review of applications prior to actual enrollment. In certain embodiments, the system, through its security system, can allow such members to enroll through the Internet (with the application being processed through the enrollment/eligibility business rules), then route the completed application to the agent/broker (versus directly into the system after passing all the business rules), in order to allow the agent/broker to review the application. In certain embodiments, upon completion of such review and approval by the agent/broker, the system can automatically finalize the enrollment.
In certain embodiments, the benefits administration system may also provide the automatic generation of documents and other communications, customizable to the desires of the users. In this regard, the system may provide a flexible mail merge system for handling external business correspondence. In certain embodiments, the merge templates are basically RTF files with placeholders for dynamic data to be merged into them. In certain embodiments, the output is either a RTF file or a PostScript or a PDF document.
In certain embodiments, the system can also maintain a log of mail merge letters generated. The log information may include the template identification, a timestamp, the triggering application, and identification of the user generating the letter and to whom the letter is addressed (i.e., which group or member or agent). In certain embodiments, the templates are readily available, and the system may accommodate a virtually unlimited number of templates.
For example, when the agent/broker provides final approval for association member enrollment, in certain embodiments the system may issue enrollment approval and related correspondence. In certain embodiments, such correspondence or other documentation may be customized through the system to issue on the agent/broker's letterhead.
In certain embodiments, the system may provide for customizable work groups. Workgroups may define the broad categorization of a group of agents, internal working personnel, external working personnel, and mailing groups. In certain embodiments, the workgroup customization process includes creating a hierarchy of one or more parent entities and defining other workgroups under the parent(s).
In this event, a parent may be the highest in the hierarchy of a workgroup. Examples of parent work groups may include agent work groups or internal work groups. Examples of workgroups under the parent group may include groups of agents of differing authority levels within a given agent work group. In certain embodiments, further sub-groups or child groups may be established within the system. An example may include may include agents in a given geographical area or a customer group that has been enrolled in the system. In certain embodiments, the system includes the ability to exchange workgroup members or duplicate workgroup members in whole or in part.
In certain embodiments, the benefits administration system provides automatic but flexible account reconciliation. Cash reconciliation can provide a process of reconciling the cash receipts to individual invoices and reconciling the amount paid by the group. In certain embodiments, the system may provide a rule for reconciliation such as, for example:

    
    
        a. determine if negative cash is available and reconcile it with the positive cash (e.g., for NSF checks); and
        b. identify the oldest unreconciled invoice and reconcile it with the oldest cash.
        c. The reconciliation process may include automatic review of all invoices that have not been reconciled for a specific group and reconciling the invoice that has the earliest date with the cash received. It also may match the cash receipt with the invoice amount.
        d. In certain embodiments, the reconciliation process can be started automatically when a cash receipt batch is closed to reconcile cash received with invoices.
        e. Other functions that may be automatically performed in cash reconciliation may include one or more of the following:
        f. Billed amounts and cash receipt: this reconciliation process may reconcile an invoice that has not yet been reconciled for a specific group, determine if the invoice is the earliest unreconciled invoice for the specific group, and reconcile the invoice with the cash received from the group/member;
        g. Cash to negative cash: this process may reconcile negative cash with the positive cash received from the group. This may arise from receipt of a NSF (Non-Sufficient Funds) check after the applicable group's invoice has been reconciled. Upon receipt of notification of the NSF check, the NSF cash receipt entry may be created in the system. Upon receipt of a replacement check for the NSF check, the NSF check may be automatically reconciled with the replacement check provided the amount of the replacement check is the same as the amount of the NSF check.
    
    


Adjustments to cash: this process may include reconciling a cash receipt with the adjustment that may be available in the next invoice. For example, if the group has received the invoice for the next month and an employee has been terminated during the month but after the generation of invoice, the generated invoice may not identify this adjustment for the termed employees. The applicable group may deduct the adjustments for the terminated employee and forward the cash that does not match the original invoice. In certain embodiments, the system can automatically identify the discrepancy and adjust the cash receipt for the invoice with the termination adjustment taken in to account. In certain embodiments, the next invoice may identify the cash receipt and the adjustment for employee termination.
Adjustment to billed amounts: this process can identify previously billed invoices for the group provide adjustment as needed to the next invoice.
Billed amount to itself if no payment is due: this process can identify if the group has been terminated after the invoice for the group has been created. In certain embodiments, the system automatically creates an invoice for the terminated group and adjusts the amount due based on the previous invoice. In certain embodiments, the system issues a final invoice for the terminated group showing net amount due, if any, or refunded.
Adjustment to adjustment: this process may reconcile invoice adjustments against each other. For example, if a payment late fee accrues but is later waived, in certain embodiments the system may automatically adjust (eliminate) the late fee. Another may involve reinstatement of an employer group termination and associated charging of a reinstatement fee. If such a fee were to then be waived, in certain embodiments the system may automatically reconcile the waived fee.
Certain embodiments of the benefits administration system provide a substantially improved ability to handle much larger data sets and to handle data more efficiently. In addition, certain embodiments utilize an independent platform and portable programming language such as Java. Preferably, the system components are built using object oriented programming concepts. Preferably, these object-oriented components can be reused in other applications with similar requirements or extended further with additional features when and wherever required. Preferably, the system is developed using scalable J2EE standards.
In certain embodiments, the system may allow a given user to work with the system in differing roles or capacities. For example, a manager may seek to perform the role of data entry as well as that of a manager or authorizing entity. In certain embodiments, the system allows modification or addition of user roles as desired. In certain embodiments, the CAS (Core Administration System) system is, however, pre-configured for a basic set of predefined roles.
In certain embodiments, the benefits administration may further provide one or more of the following aspects:

    
    
        a. selective issuance of notices to sub-groups meeting certain criteria;
        b. automated creation of a Cobra record from information in the system for a given beneficiary;
        c. automatic issuance of notice to a member prior to termination of the re-qualification period;
        d. automatic revision of employee status upon change of employee coverage;
        e. automatic issuance of notices when data is not entered correctly or completely, including issuance of other than on-screen notices to one or more system administrators or other entity;
        f. ability of a user to customize how the user may be provide notices or correspondence, such as by e-mail, mail, or facsimile; and
        g. enhanced carrier data maintenance within the system.
    
    


The system may be utilized by a benefits provider as part of it business and operation. Alternatively, the system may be utilized by a service provider, such as for or in connection with remuneration provided to the service provider by customers. For example, user fees may be provided by the users of the system, such as benefits providers or employers.
The system may also be utilized by an employer or group of employers, and their employees, to provide automated benefits administration for the employer or group of employers.
In certain embodiments, all features identified above may be provided by the system. The system may thereby provide an automated benefits administration and method of use of the system and doing business in conjunction with it.
The following sections include implementation details, detailed explanations and detailed illustrations of various aspects of embodiments of the present invention. These sections include:

    
    
        1. an architectural design specification, which proceeds with reference to FIGS. A-1 to A-3;
        2. a user manual concerning carrier maintenance, which proceeds with reference to FIGS. B-1 to B-88;
        3. a user manual concerning enrollment, which proceeds with reference to FIGS. C-1 to C-399;
        4. a user manual concerning finance, which proceeds with reference to FIGS. D-1 to D-62;
        5. a user manual concerning other features, which proceeds with reference to FIGS. E-1 to E-26;
        6. a user manual concerning sales and marketing, which proceeds with reference to FIGS. F-1 to F-106;
        7. a user manual concerning user administration, which proceeds with reference to FIGS. G-1 to G-66;
        8. a process specification for various use cases, which proceeds with reference to FIGS. H-1 to H-36;
        9. process specifications for COBRA enrollment, change management, ROE/OE processes, termination, reinstatement, appeals and grievances, association masters and carrier issues, which proceed with reference to FIGS. I-1 to I-77;
        10. process specifications for billing, cash receipt and cash reconciliation, and risk adjustment, which proceed with reference to FIGS. J-1 to J-8;
        11. a functional specification document concerning mail merge, which proceeds with reference to FIGS. K-1 and K-2;
        12. a process specification for reports, which proceeds with reference to FIGS. L-1 to L-3;
        13. process specifications for campaigns, sales masters, agent profiles and quote creation, which proceed with reference to FIGS. M-1 to M-53;
        14. process specifications for supply requests, workgroups, associates and call tracking, which proceed with reference to FIGS. N-1 to N-13;
        15. a process specification for security mechanisms, which proceeds with reference to FIGS. P-1 to P-38; and
        16. a process specification for common functional features.
    
    


Benefit Partners Inc
BPI
Software Architecture Document
Architectural Design Specification Document


    
    
        Document Id: BPI_CAS_ADS
        Version: <1.0>
    
    


1. Introduction
The Software Architecture Document will provide an overview of the entire “Software Architecture” that will be used to develop Web Interface Module for BPI.
1.1. Purpose
This document provides a comprehensive architectural overview of the system, using a number of different architectural views to depict different aspects of the system. It is intended to capture and convey the significant architectural decisions that have been made on the system.
1.2. Definitions, Acronyms and Abbreviations
Some of the common acronyms used in this document are as follows:














Abbreviations
Description









EJB
Enterprise Java Beans



HTML
Hypertext Markup Language



J2EE
Java 2 Enterprise Edition



JMS
Java Messaging Services



JNDI
Java Naming and Directory Interface



JSP
Java Server Pages



MVC
Model View Controller



W3C
World Wide Web Consortium



XML
Extensible Markup Language



BPI
Benefit Partners Inc










1.3. Overview
This Software Architecture Document, at high level, will contain:

    
    
        a. Architectural representation of proposed system
        b. Architectural goals
        c. Software requirement
        d. Software selection for the proposed system
        e. Standards and methodologies that will be adopted for the proposed system
    
    


2. Architectural Goals
These guidelines will lay a foundation for the design and implementation strategy, selection of development tools, application software, and testing tools. The basic goals of the architectural design are discussed below.
2.1. Portability
Java is a platform independent and portable language. Applications developed in Java are proven to be portable across popular platforms.
2.2. Distribution
The J2EE Standards will be adopted to develop the new application. J2EE standards demonstrate consistency of distributed applications that access various data sources.
2.3. Reusability
The components will be built using Object Oriented concepts. These object-oriented components can be reused in other applications with similar requirements or extended further with additional features when and wherever required.
2.4. Scalability
Applications developed using the J2EE Standards are proven to be scalable. Therefore, the system will be built in conformance with the J2EE Standards.
2.5. Performance
Identifying the latencies within the system and outside the system boundaries enables us to increase the performance of the application. Since most of the threading issues that lower the performance of an application are well handled within the Websphere application server, Websphere server's features and resources will be effectively utilized to achieve performance.
3. Architectural Representation of the Proposed System
The System will be developed based on the J2EE specification and follow the N-tier MVC architecture.
A tier is a logical partition of the separation of concerns in the system. Each tier is assigned its unique responsibility in the system.
J2EE specifications are multi tiered consisting of the Client Tier, Middle Tier (Presentation Layer, Business Layer, and Integration Layer), and the Data source. The J2EE architecture diagram is described below. (See FIG. A-1)
3.1. Client Tier
This tier represents all devices or system clients accessing the system or the application. In this case, the client would be a web browser or other application.
3.2. Middle Tier
The middle tier can be classified into multiple logical layers depending upon the business requirements and programming model. Three basic classifications are discussed below.
3.2.1. Presentation Layer
This tier encapsulates all presentation logic required to service the clients that access the system. The presentation tier intercepts the client requests, provides single sign-on, session management and accesses business services, constructs the response, and delivers the response to the client. Servlets, JSP, HTML reside in this tier.
3.2.2. Business Layer
This tier provides the business services required by the application clients. The tier contains the business data and business logic. All business processing for the application is centralized into this tier. The enterprise bean components are the choice for implementing the business objects in the business tier.
3.2.3. Integration Layer
This tier is responsible for communicating with external resources and systems, such as data stores and legacy applications. The business tier is coupled with the integration tier whenever the business objects require data or services that reside in the resource tier. The components in this tier can use JDBC, J2EE connector technology, or some proprietary middleware to work with the resource tier.
3.3. Data Source
This is the tier that contains the database and external resources such as legacy systems, business-to-business (B2B) systems, and services, such as, credit card authorization and EFT.
3.4. Framework
The following figure depicts the interaction model of a typical Model View Controller or the JSP Model 2 Architecture that is adopted in the Framework. (See FIG. A-2)
Here, the servlet acts as the controller and is in charge of processing the request and creating any objects of the beans used by the JSP. It also redirects, to the respective JSP, based on the Browser's request. There will be very minimal logic present in the JSP regarding the presentation. All the database access and program business logic will be processed within the bean.
There will be different beans for data source access (database, enterprise systems, queue, XML, etc.), error handling, access logging, and module wise application business logic processing. This clearly separates the presentation from the content and enables easy maintenance and scalability.
This model is the widely used and accepted model for application development in Java. This model is also adopted by Apache Struts framework for Java application development.
4. Software Selection for the Proposed System
This section provides an insight on the software selection for the various tiers depicted in this document.
4.1. Software Selection











Component
Software Name and Version







Operating System
Server/Client - Win NT/Win 2000


Browser
IE 5.5 and above


Client Side Scripting
HTML 4.0, Java Script 1.2


Server Side Programming
JSP 1.1, Java Servlets 2.2, JDK 1.3


Database Server
DB2 UBD Version V 7.3


Web Server
IBM HTTP Server V 1.3.19


Application Server
Websphere Application Server Advanced 



Edition Version 4.0


Report Server
Seagate Crystal Reports 8.5


Office Tools
Microsoft Office 2000 (select Word 2000, 



Excel 2000 and Outlook 2000 and Access 



2000), Post Script Printer, Adobe Acrobat 5.0


Servlet, Bean
Visual Age 4.0


Development



HTML, JSP, XML, etc.
Dream Weaver 4.0


Testing
JTest 4.5


Data Flow and Class
UML Studio


Design









4.2. API Versions












API Name
Version
Remarks







J2EE
Specification 1.2
Supported by Websphere




4.0


EJB
Specification 1.2
Supported by Websphere




4.0


JDK
JDK 1.2.2
Supported by Websphere




4.0


Servlet
Servlet 2.2
Supported by Websphere




4.0


JSP
JSP 1.1
Supported by Websphere




4.0


HTTP
HTTP/1.1
Stable W3C Specification









5. Standards and Methodologies
The standards and methodologies that will be followed for the application development are discussed below.
5.1. Design Document
Detailed design document will be prepared based on the scope of the application prior to the development. This document will contain the details on graphic user interface, navigation, class diagrams, data dictionary, field validation criteria, and program logic.
5.2. Bean Classification
The types of Java beans that will be used to perform different business logics will be decided during the design stage. The bean types will be classified based on the complexity of the business logic and the scalability.
5.3. Coding
A separate document will be prepared outlining the coding standards that will be adopted in the application development. The document will contain details on program naming conventions to be used while coding. All programs developed will follow this standard.
5.4. Testing
Test plan and test case documents will be prepared for unit and integration testing of the application. The test cases will be used to test the application modules and integration. JTest will be used for testing code construction (white-box testing), code functionality (black-box testing), and code integrity (regression testing).
5.5. Error Handling
All error messages and error codes for the application will be stored in the database. Run time errors will be logged to text files that will be generated periodically by the system. Input validations will occur in both the client tier and the middle tier. The input validation error messages captured in the client tier will be displayed using JavaScript alerts. The input validation error messages captured in the middle tier will be displayed in HTML format, on the same page on which the error has occurred, in a different color.
5.6. Page Design
A Page Design Guidelines document will be created by Mascon, and approved by BPI, prior to the development. All pages in the application will conform to the standards depicted in this document. This document will contain the specifications for fonts, layouts, images, and other relevant details.
5.7. Parameterization
Custom JSP tag libraries will be created for all initial values and parameters used in the application. JSP tag libraries define declarative, modular functionality that can be reused by any JSP page. Tag libraries reduce the necessity to embed large amounts of Java code in JSP pages by moving the functionality provided by the tags into tag implementation classes. In doing so, tag libraries make authoring JSP pages easier and modular.
6. System Architecture and Hardware Selection
This section provides the details of the system architecture with nodes, terminals and their placement within the respective zones.
6.1. Physical Architecture (See FIG. A-3)
6.2. Hardware Selection

















Current



#
Server
Base
Configuration
Software/Hardware




















1
Database
Intel Pentium
Intel XEO
1.
Windows 2000



Server
Processor, 
Processor

Advanced Server




2 CPU, HD 104
1 CPU
2.
IE 5.5 and above




GB, 2 GB 
HDD 34 GB
3.
IBM DB2 UDB




RAM, Raid 5
2 GB RAM

version 7.2.x





CPU 2.4 Ghz.




2
Application
Intel Pentium
Intel XEO
1.
Windows 2000



Server -
Processor, CPU
Processor

Advanced Server



Intranet
1, HD 18 GB, 2
1 CPU
2.
IE 5.5 and above




GB RAM
HDD 200 GB
3.
Websphere





2 GB RAM

Application Server





CPU 2.4 Ghz.

Advanced Edition







Version 4.0






4.
IBM DB2 UDB







version 7.2.x (For







WAS Repository)






5.
IBM HTTP Server







1.3.19






6.
Microsoft Office







2000 (select Word







2000, Excel 2000







and Outlook 2000







and Access 2000),







Post Script Printer,







Adobe Acrobat 5.0


3
Application
Intel Pentium
Not Available
1.
Windows 2000



Server -
Processor, CPU


Advanced Server



Internet
1, HD 18 GB, 2

2.
IE 5.5 and




GB RAM


Netscape 4.7 and







above






3.
Websphere







Application Server







Advanced Edition







Version 4.0






4.
IBM DB2 UDB







version 7.2.x (For







WAS Repository)






5.
Microsoft Office







2000 (select Word







2000, Excel 2000







and Outlook 2000







and Access 2000),







Post Script Printer,







Adobe Acrobat 5.0


4
Report 
Intel Pentium
Intel Processor
1.
Windows 2000



Server -
Processor, CPU
1 CPU

Advanced Server



Crystal
1, HD 18 GB, 2
HDD 17 GB
2.
IE 5.5 and above



Reports
GB RAM
2.3 GB RAM
3.
Seagate Crystal





CPU 1266 Mhz.

Reports 8.5






4.
Microsoft Office







2000 (select Word







2000, Excel 2000







and Outlook 2000







and Access 2000),







Post Script Printer,







Adobe Acrobat 5.0






5.
IIS for Crystal







reports


5
Web 
Intel Pentium
Not Available
1.
Windows 2000



Server -
Processor, CPU


Advanced Server



Internet
1, HD 18 GB, 2

2.
IE 5.5 and above




GB RAM

3.
IBM HTTP Server







1.3.19






4.
Microsoft Office







2000 (select Word







2000, Excel 2000







and Outlook 2000







and Access 2000),







Post Script Printer,







Adobe Acrobat 5.0









7. Browser Client Application Limitations and Work Around Solutions
The limitations of the Web Browser (thin client) based application, when compared to thick clients, are as follows:

    
    
        a. Input field masking, such as automatic date formatting and phone number formatting, are not easily handled in this environment. The thin client user interface is not as easy and robust as the thick client user interface. A work around must be designed to force the user to enter values in the required format.
        b. Due to the limitations of different browsers, a common methodology will be adopted that will work for all indicated browsers. This narrows down the user interface implementation features in a browser.
        c. Because of the lower level on interactivity, some actions that are presented entirely on one screen in the thick client may span multiple screens. Since each screen presentation involves a round trip to the server, this will result in slightly slower screen response when compared to the single screen approach. This can be minimized with some re-design of the user interface workflow, but overall, thin clients require more “clicks” than thick clients.
        d. Hot-keys validation scripts are cumbersome and take longer to download. Thus, hot-key functionality will be limited.
    
    


PX2 User Manual
Carrier Maintenance
1 Introduction
Carrier Maintenance is the master module that encompasses the process of creating and maintaining all master information that is required for the PX2 System like Master Plan, Carrier Master, Product Profile, Rate Administration and Carrier Maintenance operations like import and export utilities.
The Applications
The above-mentioned processes are accomplished in several applications embedded into the Carrier Maintenance Module. These applications steer the tasks of creating, and maintaining master information for the PX2 entities, thereby helping achieve the goals of the Carrier Maintenance.
Master Plan—Master plan is to setup high-level information from a broad spectrum of coverages, plan and benefits offered by PacAdvantage. This includes line of coverage like Medical, Dental Vision and Chiropractic, plan type like HMO, PPO, POS, indemnity etc. and benefit level like Standard, Preferred Plus etc.
Carrier Master—Carrier Master is to setup information on the carriers. This provides demographic information about the carrier.
Product Profile—Product Profile is the product or the plan offered by each carrier based on the broad spectrum of master plan provided by PacAdvantage. The product includes wide range of benefits provide by the carriers. For example Blue Shield—HMO, American Specialty Health Plan etc. This also includes information about premium and enrollment data transmission profiles of each carrier for the specific plan.
Rate Administration—Rate administration is to administer various rate and fees to calculate the premium amount. These different fees structures are classified as admin fees, agent fees, additional fees and differential factor.
Carrier Maintenance Operations—Various utility operations are performed for the maintenance of the Carrier Master Module. These utilities include import and export of data into or from the PX2 System. Various Carrier Maintenance operations are.
Import Zip Codes—is to upload all zip codes in the state of California or USA. This information would be used for rates calculation based on employee's zip code of residence.
Import and Export Rates—is to upload raw rates for all the plans and export the rates in the given formats.
Import and Export Plan Availability—is to upload the Plans available for the specific carrier in the specific service area/county/zip and export the plans available for the specific carrier in the specific Service area/county/zip in a given format.
2 Master Plan
MPlan (Master Plan) is to setup basic information like Line of Coverage, Plan Type, Benefit Level offered through PACAdvantage. All Benefit Level, Plan type and the line of coverage offered by PACAdvantage is available in the Master Plan.
Access
The application can be accessed from the main menu as follows:

    
    
        Carrier Maintenance→Master Plan→Line of Coverage.
        Carrier Maintenance→Master Plan→Plan Type.
        Carrier Maintenance→Master Plan→Benefit Level.
    
    


Pre-Requisites.
There are no pre-requisites for using this application.
Application Functions
This application has the following functions:

    
    
        Line of Coverage—to create, edit and delete Line of Coverage.
        Plan Type—to create, edit and delete Plan Type.
        Benefit Level—to create, edit and delete Benefit Level.
    
    


Line of Coverage

    
    
        The line of coverage screen is to enter the details of line of coverage (LOC). The screen provides functionality to add, modify, view, and delete line of coverage.
        The sequential steps involved in the creation of a line of coverage are listed below.
        
            Step—1: After successful logon, click the menu Carrier Maintenance. Select Master Plan and then Line of Coverage. (See FIG. B-1)
            Step—2: Enter the values in the respective field, as per the format briefed in field's explanation section. (See FIG. B-2)
            Step—3: Click Add button to have a temporary storage.
            Step—4: Also Edit button can be clicked for any modifications.
            Step—5: Change the contents to be modified and click Update. (See FIG. B-3)
            Step—6: Click Save button to save the contents.
        
        
    
    


Fields Explanation











Element
Description







Line of coverage
The text for line of coverage. Accepts alphabets and



numeric values of length not exceeding 20



characters. Entry to this field is mandatory. Line of



Coverage does not accept duplicate values









Button Functionality














Element
Description









Add
Add the name of line of coverage. It is only a




temporary addition. Becomes permanent record only




after saving



Edit
Edit button will allow for editing a specific record in




the table.



Update
Update the contents of line of coverage. It is only a




temporary updation. Becomes permanent record




only after saving



Delete
Delete button will delete the records in the table




checked for deletion. It is only a temporary deletion.




Only the records that does not have reference




elsewhere can be deleted. Becomes permanent




record only after saving



Print
The Print will pops up a screen displaying the




content of the table created and enables the user to




have print out of the same.



Check Box
Check box will be disabled which has any reference




to other fields. Otherwise the checkbox will be




enabled to have the utility of check all/clear all.



Check All
The “Check All” Link will check all the enabled




records in the table



Clear All
The “Clear All” Link will uncheck all the enabled




records in the table that are checked.



Save
Saves the entered line of coverage in the database.




The page gets refreshed and the contents entered in




the fields are cleared.



Cancel
Clears the contents entered in the fields and restore




to the previous state as was before saving the




changes.










Plan Type
The plan type screen is to enter the details of plan type. The screen provides functionality to add, modify, view, and delete plan type.
The sequential steps involved in the creation of a plan type are listed below.


    
    
        Step—1: After successful logon, click the menu Carrier Maintenance. Select Master Plan and then Plan Type. (See FIG. B-4)
        Step—2: Enter the values in the respective fields, as per the format briefed in fields' explanation section
        Step—3: Click Add button to have a temporary storage. (See FIG. B-5)
        Step—4: Also Edit button can be clicked for any modifications.
        Step—5: Change the contents to be modified and click update. (See FIG. B-6)
        Step—6: Click Save button to save the contents
    
    


Fields Explanation
Element Description


    
    
        The text for plan type. Accepts alphabets and numeric values of length not exceeding 25 characters. Entry to this field is mandatory. Does not accept duplicate values
    
    


Button Functionality














Element
Description









Add
Add the name of plan. It is only a




temporary addition. Becomes permanent




record only after saving



Edit
Edit button will allow for editing a




specific record in the table.



Update
Update the contents of Plan Type. It is




only a temporary update. Becomes permanent




record only after saving



Check Box
Check box will be disabled which has any




reference to other fields. Otherwise the




checkbox will be enabled to have the




utility of check all/clear all.



Delete
Delete button will delete the records in




the table checked for deletion. It is only




a temporary deletion. Only the records




that does not have reference elsewhere can




be deleted. Becomes permanent record only




after saving



Print
The Print will pops up a screen displaying




the content of the table created and




enables the user to have print out of the




same.



Check All
The “Check All” Link will check all the




enabled records in the table



Clear All
The “Clear All” Link will uncheck all the




enabled records in the table that are




checked.



Save
Saves the entered plan type in the




database. The page gets refreshed and the




contents entered in the fields are




cleared.



Cancel
Clears the contents entered in the fields




and restore to the previous state as was




before saving the changes.










Benefit Level
The Benefit Level screen is to enter the details of benefit level. The screen provides functionality to add, modify, view, and delete benefit level.
The sequential steps involved in the creation of a benefit level are listed below.

    
    
        Step—1: After successful logon, click the menu Carrier Maintenance. Select Master Plan and then Benefit Level. (See FIG. B-7)
        Step—2: Enter the values in the respective fields, as per the format briefed in fields' explanation section. (See FIG. B-8)
        Step—3: Click Add button to have a temporary storage.
        Step—4: Also Edit button can be clicked for any modifications.
        Step—5: Change the contents to be modified and click Update. (See FIG. B-9)
        Step—6: Click Save button to save the contents
    
    


Fields Explanation











Element
Description







Benefit level
The text for benefit level. Accepts alphabets and



numeric values of length not exceeding 255 characters.



Entry to this field is mandatory. Does not accept



duplicate values









Button Functionality











Element
Description







Add
Add the name of benefit level. It is only a temporary



addition. Becomes permanent record only after saving


Save
Saves the entered benefit level in the database. The



page gets refreshed.


Edit
Edit button will allow for editing a specific record in



the table.


Update
Update the contents of Benefit Level. It is only a



temporary update. Becomes permanent record only



after saving


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Only the records that does not have reference



elsewhere can be deleted. Becomes permanent record



only after saving


Print
The Print will pops up a screen displaying the content



of the table created and enables the user to have print



out of the same.


Check Box
Check box will be disabled which has any reference to



other fields. Otherwise the checkbox will be enabled to



have the utility of check all/clear all.


Check All
The “Check All” Link will check all the enabled records



in the table


Clear All
The “Clear All” Link will uncheck all the enabled



records in the table that are checked.


Cancel
Clears the contents entered in the fields and restore to



the previous state as was before saving the changes.









Related Applications
There are no related applications.
3 Carrier Master
Carrier Master is to setup basic information about carriers who provide coverage to plans offered through PACAdvantage. This holds master record for the carriers alternatively called “Health Insurance Service provider” and provides facility to create/edit or modify/inactivate the Carrier Master records.
Access
The application can be accessed from the main menu as follows:

    
    
        Carrier Maintenance→Carrier Master→Create Carrier Master
        Carrier Maintenance→Carrier Master→Search Carrier Master
    
    


Pre-Requisites
There are no pre-requisites for using this application.
Application Functions
This application has the following functions:

    
    
        Carrier Information—to input details of a carrier
        Search Carrier—to search a specific carrier record
    
    


Create Carrier Master
The carrier information screen is to enter details of a carrier. The screen provides functionality to add, modify, view, and delete carrier details.
The sequential steps involved in the creation of a new module are listed below.

    
    
        Step—1: After successful logon, click the menu Carrier Maintenance. Select Carrier Master and then Create Carrier Master. (See FIG. B-10)
        Step—2: Enter the values in the respective field, as per the format briefed in fields explanation section Field Explanation, and click Save button. (See FIG. B-11)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description















General Information








Company Name
The text for company name. Accepts alphabets,



numeric and special characters except double quotes



with values not exceeding 50 characters. Entry to this



field is mandatory. Company Name does not accept



duplicate values


Address
The text for company address. Accepts alphabets,



numeric and special characters except double quotes



with values not exceeding 35 characters. Entry to this



field is mandatory.


Suite
The text for company suite. Accepts alphabets,



numeric and special characters except double quotes



with values not exceeding 35 characters.


City
The text for city. Accepts alphabets not exceeding 30



characters. Entry to this field is mandatory.


State
Choose the name of the state from the drop down list



of States available in United States of America Entry



to this field is mandatory.


Zip
The text for zip. Accepts numeric of exactly 5 digits.



Entry to this field is mandatory.







Department Information








Contact
Choose the name of the contact department from the


Department
drop down list of contact departments available. Entry



to this field is mandatory


Salutation
Choose the salutation from the drop down list of



salutations available.


First Name
The text for contact first name. Accepts alphabets,



numeric and special characters except double quotes



with values not exceeding 25 characters.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for contact last name. Accepts alphabets,



numeric and special characters except double quotes



with values not exceeding 35 characters.


Suffix
Choose the suffix from the drop down list of suffixes



available.


Title
The text for title. Accepts alphabets, numeric, and



special characters except double quotes with values not



exceeding 255 characters.


Address
The text for company address. Accepts alphabets,



numeric and special characters except double quotes



with values not exceeding 35 characters. Entry to this



field is mandatory.


Suite
The text for company suite. Accepts alphabets,



numeric and special characters except double quotes



with values not exceeding 35 characters.


City
The text for city. Accepts alphabets not exceeding 30



characters. Entry to this field is mandatory.


State
Choose the name of the state from the drop down list



of States available in United States of America Entry



to this field is mandatory.


Zip
The text for zip. Accepts numeric of exactly 5 digits.



Entry to this field is mandatory.


Mode of
Choose the mode of communication from the drop


Communication
down list of modes available. Based on the selection,



the respective fields are mandatory.


Phone
The text for telephone number of the contact person.



Accepts numeric values not exceeding 10 digits. The



format is (999) 999-9999.


Fax
The text for fax number of the contact person. Accepts



numeric values not exceeding 10 digits. The format is



(999) 999-9999.


E-mail
The text for email of the contact person. Accepts



alphabets, numeric and special characters in the



standard email format with length not exceeding 100



characters.









Button Functionality
The following table provides explanation for each button in the screen.











Element 
Description







Save
Saves the carrier information, department information



if any that has been added to the table, into the



database. The page gets refreshed and the contents



entered in the general Information fields are shown.


Add
Add the contents of department information. It is only



a temporary addition. Becomes permanent record only



after saving


Edit
Edit button will allow for editing a specific record in



the table.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent record only after saving


Update
Update the contents of department information. It is



only a temporary update. Becomes permanent record



only after saving


Print
The Print will pops up a screen displaying the content



of the table created and enables the user to have print



out of the same.


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


New
New button will create a new carrier general info page



for entering the new set of data for the carrier.


Cancel
Clears the contents entered in the fields and restore to



the previous state as was before saving the changes.









Search Carrier
The search carrier screen displays the available carrier names. The screen provides the option to view, edit and delete the contents of Carrier Information.
The sequential steps involved in searching an existing carrier are listed below.

    
    
        Step—1: After successful logon, click the menu Carrier Maintenance. Select Carrier Master and then Search Carrier. (See FIG. B-12)
        Step—2: Company name has to be selected from the drop down list (See FIG. B-13)
        Step—3: Select either View/Delete or Edit to display the contents of selected company name. If the selected option is View/Delete, Displays the contents for viewing or deleting. (See FIG. B-14)
        Step—4: To go back again to search screen, click Back.
        Step—5: If the selected option is Edit, displays the contents and allows to modify.
        Step—6: Modifications can be made for both the general information, as well as department information. Also choosing a record by clicking Edit button can modify department information. (See FIG. B-15)
        Step—7: Change the contents to be modified and click Update.
        Step—8: Click Save button to save the contents.
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description















General Information








Company Name
The text for company name. Accepts alphabets,



numeric and special characters except double quotes



with values not exceeding 50 characters. Entry to this



field is mandatory. Company Name does not accept



duplicate values


Address
The text for company address. Accepts alphabets,



numeric and special characters except double quotes



with values not exceeding 35 characters. Entry to this



field is mandatory.


Suite
The text for company suite Accepts alphabets,



numeric and special characters except double quotes



with values not exceeding 35 characters.


City
The text for city. Accepts alphabets not exceeding 30



characters. Entry to this field is mandatory.


State
Choose the name of the state from the drop down list



of States available in United States of America.


Zip
The text for zip. Accepts numeric of exactly 5 digits.



Entry to this field is mandatory.







Department Information








Contact
Choose the name of the contact department from the


Department
drop down list of contact departments available.


Salutation
Choose the salutation from the drop down list of



salutations available.


First Name
The text for contact first name. Accepts alphabets,



numeric and special characters except double quotes



with values not exceeding 25 characters.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for contact last name. Accepts alphabets,



numeric and special characters except double quotes



with values not exceeding 35 characters.


Suffix
Choose the suffix from the drop down list of suffixes



available.


Title
The text for title. Accepts alphabets, numeric and



special characters except double quotes with values not



exceeding 255 characters.


Address
The text for company address. Accepts alphabets,



numeric and special characters except double quotes



with values not exceeding 35 characters. Entry to this



field is mandatory.


Suite
The text for company suite. Accepts alphabets,



numeric and special characters except double quotes



with values not exceeding 35 characters.


City
The text for city. Accepts alphabets not exceeding 30



characters. Entry to this field is mandatory.


State
Choose the name of the state from the drop down list



of States available in United States of America Entry



to this field is mandatory.


Zip
The text for zip. Accepts numeric of exactly 5 digits.



Entry to this field is mandatory.


Mode of
Choose the mode of communication from the drop


Communication
down list of modes available.


Phone
The text for telephone number of the contact person.



Accepts numeric values not exceeding 10 digits. The



format is (999) 999-9999.


Fax
The text for fax number of the contact person. Accepts



numeric values not exceeding 10 digits. The format is



(999) 999-9999.


E-mail
The text for email of the contact person. Accepts



alphabets, numeric and special characters in the



standard email format with length not exceeding 100



characters.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Save
Saves the carrier information, department information



if any that has been added to the table, into the



database. The page gets refreshed and the contents



entered in the general Information fields are shown.


Add
Add the contents of department information. It is only



a temporary addition. Becomes permanent record only



after saving


Edit
Edit button will allow for editing a specific record in



the table.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent record only after saving


Update
Update the contents of department information. It is



only a temporary update. Becomes permanent record



only after saving


Print
The Print will pops up a screen displaying the content



of the table created and enables the user to have print



out of the same.


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


New
New button will create a new carrier general info page



for entering the new set of data for the carrier.


Cancel
Clears the contents entered in the fields and restore to



the previous state as was before saving the changes.









Related Applications
There are no related applications.
4 Product Profile
Product Profile is to create information on Product and Plan pertaining to a carrier. This is also used to create transmission profiles for Enrollment and Premium. It facilities to create/Edit or modify carrier product information.
Access
The application can be accessed from the main menu as follows:

    
    
        Carrier Maintenance→Product Profile→Create Product Profile
        Carrier Maintenance→Product Profile→Search Product Profile
    
    


Pre-Requisites

    
    
        Master Plan records must be available in the system.
        Carrier Master records must be available in the system.
    
    


Application Functions

    
    
        This application has the following functions:
        
            Create Product Profile—to enter the information pertaining to a product and plan
            Search Product—to search a product and plan
        
        
    
    


Create Product Profile
The carrier product info screen is to add the information pertaining to a product and plan.
The sequential steps involved in the creation of carrier product information are listed below.

    
    
        Step—1: After successful logon, click Carrier Maintenance. Select Product Profile and then Create Product Profile. (See FIG. B-16)
        Step—2: Enter the values in the respective fields, as per the format briefed in field's explanation section. (See FIG. B-17)
        Step—3: The enrollment transmission is mainly meant for entering information and schedule for a transmission for a plan. Also Premium Transmission can be navigated from this screen. (See FIG. B-18)
        Step—4: The premium transmission is mainly meant for entering information and schedule for a transmission for a plan. Also Enrollment Transmission can be navigated from this screen (See FIG. B-19)
        Step—5: Click Save button to save the contents
    
    


Fields Explanation











Element
Description







Trans Id
Enter the value of trans id. Accepts numeric value of



exactly 3 digits. Once clicking save button creates a



trans id, it gets disabled not to modify the trans id.



This is mandatory field


Plan Name
Enter the text for plan name. Plan name accepts



alphanumeric and special characters except double



quotes with values not exceeding 50 characters. This is



mandatory field


Carrier Name
Choose the name of the carrier from the drop down list



of carrier names available. This is mandatory field


Plan ID
System generated field with Plan ID. This is a read



only field.


Line of 
Choose a name from the drop down list of line of


coverage
coverage available. This is mandatory field


Plan Type
Choose a name from the drop down list of plan type



available. This is mandatory field


Product 
Click the check box to enter the details of information


Required
pertaining to a product. By default, it will be



unchecked state. If this is unchecked then default



Benefit will be added in to the Product Info table



below.


Benefit level
Choose a name from the drop down list of benefit levels



available. This is mandatory field if Product Required



option is checked.


Product 
Enter the text for product name. The field is alphabets,


Name
numeric and special character except double quotes



with values not exceeding 60 characters. This is



mandatory field if Product Required option is checked.


Alternate 
Enter the text for product name. The field is alphabets,


Name
numeric and special character except double quotes



with values not exceeding 255 characters.







Enrollment Transmission








Plan Id
Read only field. System generated Plan ID.


Plan Name
Read only field. Displays the Plan Name.


Carrier 
Choose an option from the check box to have


requires
enrollment transmission. Upon selection of this, will


Enrollment
enable to enter details for transmission information


transmission
and transmission schedule. The field is mandatory


Data format
Choose a format from the drop down list of data



formats available.


Mode of
Choose a mode from the drop down list of modes


transmission
available. Upon selecting the mode, will enable the



carrier profile id for entering data. Only when the



selection is carrier's ftp, carrier URL, user id,



password fields will be enabled for entry.


Carrier 
Enter the text for carrier profile id. Accepts


profile id
alphanumeric of 10 digits only


Carrier URL
Enter the text for URL. Accepts a valid URL not



exceeding 60 characters.


Carrier User 
Enter the text for user id. Accepts alphanumeric value


Id
not exceeding 20 characters.


Carrier 
Enter the text for password. Accepts alphanumeric


Password
character not exceeding 20 characters.


Confirm file
Choose an option from the check box to have


required
confirmation file


Transmission
Choose a type of transmission from the drop down list


periodicity
for transmission periodicity. Upon the selecting the



value namely, hourly, daily, weekly, monthly



corresponding field will only be enabled for entry



others will get disabled.


Start time
Enter the time for start time in the format HH:MM.



Accepts only numeric values of 5 digits.


Days
Choose the days from the available checkboxes for the



days required for transmission. This field will be



enabled only upon if the selection is daily in the



transmission periodicity field.


Week day
Choose a weekday from the drop down list of weekdays



available. This field will be enabled only upon if the



selection is daily in the transmission periodicity field.


Day of month
Choose a day from the drop down list of days in a



month available. This field will be enabled only upon if



the selection is daily in the transmission periodicity



field.


Disable
Choose an option from the check box to have


transmission
transmission disabled.







Premium Transmission








Plan Id
Read only field. System generated Plan ID.


Plan Name
Read only field. Displays the Plan Name


Carrier 
Choose an option from the check box to have


requires
enrollment transmission. Upon selection of this, will


Enrollment
enable to enter details for transmission information


transmission
and transmission schedule. The field is mandatory


Mode of
Choose a mode from the drop down list of modes


transmission
available. Upon selecting the mode, will enable the



carrier profile id for entering data. Only when the



selection is carrier's ftp, carrier URL, user id,



password fields will be enabled for entry.


Carrier 
Enter the text for carrier profile id. Accepts


profile id
alphanumeric of 10 digits only


Carrier URL
Enter the text for URL. Accepts a valid URL not



exceeding 60 characters.


Carrier User 
Enter the text for user id. Accepts alphanumeric value


Id
not exceeding 20 characters.


Carrier 
Enter the text for password. Accepts alphanumeric


Password
character not exceeding 20 characters.


Confirm file
Choose an option from the check box to have


required
confirmation file


Transmission
Choose a type of transmission from the drop down list


periodicity
for transmission periodicity. Upon the selecting the



value namely, hourly, daily, weekly, monthly



corresponding field will only be enabled for entry



others will get disabled.


Start time
Enter the time for start time in the format HH:MM.



Accepts only numeric values of 5 digits.


Days
Choose the days from the available checkboxes for the



days required for transmission. This field will be



enabled only upon if the selection is daily in the



transmission periodicity field.


Week day
Choose a weekday from the drop down list of weekdays



available. This field will be enabled only upon if the



selection is daily in the transmission periodicity field.


Day of month
Choose a day from the drop down list of days in a



month available. This field will be enabled only upon if



the selection is daily in the transmission periodicity



field.


Disable
Choose an option from the check box to have


transmission
transmission disabled.









Button Functionality











Element
Description







Save
Click on save button to save contents of product



information and plan information.


Edit
Edit button will allow for editing a specific record in



the table.


Update
Update the contents of Product. It is only a temporary



update. Becomes permanent record only after saving


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Only the records that does not have reference



elsewhere can be deleted. Becomes permanent record



only after saving


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


New
Click on new button to add a new product and plan



information.


Cancel
Click on the cancel button to clear the data entered on



the screen and returns the same screen to proceed.







Enrollment and Premium Transmissions








Save
Click on save button to save contents of transmission



information.


Back
Click on back button will navigate back to carrier



product info screen.









Search Product
The search product screen is to view and edit/modify the information in an existing plan name. Choosing a plan name from the drop down list of plan names available can carry out the search.
The sequential steps involved in searching an existing product are listed below.

    
    
        Step—1: After successful logon, click the menu Carrier Maintenance. Select Product Profile and then Search Product. (See FIG. B-20)
        Step—2: Plan name has to be selected from the drop down list (See FIG. B-21)
        Step—3: Select either View/Delete or Edit to display the contents of selected plan name.
        If the selected option is View/Delete, displays the contents for viewing and deleting. (See FIG. 22) (See FIG.
        Step—4: To go back again to search screen, click Back.
        Step—5: If the selected option is Edit, displays the contents and allows to have modifications. Click Save. (See FIG. B-23)
    
    


Fields Explanation
Refer field explanations provided for Create Product Profile
Button Functionality
Refer Button Functionality explanations provided for Create Product Profile
Related Applications
Related applications are:

    
    
        Carrier Master
        Master Plan
    
    


5 Rate Administration
Rate Master is to setup basic information about various types of rates offered through PACAdvantage. Rates are the rates for the products offered by each carrier and their classification into various fee structures. The rates are classified as Admin Fees, Agent fees, Additional Fees and Rate Differential. These classifications are applied to the raw rate to arrive to the actual premium payable by group/member.
Access
The application can be accessed from the main menu as follows:

    
    
        Carrier Maintenance→Rate Administration→Admin Fees
        Carrier Maintenance→Rate Administration→Admin Fees Search
        Carrier Maintenance→Rate Administration→Agent Fees
        Carrier Maintenance→Rate Administration→Agent Fees Search
        Carrier Maintenance→Rate Administration→Additional Fees
        Carrier Maintenance→Rate Administration→Additional Fees Search
        Carrier Maintenance→Rate Administration→Rate Differential
        Carrier Maintenance→Rate Administration→Rate Differential Search
    
    


Pre-Requisites
Pre requisites for Rate Administrations are following:

    
    
        Association Master—Association master must be created and available in the system for assigning the rate for association groups.
        Association Acronym—Association acronym is to display the association name in an abbreviated form inside the table for display. A mapping file has to be configured to ensure that each Association ID/Association name is mapped with the Acronym name in the mapping file as in PX2 system.
    
    


The mapping file can usually be located in the following path:

    
    
        <config_root>/bpicas/assacyronym.xml
        Sample mapping
        <asst id=“0000000001”> Here goes the acronym name as defined by user</asst>
        asst id=Should have a valid association ID from the PX2 System.
        Acronym name should be edited in area shown in bold not exceeding 25 characters.
    
    


Application Functions
This application has the following functions:

    
    
        Admin Fees—to create/edit details of Admin Fees
        Admin Fees Search—to search the details of admin fee for view, modification or deletion
        Agent Fees—to create/edit details of Agent Fees
        Agent Fees Search—to search the details of Agent Fees for view, modification or deletion
        Additional Fees—to create/edit details of Additional Fees
        Additional Fees Search—to search the details of Additional Fees for view, modification or deletion
        Rate Differential—to create/edit details of Rate Differential
        Rate Differential Search—to search the details of Rate Differential for view, modification or deletion
    
    


Admin Fees
The admin fees screen is to enter the details of rate type, whether the rate classification is for enrollment or renewal, group type, association Ids for a chosen association only, Individual Member or Association Group for a guaranteed association, percentage premium, effective date, group level fees, and member level fees. The screen provides functionality to save, edit or add new admin fees. Admin fees is broadly defined for two types of rates, namely consolidated [blended] and unconsolidated [non-blended].
The sequential steps involved in the creation of admin fees are listed below.

    
    
        Step—1: After successful logon, click menu Carrier Maintenance. Select Rate Administration and then Admin Fees. (See FIG. B-24)
        Step—2: Enter the values in the respective fields, as per the format briefed in field's explanation section. (See FIG. B-25)
        Step—3: Click Save button to save the contents. (See FIG. B-26)
    
    


Fields Explanation











Element
Description







Rate Type
Choose the rate type from the option button. Rate type



can be either blended or non-blended. Blended rates



will allow for entering only percent premium based on



effective date for a specific group type. Non-blended



rates will allow for entering group level fees which



includes flat $ amount and member level fees which



includes flat $ amount for medical and dental, percent



premium for vision and cam [lines of coverage].


Enroll/Renew
Choose this option to create the admin fee for groups



during enrollment or renewal.


Group Type
Choose the group type from the drop down list of group



types available. Only group type of guaranteed



association would allow choosing individual member or



association groups.


Association 
Choose the association name from the drop down list of


Name
ids for the association available. Association name



would be enabled only if the group type has



guaranteed, endorsed, PEO's and chambers.


Member type
Choose the member type from the option buttons. Only



group type of guaranteed association would allow



choosing individual member or association groups



[member type].


Percentage
Enter the value for percentage premium. Accepts


Premium
numeric value in the range of 0 to 100 with decimal



points (example 99.99)


Effective Date
Enter the date or choose from the calendar icon. Date



accepts the format in MM/DD/YYYY.


Group Level 
Enter the value for group level fees. Accepts value in


Fees
the format of currency (example 999999999.99 or



99999999999)


Member Level 
Enter the value for member level fees. Accepts value in


Fees
the format of currency (example 999999999.99 or



99999999999) for fees in $ and accepts numeric value



in the range of 0 to 100 for fees in percentage.









Button Functionality











Element
Description







Save
Saves the entered admin fees in the database and



navigates to the confirmation page.


Cancel
Clears the contents entered in the fields and restore to



the previous state as was before saving the changes.


New Admin Fee
Navigates to admin fee screen for creating a new one









Admin Fees Search
The admin fees search screen displays the available admin fees. The screen provides the option to view, edit and delete the contents of Admin Fee
The sequential steps involved in the Searching for admin fees are listed below.

    
    
        Step—1: After successful logon, click menu Carrier Maintenance. Select Rate Administration and then Admin Fees Search. (See FIG. B-27)
        Step—2: Choose a rate type, Enrolled/Renew Status, group type, association name and effective date to have a search option. (See FIG. B-28)
        Step—3: This displays a screen with search result. (See FIG. B-29)
        Step—4: Choose a Rate type either to Modify or View/Delete.
        Step—5: If the option is Modify the following will be the screen to have any modifications. (See FIG. B-30)
        Step—6: Update the contents and click Save. Navigates to confirmation Screen (See FIG. B-31)
        Step—7: If the option is View/Delete the contents are displayed to view and delete (See FIG. B-32)
        Step—8: Clicking Delete will have the confirmation screen as follows. (See FIG. B-33)
    
    


Fields Explanation
Refer field explanations provided for Admin Fees
Button Functionality
Refer button functionality provided for Admin Fees
Agent Fees
The agent fees screen is to enter the details of rate type, group type, percentage of premium, effective date, group size like lower limit and upper limit with Amount and member level fees. The screen provides functionality to save, edit or add new admin fees. Agent fees is broadly defined for two types of rates, namely consolidated [blended] and unconsolidated [non-blended].
The sequential steps involved in the creation of agent fees are listed below.

    
    
        Step—1: After successful logon, click Carrier Maintenance.
    
    


Select Rate Administration and then Agent Fees. (See FIG. B-34)

    
    
        Step—2: Enter the values in the respective fields, as per the format briefed in field's explanation section. (See FIG. B-35)
        Step—3: Click Save button to save the contents. (See FIG. B-36)
    
    


Fields Explanation











Element
Description







Rate Type
Choose the rate type from the option button. Rate type



can be either blended or non-blended. Blended rates



will allow for entering only percent premium based on



effective date for a specific group type. Non-blended



rates will allow for entering group level fees which



includes group size lower limit, group size upper limit



flat $ amount and member level fees which includes



flat $ amount for medical and dental, percent premium



for vision and cam [lines of coverage]. Group size



lower limit should not be greater than the group size



upper limit.


Enroll/Renew
Choose this option to create the admin fee for groups



during enrollment or renewal.


Enrolled before
Check this field if the agent fees is for the groups


1997
enrolled before 1997.


Group Type
Choose the group type from the drop down list of group



types available. Only group type of guaranteed



association would allow choosing individual member or



association groups.


Association 
Choose the association name from the drop down list of


Name
names for the association available. Association name



would be enabled only if the group type has



guaranteed, endorsed PEO's and chambers.


Member type
Choose the member type from the option buttons. Only



group type of guaranteed association would allow



choosing individual member or association groups



[member type].


Percentage
Enter the value for percentage premium. Accepts


Premium
numeric value in the range of 0 to 100


Effective Date
Enter the date or choose from the calendar icon. Date



accepts the format in MM/DD/YYYY.


Group size 
Enter the value for group size lower limit. Accepts


lower limit
numeric values of maximum 3 digits. Lower limit



value should be less than the value of upper limit.


Group size 
Enter the value for group size upper limit. Accepts


upper limit
numeric values of maximum 3 digits. Upper limit



value should not be less than lower limit value.


Amount
Enter the value for group level fees. Enter the value



for group level fees. Accepts value in the format of



currency (example 999999999.99 or 99999999999)


Member Level 
Enter the value for member level fees. Accepts value in


Fees
the format of currency (example 999999999.99 or



99999999999) for fees in $ and accepts numeric value



in the range of 0 to 100 for fees in percentage.









Button Functionality











Element
Description







Save
Saves the entered agent fees in the database and



navigates to confirmation screen


Cancel
Clears the contents entered in the fields and restore to



the previous state as was before saving the changes.


New Agent Fee
Navigates to agent fee screen for creating a new one









Agent Fees Search
The agent fees search screen displays the available agent fees. The screen provides the option to view, edit and delete the contents of agent fee
The sequential steps involved in the searching admin fees are listed below.

    
    
        Step—1: After successful logon, click menu Carrier Maintenance. Select Rate Administration and then Agent Fees Search. (See FIG. B-37)
        Step—2: Choose a rate type, enroll/renew option, group type, association name and effective date to have a search operation. (See FIG. B-38)
        Step—3: This displays a screen with search result. (See FIG. B-39)
        Step—4: Choose a Rate type either to Modify or View/Delete.
        Step—5: If the option is Modify the following will be the screen to have any modifications. (See FIG. B-40)
        Step—6: Update the contents and click Save. On saving displays the confirmation screen. (See FIG. B-41)
        Step—7: If the option is View/Delete the contents are displayed to view and delete (See FIG. B-42)
        Step—8: Clicking Delete will have the confirmation screen as follows. (See FIG. B-43)
    
    


Fields Explanation
Refer field explanations provided for Agent Fees
Button Functionality
Refer button functionality provided for Agent Fees
Additional Fees
The additional fees screen is to enter the details of COBRA type, percentage of additional fees, effective date. The screen provides functionality to save, edit or add new additional fees. Additional fees is broadly defined for two types namely Cal COBRA and Federal COBRA.
The sequential steps involved in the creation of additional fees are listed below.

    
    
        Step—1: After successful logon, click Carrier Maintenance. Select Rate Administration and then Additional Fees. (See FIG. B-44)
        Step—2: Enter the values in the respective fields, as per the format briefed in field's explanation section. (See FIG. B-45)
        Step—3: Click Save button to save the contents. (See FIG. B-46)
    
    


Fields Explanation











Element
Description







Rate Type
Choose the rate type from the option button. Rate type



can be either Cal COBRA or Federal COBRA.


Percentage of
Enter the value for percentage premium. Accepts


Additional Fees
numeric value in the range 0 to 100.


Effective Date
Enter the date or choose from the calendar icon. Date



accepts the format in MM/DD/YYYY.









Button Functionality











Element
Description







Save
Saves the entered additional fees in the database and



navigates to confirmation screen.


Cancel
Clears the contents entered in the fields and restore to



the previous state as was before saving the changes.


New Additional Fee
Navigates to additional fee screen for creating a new



one









Additional Fees Search
The additional fees search screen displays the available additional fees. The screen provides the option to view, edit and delete the contents of additional fee
The sequential steps involved in the Searching additional fees are listed below.

    
    
        Step—1: After successful logon, click menu Carrier Maintenance. Select Rate Administration and then Additional Fees Search. (See FIG. B-47)
        Step—2: Choose Cal Cobra or Federal Cobra and enter Additional Fee % and Effective Date to have a search operation. (See FIG. B-48)
        Step—3: This displays a screen with search result. (See FIG. B-49)
        Step—4: Choose a Rate type either to have Modify or View/Delete.
        Step—5: If the option is Modify the following will be the screen to have any modifications. (See FIG. B-50)
        Step—6: Update the contents and click Save. Displays the confirmation screen (See FIG. B-51)
        Step—7: If the option is View/Delete the contents are displayed to view and delete (See FIG. B-52)
        Step—8: Clicking Delete will have the confirmation screen as follows. (See FIG. B-53)
    
    


Fields Explanation
Refer field explanations provided for Additional Fees
Button Functionality
Refer button functionality provided for Additional Fees
Rate Differential
The Rate Differential screen is to enter the details of New Business Enrollment or New Business Enrollment & Renewal, Group Size criteria, group size lower limit, group size upper limit, differential factor, and effective date. The screen provides functionality to save, edit or add new Rate Differential.
The sequential steps involved in the creation of Rate Differential are listed below

    
    
        Step—1: After successful logon, click Carrier Maintenance. Select Rate Administration and then Rate Differential. (See FIG. B-54)
        Step—2: Enter the values in the respective fields, as per the format briefed in field's explanation section. (See FIG. B-55)
        Step—3: Click Save button to save the contents. (See FIG. B-56)
    
    


Fields Explanation











Element
Description







Line of 
The field is a read only and will always have the value


coverage
as Medical.


Group size 
Enter the value for group size lower limit. Accepts


lower limit
numeric values of maximum 3 digits. Lower limit



value should be less than the value of upper limit.



Entry to this field is mandatory


Group size 
Enter the value for group size upper limit. Accepts


upper limit
numeric values of maximum 3 digits. Upper limit



value should not be less than lower limit value. Entry



to this field is mandatory


Differential 
Enter the value for differential factor. Accepts decimal


factor
values of positive integer with max of 6 digits, example



99.999. Differential factor cannot have zero or



negative values. Entry to this field is mandatory


Effective Date
Enter the date or choose from the calendar icon. Date



accepts the format in MM/DD/YYYY. Entry to this



field is mandatory


Applied For
Choose the option as new business enrollment or new



business enrollment and renewal


Group Size 
Choose the option as enrolled employee or eligible


Criteria
employee









Button Functionality











Element
Description







Save
Saves the entered Rate Differential in the database



and navigates to confirmation screen


Cancel
Clears the contents entered in the fields and restore to



the previous state as was before saving the changes.


New Rate
Navigates to rate differential fee screen for creating a


Differential Fee
new one









Rate Differential Search
The rate differential search screen displays the available Rate Differential. The screen provides the option to view, edit and delete the contents of Rate Differential
The sequential steps involved in the creation of Rate Differential are listed below.

    
    
        Step—1: After successful logon, click menu Carrier Maintenance. Select Rate Administration and then Rate Differential Search. (See FIG. B-57)
        Step—2: Choose the option for applicable for, group size criteria, group size lower and upper limit, differential factor and effective date to have a search operation. (See FIG. B-58)
        Step—3: This displays a screen with search result. (See FIG. B-59)
        Step—4: Choose a Rate type either to have Modify or View/Delete.
        Step—5: If the option is Modify the following will be the screen to have any modifications. (See FIG. B-60)
        Step—6: Update the contents and click Save. Displays confirmation screen (See FIG. B-61)
        Step—7: If the option is View/Delete the contents are displayed only to have view and delete can be done. (See FIG. B-62)
        Step—8: Clicking Delete will have the confirmation screen as follows. (See FIG. B-63)
    
    


Fields Explanation
Refer field explanations provided for Rate Differential
Button Functionality
Refer button functionality provided for Rate Differential
Related Applications
Related applications are as follows.

    
    
        Association Master—Refer User manual for Association Master.
    
    


6 Import Zip Codes
Import Zip Codes is the functionality to provide for import of zip code data and any updates of the same.
Access
The application can be accessed from the main menu as follows:

    
    
        Carrier Maintenance→CM Operations→Import Zip
    
    


Pre-Requisites
The latest zip code and zip code with multiple counties database from TPS Products and Services, Inc should be available for import. The format of the database files has to be either Comma Delimited ASCII (CSV) or Fixed Column ASCII, the 2 formats currently supported by PX2.
Application Functions
This application has the following functions:

    
    
        Import Zip Codes
        Commit Import of Zip Codes
    
    


Import Zip
Zip import will enable to bring the zip codes and zip counties in a specified format namely CSV ASCI [comma separated value] and Fixed position ASCII, which will transform the data in other format to these formats and will ease to read and store the data in database.
The sequential steps involved in importing a zip code are listed below.

    
    
        Step—1: After successful logon, click the menu Carrier Maintenance. Select CM Operations and then Import Zip. (See FIG. B-64)
        Step—2: Enter the values in the respective fields, as per the format briefed in field's explanation section. (See FIG. B-65)
        Step—3: Click Import button. (See FIG. B-66)
        Step—4: Click Commit button. (See FIG. B-67)
    
    


Fields Explanation











Element
Description







Import Id
Read only field to display import id value


Status
Read only field to display the status of import


Imported By
Read only field to display the user who imported the



files


Import Date
Read only field to display the import date


Committed By
Read only field.


Committed Date
Read only field to display the commit date.


Zip File Path
Enter the file path of zip file or select the path by



clicking browse button. The field is mandatory.


Zip File Format
Choose a format from drop down list for zip file 



format, which should match with selection of zip file. 



The field is mandatory.


Zip Counties 
Enter the file path of zip county or select the path by


File Path
clicking browse button. The field is mandatory.


Zip Counties 
Choose a format from drop down list for zip county


File Format
format, which should match with selection of zip



county. The field is mandatory









Button Functionality











Element
Description







New
Click on new button enables to have a new import of



files.


Import
Click on import button will perform the action of



importing the selected valid files temporally. Once an



import action is carried out, will enable the commit



button.


Search
Click on search button navigates to a screen to have a



search on entering Import id.


Commit
Initially commit button will be in disabled state. Once



an import activity is carried out, commit button will be



enabled to have a permanent storage in the selected



file formats.


View Import 
Click on view import log to have a pop up display


Log
showing the status of imported files


Hide Import 
Click on hide import log to hide the pop up display


Log
message.









Commit Import Zip Codes
Commit zip codes can also be done by searching an import id.
The sequential steps involved in committing an import id are listed below.

    
    
        Step—1: Click Search button to search an import id.
        Step—2: This opens up a new screen to displaying import id to search. (See FIG. B-68)
        Step—3: Import ids can be selected by either entering import id and clicking search button or Click an import id, which are imported and are not committed. Back button is to go back to search screen without selecting an import id for commit.
        Step—4: Screen navigates displaying the selected import id, enabling commit button. (See FIG. B-69)
        Step—5: Click Commit button.
        Step—6: Screen gets refreshed and displays the confirmation as committed in the status field. (See FIG. B-70)
    
    


Fields Explanation











Element
Description







Import Id
Read only field to display import id value


Status
Read only field to display the status of import


Imported By
Read only field to display the user who imported the



files


Import Date
Read only field to display the import date


Committed By
Read only field.


Committed Date
Read only field to display the commit date.


Zip File Path
Enter the file path of zip file or select the path by



clicking browse button. The field is mandatory.


Zip File Format
Choose a format from drop down list for zip file 



format, which should match with selection of zip file. 



The field is mandatory.


Zip Counties 
Enter the file path of zip county or select the path by


File Path
clicking browse button. The field is mandatory.


Zip Counties 
Choose a format from drop down list for zip county


File Format
format, which should match with selection of zip



county. The field is mandatory









Button Functionality











Element
Description







New
Click on new button enables to have a new import of



files.


Import
Click on import button will perform the action of



importing the selected valid files temporally. Once an



import action is carried out, will enable the commit



button.


Search
Click on search button navigates to a screen to have a



search on entering Import id.


Commit
Initially commit button will be in disabled state. Once



an import activity is carried out, commit button will be



enabled to have a permanent storage in the selected



file formats.


View Import Log
Click on view import log to have a pop up display



showing the status of imported files


Hide Import Log
Click on hide import log to hide the pop up display



message.


Back
Click back button to go back to the search screen.









Related Applications
There is no related application.
7 Rate Files
Import Rates provides for import of rates information received from PacAdvantage and export of rates information to carriers for verification.
Access
The application can be accessed from the main menu as follows:

    
    
        Carrier Maintenance→CM Operations→Import Rate Files
        Carrier Maintenance→CM Operations→Export Rate Files
    
    


Pre-Requisites
Before importing rate files, a mapping file has to be configured to ensure that each plan/product listed in the rate file has an entry in the mapping file and is mapped to the corresponding plan id/product id as in PX2 system.
The mapping file can usually be located in the following path:

    
    
        <config_root>/bpicas/ec/conf/DataMap.xml
        Here <config_root> refers to the root directory where all configuration files required for PX2 system are placed. Ask for your System Administrator's assistance in locating the configuration root in the system in which PX2 is installed.
        Open the mapping file using any standard text editors (e.g. Notepad). In the file you will be able to locate entries like
        <productId keyName=“1,AETNA,HMO,PLUS” keyValue=“PL001-02,PL001”/>
        These are the entries that establish the mapping between plan/product listed in the rate file and the corresponding plan id/product id as in PX2 system.
        The entries have a format like this
        
            <productId keyName=
            “<LOC_CODE>,<PLAN_NAME,<PLAN_TYPE>,<COPAY>” keyValue=
            “<PX2_PRODUCT_ID>,PX2_PLAN_ID”/>
            where
        
        
        LOC CODE is a codification for the line of coverage; 1 stands for Medical, 2 for Dental, 3 for Vision and 4 for CAM
        PLAN_NAME is the name of the plan as in the Excel file; this usually corresponds to the value of the 1st column in the Excel sheet
        PLAN_TYPE is the type of plan; whether HMO, PPO, POS etc; this usually corresponds to the value of the 2nd column in the Excel sheet; an exception is the worksheet for CAM which doesn't have a plan type
        COPAY is the copay option of the plan; whether Standard, Plus or Preferred; this usually corresponds to the value of the 3rd column in the Excel sheet; an exception is the worksheet for CAM which has this information in the 2nd column
        PX2_PRODUCT_ID is the product id that corresponds to the product id in the excel sheet
        PX2_PLAN_ID is the plan id that corresponds to the plan id in the excel sheet
        If required, suitably modify these entries to ensure that a correct mapping has been established between the plan/products in the Excel sheet to the plans/products in PX2 system. After modifying, save and close the mapping file.
    
    


Application Functions

    
    
        This application has the following functions:
        
            Import Rates
            Export Rates
        
        
    
    


Import Rate

    
    
        Rate import will enable to import the files pertaining to medical, dental, vision, CAM with effective date. Rate export can also be navigated from this screen.
        
            The sequential steps involved in importing a rate are listed below.
            
                Step—1: Before start of importing, open the rates file (.xls) in Microsoft Excel. Rates for all the 4 line of coverage, namely Medical, Dental, Vision and CAM would be available in the Excel as 4 separate worksheets. Switch to Medical worksheet. Save the work sheet in “Comma-delimited” format using the File, Save As menu. Repeat this procedure for Dental, Vision and CAM worksheets. All these 4 CSV files will be used for rates import.
                Step—2: After successful logon, click the menu Carrier Maintenance. Select CM Operations and then Import Rate Files. (See FIG. B-71)
                Step—3: Enter the values in the respective fields, as per the format briefed in field's explanation section. (See FIG. B-72)
                Step—4: Import ids can be either entered directly or can be chosen by clicking search button. Respective file paths can be selected by clicking browse button. Click import button. Following is the screen shot showing the status after entering all the fields (See FIG. B-73)
            
            
        
        
    
    


Fields Explanation











Element
Description







Import Id
Read only field to display import id value


Status
Read only field to display the status of import


Imported By
Read only field to display the user who imported the



files


Import Date
Read only field to display the import date


Medical file path
Enter the file path of medical file or select the path by



clicking browse button. If the status is imported or not



imported this fields would not be editable. At least one



file path is required


Dental file path
Enter the file path of dental file or select the path by



clicking browse button. If the status is imported or not



imported this fields would not be editable. At least one



file path is required


CAM file path
Enter the file path of CAM file or select the path by



clicking browse button. If the status is imported or not



imported this fields would not be editable At least one



file path is required.


Vision file path
Enter the file path of vision file or select the path by



clicking browse button. If the status is imported or not



imported this fields would not be editable. At least one



file path is required


Effective Date
Enter the date or choose from the calendar icon. Date



accepts the format in MM/DD/YYYY. The field is



mandatory









Button Functionality











Element
Description







New
Click on new button enables to have a new import of



files.


Import
Click on import button will perform the action of



importing the selected valid files to have a permanent



storage in the selected file formats.


Search
Click on search button navigates to a screen to have a



search on entering Import id.


View Import Log
Click on view import log to have a pop up display



showing the status of imported files


Hide Import Log
Click on hide import log to hide the pop up display



message.


Back
Click back button to go back to the import screen









Export Rate Files
Rate export will enable to export a product from selecting a product id by clicking product search icon. Rate import can also be navigated from this screen.
The sequential steps involved in rates export are listed below.

    
    
        Step—1: After successful logon, click the menu Carrier Maintenance. Select CM Operations and then Export Rate Files (See FIG. B-74)
        Step—2: Enter the values in the respective fields, as per the format briefed in field's explanation section. (See FIG. B-75)
        Step—3: Export ids can be selected by either entering export id and clicking search button or Click an export id. Back button is to go back to export screen without selecting an export id for commit (See FIG. B-76)
        Step—4: Click Export button. (See FIG. B-77)
        Step—5: Click Ok to download the file. (See FIG. B-78)
    
    


Fields Explanation











Element
Description







Export Id
Read only field to display export id value


Status
Read only field to display the status of export


Exported By
Read only field to display the user who exported the



files


Export Date
Read only field to display the export date


Product Id
Read only field. Choose a product id by clicking the



product id search icon


Product Name
Read only field. Displays the corresponding value of



the product id selected.


Effective Date
Enter the date for effective date or select a date by



clicking calendar icon. The field is mandatory. Date



accepts the format in MM/DD/YYYY









Button Functionality











Element
Description







New
Click on new button enables to have a new export of a



product id.


Export
Click on export button will perform the action of



exporting the selected product id. Once it is exported,



export button will be in a disabled state. For any



further export of files, click on new button


View Export Log
Click on view export log to have a pop up display



showing the status of exported files


Hide Export Log
Click on hide export log to hide the pop up display



message.


Search
Click on search button navigates to a screen to have a



search on entering product id.


Back
Click back button to go back to the search screen









Export Loaded Rate Files
Export loaded rate files will enable to know the status of the selected files for export.
The sequential steps involved in export loaded rate files are listed below.

    
    
        Step—1: After successful logon, click the menu Carrier Maintenance. Select CM Operations and then Export Rate Files (See FIG. B-79)
        Step—2: Screen navigates to Export Loaded Rates. (See FIG. B-80)
        Step—3: Enter Effective date and other related fields as per the format briefed in fields' explanation table
        Step—4: Click Export button.
        Step—5: Click Search to know the status of the export id generated. (See FIG. B-81)
        Step—6: Click back to go back to Export Imported Rate File screen.
    
    


Fields Explanation











Element
Description







Export Id
Read only field to display export id value


Status
Read only field to display the status of export


Exported By
Read only field to display the user who exported the



files


Export Date
Read only field to display the export date


Effective Date
Enter the date for effective date or select a date by



clicking calendar icon. The field is mandatory. Date



accepts the format in MM/DD/YYYY


Product Id
Read only field. Choose a product id by clicking the



product id search icon


Line of Coverage
Choose a line of coverage from the drop down list



available


Rate Type
Choose a rate type either from the available option say



Blended or Non-Blended


RAF
Based on the selected value, RAF will be enabled for



entering. Accepts numeric value.


Agent Fee
Text for agent fee. Accepts numeric values ranging



from the values of 0-100


Admin Fee
Text for admin fee. Accepts numeric values ranging



from the values of 0-100


CAL Cobra Fee
Text for CAL Cobra fee. Accepts numeric values



ranging from the values of 0-100


Product Name
Read only field. Displays the corresponding value of



the product id selected.









Button Functionality











Element
Description







New
Click on new button enables to have a new export of a



product id.


Export
Click on export button will perform the action of



exporting the selected product id. Once it is exported,



export button will be in a disabled state. For any



further export of files, click on new button


View Export Log
Click on view export log to have a pop up display



showing the status of exported files


Hide Export Log
Click on hide export log to hide the pop up display



message.


Search
Click on search button navigates to a screen to have a



search on entering product id.


Back
Click back button to go back to the search screen









Related Applications
Related applications are:

    
    
        Product Profile
    
    


8 Plan Availability Files
Plan Availability is to provide for export & import of existing plan availability data to carriers and import of plan availability data received from carriers.
Access
The application can be accessed from the main menu as follows:

    
    
        Carrier Maintenance→CM Operations→Import Plan Availability
        Carrier Maintenance→CM Operations→Export Plan Availability
    
    


Pre-Requisites
The plan for which data has to be imported/exported should have already been defined in the PX2 system.
The format for records in the import file is shown below:

    
    
        [00539]<COUNTY_NAME><TAB><COUNTY_CODE><TAB><ZIP_CODE><TAB>
        <RATING_REGION><TAB><AVAILABLE_FLAG>
        where
        TAB denotes a single TAB character
        COUNTY_NAME is county name
        COUNTY_CODE is the 5-character county code comprising 2-character state+3-character county code (FIPS code)
        ZIP_CODE is the 5-digit zip code
        RATING_REGION is the 2-character rating region
        AVAIL_FL indicates whether the plan is available at the specific zip code (and county) or not; a value of X indicates availability and a blank value indicates non-availability
    
    


Application Functions
This application has the following functions:

    
    
        Import Plan Availability
        Export Plan Availability
    
    


Import Plan Availability

    
    
        Plan availability import will enable to import a file under a plan type. Also Plan availability export can be navigated from this screen.
        The sequential steps involved in importing plan availability data are listed below.
        
            Step—1: After successful logon, click the menu Carrier Maintenance. Select CM Operations and then Import Plan Availability. (See FIG. B-82)
            Step—2: Enter the values in the respective fields, as per the format briefed in field's explanation section. (See FIG. B-83)
            Step—3: Click Import button
            Step—4: Also import id for plan availability can be selected by clicking search button. This leads to a screen displaying import ids. Click it to select an id (See FIG. B-84)
        
        
    
    


Fields Explanation











Element
Description







Import Id
Read only field to display import id value


Status
Read only field to display the status of import


Imported By
Read only field to display the user who imported the



files


Import Date
Read only field to display the import date


Plan
Choose a plan from the drop down list from the plan



name available


Import File
Enter the file path or select the path by clicking



browse button. The field is mandatory


Effective Date
Enter the date for effective date or select a date by



clicking calendar icon. The field is mandatory. Date



accepts the format MM/DD/YYYY









Button Functionality











Element
Description







New
Click on new button enables to have a new import of



plan availability.


Import
Click on import button will perform the action of



importing the selected valid to have a permanent



storage in the selected file formats.


Search
Click on search button navigates to a screen to have a



search on entering Import id.


View Import Log
Click on view import log to have a pop up display



showing the status of imported files


Hide Import Log
Click on hide import log to hide the pop up display



message.


Back
Click back button to go back to the import screen









Export Plan Availability

    
    
        Plan availability export will enable to import a file under a plan type. Also Plan availability import can be navigated from this screen.
        The sequential steps involved in exporting plan availability are listed below.
        
            Step—1: After successful logon, click the menu Carrier Maintenance. Select CM Operations and then Export Plan Availability (See FIG. B-85)
            Step—2: Enter the values in the respective fields, as per the format briefed in field's explanation section. (See FIG. B-86)
            Step—3 Also export id for plan availability can be selected by clicking search button. This leads to a screen displaying export ids. Click an id to select (See FIG. B-87)
            Step—4: Click Export button.
            Step—5: Click Ok to download the file. (See FIG. B-88)
        
        
    
    


Fields Explanation











Element
Description







Export Id
Read only field to display export id value


Status
Read only field to display the status of export


Exported By
Read only field to display the user who exported the



files


Export Date
Read only field to display the export date


Plan
Choose a plan from the drop down list from the plan



name available


Effective Date
Enter the date or choose from the calendar icon. Date



accepts the format in MM/DD/YYYY.



Field is mandatory









Button Functionality











Element
Description







New
Click on new button enables to have a new export of



plan availability.


Export
Click on export button will perform the action of



importing the selected valid plans. Once it is exported,



export button will be in a disabled state. For any



further export of plans, click on new button


View Export Log
Click on view export log to have a pop up display



showing the status of exported plans


Hide Export Log
Click on hide export log to hide the pop up display



message.


Search
Click on search button navigates to a screen to have a



search on entering export id.


Back
Click back button to go back to the search screen









Related Applications
Related applications are:

    
    
        Product Profile
    
    


PX2 User Manual
Enrollment
1 Introduction
Enrollment is the transaction module that encompasses the process of creating and maintaining all information about the groups and Members who participate in the PacAdvantage program. The enrollment module within PX2 system is classified broadly into following transactions to accommodate the business rules. They are New Business Enrollment, COBRA enrollment, Add-On and Changes, ROE/OE, Termination and Reinstatement, Appeals and Grievance and Carrier Issues and Enrollment Operations.
The Applications
The above-mentioned processes are accomplished in several applications embedded into the Enrollment Module. These applications steer the tasks of creating, and maintaining operational information for the small employer groups, employee, dependent and members like individual association member, COBRA member etc in the PX2 entities, thereby helping achieve the goals of the Enrollment.
The basic process of enrollment can be sub divided into following applications.
Association—Association is to setup high-level information associations within the State of California who can participate in the PacAdvantage program. They are classified as Guaranteed, Endorsed, PEO's or Chambers with each association having a set of business rules to participate in the PacAdvantage program.
New Business Enrollment—New Business Enrollment is the process of Enrolling the Employer Group and members to the PacAdvantage program. The groups and members who can participate in the program are Small Employer Group with employees and dependent, Association Groups with employees and dependents and individual members with dependents. Each group and member must qualify the eligibility rules as applicable to participate in the PacAdvantage program.
COBRA Enrollment—COBRA enrollment is the process of enrolling the members for COBRA coverage. California State laws and federal laws govern COBRA Rules based on whether it is Cal COBRA or Federal COBRA. COBRA eligibility and the coverage are governed by set of California State laws and federal laws. COBRA enrollment can be further sub divided into two streams. Namely, Enrollment of New Business COBRA wherein the Group enrolling with the program bring in their COBRA members also to participate in the program. Existing COBRA Enrollment wherein the members terminated from the existing groups are enrolled as COBRA group/member.
Add-On—Add-On is the process of adding new members like employee and dependents to the existing groups and employees respectively. Add-On process has business rules attached based on which the Add-On process is either accepted or denied.
Changes—Changes are the process of accommodating the changes that the group and or member sought during their participation in the PacAdvantage program. Change process has business rules attached based on which the Change process is either accepted or denied.
ROE/OE—ROE (Re-qualification and open enrollment) is the process of Re-qualifying the Group and Members on their anniversary. Once a year, on the anniversary date of a group's enrollment in PacAdvantage, the group's participation, contribution and qualification is reviewed. This review is to ensure that the group meets the qualification requirement. The main objective of this process is to review these criteria and re qualify as needed, notify them of rate changes and provide an opportunity for employees of the group to make changes to their enrollment.
OE (Open Enrollment) is the process during the anniversary of the group wherein the group has the privilege to make the changes to the plan, waiting period etc that were earlier not open for changes.
Termination and Reinstatement—Termination is the process of terminating the Groups and or members from the PacAdvantage program due to various reasons governed by business rules. The reasons for termination can be non-payment of premium, group's request for termination etc. Reinstatement is the process of revoking the terminated groups and or members based on the reasons governed by business rules. The reasons for reinstatement can be Premium paid through, processing error etc.
Appeals and Grievances—Appeals and Grievance is the process of maintaining a status for all Appeals and Grievances received from the customer and follow up with the decision made either by PacAdvantage-Roseville or PacAdvantage-SF.
Carrier Issues—Carrier Issues is the process of maintaining a status for all Carrier Issues received from the customer and follow up with the carrier for resolution and inform the customer of resolution.
Enrollment Operation—Enrollment operation is the process of generating out data for transmission of enrollment date. This consists of Member Data Transmission, Enrollment Data Transmission, PacAdvantage Transmission, ROE/OE Transmission
2 Association
Association is the master module that encompasses the process of creating and maintaining all master information that is required for maintaining the Association information in the PX2 System.
Associations are basically a body of groups/members representing certain types of associations within the State of California. Association Groups and Association Members can participate in the PacAdvantage program similar to small employer groups or members. Associations are classified as Guaranteed, Endorsed, PEO's or Chambers. Each of the associations classified have specific business rules when participating in PacAdvantage program
Access
The application can be accessed from the main menu as follows:

    
    
        Enrollment→Association→Create Association
        Enrollment→Association→Modify Association
    
    


Pre-Requisites
There are no pre-requisites for using this application.
Application Functions
This application has the following functions:

    
    
        Create Association—to input details of a association
        Modify Association—to search a specific association record
    
    


Create Association
The create association screen is to enter details of an association. The screen provides functionality to save, edit or add new association details.
The sequential steps involved in the creation of a new association are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment. Select Association and select the option Create Association. (See FIG. C-1)
        Step—2: Enter the values in the respective field, as per the format briefed in fields' explanation section Field Explanation, and click Continue button. (See FIG. C-2)
        Step—3: Screen navigates to coverage information with auto generated association id. Choose relevant information pertaining to coverage and click Continue button. (See FIG. C-3)
        Step—4: Screen navigates to other information. (See FIG. C-4)
        Step—5: For internal work group click search icon. This pops up a screen to select internal work group.
        Step—6: Click on any internal work group for selection. (See FIG. C-5)
        Step—7: After filling the relevant information for other information and special handling as per the format briefed in fields' explanation section, click Continue button
        Step—8: Screen navigates to confirming successful creation of an association. (See FIG. C-6)
    
    


Fields Explanation

    
    
        The following table provides explanations for each of the screen fields.
    
    













Element
Description















General Info Tab








Association 
The text for association name. Accepts alphanumeric


Name
and special characters not exceeding 60 characters.



Entry to this field is mandatory.


Association 
Choose a type of association from the drop down list.


Type
Entry to this field is mandatory


Street Address
The text for association address. Accepts alphanumeric



and special characters not exceeding 35 characters.



Entry to this field is mandatory


Suite #
The text for suite #. Accepts alphanumeric and special



characters not exceeding 35 characters. Entry to this



field is mandatory


City
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters. Entry to this



field is mandatory


State
Choose the name of the state from the drop down list



of States available in United States of America. Entry



to this field is mandatory


Zip
The text for zip. Accepts numeric of either 5 or 9



digits. Entry to this field is mandatory


Salutation
Choose the salutation from the drop down list of



salutations available. Entry to this field is mandatory


First Name
The text for first name. Accepts alphabets and special



character like hyphen and single quotes not exceeding



25 characters. Entry to this field is mandatory


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for Last name. Accepts alphabets and special



character like hyphen and single quotes not exceeding



35 characters. Entry to this field is mandatory


Suffix
Choose the suffix from the drop down list of suffixes



available.


Phone
The text for telephone number of the contact name.



Accepts numeric values not exceeding 10 digits. The



format is (999) 999-9999. Entry to this field is



mandatory


Extension
The text for telephone extension number. Accepts



numeric values not exceeding 5 digits. The format is



9999


Fax
The text for fax number of the contact name. Accepts



numeric values not exceeding 10 digits. The format is



(999) 999-9999. Entry to this field is mandatory


E-mail
The text for email of the contact name. Accepts



alphabets, numeric and special characters in the



standard email format of length not exceeding 100



characters.







Coverage Info Tab








Association ID
Text for association id. This is a read only field


Association 
Text for association name. This is a read only field


Name



Line of 
Choose the line of coverage offered by the association


Coverage
by checking the check box/boxes.


Domestic 
Choose yes or no to state if domestic partner coverage


Partner
is offered.


Coverage Rate 
Choose yes or no to state the rate type (Blended or Non


Type
Blended)







Other Info








Association ID
Text for association id. This is a read only field


Association 
Text for association name. This is a read only field


Name



Internal Work
Choose a internal work group by clicking search icon


Group



Membership 
Select a value for membership status from the drop


Status
down list Values can be active, closed, frozen.


Contract Date
Choose a date of contract by clicking calendar icon.



The date can be in the format MM/DD/YYYY


Association Re-
The text for re-qualification period. Accepts numeric


qualification 
values not exceeding 2 digits. The value states number


Period
of months for Association Re-qualification Period


Batch Billing
Choose the option of batch billing if the association if



preferred by association.


Desired 
Choose the option to have name of association on the


Association
bill if preferred by association.


Name on the Bill









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    
















Element
Description









Continue
Saves the entered information and navigates to next




level. The flow screen is from general info to coverage




info then to other info. Screen flow should start from




general info. Switchover in between the screens is




possible only if clicking the Continue button saves the




first screen “General Info”.



Cancel
Cancel the contents entered in the fields and restore




to the previous state as was before saving the changes.










Modify Association
The modify association enables to modify the contents of an existing association. Alternatively you can also modify the record for the association by clicking the “Search Icon” for selecting the Association name or ID for modification when in create mode.
The sequential steps involved in modifying an existing association are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment. Select Association and select the option Modify Association. (See FIG. C-7)
        Step—2: Association name has to be selected from the drop down list or association id has to be entered for selecting an association. (See FIG. C-8)
        Step—3: Modify the values in the respective field, as per the format briefed in fields explanation section Field Explanation, and click Continue button. (See FIG. C-9)
        Step—4: Screen navigates to coverage information for any modifications. Modify relevant information pertaining to coverage and click Continue button. (See FIG. C-10)
        Step—5: Screen navigates to other information. (See FIG. C-11)
        Step—6: For internal work group click search icon. This pops up a screen to select internal work group. (See FIG. C-12)
        Step—7: Click on any internal work group for selection.
        Step—8: After modifying the information of other information and special handling as per the format briefed in field's explanation section, click Continue button
        Step—9: Screen navigates to confirming successful creation of an association. (See FIG. C-13)
        Step—10: If the option is Inactivate and confirming the inactivation, the following screen appears. (See FIG. C-14)
    
    


Fields Explanation
Refer field explanation provided for create association. In case of modify association, either association id can be entered or association name can be selected from the drop down list. In case of association id, it accepts alphanumeric values. The difference in modify mode the data available is populated for making modifications, if required.
Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Modify
Clicking the Modify Button navigates to the General



Info screen populating the records for the association



name selected or association ID entered.


Inactivate
Clicking the Inactivate button would inactivate the



records for the association name selected or association



ID entered.


Continue
Saves the entered information and navigates to next



level. The flow from general info to coverage info then



to other info. Screen flow should start from general



info. Switchover in between the screens is possible only



if the first screen “General Info” is saved by clicking



the Continue button or if the mode is Modify.


Cancel
Cancel the contents entered in the fields or restore to



the previous state as was before saving the changes.









Related Applications
There is no related application.
3 New Business Enrollment
New Business Enrollment is the transaction module that encompasses the process of enrolling and maintaining all information that is required for various entities that are eligible to participate in the PacAdvantage program in the PX2 System. This module captures all the relevant information required to enroll a group and members to the program. The group and member must satisfy certain eligibility criteria to enroll themselves.
Various groups and members are classified as “Small Employer Group with employees and their dependents, Association Group (Groups affiliated to an associations) with employees and their dependents, Individual Member (Members affiliated to an association) with or without dependents.
Access
The application can be accessed from the main menu as follows:

    
    
        Enrollment→New Business Enrollment
        →Group Enrollment
        
            →Create New Group
            →Modify Group
            →Inactivate Group
        
        
        →Employee Enrollment
        
            →Create Employee
            →Modify Employee
            →Inactivate Employee
        
        
        →Dependent Enrollment
        
            →Create Dependent
            →Modify Dependent
            →Inactivate Dependent
        
        
        →Individual Member
        
            →Individual Member
            →Modify Individual Member
            →Inactivate Individual Member
        
        
        Individual Member Dependent
        
            →Create Dependent
            →Modify Dependent
            →Inactivate Dependent
        
        
    
    


Pre-Requisites
All master records must be available in the system for a successful enrollment. Master Records are as follows:

    
    
        Carrier Maintenance—Refer “User Manual for Carrier Maintenance” for further information on the master records.
        Agent/Agency—Refer “User Manual for Sales and Marketing” for further information on the Agent/Agency records.
        Work Group—Refer “User Manual for Sales and Marketing” for further information on the Work Group records.
        Internal Associates—Refer “User Manual for Sales and Marketing” for further information on the Internal Associates records.
        Association Master—Association Master must be available in the system. Refer Section 2 of this document on “Association Master”.
        Eligibility Criteria—Business rules identifies the eligibility criteria for the Groups and member for participating in the PacAdvantage Program. For a successful enrollment the business rules must be met with.
        For entering Employee records the group must be available in the system and the enrolled status must be “Enroll Pend”.
        For entering Dependent records the Employee must be available in the system and the enrolled status must be “Enroll Pend”.
    
    


Application Functions
This application can be sub divided into following major functions:

    
    
        Group Enrollment—Group Enrollment consist of the following operations:
        
            Create Small Employer Group—to input details of a Small Employer Group.
            Create Alternate Group—to input details of an Alternate Group
            Create Individual Association Member—to input details of an Individual Association Member.
            Modify Group—to search a specific group for modification prior to enrollment. This search feature would allow searching for Small Employer Group or Association Group.
            Inactivate Group—to search a specific Small Employer Group or Association Group and make inactive.
        
        
        Employee Enrollment—Employee Enrollment consist of the following operations:
        
            Create Employee—to input details of an Employee for a specific group.
            Modify Employee—to search a specific employee for modification prior to enrollment. This search feature would allow searching employees attached to Small Employer Group or Association Group.
            Inactivate Employee—to search a specific Employee attached to Small Employer Group or Association—Group and make inactive.
        
        
        Dependent Enrollment—Dependent Enrollment consist of the following operations:
        
            Create Dependent—to input details of a Dependent of a specific employee.
            Modify Dependent—to search a specific dependent for modification prior to enrollment. This search feature would allow searching for dependent attached to an employee of a Small Employer Group or Association Group.
            Inactivate Dependent—to search a specific Dependent attached to an employee of Small Employer Group or Association Group and make inactive.
        
        
        Individual Member Enrollment—Individual Member Enrollment consist of the following operations:
        
            Modify Individual member—to search a specific member for modification prior to enrollment. This search feature would allow searching only for individual member who are attached to a guaranteed association.
            Inactivate Individual Member—to search a specific member those attached to a guaranteed association and make inactive.
            Create Individual Member Dependent—to input details of a Dependent of a specific individual member.
            Modify Individual Member Dependent member—to search a dependent of a specific individual member for modification prior to enrollment. This search feature would allow searching only for dependent of an individual member who is attached to a guaranteed association.
            Inactivate Dependent of Individual Member—to search a dependent of a specific individual member who are attached to a guaranteed association and make inactive.
        
        
    
    


Create Group (Small Employer Group)
The create group screen is to enter details of a group. The screen provides functionality to save, edit or add new group details.
The sequential steps involved in the creation of a new group by selecting small employer group are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Then select the option Group Enrollment and Create Group. (See FIG. C-15)
        Step—2: Screen displays with the option of selecting a group hierarchy. (See FIG. C-16)
        Step—3: On choosing Small Employer Group and Clicking continue button screen navigates to General Info. Enter the values in the respective field, as per the format briefed in fields explanation section Field Explanation, and click Continue. (See FIG. C-17)
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Post Mark Date
Text for post mark date. Choose a date by clicking



calendar icon. Accepts in the format MM/DD/YYYY


Received Date
Text for received date. Choose a date by clicking



calendar icon. Accepts in the format MM/DD/YYYY







Company Information








Legal Name
The text for name of the group. Accepts alphanumeric



and special characters not exceeding 60 characters.



Field is mandatory


Doing Business 
The text for business nature. Accepts alphanumeric


As
and special characters not exceeding 60 characters.



Field is optional


Type of 
Choose the type of business from the drop down list


Business
available


Tax 
The text for tax identification. Accepts numeric values


Identification
of exactly 9 digits







Address Information: Physical and Billing Address - Note: Enter Billing


Address if different from the Physical Address.








Street Address
The text for company address. Accepts alphanumeric



and special characters not exceeding 35 characters


Suite
The text for company suite/apt # Accepts



alphanumeric and special characters not exceeding 35



characters


Zip
The text for zip. Accepts numeric value of either 5 or 9



digits. City, State and County are populated



automatically on entering the correct zip code and



entering the tab key.


City
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters.


State
Choose the name of the state from the drop down list



of States available in United States of America


County
Choose the name of the county from the drop down list



of counties available for the ZIP Code entered.







Contact Information








Mode of
Choose the mode of correspondence from the drop


Correspondence
down list available.







Contact 1 and Contact 2 - Fill in the relevant for Contact 1 and 2.








Salutation
Choose the salutation from the drop down list of



salutations available.


First Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 25 characters.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 35 characters.


Suffix
Choose the suffix from the drop down list of suffixes



available.


Phone Number
The text for telephone number of the contact person.



Accepts numeric values of exactly 10 digits. The format



is (999) 999-9999


Extension
The text for extension number of the contact person.



Accepts numeric values not exceeding 5 digits.


Fax
The text for fax number of the contact person. Accepts



numeric values of exactly 10 digits. The format is



(999) 999-9999


Email
The text for email of the contact person. Accepts



alphabets, numeric and special characters in the



standard email format of length not exceeding 100



characters


Contact 
The text for comments. Accepts alphabets, numeric


Comments
and special characters. Field is optional









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    
















Element
Description









Continue
Saves the data and navigates to Billing Information




screen and the system generates Group ID.



Cancel
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes



Tabs
General Info, Billing Info, Agent Info, Coverage Info




and Add Employees are the tabs visible on this screen.




The navigation between tabs is possible only if there is




a valid group ID generated and assigned to the group.




Also while navigating through the tab the content that




are changed on the screen are not saved unless




explicitly saved by other operations on the screen.










    
    
        Step—4: Screen navigates to billing information. Enter the values in the respective fields, as per the format briefed in field's explanation section and click Continue. (See FIG. C-18)
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Mode of payment
Choose a mode of payment from the drop down list



available. Based on selection corresponding fields will



enable to enter the values. For e.g. if the value selected



is card payment, EFT will be disabled and allows only



entering card details and vice versa.







Credit Card Information








Cardholder's
The text for cardholder's name. Accepts alphabets and


Names
space between two words.


Credit Card Type
Choose the type of credit card from the drop down list



available.


Credit Card No
The text for credit card number. Accepts numeric



values not exceeding 30 digits


Expiration Date
Choose a month of expiration from the drop down list



available


Expiration Year
The text for expiration year. Accepts numeric values



of exactly 4. Example 2002.


Billing Address 
As it appears on the credit Card


Street Address
The text for company address. Accepts alphanumeric



and special characters not exceeding 35 characters.


ZIP
The text for zip. Accepts numeric value of either 5 or 9



digits.


State
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters.


City
Choose the name of the state from the drop down list



of States available in United States of America







EFT Information








Bank Name
The text for bank name. Accepts alphabets and space



between two words.


Routing Number
The text for routing number. Accepts numeric values



not exceeding 9 digits.


Account Number
The text for account number. Accepts numeric values



not exceeding 9 digits.


Account Type
Choose the type of account from the drop down list



available.


Depositor's Name
The text for depositor's name. Accepts alphabets and



space between two words.







Initial Payment Information








Amount Received
The text for amount received. Accepts only numeric



values in the format 999999999.99


Date Receive
The text for date received. Choose from the calendar



icon in the format MM/DD/YYYY.


Check #
The text for check number. Accepts numeric values not



exceeding 9 digits.


No Check Received
Check the option of no checks received for any non-



receipt of checks.









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Continue
Saves the data and Navigates to Agent Information



screen.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Enrollment
Click enrollment summary refreshes the screen and


Summary
display the summary of information entered for group.


Missing
Click missing information refreshes the screen and


Information
displays the missed information for the group.


Tabs
General Info, Billing Info, Agent Info, Coverage Info



and Add Employees are the tabs visible on this screen.



The navigation between tabs is possible only if there is



a valid group ID generated and assigned to the group.



Also while navigating through the tab the content that



are changed on the screen are not saved unless



explicitly saved by other operations on the screen.









    
    
        Step—5: Screen navigates to Agent Info screen. Agent/Agency ID is selected by clicking search icon. (See FIG. C-19)
        Step—6: This pops up a screen to select agent/agency id. Enter value in any one of the fields, or simply click search button to perform search operation. (See FIG. C-20)
        Step—7: Click on agent/agency id for selection. (See FIG. C-21)
        Step—8: Add the Agent information to the table for temporary storage. After filling other relevant information in agent info screen, as per the format briefed in field's explanation section and click Continue
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Agent ID
Choose an agent id by clicking search icon


Agent Type
Choose an agent type from the drop down list



available. Based on the selection of the agent type the



percent commission split entry and the Receive ROE



packets option would be available.


Percent commission
The text for percent commission. Accepts numeric


split
values in the range of 1-100 (Example 100.00). This



will be enabled only if the Agent type selected is 



“Agent Of Record”



Sum of the percentage for all the Agent of Record



added should be equal to 100.00.


Receive ROE/OE
Click the check box to receive ROE/OE packets for


packets
agent. This option will not be available for Agent 



Type “General Agent”.


Agent Commission
The text for agent commission. Defaults the value



defined in CM - rate Administration for Agent



Commission. Accepts numeric values less than or



equal to the defaulted value in the in the range of 



1-100 (Example 4.45)


Check the box if the
Click the check box for a group with out an agent. 


group is without an
This option will be available only for the Agent Type, 


agent
“Agent of Record and Writing Agent”.









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Add
Add the contents of agent information. It is only a



temporary addition. Becomes permanent only on



saving the record.


Edit
Edit button will allow for editing a specific record in



the table.


Update
Update the contents of agent information. It is only a



temporary update. Becomes permanent only on saving



the record


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent only on saving the record


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


Enrollment
Click enrollment summary refreshes the screen and


Summary
display the summary of information entered for group



creation


Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


Continue
Saves the data and navigates to Coverage Information



screen.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tab
General Info, Billing Info, Agent Info, Coverage Info



and Add Employees are the tabs visible on this screen.



The navigation between tabs is possible only if there is



a valid group ID generated and assigned to the group.



Also while navigating through the tab the content that



are changed on the screen are not saved unless



explicitly saved by other operations on the screen









    
    
        Step—9: Screen navigates to coverage information. Enter the values in the respective fields, as per the format briefed in field's explanation section and click Continue. (See FIG. C-22)
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description















Waiting Period Information








Employee Type
Choose an Employee Type from the drop down list



available


Waiting Period
Choose a waiting period from the drop down list



available







RAF Discounting








RAF
List the RAF tier applicable for the group based on the



RAF tier available on group's effective date.







Contribution








Line of Coverage
Choose a line of coverage from the drop down list


elected
available


Contribution For
Choose a contribution for from the drop down list



available. Contribution can be for an employee or



dependent.


Contribution Type
Choose a contribution type from the drop down list



available. List the contribution type “% Lowest Cost



HMO”, “% Lowest Cost Plan”, “% Specified Plan”, 



“Flat $ Amount”. On Selecting % Specified Plan the



page would get refreshed and the Plan Name for the



Specified LOC would be populated in the Drop Down



List “Plan Name”


Contribution
The text for contribution amount. Accepts numeric


Amount
values in the format 99999999.99 for flat $ amount



and for the rest of the option it accepts as % value say



100.00


Plan Name
Choose a plan name from the drop down list available



if the Contribution Type selected is “% Specified 



Plan”.


Current Group
Choose a group insurer from the drop down list


Insurer
available


Whether group
Click the option yes or no


legally required to



provide workers



compensation



coverage



Workers
Choose a compensation carrier name from the drop


compensation
down list available


carrier name



Number of
The text for total number of employees including full


Employees (Full
time and part time. Accepts numeric values


time and part time)



Number of full time
The text for number of full time employees at the time


employees at the
of applying. Accepts numeric values


time of application



Number of eligible
The text for number of eligible employees at the time


employees at the
of applying. Accepts numeric values


time of application



Number of
The text for number of employees at the time of


employee applying
applying. Accepts numeric values


Have you employed
Click the option yes or no


20 or more



employees for 20 or



more weeks during



the current or



preceding year



(TEFRA)



Have you employed
Click the option yes or no


20 or more



employees during



at least 50% of the



preceding calendar



year (COBRA)



Are you offering
Click the option yes or no


coverage to



employees working



more 20-29 hours



per week



Are you offering
Click the option yes or no


coverage to



domestic partners



Are you offering
Click the option yes or no


coverage to 1099



Employer's
Check this Check box if Employer's signature is


Signature
verified.


Date Signed
The text for Date Signed. Choose a date by clicking



calendar icon. Date accepts the format 



MM/DD/YYYY.









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Add (Waiting
Add the contents of Waiting Period information. It is


Period Information)
only a temporary addition. Becomes permanent only



on saving the record.


Add (Contribution)
Add the contents of Contribution and Coverage 



elected. It is only a temporary addition. Becomes 



permanent only on saving the record.


Update (Waiting
Updates the contents of Waiting Period information. It


Period Information)
is only a temporary update. Becomes permanent only



on saving the record.


Update
Update the contents of Contribution and Coverage


(Contribution)
elected. It is only a temporary update. Becomes



permanent only on saving the record.


Cancel
Cancels the operation that was currently performed



prior to saving the record.


Edit
Edit button will allow for editing a specific record in



the table.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent only on saving the record.


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in 



the table that are checked.


Enrollment
Click enrollment summary refreshes the screen and


Summary [Link]
display the summary information entered for group



creation


Missing
Click missing information refreshes the screen and


Information [Link]
displays the missed information. For a successful



creation of a group, there should be no missing



information


Missing Info
Saves the data and navigates to Missing Information



Page


Continue/Add EE
Saves the data and navigates to Add Employee screen.


Create New Group
Saves the data entered and navigates to the screen



Group Hierarchy for creating New Group.


Cancel
Clears or restores the content entered in the fields only



prior to saving the records.


Tab
General Info, Billing Info, Agent Info, Coverage Info



and Add Employees are the tabs visible on this screen.



The navigation between tabs is possible only if there is



a valid group ID generated and assigned to the group.



Also while navigating through the tab the content that



are changed on the screen are not saved unless



explicitly saved by other operations on the screen









    
    
        Step—10: Screen navigates to add employee general information. Enter the values in the respective fields, as per the format briefed in field's explanation section. (See FIG. C-23)
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description















Employee Information








Salutation
Choose the salutation from the drop down list of



salutations available.


First Name
The text for first name. Accepts alphabets and special



character like hyphen and single quotes not exceeding



25 characters. First name is mandatory.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for last name Accepts alphabets and special



character like hyphen and single quotes not exceeding



35 characters. Last name is mandatory.


Suffix
Choose the suffix from the drop down list of suffixes



available.


Date of Birth
The text for date of birth. Choose a date by clicking



calendar icon. Date accepts the format MM/DD/YYYY.



Birth date cannot be later than the current date.


Social Security
The text for social security number for every


Number
individual. This can also be auto generated by clicking



auto generate link. Accepts numeric value of exactly 9



digits. Users with User Role as Level 2 and above can



only auto generate SSN.


Gender
Choose a gender from the drop down list available.







Address Information: Physical and Alternate Address - Note: Enter


Alternate Address if different from the Physical Address.








Street Address
The text for address. Accepts alphanumeric and special



characters with values not exceeding 35 characters


Apt
The text for suite/apt # . . . Accepts alphanumeric and



special characters with values not exceeding 35



characters


Zip
The text for zip. Accepts numeric value of either 5 or 9



digits. City, State and County are populated



automatically on entering the correct zip code and



entering the tab key.


City
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters.


State
Choose the name of the state from the drop down list



of States available in United States of America


County
Choose the name of the county from the drop down list



of States available in United States of America


Mode of
Choose the mode of correspondence from the drop


Correspondence
down list available


Phone Number
The text for telephone number of the employee.



Accepts numeric values not exceeding 10 digits. The



format is (999) 999-9999


Extension
The text for extension number of the employee.



Accepts numeric values not exceeding 5 digits


Fax
The text for fax number of the employee. Accepts



numeric values not exceeding 10 digits. The format is



(999) 999-9999


Email
The text for email of the employee. Accepts alphabets,



numeric and special characters in the standard email



format of length not exceeding 100 characters









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Continue
Saves the data and navigates to coverage information



for employees.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Enrollment
Click enrollment summary refreshes the screen and


Summary
display the summary information entered for group



creation


Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


Group ID
Click Group ID to navigates to the Group's general info



screen.


Tab
General Info, Coverage Info, Add Dependent are the



tabs visible on this screen. The navigation between the



tabs is possible only if there is a valid Employee ID



generated and assigned to the employee. Also while



navigating through the tab the content that are



changed on the screen are not saved unless explicitly



saved by other operations on the screen









    
    
        Step—11: Screen navigates to coverage information. Enter the values in the respective fields, as per the format briefed in field's explanation section and click Continue. (See FIG. C-24)
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description















Employee Information








Hours worked 
The text for worked hours per week. Accepts numeric


per week
values not exceeding 2 digits.


Date of 
The text for date of employment. Choose a date by


employment
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Employee type
Choose an employee type from the drop down list



available







Plan Information








Line of coverage
Choose a line of coverage from the drop down list



available


Medical waived
Click the check box for medical waive if the employee



is waiving medical.


Carrier selection
Choose a carrier selection from the drop down list


(Benefit level)
available


Coverage choice
Choose a coverage from the drop down list available


PCP ID/Medical
The text for PCP ID. Accepts alphabets and numeric


group ID
values not exceeding 10 characters.


Are you an 
Click the check box if you are an existing patient


existing patient



PCP last name
The text for PCP last name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 35 characters.


PCP first name
The text for PCP first name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 25 characters.


Prior plan type
Choose a plan type from the drop down list available


Prior plan name
Choose a plan name from the drop down list available


Prior insurance
The text for insurance start date. Choose a date by


start date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Prior insurance 
The text for insurance end date. Choose a date by


end date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Other coverage 
The text for other coverage. Accepts alphabets with


kept
values not exceeding 50 characters.


Employee 
Click the check box, to have employee signature


signature
The text for date signed. Choose a date by clicking


Date signed
calendar icon. Date accepts the format MM/DD/YYYY.



Date cannot accept future date.









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Add
Add the contents of employee coverage information. It



is only a temporary addition. Becomes permanent only



on saving the record.


Edit
Edit button will allow for editing a specific record in



the table.


Update
Update the contents of Plan Information. It is only a



temporary update. Becomes permanent only on saving



the record.


Cancel
Cancels the operation that was currently performed



prior to saving the record.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent only on saving the record.


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


Enrollment
Click enrollment summary refreshes the screen and


Summary [Link]
display the summary of information entered for group



creation


Missing
Click missing information refreshes the screen and


Information 
displays the missed information. For a successful


[Link]
creation of a group, there should be no missing



information


Group ID
Click Group ID to navigates to the Group's general info



screen.


Continue
Saves the data and navigates to Coverage Information



screen.


Enrollment
Click enrollment summary refreshes the screen and


Summary
display the summary of information entered for group



creation


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tab
General Info, Coverage Info, Add Dependent are the



tabs visible on this screen. The navigation between the



tabs are possible only if there is a valid Employee ID



generated and assigned to the employee Also while



navigating through the tab the content that are



changed on the screen are not saved unless explicitly



saved by other operations on the screen









    
    
        Step—12: Screen navigates to add dependent information. Enter the values in the respective fields, as per the format briefed in field's explanation section and click anyone of the button shown for subsequent operation. (See FIG. C-25)
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description















Dependent Information








First Name
The text for first name. Accepts alphabets and special



character like hyphen and single quotes not exceeding



25 characters. First name is mandatory.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for last name. Accepts alphabets and special



characters like hyphen and single quotes not exceeding



35 characters. Last name is mandatory.


Suffix
Choose the suffix from the drop down list of suffixes



available.


Date of Birth
The text for date of birth. Choose a date by clicking



calendar icon. Date accepts the format



MM/DD/YYYY. Birth date cannot be later than the



current date.


Social Security
The text for social security number for every


Number
individual. This can also be auto generated by clicking



auto generate link. Accepts numeric value of exactly 9



digits. Users with User Role as Level 2 and above can



only auto generate SSN.


Gender
Choose a gender from the drop down list available.


Relationship
Choose the relationship from the drop down list



available.


Street Address
The text for address. Accepts alphanumeric and special



characters with values not exceeding 35 characters


Suite
The text for suite/apt # . . . Accepts alphanumeric and



special characters with values not exceeding 35



characters


Zip
The text for zip. Accepts numeric value of either 5 or



9 digits. City, and State are populated automatically



on entering the correct zip code and entering the tab



key.


City
The text for city. Accepts alphabets not exceeding 30



characters.


State
Choose the name of the state from the drop down list



of States available in United States of America







Line of Coverage








Selected carrier
The text for selected carrier. It is a read only field


Coverage choice
The text for coverage. It is a read only field


Service area
The text for service area. It is a read only field


Prior plan type
Choose a plan type from the drop down list available


Prior plan
The text for plan name. Accepts alphabets


Waived
Click the check box if Line of Coverage is waived.


Start date
The text for insurance start date. Choose a date by



clicking calendar icon. Date accepts the format



MM/DD/YYYY.


End date
The text for insurance end date. Choose a date by



clicking calendar icon. Date accepts the format



MM/DD/YYYY.


PCP ID/
The text for PCP ID. Accepts alphabets and numeric



values not exceeding 10 characters.


PCP last name
The text for PCP last name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 35 characters.


PCP first name
The text for PCP first name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 25 characters.


Disabled 
Click the option of temporary or permanent. This is


dependent
enable if the relationship opted is child


Domestic partner
Click the option for domestic partner. It depends on



the value selected in relationship


Legal guardian
Click the option for legal guardian. It depends on the



value selected in relationship


Signature
Click the check box if the signature is opted









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Add Employee
Saves the data and navigates to the screen for adding



employees.


Add Dependent
Saves the data and navigates to the screen for adding



dependent


Enrollment
Click enrollment summary refreshes the screen and


Summary
display the summary of information entered for group



creation


Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tab
General Info, Coverage Info, Add Dependent are the



tabs visible on this screen. The navigation between the



tabs are possible only if there is a valid Employee ID



generated and assigned to the employee Also while



navigating through the tab the content that are



changed on the screen are not saved unless explicitly



saved by other operations on the screen









    
    
        Step—13: Clicking enrollment summary button screen navigates to enrollment summary. This screen shows the overall information that is entered. Enter the values in the respective fields, as per the format briefed in field's explanation section and click Pre Enrollment button for checking the eligibility criteria for the Group and Members. (See FIG. C-26)
    
    


Field Explanation

    
    
        The following table provides explanation for each element in the screen.
    
    













Element
Description







Group
Contains header information of the Group


Information



Header



Name of the 
Text for the Name of the Group


Group



Group ID
Text and Link for the Group ID to navigate to the



Group General Info screen


Group Type
Specifies the Type of the Group like Small Employer



Group


Proposed 
The text for Proposed Effective Date. Choose a date by


Effective Date
clicking calendar icon. Date accepts the format



MM/DD/YYYY. Default effective date is first of the



following month. Effective date cannot be past date


Status
Text to specify the status of the group.


Work Group
Text for Work Group. This specifies the internal work



group attached to the Group. This is based on the



writing agent's work group.


Enrollment
Enrollment Summary Information is broken down into


Summary
tree structure. The tree can by expanded or collapsed.


Information
The level of the tree is as per the example given below:



− Employee



 − Dependent



 − Dependent



− Employee



 − Dependent



− Employee



+ Employee



− Employee



 + Dependent



+− Employee



Where (−) signifies expanded view and (+) signifies



collapsed view.


Employee ID
Text for Employee ID


Employee SSN
Text for Employee SSN


Employee Name
Text for employee Name (First Name and Last Name)


Effective Date
Text for Employee Effective date. Choose a date by



clicking calendar icon. Date accepts the format



MM/DD/YYYY. Defaults effective date of the Group.



Effective date cannot be past date


Status
Text to specify the status of the employee.


Dependent ID
Text for Dependent ID


Dependent SSN
Text for Dependent SSN


Dependent Name
Text for Dependent Name (First Name and Last



Name)


Effective Date
Text for Dependent Effective date. Choose a date by



clicking calendar icon. Date accepts the format



MM/DD/YYYY. Defaults effective date of the



Employee. Effective date cannot be past date


Status
Text to specify the status of the Dependent.


Enrollment
There are two part of this information:


Information
 1) Entered based on verification



 2) Based on the information provide on the



  Coverage Info screen







Entered based on verification








Total Full Time
Value is shown based on the actual full time employee


Applied (A)
applied (System Identified)


Total part Time
Value is shown based on the actual part time employee


Applied (B)
applied (System Identified)


Employee Waived
Text to enter Employee Waived. Contains only whole


(C)
number. Accepts numbers not exceeding 5 digits.



Manually entered based on verification.


Employee 
Text to enter Employee Declined. Contains only whole


Declined (D)
number. Accepts numbers not exceeding 5 digits.



Manually entered based on verification.


Total Eligible
Text to display total eligible employee. Employee


Employee (E) =
Applying is sum total of A + B + D.


Total Employee
Text to display total employee applying. Employee


Applying (F)
Applying is sum total of A + B.


% Participation
Test to display % participation. Participation is % of



E/F







Based on Info Provided








Total Full Time
Text for Total Full Time Applied. Based on the


Applied (A)
information provide on the Coverage Info screen


Total part Time
Text for Total Part Time Applied. Based on the


Applied (B)
information provide on the Coverage Info screen


Total Employees
Text to display total employee applied. Employee


Applied
Applied is sum total of A + B









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


<<, <, >, >>
The enrollment summary shows record for 5 employees



on single screen. If the employee size increases more



than 5. These buttons are used for navigating to the



next and previous records for viewing.



<< - Show first record(s)



< - Show previous record(s)



> - Show next record(s)



>> - Show last record(s)


Group ID
Click Group ID to navigates to the Group's general info



screen.









    
    
        Step—14: Clicking pre enrollment navigates to missing info screen. Missing information screen provide information on the data that is required to complete an enrollment process. This also checks for the eligibility of the group and member for enrolling into PacAdvantage Program. For a successful creation of a group the missing information should be empty. The user role and authority can overrule certain missing information.
        Enter the values in the respective fields, as per the format briefed in field's explanation section and click Enroll button for enrolling the Group and Members. (See FIG. C-27)
    
    


Field Explanation

    
    
        The following table provides explanation for each element in the screen.
    
    













Element
Description







Group
Contains header information of the Group


Information



Header



Name of the 
Text for the Name of the Group


Group



Group ID
Text and Link for the Group ID to navigate to the



Group General Info screen


Group Type
Specifies the Type of the Group like Small Employer



Group


Proposed 
The text for Proposed Effective Date. Choose a date by


Effective Date
clicking calendar icon. Date accepts the format



MM/DD/YYYY. Default effective date is first of the



following month. Effective date cannot be past date


Status
Text to specify the status of the group.


Work Group
Text for Work Group. This specifies the internal work



group attached to the Group. Internal is based on the



writing agent's work group.


Tree Structure
Enrollment Missing Information is broken down into



tree structure. The tree can by expanded or collapsed.



The level of the tree is as per the example given below:



− Employee



 − Dependent



 − Dependent



− Employee



 − Dependent



− Employee



+ Employee



− Employee



 + Dependent



+− Employee



Where (−) signifies expanded view and (+) signifies



collapsed view.


Group Missing
This identifies all the eligibility rules and the


Info
information that are incomplete on Group level for



completing the enrollment process.


Missing Entities
List the missing entities for the group. Provides a link



to go to the respective screen to fill in the relevant



information to complete all the required entries.


Message
List the message against each missing entities.


Employee
This identifies all the eligibility rules and the


Missing Info
information that are incomplete on Employee level for



completing the enrollment process.


Missing Entities
List the missing entities for the employee. Provides a



link to go to the respective screen to fill in the relevant



information to complete all the required entries.


Message
List the message against each missing entities.


Dependent
This identifies all the eligibility rules and the


Missing Info
information that are incomplete on dependent level for



completing the enrollment process.


Missing Entities
List the missing entities for the dependent. Provides a



link to go to the respective screen to fill in the relevant



information to complete all the required entries.


Message
List the message against each missing entities.


Enrollment 
Choose from the drop down list the action to be


Action
performed for enrollment. Enroll/Decline


Remarks
Text for remarks if any.


Reasons for 
Choose from the drop down list the reasons for decline.


Decline



Reasons for 
Text for other reason. If the reason for decline is other


Other
than the reasons available.









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Send mail
Click this link to send missing information to the



Internal Work Group (GMS representatives) attached



to this Group.


Preview Invoice
Click this Link to preview the Invoice details prior to



generation of invoice.


Enroll
Saves the data if there are no missing information and



navigates to enrollment confirmation page.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


<<, <, >, >>
The enrollment missing information shows record for 5



employees on single screen. If the employee size



increases more than 5. These buttons are used for



navigating to the next and previous records for



viewing.



<< - Show first record (s)



< - Show previous record (s)



> - Show next record (s)



>> - Show last record (s)


Group ID
Click Group ID to navigates to the Group's general info



screen.


Preview Invoice
Click Preview Invoice to pop up a new browser window



to preview the invoice for the group









Missing Information

    
    
        The following table provides explanation for each missing information and what needs to be done to remove missing information from the screen
    
    














Missing Entity
Message
Reasons/Remedy















Group Level








General
These are missing information pertains to the


Information
Group Level information required in the Group



General Information Screen









Employer Tax ID
Employer Tax ID is not
Fill in the Employer tax



specified
ID in the Group General




Info Screen


Type of Business
Type of Business is not
Choose the Type of



specified
Business Listed from the




list in Group General Info




Screen


Address
Address information is
Fill in the address



not specified
information in the Group




General Info Screen


ZIP
ZIP Code is not specified
Fill in the zip code in the




Group General Info




Screen


City
City name is not specified 
Fill in the City name in




the Group General Info




Screen


County
County is not specified
Choose County for Group




from the list in group




general info screen


State
State name is not
Choose the State from the



specified
list in group general info




screen


Mode of
Mode of Correspondence
Choose the Mode of


Correspondence
is not specified
Correspondence for




Contact 1 from the list in




group general info screen


Contact First 
Contact first name for
Fill in the Contact first in


Name
Contact 1 is not specified 
the Group General Info




Screen


Contact Last 
Contact last name for
Fill in the Contact last in


name
Contact 1 is not specified
the Group General Info




Screen


Phone
Phone for Contact 1 is not 
Fill in the Contact Phone



specified
in the Group General Info




Screen


Email
Email for Contact 1 is not 
This is required if the



specified
mode of correspondence




selected is Email. Fill in




the Contact Email in the




Group General Info




Screen








Billing
These missing information pertains to the Group


Information
Level information required in the Billing



Information Screen









Mode of 
Mode of payment is not
Choose the Mode of


payment
specified
Payment for the group




from the list in Group




Billing Info Screen


Check Number
Check Number is not
Fill in the Check number



specified.
in the Group Billing Info




Screen


Check Date
Date Check received is
Fill in the Date received



not specified
in the Group Billing Info




Screen


Check Number
Check Number received
Fill in the Check Number



is not specified
in the Group Billing Info




Screen


Initial Payment
Initial payment not
If initial payment check is



received
received then uncheck the




box “No Check Received”




in the Group Billing Info




Screen


Initial Payment
Initial Payment is not
If initial payment check is



sufficient to get enrolled 
received but there is a




shortfall in the amount




this message would be




shown. Check the short




fall by previewing the




invoice with the amount




received.




The variation in amount




received by more than (−)




$2 will allow user with




level II and above only to




enroll.




The variation in amount




received by more than (−)




$50 will allowing user




with level III and above




only to enroll




The variation in amount




received by more than (−)




$100 will allow user with




level IV and above only to




enroll


Cardholder's 
Cardholder's name is not
This is required if the


Name
specified
mode of payment opted by




group is Credit Card. Fill




in the Cardholder's name




in the Group Billing Info




Screen.


Credit Card Type
Credit Card Type is not 
This is required if the



specified.
mode of payment opted by




group is Credit Card




Choose the Credit Card




Type for the group from




the list in Group Billing




Info Screen


Credit Card
Credit Card Number is
This is required if the


Number
not specified
mode of payment opted by




group is Credit Card. Fill




in the Credit Card




Number in the Group




Billing Info Screen.


Expiration Date
Credit Card Expiration
This is required if the



Date is not specified
mode of payment opted by




group is Credit Card. Fill




in the Credit Card




Expiration Date in the




Group Billing Info Screen.


Bank Name
Bank name is not
This is required if the



specified
mode of payment opted by




group is EFT. Fill in the




Bank Name in the Group




Billing Info Screen.


Routing Number
Routing Number is not
This is required if the



specified
mode of payment opted by




group is EFT. Fill in the




Routing Number in the




Group Billing Info Screen.


Account Type
Account Type is not
This is required if the



specified
mode of payment opted by




group is EFT. Fill in the




Account Type in the




Group Billing Info Screen


Depositor's 
Depositor's Name is not 
This is required if the


Name
specified
mode of payment opted by




group is EFT. Fill in the




Depositor's Name in the




Group Billing Info Screen








Agent
These missing information pertains to the Group


Information
Level information required in the Agent



Information Screen









Writing Agent
Writing Agent is not
Choose the Writing Agent



specified
for the Group in the




Group Agent Info Screen


Agent of Record
Agent of Record is not
This is required if



specified
commission for the agent




exists. Choose the Agent




of Record for the Group in




the Group Agent Info




Screen


Agent License
Agent License Number is
Go to Agent/Agency


Number
not specified
Master Screen, search for




the agent/agency




attached with group and




fill in the License




information.


License Expiry
License Expiry Date is
Go to Agent/Agency


Date
not specified
Master Screen, search for




the agent/agency




attached with group and




fill in the License




information.


License Expiry
Agent License Number is
Go to Agent/Agency


Date
expired
Master Screen, search for




the agent/agency




attached with group and




modify the license expiry




date.


Commission
% Commission split is 
Check if the commission



not specified
split for the agent of




record exists. If not edit




the corresponding agent




of record and enter %




commission split for the




Agent of Record in the




Group Agent Info Screen


Total
% Split in commission is
Check if the total of the


Commission 
less than 100%
commission split's for the


Split

agent of record is 100. If




not edit the corresponding




agent of record and make




changes to make




commission split total to




100% in the Group Agent




Info Screen








Coverage
These missing information pertains to the Group


Information
Level information required in the Coverage



Information Screen









RAF
Rate Differential factor is 
This is required to arrive



not specified
to the Premium




Calculation for the Group.




Select the RAF from the




list in Group Coverage




Info Screen


Workers
Is your Group legally
Choose the Option Yes or


compensation
required to provide
No in Group Coverage


coverage
workers compensation
Info Screen



coverage?



Worker
Worker Compensation
This is required if the


Compensation
Carrier Name is not
Workers compensation


Carrier Name
specified
coverage opted is yes.




Choose the Worker




Compensation Carrier




Name from the list in




Group Coverage Info




Screen


Total Employee
How many employees 
Fill in the “How many



(full time and part time)
employees (full time and



available with the Group
part time)” available with




the Group in the Group




Coverage Info Screen


Full Time
How many full time
Fill in the “How many full


Employee
employees available with
time employees” available



the Group
with the Group in the




Group Coverage Info




Screen


Eligible 
How many eligible
Fill in the “How many


Employee
employees at the time of
eligible employees at the



application
time of application” 




available with the Group




in the Group Coverage




Info Screen


Employees
How many employees
Fill in the “How many


Applying
applying
employees applying” in




the Group Coverage Info




Screen


TEFRA
Have you employed 20 or
Choose the Option Yes or



more employees for 20 or
No in Group Coverage



more weeks during the
Info Screen



current or preceding year




(TEFRA)



COBRA
Have you employed 20 or
Choose the Option Yes or



more employees during at
No in Group Coverage



least 50% of the preceding 
Info Screen



calendar year (COBRA)



Part time 
Are you offering coverage
Choose the Option Yes or


Coverage
to permanent employee
No in Group Coverage



working 20-29 hours per
Info Screen



week?



Domestic Partner
Are you offering coverage
Choose the Option Yes or


Coverage
to domestic partners?
No in Group Coverage




Info Screen


Waiting Period
Waiting Period for the
Add waiting period for the



employees is not specified 
employee based on the




employee type in Group




Coverage Info Screen


Waiting Period
Managerial Employee
Edit the waiting period



Waiting period not
information and update



specified
the waiting period for the




employee type in Group




Coverage Info Screen


Waiting Period
Non- Managerial
Edit the waiting period



Employee Waiting period
information and update



not specified
the waiting period for the




employee type in Group




Coverage Info Screen


Waiting Period
Exempt Employee
Edit the waiting period



Waiting period not
information and update



specified
the waiting period for the




employee type in Group




Coverage Info Screen


Waiting Period
Non - Exempt Employee
Edit the waiting period



Waiting period not
information and update



specified
the waiting period for the




employee type in Group




Coverage Info Screen


Waiting Period
Union Employee Waiting
Edit the waiting period



period not specified
information and update




the waiting period for the




employee type in Group




Coverage Info Screen


Waiting Period
Non- Union Employee
Edit the waiting period



Waiting period not
information and update



specified
the waiting period for the




employee type in Group




Coverage Info Screen


Waiting Period
Full-Time Employee
Edit the waiting period



Waiting period not
information and update



specified
the waiting period for the




employee type in Group




Coverage Info Screen


Waiting Period
Part-Time Employee
Edit the waiting period



Waiting period not
information and update



specified
the waiting period for the




employee type in Group




Coverage Info Screen


Line of Coverage 
Line of coverage not
Add Line of Coverage in



specified
Group Coverage Info




Screen


Contribution 
Employee Contribution
Edit the Line of coverage


Type
type not specified
wherein the Contribution




Type is not specified and




update the Contribution




Type in Group Coverage




Info Screen


Contribution
Employee Contribution 
Edit the Line of coverage


Amount
Amount not specified
wherein the Contribution




Amount is not specified




and update the




Contribution Amount in




Group Coverage Info




Screen


Contribution 
Dependent Contribution
Edit the Line of coverage


Type
type not specified
wherein the Contribution




Type is not specified and




update the Contribution




Type in Group Coverage




Info Screen


Contribution
Dependent Contribution
Edit the Line of coverage


Amount
Amount not specified
wherein the Contribution




Amount is not specified




and update the




Contribution Amount in




Group Coverage Info




Screen


Contribution 
Contribution Type for
Employee and Dependent


Type Variation
Employee and Dependent
must have same



differs.
Contribution Type.




Edit the Line of coverage




wherein the Contribution




Type varies and update




the Contribution Type in




Group Coverage Info




Screen


Plan Name
Plan not selected for 
Edit the Line of coverage



Contribution Type “%
wherein the Plan Name is



Specified Plan”
not specified and update




the Plan Name in Group




Coverage Info Screen








Employee
These missing information pertains to the


General
Employee Level information required in the


Information
Employee General Information Screen









Address
Address information is
Fill in the address



not specified
information in the




Employee General Info




Screen


City
City is not specified
Fill in the City in the




Employee General Info




Screen


State
State is not specified
Fill in the City in the




Employee General Info




Screen


ZIP Code
ZIP Code is not specified 
Fill in the ZIP Code in the




Employee General Info




Screen


Date of Birth
Date of Birth is not
Fill in the Date of Birth in



specified
the Employee General




Info Screen


Gender
Gender is not specified
Choose the Gender in the




Employee General Info




Screen


SSN
SSN is not specified
Fill in the SSN in the




Employee General Info




Screen. If the employee




refuse to provide SSN




then click auto generate




SSN/Unique ID in the




Employee General Info




Screen. Auto generation




of SSN/Unique ID will be




available only for the user




with role as level II and




above


Mode of
Mode of Correspondence
Choose the Mode of


Correspondence
is not specified
Correspondence for




Employee from the list in




Employee general info




screen


Email
Email for Employee is not 
This is required if the



specified
mode of correspondence




selected is Email. Fill in




the Email in the




Employee general info




screen








Employee
These missing information pertains to the


Coverage
Employee Level information required in the


Information
Employee Coverage Information Screen









Hours Worked
Hours worked per week
Fill in the Hours worked



not specified
per week in the Employee




Coverage Info Screen


Date of
Date of employment not
Fill in the Date of


Employment
specified
Employment in the




Employee Coverage Info




Screen


Employee
Employee signature is
Verify employee's


Signature
missing
signature and check




Employee Signature




checkbox in the Employee




Coverage Info Screen


Date Signed
Date Signed is missing
Verify Date signed and fill




in the Date Signed in the




Employee Coverage Info




Screen


Employee Type
Employee Type not
Choose the Employee



specified
Type for Employee Type




from list in Employee




Coverage info screen


Employee Type -
Variation in Employee
Check for the Employee


Waiting Period
Type at Group and
Type specified in the



Employee Level
Group Coverage Info and




the Employee Coverage




Info. Employee Type




specified in The Group




Level and the Employee




Level can have variation.




Either change the




Employee Type in




Employee Coverage Info




screen or add the




Employee Type in the




Group Coverage Info.


Employee 
Employee's Line of
Choose the Line of


Coverage
Coverage not specified
Coverage for the




Employee in Employee




Coverage info screen


Medical 
Medical Line of Coverage 
Choose the Line of


Coverage
not specified
Coverage for the




Employee in Employee




Coverage info screen. If




the employee waives




medical coverage check




the checkbox Medical




Waived.


Dental Coverage
Dental Line of Coverage 
This is required if the



not specified
Group offers optional




benefits. Choose the Line




of Coverage for the




Employee in Employee




Coverage info screen


Vision Coverage
Vision Line of Coverage 
This is required if the



not specified
Group offers optional




benefits. Choose the Line




of Coverage for the




Employee in Employee




Coverage info screen


CAM Coverage
CAM Line of Coverage 
This is required if the



not specified
Group offers optional




benefits. Choose the Line




of Coverage for the




Employee in Employee




Coverage info screen


Coverage Choice
Coverage Choice between 
Choose the appropriate



the Line of Coverage
coverage choices as per



differs
the illustration provided




in the column below and




edit the coverage choice




for the specific Line of




Coverage and update in




Employee Coverage info




screen. Or In dependent




Info Screen waive the




Optional coverage choice




for dependent under 2 by




checking the check box




Waive.








Coverage Choice
Coverage choice for the Medical should have highest


Illustration
precedence. There are Four Coverage Choices



1 - Employee Family



2 - Employee Child



3 - Employee Spouse



4 - Employee Only



Case 1:



If coverage choice for medical is Employee Child,



Optional benefit cannot have employee spouse. It



should be Employee Child or Employee Only provided



child is under 2



Case 2:



If Coverage Choice for Medical is Employee Spouse



optional benefits cannot have employee child. It should



also be Employee Spouse



Case 3:



If Coverage Choice for Medical is Employee Child



optional benefits cannot have employee only if at least



one child is above 2 years of age. It should also be



Employee child









Dependent 
Number of Dependents is
This would be the case


Count
not sufficient to satisfy 
when the dependent



Coverage Choice.
information is not entered




into the system. Add




Dependent.




This can also occur if the




number of dependent as




specified in coverage




choice does not match




with the dependents




available. Add or




Inactivate dependent as




applicable.


Dependent
Dependent information is
This would occur if the



not specified
Coverage choice specified




is other than employee




only and depended record




is not entered. Add




Dependent








Dependent
These missing information pertains to the


Information
Dependent Level information required in the



Dependent Information Screen









Date of Birth
Date of Birth is not
Fill in the Date of Birth in



specified
the Dependent General




Info Screen


Gender
Gender is not specified
Choose the Gender in the




Dependent General Info




Screen


SSN
SSN is not specified
Fill in the SSN in the




Dependent General Info




Screen. If the dependent




refuse to provide SSN




then click auto generate




SSN/Unique ID in the




Dependent General Info




Screen. Auto generation




of SSN/Unique ID will be




available only for the user




with role as level II and




above


Relationship
Relationship of the
Choose the dependent



dependent with the
relationship from the



employee not specified
Dependent Info Screen


Relationship -
Relationship, child is
Verify if the child is


Child
specified for child above
disabled and choose if



23 years of age
Disabled Permanent or




Temporary.


Signature
Dependent signature is
This is required if the



missing
dependent age is above




18. Verify the signature




for the dependent and




check the checkbox




Signature in the




dependent info screen


Relationship
Number of spouse is more
Check for the relationship



than one
in the dependent info




screen. There can only be




one of the following




relationship for the




dependent:




Spouse or Ex - Spouse or




domestic partner.




Choose different




relationship for the other




dependent in the




dependent info screen or




inactivate the other




dependent








General Missing
This missing information pertains to the All


Information on
Level of information. This may be due to non


All Level
availability of sufficient master record to



process enrollment or may require business



decisions or administrative changes in the



system to overcome this missing information









Employee 
Employee Record Does 
Probably the entries for


Record
not exist
the employees are not




made. Add employees to




satisfy this eligibility rule.


Group Size
Group Size cannot be less
Probably the entries for



than 2 Employees
the employees are not




made or less that two




employee records only




exist in the system. Add




at least 2 employees to




satisfy this eligibility rule.


Group Size
Group Size cannot be
Probably the entries for



greater than 50
the employees are more



Employees
than 50 records. This does




not satisfy eligibility




criteria rule for Small




Employer Group. Group




cannot be enrolled.


Participation 
Participation Rule is not
Participation rule states


Rule
satisfied
that 65% of the eligible




employees need to enroll




if the group size is >3 and




100% of the eligible




employees need to enroll




if the group size is <=3.




Check if this is met with.




If not then the group does




not satisfy the eligibility




rule. Group cannot be




enrolled. Check this in




Group Summary Screen.


Contribution 
Contribution Rule for
The employer


Rule
Medical is not satisfied
contribution for the




Medical Line of Coverage




is not satisfied. Check the




Contribution Amount.




Edit the Line of coverage




and change the




contribution Amount and




update in the Group




Coverage Info Screen.


Contribution 
Contribution Rule for
The employer


Rule
Dental is not satisfied
contribution for the Line




of Coverage is not




satisfied. Check the




Contribution Amount.




Edit the Line of coverage




and change the




contribution Amount and




update in the Group




Coverage Info Screen.


Contribution 
Contribution Rule for
The employer


Rule
Vision is not satisfied
contribution for the Line




of Coverage is not




satisfied. Check the




Contribution Amount.




Edit the Line of coverage




and change the




contribution Amount and




update in the Group




Coverage Info Screen.


Contribution 
Contribution Rule for
The employer


Rule
CAM is not satisfied
contribution for the Line




of Coverage is not




satisfied. Check the




Contribution Amount.




Edit the Line of coverage




and change the




contribution Amount and




update in the Group




Coverage Info Screen.


Rate Availability
Rate is not available for
This is possible if the



the Plan opted by the
Rates are not loaded for



Employee
the Group's effective date




of enrollment. Load the




rates for the specific plan




from the Carrier




Maintenance - Rate




Import utility.


Admin Fees
Admin Fees for the Small 
This is possible if the



Employer Group is not
Admin Fees is not



specified
specified for the Group's




Effective date. Add Admin




fees from the Carrier




Maintenance - Rate




Administration


Agent 
Agent Commission for the 
This is possible if the


Commission
Small Employer Group is
Agent Commission is not



not specified
specified for the Group's




Effective date. Add Agent




Commission from the




Carrier Maintenance - 




Rate Administration


Rate Differential
Rate Differential Factor 
This is possible if the Rate


Factor
for the Small Employer
Differential Factor is not



Group is not specified
specified for the Group's




Effective date. Add Rate




Differential Factor from




the Carrier Maintenance -




Rate Administration


Plan availability
Medical Plan selected by 
Normally the Plan for the



the Employees not
employee is listed based



available in the service 
on the Plan available in



area.
the employees Service




Area. Rare cases if the




User Modifies the ZIP




Code in the Employee




General Info Screen and




fails to update the Plan




for the specific ZIP code,




Service Area combination




this message would be




shown. Pick the plans




that are available for the




Employee in the




Employee Coverage Info




screen.


Plan availability
Dental Plan selected by
Normally the Plan for the



the Employees not
employee is listed based



available in the service 
on the Plan available in



area.
the employees Service




Area. Rare cases if the




User Modifies the ZIP




Code in the Employee




General Info Screen and




fails to update the Plan




for the specific ZIP code,




Service Area combination




this message would be




shown. Pick the plans




that are available for the




Employee in the




Employee Coverage Info




screen.


Plan availability
Vision Plan selected by
Normally the Plan for the



the Employees not
employee is listed based



available in the service 
on the Plan available in



area.
the employees Service




Area. Rare cases if the




User Modifies the ZIP




Code in the Employee




General Info Screen and




fails to update the Plan




for the specific ZIP code,




Service Area combination




this message would be




shown. Pick the plans




that are 'available for the




Employee in the




Employee Coverage Info




screen.


Plan availability 
CAM Plan selected by the
Normally the Plan for the



Employees not available
employee is listed based



in the service area.
on the Plan available in




the employees Service




Area. Rare cases if the




User Modifies the ZIP




Code in the Employee




General Info Screen and




fails to update the Plan




for the specific ZIP code,




Service Area combination




this message would be




shown. Pick the plans




that are available for the




Employee in the




Employee Coverage Info




screen.









    
    
        Step—15: On completing all the relevant information that is required for a successful enrollment of a group, the following is the sample screen for a successful enrollment of a group. (See FIG. C-28)
    
    


Create Group (Alternate Group—Individual Member)
The create group screen is to enter details of a group. The screen provides functionality to save, edit or add new group details.
The sequential steps involved in the creation of a new group by selecting group under alternate group are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Then select the option Group Enrollment and Create Group. (See FIG. C-29)
        Step—2: Screen displays with the option of selecting a group hierarchy. (See FIG. C-30)
        Step—3: Screen navigates select an alternate group. Enter a 10-digit number or choose an association name. (See FIG. C-31)
        Step—4: Choose the option of individual member and click Continue. (See FIG. C-32)
        Step—5: Clicking continue button screen navigates to general info. Enter the values in the respective field, as per the format briefed in fields explanation section Field Explanation, and click Continue. (See FIG. C-33)
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Post Mark Date
Text for post mark date. Choose a date by clicking



calendar icon. Accepts in the format MM/DD/YYYY


Received Date
Text for received date. Choose a date by clicking



calendar icon. Accepts in the format MM/DD/YYYY







Employee Information








Salutation
Choose the salutation from the drop down list of



salutations available.


First Name
The text for first name. Accepts alphabets and special



character like hyphen and single quotes not exceeding



25 characters. First name is mandatory.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for contact name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 35 characters. Last name is mandatory


Suffix
Choose the suffix from the drop down list of suffixes



available.


Date of Birth
The text for date of birth. Choose a date by clicking



calendar icon


Social Security
The text for social security number for every


Number
individual. This can also be auto generated by clicking



auto generate link. Accepts numeric value of exactly 9



digits. Users with User Role as Level 2 and above can



only auto generate SSN.


Gender
Choose a gender from the drop down list available.







Address Information; Physical and Alternate Address- Note: Enter


Alternate Address if different from the Physical Address.








Street Address
The text for address. Accepts alphanumeric and special



characters not exceeding 35 characters


Suite
The text for suite/apt # Accepts alphanumeric and



special characters not exceeding 35 characters


Zip
The text for zip. Accepts numeric value of either 5 or 9



digits. City, State and County are populated



automatically on entering the correct zip code and



entering the tab key.


City
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters.


State
Choose the name of the state from the drop down list



of States available in United States of America


County
Choose the name of the county from the drop down list



of counties available for the ZIP Code entered.


Mode of
Choose the mode of correspondence from the drop


Correspondence
down list available.


Phone Number
The text for telephone number of the contact person.



Accepts numeric values not exceeding 10 digits. The



format is (999) 999-9999


Extension
The text for extension number of the contact person.



Accepts numeric values not exceeding 5 digits.


Fax
The text for fax number of the contact person Accepts



numeric values not exceeding 10 digits. The format is



(999) 999-9999


Email
The text for email of the contact person. Accepts



alphabets, numeric and special characters in the



standard email format of length not exceeding 100



characters









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    
















Element
Description









Continue
Navigates to Billing Information screen.



Cancel
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes



Tabs
General Info, Billing Info, Agent Info, Coverage Info




and Add Employees are the tabs visible on this screen.




The navigation between tabs is possible only if there is




a valid group ID generated and assigned to the group.




Also while navigating through the tab the content that




are changed on the screen are not saved unless




explicitly saved by other operations on the screen.










    
    
        Step—6: Screen navigates to billing information. Enter the values in the respective fields, as per the format briefed in field's explanation section and click Continue. (See FIG. C-34)
    
    


Field Explanation
Refer field explanation provided for Small Employer Group—Billing Info.
Button Functionality
Refer button functionality provided for Small Employer Group—Billing Info

    
    
        Step—7: Screen navigates to Agent Info screen. Agent/Agency ID is selected by clicking search icon. (See FIG. C-35)
        Step—8: This pops up a screen to select agency id Enter value in any one of the field or simply click Search button to perform search operation. (See FIG. C-36)
        Step—9: Click on agency id for selection. (See FIG. C-37)
        Step—10: After filling other relevant information in agent info screen, as per the format briefed in field's explanation section and click Continue
    
    


Field Explanation
Refer field explanation provided for Small Employer Group—Agent Info.
Button Functionality
Refer button functionality provided for Small Employer Group—Agent Info.

    
    
        Step—11: Screen navigates to coverage information. Enter the values in the respective fields, as per the format briefed in field's explanation section and click Continue. (See FIG. C-38)
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Hours worked per
The text for worked hours per week. Accepts numeric


week
values.


Date of hire
The text for date of employment. Choose a date by



clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Employee type
Choose an employee type from the drop down list



available


Pay Roll
Check box for Pay Roll verification. Check this if pay



roll is verified.


RAF
Text to display the RAF applicable for the Individual



Association Member.


Line of coverage
Choose a line of coverage from the drop down list



available


Medical waived
Click the check box for medical waive if the employee



is waiving medical.


Carrier selection
Choose a carrier selection from the drop down list


(Benefit level)
available


Coverage choice
Choose a coverage from the drop down list available


PCP ID/Medical
The text for PCP ID. Accepts alphabets and numeric


group ID
values not exceeding 10 characters.


Are you an existing
Click the check box if you are an existing patient


patient



PCP last name
The text for PCP last name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 35 characters.


PCP first name
The text for PCP first name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 25 characters.


Prior plan type
Choose a plan type from the drop down list available


Prior plan name
Choose a plan name from the drop down list available


Prior insurance
The text for insurance start date. Choose a date by


start date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Prior insurance end
The text for insurance end date. Choose a date by


date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Other coverage kept
The text for other coverage. Accepts alphabets with



values not exceeding 50 characters.


Employee signature
Click the check box, to have employee signature


Additional coverage
The text for any additional coverage. Accepts



alphabets with values not exceeding 50 characters.


Date signed
The text for date signed. Choose a date by clicking



calendar icon. Date accepts the format 



MM/DD/YYYY. Date cannot accept future date.









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    
















Element
Description









Add
Add the contents of employee coverage information. 




It is only a temporary addition. Becomes permanent 




only on saving.



Edit
Edit button will allow for editing a specific record 




in the table.



Update
Update the contents of Plan Information. It is only 




a temporary update. Becomes permanent only on 




saving.



Cancel
Cancels the operation that was currently performed




prior to saving the record.



Delete
Delete button will delete the records in the table




checked for deletion. It is only a temporary deletion.




Becomes permanent only on saving.



Check All 
The “Check All” Link will check all the records in 




the table



Clear All 
The “Clear All” Link will uncheck all the records 




in the table that are checked.



Enrollment
Click enrollment summary refreshes the screen 



Summary
and display the summary of information entered 




for group creation



Missing
Click missing information refreshes the screen and



Information
displays the missed information. For a successful




creation of a group, there should be no missing




information



Group ID
Click Group ID to navigates to the Group's general 




info screen.



Continue
Saves the data and navigates to Coverage 




Information screen. .



Cancel
Clears the contents entered in the fields or restore 




to the previous state as was before saving the 




changes



Tab
General Info, Billing Info, Agent Info, Coverage 




Info and Add Employees are the tabs visible on 




this screen.The navigation between tabs is possible




only if there is a valid group ID generated and 




assigned to the group. Also while navigating




through the tab the content that are changed on




the screen are not saved unless explicitly saved




by other operations on the screen










    
    
        Step—12: Screen navigates to add dependent information. First name and last name fields are mandatory and other fields are optional. Enter the values in the respective fields, as per the format briefed in field's explanation section and click Continue. (See FIG. C-39)
    
    


Field Explanation
Refer field explanation provided for Small Employer Group—Add Dependent.
Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Add Dependent
Saves the data and navigates to the screen for 



adding dependent


Enrollment
Click enrollment summary refreshes the screen 


Summary
and display the summary of information entered 



for group creation


Missing
Click missing information refreshes the screen 


Information
and displays the missed information. For a 



successful creation of a group, there should be 



no missing information


Cancel
Clears the contents entered in the fields or restore 



to the previous state as was before saving the 



changes


Tabs
General Info, Coverage Info, Add Dependent are 



the tabs visible on this screen. The navigation 



between the tabs are possible only if there is a valid 



Employee ID generated and assigned to the employee 



Also while navigating through the tab the content 



that are changed on the screen are not saved unless 



explicitly saved by other operations on the screen









    
    
        Step—13: Clicking enrollment summary button screen navigates to enrollment summary. This screen shows the overall information that are entered will be shown. (See FIG. C-40)
    
    


Field Explanation

    
    
        The following table provides explanation for each element in the screen.
    
    













Element
Description







Group
Contains header information of the Group


Information Header



Name of the Group
Text for the Name of the Group


Group ID
Text and Link for the Group ID to navigate to the



Group General Info screen


Group Type
Specifies the Type of the Group like Small 



Employer Group


Proposed Effective
The text for Proposed Effective Date. Choose a 


Date
date by clicking calendar icon. Date accepts the 



format MM/DD/YYYY. Default effective date is 



first of the following month. Effective date cannot 



be past date


Status
Text to specify the status of the group.


Work Group
Text for Work Group. This specifies the internal 



work group attached to the Group. Internal is 



based on the writing agent's work group.


Association ID
Text to specify the Association ID


Association Name
Text to specify the Association Name


Enrollment
Enrollment Summary Information is broken 


Summary
down into tree structure. The tree can by expanded 


Information
or collapsed. The level of the tree is as per the 



example given below:



− Employee



 − Dependent



 − Dependent



 + Dependent



Where (−) signifies expanded view and (+) 



signifies collapsed view.


Employee ID
Text for Employee ID


Employee SSN
Text for Employee SSN


Employee Name
Text for employee Name (First Name and 



Last Name)


Effective Date
Text for Employee Effective date. Choose a 



date by clicking calendar icon. Date accepts 



the format MM/DD/YYYY. Defaults effective 



date of the Group. Effective date cannot be 



past date


Status
Text to specify the status of the employee.


Dependent ID
Text for Dependent ID


Dependent SSN
Text for Dependent SSN


Dependent Name
Text for Dependent Name (First Name and 



Last Name)


Effective Date
Text for Dependent Effective date. Choose a 



date by clicking calendar icon. Date accepts 



the format MM/DD/YYYY. Defaults effective 



date of the Employee. Effective date cannot 



be past date


Status
Text to specify the status of the Dependent.









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    
















Element
Description









Missing
Click missing information refreshes the screen and



Information
displays the missed information. For a successful




creation of a group, there should be no missing




information



Cancel
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes



Group ID
Click Group ID to navigates to the Group's general 




info screen.










    
    
        Step—14: Clicking pre enrollment navigates to missing info screen. It gives the information that is left out while entering input for creating a group. For a successful creation of a group the missing information should be empty. (See FIG. C-41)
    
    


Field Explanation

    
    
        The following table provides explanation for each element in the screen.
    
    













Element
Description







Group
Contains header information of the Group


Information Header



Name of the Group
Text for the Name of the Group


Group ID
Text and Link for the Group ID to navigate to 



the Group General Info screen


Group Type
Specifies the Type of the Group like Small 



Employer Group


Proposed Effective
The text for Proposed Effective Date. Choose a 


Date
date by clicking calendar icon. Date accepts the 



format MM/DD/YYYY. Default effective date 



is first of the following month. Effective date 



cannot be past date


Status
Text to specify the status of the group.


Work Group
Text for Work Group. This specifies the internal 



work group attached to the Group. Internal is 



based on the writing agent's work group.


Association ID
Text to specify the Association ID


Association Name
Text to specify the Association Name


Tree Structure
Enrollment Missing Information is broken 



down into tree structure. The tree can by 



expanded or collapsed. The level of the tree 



is as per the example given below:



− Employee



 − Dependent



 − Dependent



Where (−) signifies expanded view and (+) 



signifies collapsed view.


Group Missing Info
This identifies all the eligibility rules and the



information that are incomplete on Group level 



for completing the enrollment process.


Missing Entities
List the missing entities for the group. Provides 



a link to go to the respective screen to fill in the 



relevant information to complete all the required 



entries.


Message
List the message against each missing entities.


Employee
This identifies all the eligibility rules and the


Missing Info
information that are incomplete on Employee 



level for completing the enrollment process.


Missing Entities
List the missing entities for the employee. 



Provides a link to go to the respective screen 



to fill in the relevant information to complete 



all the required entries.


Message 
List the message against each missing entities.


Dependent
This identifies all the eligibility rules and the


Missing Info
information that are incomplete on dependent 



level for completing the enrollment process.


Missing Entities
List the missing entities for the dependent. 



Provides a link to go to the respective screen 



to fill in the relevant information to complete 



all the required entries.


Message
List the message against each missing entities.


Enrollment Action
Choose from the drop down list the action to be



performed for enrollment. Enroll/Decline


Remarks
Text for remarks if any.


Reasons for Decline
Choose from the drop down list the reasons 



for decline.


Reasons for Other
Text for other reason. If the reason for decline 



is other enter the reasons here.









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Enroll
Saves the data if there are no missing information and



navigates to enrollment confirmation page.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Group ID
Click Group ID to navigates to the Group's general info



screen.









Missing Information

The following table provides explanation for each missing information and what needs to be done to remove missing information from the screen












Missing Entity
Message
Reasons/Remedy















Member Level








Employee
These missing information pertains to the


General 
Member Level information required in the


Information
General Information Screen









Address
Address information is 
Fill in the address



not specified
information in the




Employee General Info




Screen


City
City is not specified
Fill in the City in the




Employee General Info




Screen


State
State is not specified
Fill in the City in the




Employee General Info




Screen


ZIP Code
ZIP Code is not specified 
Fill in the ZIP Code in the




Employee General Info




Screen


Date of Birth
Date of Birth is not
Fill in the Date of Birth 



specified
in the Employee General




Info Screen


Gender
Gender is not specified
Choose the Gender in the




Employee General Info




Screen


SSN
SSN is not specified
Fill in the SSN in the




Employee General Info




Screen. If the employee




refuse to provide SSN




then click auto generate




SSN/Unique ID in the




Employee General Info




Screen. Auto generation




of SSN/Unique ID will be




available only for the user




with role as level II and




above


Mode of
Mode of Correspondence
Choose the Mode of


Corre-
is not specified
Correspondence for


spondence

Employee from the list 




in Employee general 




info screen


Email
Email for Employee is not 
This is required if the



specified
mode of correspondence




selected is Email. Fill in




the Email in the




Employee general info




screen








Billing
These missing information pertains to the


Information
Member Level information required in the










Billing Information Screen



Mode of 
Mode of payment is not
Choose the Mode of


payment
specified
Payment for the group




from the list in Group




Billing Info Screen


Check Number
Check Number is not
Fill in the Check number



specified.
in the Group Billing Info




Screen


Check Date
Date Check is received is 
Fill in the Date received



not specified
in the Group Billing Info




Screen


Check Number
Check Number is received
Fill in the Check Number



is not specified
in the Group Billing Info




Screen


Initial 
Initial payment not
If initial payment check is


Payment
received
received then uncheck the




box “No Check Received”




in the Group Billing Info




Screen


Initial 
Initial Payment is not
If initial payment check 


Payment
sufficient to get enrolled
is received but there is a




shortfall in the amount




this message would be




shown. Check the short




fall by previewing the




invoice with the amount




received.




The variation in amount




received by more than (-)




$2 will allow user with




level II and above only to




enroll.




The variation in amount




received by more than (-)




$50 will allowing user




with level III and above




only to enroll




The variation in amount




received by more than (-)




$100 will allow user with




level IV and above only to




enroll


Cardholder's 
Cardholder's name is not
This is required if the


Name
specified
mode of payment opted by




group is Credit Card. Fill




in the Cardholder's name




in the Group Billing Info




Screen.


Credit Card 
Credit Card Type is not
This is required if the


Type
specified.
mode of payment opted 




by group is Credit Card




Choose the Credit Card




Type for the group from




the list in Group Billing




Info Screen


Credit Card
Credit Card Number is
This is required if the


Number
not specified
mode of payment opted 




by group is Credit Card. 




Fill in the Credit Card




Number in the Group




Billing Info Screen.


Expiration 
Credit Card Expiration
This is required if the


Date
Date is not specified
mode of payment opted by




group is Credit Card. Fill




in the Credit Card




Expiration Date in the




Group Billing Info Screen.


Bank Name
Bank name is not
This is required if the



specified
mode of payment opted by




group is EFT. Fill in the




Bank Name in the Group




Billing Info Screen.


Routing 
Routing Number is not
This is required if the


Number
specified
mode of payment opted by




group is EFT. Fill in the




Routing Number in the




Group Billing Info Screen.


Account Type
Account Type is not
This is required if the



specified
mode of payment opted by




group is EFT. Fill in the




Account Type in the




Group Billing Info Screen


Depositor's 
Depositor's Name is not 
This is required if the


Name
specified
mode of payment opted by




group is EFT. Fill in the




Depositor's Name in the




Group Billing Info Screen








Agent
These missing information pertains to the


Information
Member Level information required in the Agent










Information Screen



Writing Agent
Writing Agent is not
Choose the Writing Agent



specified
for the Group in the




Group Agent Info Screen


Agent of 
Agent of Record is not
This is required if


Record
specified
commission for the agent




exists. Choose the Agent




of Record for the Group in




the Group Agent Info




Screen


Agent License
Agent License Number is
Go to Agent/Agency


Number
not specified
Master Screen, search for




the agent/agency




attached with group and




fill in the License




information.


License Expiry
License Expiry Date is
Go to Agent/Agency


Date
not specified
Master Screen, search for




the agent/agency




attached with group and




fill in the License




information.


License Expiry
Agent License Number is
Go to Agent/Agency


Date
expired
Master Screen, search for




the agent/agency




attached with group and




modify the license expiry




date.


Commission
% Commission is split is 
Check if the commission



not specified
split for the agent of




record exists. If not edit




the corresponding agent




of record and enter %




commission split for the




Agent of Record in the




Group Agent Info Screen


Total Com-
% Split in commission is 
Check if the total of the


mission Split
less than 100%
commission split's for the




agent of record is 100. If




not edit the corresponding




agent of record and make




changes to make




commission split total to




100% in the Group Agent




Info Screen








Coverage
These missing information pertains to the


Information
Member Level information required in the



Coverage Information Screen









Hours Worked
Hours worked per week
Fill in the Hours worked



not specified
per week in the Employee




Coverage Info Screen


Date of
Date of employment not
Fill in the Date of


Employment
specified
Employment in the




Employee Coverage Info




Screen


Employee
Employee signature is
Verify employee's


Signature
missing
signature and check




Employee Signature




checkbox in the Employee




Coverage Info Screen


Date Signed
Date Signed is missing
Verify Date signed and fill




in the Date Signed in the




Employee Coverage Info




Screen


Employee 
Employee Type not
Choose the Employee


Type
specified
Type for Employee Type




from list in Employee




Coverage info screen


Employee 
Employee's Line of
Choose the Line of


Coverage
Coverage not specified
Coverage for the




Employee in Employee




Coverage info screen


Medical 
Medical Line of Coverage
Choose the Line of


Coverage
not specified
Coverage for the




Employee in Employee




Coverage info screen. If




the employee waives




medical coverage check




the checkbox Medical




Waived.


Dental 
Dental Line of Coverage 
This is required if the


Coverage
not specified
Association offers optional




benefits. Choose the Line




of Coverage for the




Employee in Employee




Coverage info screen


Vision 
Vision Line of Coverage 
This is required if the


Coverage
not specified
Association offers optional




benefits. Choose the Line




of Coverage for the




Employee in Employee




Coverage info screen


CAM 
CAM Line of Coverage not
This is required if the


Coverage
specified
Association offers optional




benefits. Choose the Line




of Coverage for the




Employee in Employee




Coverage info screen


Coverage 
Coverage Choice between 
Choose the appropriate


Choice
the Line of Coverage
coverage choices as per



differs
the illustration provided




in the column below and




edit the coverage choice




for the specific Line of




Coverage and update in




Employee Coverage info




screen. Or In dependent




Info Screen waive the




Optional coverage choice




for dependent under 2 by




checking the check box




Waive.








Coverage 
Coverage choice for the Medical should have highest


Choice
precedence. There are Four Coverage Choices


Illustration
1- Employee Family



2 - Employee Child



3- Employee Spouse



4 - Employee Only



Case 1:



If coverage choice for medical is Employee Child,



Optional benefit cannot have employee spouse. It



should be Employee Child or Employee Only provided



child is under 2



Case 2:



If Coverage Choice for Medical is Employee Spouse



optional benefits cannot have employee child. It should



also be Employee Spouse



Case 3:



If Coverage Choice for Medical is Employee Child



optional benefits cannot have employee only if at least



one child his above 2. It should also be Employee child









Dependent 
Number of Dependents is
This would be the case


Count
not sufficient to satisfy 
when the dependent



Coverage Choice.
information is not entered




into the system. Add




Dependent.




This can also occur if the




number of dependent as




specified in coverage




choice does not match




with the dependents




available. Add Dependent.


Dependent
Dependent information is
This would occur if the



not specified
Coverage choice specified




is other than employee




and depended record is




not entered. Add




Dependent


1099's
1099 not provided for
Manually verify 1099 for



verification
the employee and check




the 1099's Flag in the .




Enrollment summary for




the specific employee.


DE6
DE6 not provided for
Manually verify DE6 for



verification
the employee and check




the DE6 Flag in the




Enrollment summary for




the specific employee.








Dependent
These missing information pertains to the


Information
Dependent Level information required in the



Dependent Information Screen









Date of Birth
Date of Birth is not
Fill in the Date of Birth in



specified
the Dependent General




Info Screen


Gender
Gender is not specified
Choose the Gender in the




Dependent General Info




Screen


SSN
SSN is not specified
Fill in the SSN in the




Dependent General Info




Screen. If the dependent




refuse to provide SSN




then click auto generate




SSN/Unique ID in the




Dependent General Info




Screen. Auto generation




of SSN/Unique ID will be




available only for the user




with role as level II and




above


Relationship
Relationship of the
Choose the dependent



dependent with the
relationship from the



employee not specified
Dependent Info Screen


Relationship -
Relationship, child is
Verify if the child is


Child
specified for child above 
disabled and choose if



23 years of age
Disabled Permanent or




Temporary.


Signature
Dependent signature is
This is required if the



missing
dependent age is above




18. Verify the signature




for the dependent and




check the checkbox




Signature in the




dependent info screen


Relationship
Number of spouse is more
Check for the relationship



than one
in the dependent info




screen. There can only be




one of the following




relationship for the




dependent:




Spouse or Ex - Spouse or




domestic partner.




Choose different




relationship for the other




dependent in the




dependent info screen








General 
These are missing information pertains to the all


Missing
level of information. This may be due to non


Information 
availability of sufficient master record to


on All Level
process enrollment or may require business



decisions or administrative changes in the



system to overcome this missing information









Employee 
Employee Record Does
Probably the entries for


Record
not exist
the employees are not




made. Add employees to




satisfy this eligibility rule.


Rate 
Rate is not available for 
This is possible if the


Availability
the Plan opted by the
Rates are not loaded for



Employee
the Individual Member's




effective date of




enrollment. Load the




rates for the specific plan




from the Carrier




Maintenance - Rate




Import utility.


Admin Fees
Admin Fees for the Small
This is possible if the



Employer Group is not
Admin Fees is not



specified
specified for the




Individual Member's




Effective date. Add Admin




fees from the Carrier




Maintenance - Rate




Administration


Agent 
Agent Commission for the
This is possible if the


Commission
Small Employer Group is
Agent Commission is not



not specified
specified for the




Individual Member's




Effective date. Add Agent




Commission from the




Carrier Maintenance -




Rate Administration


Rate 
Rate Differential Factor
This is possible if the Rate


Differential
for the Small Employer
Differential Factor is not


Factor
Group is not specified
specified for the Agent




Commission Effective




date. Add Rate




Differential Factor from




the Carrier Maintenance -




Rate Administration


Plan 
Medical Plan selected by 
Normally the Plan for the


availability
the Employees not
employee is listed based



available in the service 
on the Plan available in



area.
the employees Service




Area. Rare cases if the




User Modifies the ZIP




Code in the Employee




General Info Screen and




fails to update the Plan




for the specific ZIP code,




Service Area combination




this message would be




shown. Pick the plans




that are available for the




Employee in the




Employee Coverage Info




screen.


Plan 
Dental Plan selected by
Normally the Plan for the


availability
the Employees not
employee is listed based



available in the service 
on the Plan available in



area.
the employees Service




Area. Rare cases if the




User Modifies the ZIP




Code in the Employee




General Info Screen and




fails to update the Plan




for the specific ZIP code,




Service Area combination




this message would be




shown. Pick the plans




that are available for the




Employee in the




Employee Coverage Info




screen.


Plan 
Vision Plan selected by
Normally the Plan for the


availability
the Employees not
employee is listed based



available in the service 
on the Plan available in



area.
the employees Service




Area. Rare cases if the




User Modifies the ZIP




Code in the Employee




General Info Screen and




fails to update the Plan




for the specific ZIP code,




Service Area combination




this message would be




shown. Pick the plans




that are available for the




Employee in the




Employee Coverage Info




screen.


Plan 
CAM Plan selected by the
Normally the Plan for the


availability
Employees not available 
employee is listed based



in the service area.
on the Plan available in




the employees Service




Area. Rare cases if the




User Modifies the ZIP




Code in the Employee




General Info Screen and




fails to update the Plan




for the specific ZIP code,




Service Area combination




this message would be




shown. Pick the plans




that are available for the




Employee in the




Employee Coverage Info




screen.









    
    
        Step—15: On completing all the relevant information that is required for a successful enrollment of a group, the following is the sample screen for a successful enrollment of an individual association member. (See FIG. C-42)
    
    


Create Group (Alternate Group—Small Employer Group)
The create group screen is to enter details of a group The screen provides functionality to save, edit or add new group details.
There are three different ways of creation, namely creating a group, through small employer group, alternate group that has again two methods namely individual member and group.
The sequential steps involved in the creation of a new group by selecting group under alternate group are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Then select the option Group Enrollment and Create Group. (See FIG. C-43)
        Step—2: Screen displays with the option of selecting a group hierarchy. (See FIG. C-44)
        Step—3: Screen navigates select an alternate group. Enter a 10 digit number or choose an association. (See FIG. C-45)
        Step—4: Choose the option of group and click Continue. (See FIG. C-46)
        Step—5: Clicking continue button screen navigates to general info. Enter the values in the respective field, as per the format briefed in fields explanation section Field Explanation, and click Continue. (See FIG. C-47)
    
    


Field Explanation
Refer field explanation provided for Small Employer Group—General Info.
Button Functionality
Refer button functionality provided for Small Employer Group—General Info.

    
    
        Step—6: Screen navigates to billing information. Enter the values in the respective fields, as per the format briefed in field's explanation section and click Continue. (See FIG. C-48)
    
    


Field Explanation
Refer field explanation provided for Small Employer Group—Billing Info.
Button Functionality
Refer button functionality provided for Small Employer Group—Billing Info.

    
    
        Step—7: Screen navigates to Agent Info screen. Agent/Agency ID is selected by clicking search icon. (See FIG. C-49)
        Step—8: This pops up a screen to select agency id Enter the first letter of agent name or first digit of agent id to perform search operation. (See FIG. C-50)
        Step—9: Click on agency id for selection. (See FIG. C-51)
        Step—10: After filling other relevant information in agent info screen, as per the format briefed in field's explanation section and click Continue
    
    


Field Explanation
Refer field explanation provided for Small Employer Group—Agent Info.
Button Functionality
Refer button functionality provided for Small Employer Group—Agent Info.

    
    
        Step—11: Screen navigates to coverage information. Even though the fields are optional, enter the values in the respective fields, as per the format briefed in field's explanation section and click Continue. (See FIG. C-52)
    
    


Field Explanation
Refer field explanation provided for Small Employer Group—Coverage Info.
Button Functionality
Refer button functionality provided for Small Employer Group—Coverage Info.

    
    
        Step—12: Screen navigates to add employee general information. First and Last name are mandatory other fields are optional. Enter the values in the respective fields, as per the format briefed in field's explanation section. (See FIG. C-53)
    
    


Field Explanation
Refer field explanation provided for Small Employer Group—Add Employee General Info.
Button Functionality
Refer button functionality provided for Small Employer Group—Add Employee General Info.

    
    
        Step—13: Screen navigates to coverage information. Even though the fields are optional, enter the values in the respective fields, as per the format briefed in field's explanation section and click Continue. (See FIG. C-54)
    
    


Field Explanation
Refer field explanation provided for Small Employer Group—Add Employee Coverage Info.
Button Functionality
Refer button functionality provided for Small Employer Group—Add Employee Coverage Info.

    
    
        Step—14: Screen navigates to add dependent information. Enter the values in the respective fields, as per the format briefed in field's explanation section and click anyone of the button shown for subsequent operation. (See FIG. C-55)
    
    


Field Explanation
Refer field explanation provided for Small Employer Group—Add Dependent
Button Functionality
Refer button functionality provided for Small Employer Group—Add Employee Add Dependent.

    
    
        Step—15: Clicking enrollment summary button screen navigates to enrollment summary. This screen shows the overall information that is entered. Enter the values in the respective fields, as per the format briefed in field's explanation section and click Pre Enrollment button for checking the eligibility criteria for the Group and Members. (See FIG. C-56)
    
    


Field Explanation
Refer field explanation provided for Small Employer Group—Enrollment Summary.
Button Functionality
Refer button functionality provided for Small Employer Group—Enrollment Summary.

    
    
        Step—16: Clicking pre enrollment navigates to missing info screen. Missing information screen provide information on the data that is required to complete an enrollment process. This also checks for the eligibility of the group and member for enrolling into PacAdvantage Program. For a successful creation of a group the missing information should be empty. The user role and authority can overrule certain missing information.
        Enter the values in the respective fields, as per the format briefed in field's explanation section and click Enroll button for enrolling the Group and Members. (See FIG. C-57)
    
    


Field Explanation
Refer field explanation provided for Small Employer Group—Enrollment Missing Info
Button Functionality
Refer button functionality provided for Small Employer Group—Enrollment Missing Info
Missing Information
Refer missing information provided for Small Employer Group—Missing Information

    
    
        Step—17: On completing all the relevant information that is required for a successful enrollment of a group, the following is the sample screen for a successful enrollment of a group. (See FIG. C-58)
    
    


Modify Group (Small Employer Group)
The modify group screen is to modify details of a group for the existing groups. The screen provides functionality to save, edit or add new group details.
The sequential steps involved in the modify group are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Then select the option Group Enrollment and Modify Group. (See FIG. C-59)
        Step—2: Navigates to search screen. Enter value in any one of the field or simply click search button to perform search operation. (See FIG. C-60)
        Step—3: This pop ups a screen with the search result. (See FIG. C-61)
        Step—4: Click on any group id for selection This navigates to general information of the group. The process of modification is similar to the process of flow as explained in Creation of Group. Refer Section Create Group (Small Employer Group)
    
    


Inactivate Group
The inactivate group screen is to make a group from activate state to inactivate.
The sequential steps involved in the inactivate group are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Then select the option Group Enrollment and Inactivate Group. (See FIG. C-62)
        Step—2: Navigates to search screen. Enter value in any one of the fields or simply click search button to perform search operation. (See FIG. C-63)
        Step—3: This pop ups a screen with the search result. (See FIG. C-64)
        Step—4: Click on any group id for selection. This navigates to a screen confirming for the selected group to make inactivate. Click Inactivate button. (See FIG. C-65)
        Step—5: Confirms the status Click Search to navigate back to Group Search screen. (See FIG. C-66)
    
    


Create Employee
The create employee screen is to enter details of a employee The screen provides functionality to save, edit or add new employee details.
The sequential steps involved in the creation of an employee are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Then select the option Employee Enrollment and Create Employee. (See FIG. C-67)
        Step—2: This navigates to group search screen, to create an employee for an employer Enter value in any one of the fields, or simply click search button to perform search operation. (See FIG. C-68)
        Step—3: This pops up a screen with the search result. (See FIG. C-69)
        Step—4: Click on any employer/group id for selection.
        Step—5: This navigates to general information screen pertaining to an employee. The process of creating an employee is similar to the process explained for Small Employer Group
    
    


Modify Employee
The modify employee screen is to modify details of a employee The screen provides functionality to save, edit or add new employee details.
The sequential steps involved for modifying an employee are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Then select the option Employee Enrollment and Modify Employee. (See FIG. C-70)
        Step—2: This navigates to employee search screen. (See FIG. C-71)
        Step—3: Enter value in any one of the fields or simply click search button to perform search operation. Navigates to Search result screen. (See FIG. C-72)
        Step—4: Click on any employee id for selection
        Step—5: This displays General Info screen of an employee with contents ready for any modification. The procedure and flow of modification are similar to the procedures explained for Small Employer Group
    
    


Inactivate Employee
The inactivate employee screen is to make a employee from activate state to inactivate.
The sequential steps involved in the inactivate employee are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Then select the option Employee Enrollment and Inactivate Employee. (See FIG. C-73)
        Step—2: Navigates to search screen for employees. Either enters the id or first letter of employee name to perform search. Click search button. (See FIG. C-74)
        Step—3: This pop ups a screen with the search result. (See FIG. C-75a)
        Step—4: Click on any employee id for selection. This navigates to a screen confirming for the selected employee to make inactivate. Click Inactivate button. (See FIG. C-75b)
        Step—5: Confirms the status Click Search to navigate back to Employee search screen. (See FIG. C-76)
    
    


Create Dependent
The create dependent screen is to enter details of a employee The screen provides functionality to save, edit or add new dependent details.
The sequential steps involved in the creation of an dependent are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Then select the option Dependent Enrollment and Create Dependent. (See FIG. C-77)
        Step—2: Navigates to search screen for employees. Either enters the id or first letter of employee name to perform search operation. Click search button. (See FIG. C-78)
        Step—3: This pops up a screen with the search result. (See FIG. C-79)
        Step—4: Click on any employee id for selection
        Step—5: This navigates to add dependent screen pertaining to an employee. The process of creating a dependent is similar to the process explained for Small Employer Group
    
    


Modify Dependent
The modify dependent screen is to modify details of a dependent.
The screen provides functionality to save, edit or add new dependent details.
The sequential steps involved in the modify dependent are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Then select the option Dependent Enrollment and Modify Dependent. (See FIG. C-80)
        Step—2: This navigates to dependent search screen. (See FIG. C-81)
        Step—3: Enter value in any one of the fields or simply click search button to perform search operation. (See FIG. C-82)
        Step—4: Click on any dependent id for selection
        Step—5: This displays a screen with contents ready for any modification. The procedure and flow of modification are similar to the procedures explained for Small Employer Group
    
    


Inactivate Dependent
The inactivate dependent screen is to make a employee from activate state to inactivate.
The sequential steps involved in the inactivate dependent are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Then select the option Dependent Enrollment and Inactivate Dependent. (See FIG. C-83)
        Step—2: This navigates to dependent search screen. (See FIG. C-84)
        Step—3: This pop ups a screen with the search result. (See FIG. C-85)
        Step—4: Click on any dependent id for selection. This navigates to a screen confirming for the selected employee to make inactivate. Click Inactivate button. (See FIG. C-86)
        Step—5: Confirms the status Click search button navigates to Dependent search screen. (See FIG. C-87)
    
    


Modify Individual Member
The screen is to have modification of details pertaining to an individual member. The screen provides functionality to save, edit or add new individual member details.
The sequential steps involved in modify individual member are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Select the option Individual Member. Then Select Individual member and modify individual member. (See FIG. C-88)
        Step—2: Navigates to search screen individual employee. Either enters the id or first letter of employee name to perform search operation. Click search button. (See FIG. C-89)
        Step—3: This pops up a screen with the search result. (See FIG. C-90)
        Step—4: Click on any employee id for selection
        Step—5: This navigates to general information pertaining to individual employee screen. The process of modifying individual member is similar to the process explained for Individual Member.
    
    


Inactivate Individual Member
The screen is to inactivate individual member from active state.
The sequential steps involved in inactivate individual member are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Select the option Individual Member. Then Select Individual member and inactivate individual member. (See FIG. C-91)
        Step—2: Navigates to search screen individual employee. Enter value in any one of the fields or simply click search button to perform search operation.
        Step—3: This pops up a screen with the search result. (See FIG. C-92)
        Step—4: Click on any employee id for selection. This navigates to a screen confirming for the selected employee to make inactivate. Click Inactivate button. (See FIG. C-93)
        Step—5: Confirms the status. Click search to navigate back to Group search screen. (See FIG. C-94)
    
    


Create Dependent
The screen is to create a dependent for an individual employee member.
The sequential steps involved in creating a dependent for an individual member are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Select the option Individual Member. Then Select Individual member dependent and create dependent. (See FIG. C-95)
        Step—2: Navigates to search screen individual employee. Enter value in any one of the field. (See FIG. C-96)
        Step—3: This pops up a screen with the search result. (See FIG. C-97)
        Step—4: Click on any employee id for selection. This navigates to add dependent screen. The process of creating a dependent is similar to the process explained for Individual Member creating a group by alternate with option.
    
    


Modify Dependent
The screen is to create a dependent for an individual member.
The sequential steps involved in creating a dependent for an individual member are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Select the option Individual Member. Then Select Individual member dependent and modify dependent. (See FIG. C-98)
        Step—2: Navigates to search screen individual dependent. Either enters the id or first letter of employee name to perform search operation. Click search button. (See FIG. C-99)
        Step—3: This pops up a screen with the search result. (See FIG. C-100)
        Step—4: Click on any dependent id for selection. This navigates to add dependent screen. The process of creating a dependent is similar to the process explained for Individual Member creating a group by alternate with option
    
    


Inactivate Dependent
The screen is to inactivate a dependent for an individual member.
The sequential steps involved in creating a dependent for an individual member are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Select the option Individual Member. Then Select Individual member dependent and inactivate dependent. (See FIG. C-101)
        Step—2: Navigates to search screen individual dependent. Either enters the id or first letter of employee name to perform search operation. Click search button. (See FIG. C-102)
        Step—3: This pops up a screen with the search result. (See FIG. C-103)
        Step—4: Click on any employee id for selection. This navigates to a screen confirming for the selected employee to make inactivate. Click Inactivate button. (See FIG. C-104)
        Step—5: Confirms the status of inactivation. Click search button to navigate back to dependent search. (See FIG. C-105)
    
    


4 COBRA Enrollment
Access
The application can be accessed from the main menu as follows:

    
    
        Enrollment→COBRA Enrollment→New COBRA to Existing COBRA
    
    


Pre-Requisites
All master records must be available in the system for a successful enrollment. Master Records are as follows:

    
    
        Carrier Maintenance—Refer “User Manual for Carrier Maintenance” for further information on the master records.
        Work Group—Refer “User Manual for Sales and Marketing” for further information on the Work Group records.
        Internal Associates—Refer “User Manual for Sales and Marketing” for further information on the Internal Associates records.
        Association Master—Refer Section 2 of this document on “Association”.
        Eligibility Criteria (New Business COBRA)—members must satisfy eligibility rule for COBRA.
        Member for existing COBRA Enrollment must be in termed status.
    
    


Application Functions
This application can be sub divided into following major functions:

    
    
        New COBRA Enrollment—New COBRA Enrollment for the Group who bring in their existing COBRA members into the PacAdvantage consist of the following operations:
        
            Create New COBRA—to input details of a COBRA members is for a specific group.
            Modify New COBRA—to search a COBRA prior to enrollment for making modifications.
            Inactivate New COBRA—to search a COBRA prior to enrollment for making inactive.
        
        
        Existing COBRA Enrollment—Existing COBRA Enrollment is for those employee and or dependents that have terminated from the existing group due to various reasons. This consist of the following operations:
        
            Create Existing COBRA—to input details of a COBRA members for a specific group wherein the members are terminated.
            Modify Existing COBRA—to search a COBRA Group of the termed members for making modifications prior to enrollment.
            Inactivate Existing COBRA—to search a COBRA Group of the termed members for inactivating prior to enrollment.
        
        
    
    


Create COBRA (New Business)
The screen is to create new COBRA. The screen provides functionality to save, edit or add new COBRA.
The sequential steps involved in create new COBRA are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select COBRA Enrollment. Select the New COBRA and then select Create COBRA. (See FIG. C-106)
        Step—2: The screen navigates to group search for adding COBRA. Enter value in any one of the fields, or simply click Search to perform search operation. (See FIG. C-107)
        Step—3: The screen displays the search result. (See FIG. C-108)
        Step—4: Choose a group id.
        Step—5: Choose the option of enrolling as single or member with dependents. If the option is with dependents, enter number of dependents.
        Step—6: Click continue button
        Step—7: Screen navigates to general info for new business COBRA group. First name and last name are mandatory and other fields are optional. Enter the values in the respective field as per the format briefed in field's explanation section. Click continue button. (See FIG. C-109)
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Parent Group ID
Text to display the Parent Group ID.


Parent Group
Text to display the Parent Group Name.


Name



COBRA Group ID
Text to display the COBRA Group ID.


COBRA Type
Text to display the COBRA Group Type 



whether Cal COBRA or Federal COBRA.


Group Effective
Text to display effective date of the parent 


Date
group.


Work Group
Text to Display the internal Work group 



associated with the Parent Group


Status
Text to display status of the group.


Post Mark Date
Text for post mark date. Choose a date by 



clicking calendar icon. Accepts in the 



format MM/DD/YYYY


Received Date
Text for received date. Choose a date by 



clicking calendar icon. Accepts in the 



format MM/DD/YYYY


Salutation
Choose the salutation from the drop down 



list of salutations available.


First Name
The text for first name. Accepts alphabets and 



special character like hyphen and single quotes 



not exceeding



25 characters. First name is mandatory.


Middle Initial
The text for middle initial. Accepts alphabets 



not exceeding 1 character.


Last Name
The text for last name. Accepts alphabets and 



special characters like hyphen and single 



quotes not exceeding



35 characters. Last name is mandatory.


Suffix
Choose the Suffix from the drop down list of



salutations available.


Date of Birth
The text for date of birth. Choose a date by 



clicking calendar icon


Social Security 
The text for social security number for every


Number
individual. This can also be auto generated by 



clicking auto generate link. Accepts numeric 



value of exactly 9 digits. Users with User 



Role as Level 2 and above can only auto 



generate SSN.


Gender
Choose a gender from the drop down list 



available.







Address Information: Physical Home Address or Mailing Address








Address
The text for company address. Accepts 



alphabets and numeric values not exceeding 



35 characters


Apt
The text for company suite/apt # Accepts 



alphabets and numeric values of not exceeding 



35 characters


Zip
The text for zip. Accepts numeric of either 5 



or 9 digits. City, State and County are populated



automatically for the correct zip code.


City
The text for city. Accepts alphabets of not 



exceeding 30 characters.


State
Choose the name of the state from the drop 



down list of States available in United States 



of America


County
Choose the name of the county from the drop 



down list of States available in United States 



of America


Mode of
Choose the mode of correspondence from 


Correspondence
the drop down list available


Phone Number
The text for telephone number of the contact 



person. Accepts numeric values of not 



exceeding 10 digits. 



The format is (999) 999-9999


Extension
The text for telephone number of the contact 



person. Accepts numeric values of not 



exceeding 5 digits.



The format is (999) 999-9999


Fax
The text for fax number of the contact 



person. Accepts numeric values of not 



exceeding 10 digits. The format is 9999


Email
The text for email of the contact person. 



Accepts alphabets, numeric and special 



characters in the standard email format 



of length not exceeding 100 characters









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    
















Element
Description









Continue
Saves the data and navigates to Billing Information




screen and the system generates Group ID.



Clear
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes



Tabs
General Info, Billing Info, Coverage Info and Add




Employees are the tabs visible on this screen. The




navigation between is tabs are possible only if there is




a valid group ID generated and assigned to the group.




Also while navigating through the tab the content that




are changed on the screen are not saved unless




explicitly saved by other operations on the screen.










    
    
        Step—8: Screen navigates billing info of group. Enter the values in the respective field as per the format briefed in field's explanation section. Click continue. (See FIG. C-110)
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    
















Element
Description









Mode of payment
Choose a mode of payment from the drop 




down list available. Based on selection 




corresponding fields will enable to enter 




the values. For e.g. if the value selected is 




card payment, EFT will be disabled and 




allows only entering card details and 




vice versa.







Credit Card Information










Cardholder's
The text for cardholder's name. Accepts 



Names
alphabets and space between two words.



Credit Card Type 
Choose the type of credit card from the 




drop down list available.



Credit Card No
The text for credit card number. Accepts 




numeric values not exceeding 30 digits



Expiration Date
Choose a month of expiration from the 




drop down list available



Expiration Year
The text for expiration year. Accepts 




numeric values of exactly 4. Example 




2002.







Billing Address As it appears on the credit Card










Street Address
The text for company address. Accepts 




alphanumeric and special characters not 




exceeding 35 characters.



ZIP
The text for zip. Accepts numeric value 




of either 5 or 9 digits.



State
The text for city. Accepts alphabets and 




space between two words not exceeding 




30 characters.



City
Choose the name of the state from the 




drop down list of States available in 




United States of America







EFT Information










Bank Name
The text for bank name. Accepts alphabets 




and space between two words.



Routing Number
The text for routing number. Accepts 




numeric values not exceeding 9 digits.



Account Number
The text for account number. Accepts 




numeric values not exceeding 9 digits.



Account Type
Choose the type of account from the drop 




down list available.



Depositor's Name 
The text for depositor's name. Accepts 




alphabets and space between two words.







Initial Payment Information










Amount Received
The text for amount received. Accepts 




only numeric values in the format 




999999999.99



Date Receive
The text for date received. Choose from 




the calendar icon in the format 




MM/DD/YYYY.



Check #
The text for check number. Accepts 




numeric values not exceeding 9 digits.



No Check Received
Check the option of no checks received 




for any non-receipt of checks.










Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    
















Element
Description









Continue
Saves the data and Navigates to coverage Information




screen.



Cancel
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes



Tabs
General Info, Billing Info, Coverage Info and Add




Employees are the tabs visible on this screen. The




navigation between is tabs are possible only if there is




a valid group ID generated and assigned to the group.




Also while navigating through the tab the content that




are changed on the screen are not saved unless




explicitly saved by other operations on the screen.










    
    
        Step—9: Screen navigates coverage info of group. Enter the values in the respective field as per the format briefed in field's explanation section. Click continue. (See FIG. C-111)
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







COBRA effective
The text for COBRA effective date. Choose a date 


date
by clicking calendar icon


Qualifying event
Choose a qualifying even from the drop down list



available


COBRA end date
The text for COBRA end date. Choose a date by



clicking calendar icon


Send bill to
Choose the option of sending the bills either to 



group or self (individual)







Plan Information








Line of coverage
Choose a line of coverage from the drop down list



available


Medical waived
Click the check box for medical waive if the 



employee is waiving medical.


Carrier selection
Choose a carrier selection from the drop down list


(Benefit level)
available


Coverage choice
Choose a coverage from the drop down list



available


PCP ID/Medical
The text for PCP ID. Accepts alphabets and 


group ID
numeric values not exceeding 10 characters.


Are you an existing
Click the check box if you are an existing patient


patient



PCP last name
The text for PCP last name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 35 characters.


PCP first name
The text for PCP first name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 25 characters.


Prior plan type
Choose a plan type from the drop down list available


Prior plan name
Choose a plan name from the drop down list 



available


Prior insurance
The text for insurance start date. Choose a date by


start date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Prior insurance
The text for insurance end date. Choose a date by


end date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Other coverage kept
The text for other coverage. Accepts alphabets with



values not exceeding 50 characters.


RAF
The text to display RAF applicable for the Primary



Group.


Employee signature
Click the check box, to have employee signature


Date signed
The text for date signed. Choose a date by clicking



calendar icon. Date accepts the format 



MM/DD/YYYY. Date cannot accept future date.









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Add
Add the contents of employee coverage information.



It is only a temporary addition. Becomes permanent 



only on saving the record.


Edit
Edit button will allow for editing a specific record in



the table.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent only on saving the record.


Check All
The “Check All” Link will check all the records in 



the table


Clear All
The “Clear All” Link will uncheck all the records 



in the table that are checked.


COBRA Summary
Click COBRA summary refreshes the screen and



display the summary of information entered for



COBRA creation


Continue
Navigates add dependent screen.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tabs
General Info, Billing Info, Coverage Info and Add



Employees are the tabs visible on this screen. The



navigation between is tabs are possible only if there is



a valid group ID generated and assigned to the group.



Also while navigating through the tab the content 



that are changed on the screen are not saved unless



explicitly saved by other operations on the screen.









    
    
        Step—10: Screen navigates to add dependent screen. Enter the values in the respective field as per the format briefed in field's explanation section. Click Continue. (See FIG. C-113)
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







First Name
The text for first name. Accepts alphabets and special



character like hyphen and single quotes not exceeding



25 characters. First name is mandatory.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for last name. Accepts alphabets and special



characters like hyphen and single quotes not exceed-



ing 35 characters. Last name is mandatory.


Suffix
Choose the suffix from the drop down list of suffixes



available.


Date of Birth
The text for date of birth. Choose a date by clicking



calendar icon. Date accepts the format



MM/DD/YYYY. Birth date cannot be later than the



current date.


Social Security 
The text for social security number for every


Number
individual. This can also be auto generated by click-



ing auto generate link. Accepts numeric value of 



exactly 9 digits. Users with User Role as Level 2 and 



above can only auto generate SSN.


Gender
Choose a gender from the drop down list available.


Relationship
Choose the relationship from the drop down list



available.


Street Address
The text for address. Accepts alphanumeric and 



special characters with values not exceeding 35 



characters


Suite
The text for suite/apt #. Accepts alphanumeric and



special characters with values not exceeding 35



characters


Zip
The text for zip. Accepts numeric value of either 5 or



9 digits. City, and State are populated automatically



on entering the correct zip code and entering the tab



key.


City
The text for city. Accepts alphabets not exceeding 30



characters.


State
Choose the name of the state from the drop down list



of States available in United States of America


Selected carrier
The text for selected carrier. It is a read only field


Coverage choice
The text for coverage. It is a read only field


Service area
The text for service area. It is a read only field


Prior plan type
Choose a plan type from the drop down list available


Prior plan
The text for plan name. Accepts alphabets


Waived
Click the check box if medical is waived


Start date
The text for start date. Choose a date by clicking



calendar icon


End date
The text for end date. Choose a date by clicking



calendar icon


PCP ID/
The text for PCP ID. Accepts alphabets


PCP last name
The text for PCP last name. Accepts alphabets and



special character like hyphen and single quotes


PCP first name
The text for PCP first name. Accepts alphabets and



special character like hyphen and single quotes


Disabled dependent
Click the option of temporary or permanent. This is



enable if the relationship opted is child


Domestic partner
Click the option for domestic partner. It depends on



the value selected in relationship


Legal guardian
Click the option for legal guardian. It depends on the



value selected in relationship


Signature
Click the check box if the signature is opted









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Add
Add the contents of dependent information. It is only a



temporary addition.


Edit
Edit button will allow for editing a specific record in



the table.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Continue 
Screen navigates to Missing info.


Tabs
General Info, Billing Info, Coverage Info and Add



Employees are the tabs visible on this screen. The



navigation between is tabs are possible only if there is



a valid group ID generated and assigned to the group.



Also while navigating through the tab the content that



are changed on the screen are not saved unless



explicitly saved by other operations on the screen.









    
    
        Step—11: Missing info screen displays the information that is left out while creating a COBRA. Enter the values in the respective field as per the format briefed in field's explanation section. Click Enroll. (See FIG. C-114)
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Group
Contains header information of the Group


Information



Header



Name of the 
Text for the Name of the Group


Group



Group ID
Text and Link for the Group ID to navigate to the



Group General Info screen


Group Type
Specifies the Type of the Group like Small Employer



Group


Proposed 
The text for Proposed Effective Date. Choose a date by


Effective
clicking calendar icon. Date accepts the format


Date
MM/DD/YYYY. Default effective date is first of the



following month. Effective date cannot be past date


Status
Text to specify the status of the group.


Work Group
Text for Work Group. This specifies the internal work



group attached to the Group. Internal is based on the



writing agent's work group.


Tree Structure
Enrollment Missing Information is broken down into



tree structure. The tree can by expanded or collapsed.



The level of the tree is as per the example given below:



− Employee



 − Dependent



 − Dependent



Where (−) signifies expanded view and (+) signifies



collapsed view.


Group Missing
This identifies all the eligibility rules and the


Info
information that are incomplete on Group level for



completing the enrollment process.


Missing Entities
List the missing entities for the group. Provides a link



to go to the respective screen to fill in the relevant



information to complete all the required entries.


Message
List the message against each missing entities.


Employee
This identifies all the eligibility rules and the


Missing Info
information that are incomplete on Employee level for



completing the enrollment process.


Missing Entities
List the missing entities for the employee. Provides a



link to go to the respective screen to fill in the relevant



information to complete all the required entries.


Message
List the message against each missing entities.


Dependent
This identifies all the eligibility rules and the


Missing Info
information that are incomplete on dependent level for



completing the enrollment process.


Missing Entities
List the missing entities for the dependent. Provides a



link to go to the respective screen to fill in the relevant



information to complete all the required entries.


Message
List the message against each missing entities.


Enrollment 
Choose from the drop down list the action to be


Action
performed for enrollment. Enroll/Decline


Remarks
Text for remarks if any.


Reasons for 
Choose from the drop down list the reasons for decline.


Decline



Reasons for 
Text for other reason. If the reason for decline is other


Other
than the reasons available.









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Enroll
Saves the data if there are no missing information and



navigates to enrollment confirmation page.


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


<<, <, >, >>
The enrollment missing information shows record for 5



employees on single screen. If the employee size



increases more than 5. These buttons are used for



navigating to the next and previous records for



viewing.



<< - Show first record(s)



< - Show previous record(s)



> - Show next record(s)



>> - Show last record(s)


Group ID
Click Group ID to navigates to the Group's general info



screen.


Preview Invoice
Click Preview Invoice to pop up a new browser window



to preview the invoice for the group









Missing Information

    
    
        The following table provides explanation for each missing information and what needs to be done to remove missing information from the screen
    
    














Missing Entity
Message
Reasons/Remedy















Member Level








General
These are missing information pertains to the


Information
Member Level information required in the



COBRA Member General Information Screen









Address
Address information is
Fill in the address



not specified
information in the




Employee General Info




Screen


City
City is not specified
Fill in the City in the




Employee General Info




Screen


State
State is not specified
Fill in the City in the




Employee General Info




Screen


ZIP Code
ZIP Code is not specified
Fill in the ZIP Code in the




Employee General Info




Screen


Date of Birth
Date of Birth is not
Fill in the Date of Birth in



specified
the Employee General




Info Screen


Gender
Gender is not specified
Choose the Gender in the




Employee General Info




Screen


SSN
SSN is not specified
Fill in the SSN in the




Employee General Info




Screen. If the employee




refuse to provide SSN




then click auto generate




SSN/Unique ID in the




Employee General Info




Screen. Auto generation




of SSN/Unique ID will be




available only for the user




with role as level II and




above


Mode of
Mode of Correspondence
Choose the Mode of


Correspondence
is not specified
Correspondence for




Employee from the list in




Employee general info




screen


Email
Email for Employee is not
This is required if the



specified
mode of correspondence




selected is Email. Fill in




the Email in the




Employee general info




screen








Billing
These missing information pertains to the Group


Information
Level information required in the Billing



Information Screen









Mode of payment
Mode of payment is not
Choose the Mode of



specified
Payment for the group




from the list in Group




Billing Info Screen


Check Number
Check Number is not
Fill in the Check number



specified.
in the Group Billing Info




Screen


Check Date
Date Check received is
Fill in the Date received



not specified
in the Group Billing Info




Screen


Check Number
Check Number received is
Fill in the Check Number



not specified
in the Group Billing Info




Screen


Cardholder's 
Cardholder's name is not
This is required if the


Name
specified
mode of payment opted by




group is Credit Card. Fill




in the Cardholder's name




in the Group Billing Info




Screen.


Credit Card Type
Credit Card Type is not
This is required if the



specified.
mode of payment opted by




group is Credit Card




Choose the Credit Card




Type for the group from




the list in Group Billing




Info Screen


Credit Card
Credit Card Number is
This is required if the


Number
not specified
mode of payment opted by




group is Credit Card. Fill




in the Credit Card




Number in the Group




Billing Info Screen.


Expiration Date
Credit Card Expiration
This is required if the



Date is not specified
mode of payment opted by




group is Credit Card. Fill




in the Credit Card




Expiration Date in the




Group Billing Info Screen.


Bank Name
Bank name is not
This is required if the



specified
mode of payment opted by




group is EFT. Fill in the




Bank Name in the Group




Billing Info Screen.


Routing Number
Routing Number is not
This is required if the



specified
mode of payment opted by




group is EFT. Fill in the




Routing Number in the




Group Billing Info Screen.


Account Type
Account Type is not
This is required if the



specified
mode of payment opted by




group is EFT. Fill in the




Account Type in the




Group Billing Info Screen


Depositor's Name
Depositor's Name is not
This is required if the



specified
mode of payment opted by




group is EFT. Fill in the




Depositor's Name in the




Group Billing Info Screen








Coverage
These missing information pertains to the Group


Information
Level information required in the Coverage



Information Screen









COBRA 
Qualifying Event is not
Choose the Qualifying


Qualifying
specified
Event for the group from


Event

the list in Coverage




Information Screen


COBRA End 
COBRA End Date not
Choose the Qualifying


Date
specified
Event for the group from




the list in Coverage




Information Screen to




automatically calculate




the COBRA end date




based on the Qualifying




event


Send Bill To
Where COBRA bill needs
Choose one of the option



to be sent is not specified
specified (Group or Self)




in Coverage Information




Screen


Line of Coverage
No line of Coverage is
Choose one of the line of



opted by the member
coverage in Coverage




Information Screen


Plan Selection
No Plan is elected by the
Choose one of the plan in



member
Coverage Information




Screen


Medical LOC
Medical Line of coverage
Medical line of coverage is



not elected by Member
required to decide the




Coverage Choice. Choose




Medical line of coverage




in Coverage Information




Screen


Coverage Choice
No coverage choice
Medical line of coverage is



specified for Medical Line
required to decide the



of coverage
Coverage Choice. Choose




coverage choice in




Coverage Information




Screen


Coverage 
No coverage choice
This is required if the


Choice - Dental
specified for Dental Line
member opts for Dental



of coverage
Plan. Choose coverage




choice in Coverage




Information Screen


Coverage 
No coverage choice
This is required if the


Choice - Vision
specified for Vision Line
member opts for Vision



of coverage
Plan. Choose coverage




choice in Coverage




Information Screen


Coverage 
No coverage choice
This is required if the


Choice - CAM
specified for CAM Line of
member opts for CAM



coverage
Plan. Choose coverage




choice in Coverage




Information Screen


Dependent Count
Number of Dependents is
This would be the case



not sufficient to satisfy
when the dependent



Coverage Choice.
information is not entered




into the system. Add




Dependent.




This can also occur if the




number of dependent as




specified in coverage




choice does not match




with the dependents




available. Add Dependent.


Employee
Employee signature is
Verify employee's


Signature
missing
signature and check




Employee Signature




checkbox in the Employee




Coverage Info Screen


Date Signed
Date Signed is missing
Verify Date signed and fill




in the Date Signed in the




Employee Coverage Info




Screen


Plan availability
Medical Plan selected by
Normally the Plan for the



the Employees not
employee is listed based



available in the service
on the Plan available in



area.
the employees Service




Area. Rare cases if the




User Modifies the ZIP




Code in the Employee




General Info Screen and




fails to update the Plan




for the specific ZIP code,




Service Area combination




this message would be




shown. Pick the plans




that are available for the




Employee in the




Employee Coverage Info




screen.


Plan availability
Dental Plan selected by 
Normally the Plan for the



the Employees not
employee is listed based



available in the service
on the Plan available in



area.
the employees Service




Area. Rare cases if the




User Modifies the ZIP




Code in the Employee




General Info Screen and




fails to update the Plan




for the specific ZIP code,




Service Area combination




this message would be




shown. Pick the plans




that are available for the




Employee in the




Employee Coverage Info




screen.


Plan availability
Vision Plan selected by
Normally the Plan for the



the Employees not
employee is listed based



available in the service
on the Plan available in



area.
the employees Service




Area. Rare cases if the




User Modifies the ZIP




Code in the Employee




General Info Screen and




fails to update the Plan




for the specific ZIP code,




Service Area combination




this message would be




shown. Pick the plans




that are available for the




Employee in the




Employee Coverage Info




screen.


Plan availability
CAM Plan selected by the
Normally the Plan for the



Employees not available 
employee is listed based



in the service area.
on the Plan available in




the employees Service




Area. Rare cases if the




User Modifies the ZIP




Code in the Employee




General Info Screen and




fails to update the Plan




for the specific ZIP code,




Service Area combination




this message would be




shown. Pick the plans




that are available for the




Employee in the




Employee Coverage Info




screen.








Dependent
These missing information pertains to the


Information
Dependent Level information required in the



Dependent Information Screen









Date of Birth
Date of Birth is not
Fill in the Date of Birth in



specified
the Dependent General




Info Screen


Gender
Gender is not specified
Choose the Gender in the




Dependent General Info




Screen


SSN
SSN is not specified
Fill in the SSN in the




Dependent General Info




Screen. If the dependent




refuse to provide SSN




then click auto generate




SSN/Unique ID in the




Dependent General Info




Screen. Auto generation




of SSN/Unique ID will be




available only for the user




with role as level II and




above


Relationship
Relationship of the
Choose the dependent



dependent with the
relationship from the



employee not specified
Dependent Info Screen


Relationship -
Relationship, child is
Verify if the child is


Child
specified for child above
disabled and choose if



23 years of age
Disabled Permanent or




Temporary.


Signature
Dependent signature is
This is required if the



missing
dependent age is above




18. Verify the signature




for the dependent and




check the checkbox




Signature in the




dependent info screen


Relationship
Number of spouse is more
Check for the relationship



than one
in the dependent info




screen. There can only be




one of the following




relationship for the




dependent:




Spouse or Ex - Spouse or




domestic partner.




Choose different




relationship for the other




dependent in the




dependent info screen









    
    
        Step—12: On clicking enroll button, screen navigates to confirmation screen, for having created a group under COBRA Enrollment. Click search button to navigate back to Group Search screen. (See FIG. C-115)
    
    


Modify COBRA
The screen is to have modification of details pertaining to a COBRA member. The screen provides functionality to save, edit or add new member details.
The sequential steps involved in modify COBRA are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Select the option COBRA Enrollment. Then New COBRA and modify COBRA. (See FIG. C-116)
        Step—2: Navigates to group COBRA search screen. Enter value in any one of the fields, or simply click Search to perform search operation. (See FIG. C-117)
        Step—3: This pops up a screen with the search result. (See FIG. C-118)
        Step—4: Click on any group id for selection
        Step—5: This navigates to general information pertaining to group screen. The process of modifying group is similar to the process explained vide from step 7 through step 12 of creating a COBRA group
    
    


Inactivate COBRA
The screen is to inactivate a COBRA from the active status.
The sequential steps involved in inactivate a COBRA are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Select the option COBRA Enrollment. Then select New COBRA and inactivate COBRA. (See FIG. C-119)
        Step—2: Navigates to group COBRA screen. Enter value in any one of the fields, or simply click Search to perform search operation. (See FIG. C-120)
        Step—3: This pops up a screen with the search result. (See FIG. C-121)
        Step—4: Click on any group id for selection. This navigates to a screen confirming for the selected group to make inactivate. Click Inactivate button. (See FIG. C-122)
        Step—5: Confirms the status. (See FIG. C-123)
    
    


Existing COBRA—Create COBRA
The screen is to create COBRA for existing type. The screen provides functionality to save, edit or add new COBRA.
The sequential steps involved in create new COBRA are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select COBRA Enrollment. Select the Existing COBRA and then select Create COBRA. (See FIG. C-124)
        Step—2: The screen navigates to employee search for adding COBRA. Enter employee id or enter first letter of employee name for search. Click Search button. (See FIG. C-125)
        Step—3: The screen displays the search result. (See FIG. C-126)
        Step—4: Click on employee id.
        Step—5: Choose the option of sending bill either to group or self. Enter the date by clicking calendar icon, provided if the check box is clicked for verified member signature. (See FIG. C-127)
        Step—6: Choose the Member and state COBRA Election options for each member from the table and clicks continue.
        Step—7: Screen navigates to general info of group. First name and last name are mandatory and other fields are optional. Enter the values in the respective field, as per the format briefed in field's explanation section. (See FIG. C-128)
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Parent Group ID
Text to display the Parent Group ID.


Parent Group
Text to display the Parent Group Name.


Name



COBRA Group ID 
Text to display the COBRA Group ID.


COBRA Type
Text to display the COBRA Group Type whether Cal



COBRA or Federal COBRA.


Group Effective
Text to display effective date of the parent group.


Date



Work Group
Text to Display the internal Work group associated



with the Parent Group


Status
Text to display status of the group.


Post Mark Date 
Text for post mark date. Choose a date by clicking



calendar icon. Accepts in the format MM/DD/YYYY


Received Date
Text for received date. Choose a date by clicking



calendar icon. Accepts in the format MM/DD/YYYY


Salutation
Choose the salutation from the drop down list of



salutations available.


First Name
The text for first name. Accepts alphabets and special



character like hyphen and single quotes not exceeding



25 characters. First name is mandatory.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for last name. Accepts alphabets and special



characters like hyphen and single quotes not exceed-



ing 35 characters. Last name is mandatory.


Suffix
Choose the Suffix from the drop down list of



salutations available.


Date of Birth
The text for date of birth. Choose a date by clicking



calendar icon


Social Security
The text for social security number for every


Number
individual. This can also be auto generated by clicking



auto generate link. Accepts numeric value of exactly 9



digits. Users with User Role as Level 2 and above can



only auto generate SSN.


Gender
Choose a gender from the drop down list available.







Address Information: Physical Home Address or Mailing Address








Address
The text for company address. Accepts alphabets and



numeric values not exceeding 35 characters


Apt
The text for company suite/apt # Accepts alphabets



and numeric values of not exceeding 35 characters


Zip
The text for zip. Accepts numeric of either 5 or 9



digits. City, State and County are populated



automatically for the correct zip code.


City
The text for city. Accepts alphabets of not exceeding



30 characters.


State
Choose the name of the state from the drop down list



of States available in United States of America


County
Choose the name of the county from the drop down



list of States available in United States of America


Mode of
Choose the mode of correspondence from the drop


Correspondence
down list available


Phone Number
The text for telephone number of the contact person.



Accepts numeric values of not exceeding 10 digits.



The format is (999) 999-9999


Extension
The text for telephone number of the contact person.



Accepts numeric values of not exceeding 5 digits. The



format is (999) 999-9999


Fax
The text for fax number of the contact person. Accepts



numeric values of not exceeding 10 digits. The format



is 9999


Email
The text for email of the contact person. Accepts



alphabets, numeric and special characters in the



standard email format of length not exceeding 100



characters









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    
















Element 
Description









Continue
Saves the data and navigates to Billing Information




screen and the system generates Group ID.



Cancel
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes



Tabs
General Info, Billing Info, Coverage Info and Add




Employees are the tabs visible on this screen. The




navigation between is tabs are possible only if there is




a valid group ID generated and assigned to the group.




Also while navigating through the tab the content that




are changed on the screen are not saved unless




explicitly saved by other operations on the screen.










    
    
        Step—8: Enter the values in the respective field, as per the format briefed in field's explanation section. Screen can be navigated to Billing Info by either clicking continue button or through other respective tabs. (See FIG. C-129)
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Mode of payment
Choose a mode of payment from the drop down list



available. Based on selection corresponding fields 



will enable to enter the values. For e.g. if the value 



selected is card payment, EFT will be disabled and 



allows only entering card details and vice versa.







Credit Card Information








Cardholder's
The text for cardholder's name. Accepts alphabets 


Names
and space between two words.


Credit Card Type 
Choose the type of credit card from the drop down 



list available.


Credit Card No
The text for credit card number. Accepts numeric



values not exceeding 30 digits


Expiration Date
Choose a month of expiration from the drop down 



list available


Expiration Year
The text for expiration year. Accepts numeric values



of exactly 4. Example 2002.


Billing Address
As it appears on the credit Card


Street Address
The text for company address. Accepts alphanumeric



and special characters not exceeding 35 characters.


ZIP
The text for zip. Accepts numeric value of either 5 



or 9 digits.


State
The text for city. Accepts alphabets and space 



between two words not exceeding 30 characters.


City
Choose the name of the state from the drop down list



of States available in United States of America







EFT Information








Bank Name
The text for bank name. Accepts alphabets and space



between two words.


Routing Number
The text for routing number. Accepts numeric values



not exceeding 9 digits.


Account Number
The text for account number. Accepts numeric values



not exceeding 9 digits.


Account Type
Choose the type of account from the drop down list



available.


Depositor's Name
The text for depositor's name. Accepts alphabets and



space between two words.







Initial Payment Information








Amount Received
The text for amount received. Accepts only numeric



values in the format 999999999.99


Date Receive
The text for date received. Choose from the calendar



icon in the format MM/DD/YYYY.


Check #
The text for check number. Accepts numeric values



not exceeding 9 digits.


No Check Received
Check the option of no checks received for any non-



receipt of checks.









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    
















Element
Description









Continue
Saves the data and Navigates to coverage Information




screen.



Clear
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes



Tabs
General Info, Billing Info, Coverage Info and Add




Employees are the tabs visible on this screen. The




navigation between is tabs are possible only if there is




a valid group ID generated and assigned to the group.




Also while navigating through the tab the content that




are changed on the screen are not saved unless




explicitly saved by other operations on the screen.










    
    
        Step—9: Screen can be navigated to Coverage Info by either clicking continue button or through other respective tabs. Enter the values in the respective field, as per the format briefed in field's explanation section. (See FIG. C-130)
    
    


Fields Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description















Plan Election








Choose Plan
Click on the check box to select the plan.


Send bills to
Choose the Option Group or Self for “Send bill to”.


Member Signature
Check this if member signature is verified


Date Signed
The text for Date Signed. Choose a date by clicking



calendar icon. Date accepts the format 



MM/DD/YYYY.









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Continue
Saves the data and Navigates to either Dependent Info



Screen or COBRA Summary screen.


Cobra Summary
Saves the data and Navigates COBRA Summary



screen.


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tabs
General Info, Billing Info, Coverage Info and Add



Employees are the tabs visible on this screen. The



navigation between is tabs are possible only if there is



a valid group ID generated and assigned to the group.



Also while navigating through the tab the content that



are changed on the screen are not saved unless



explicitly saved by other operations on the screen.









    
    
        Step—10: Screen can be navigated to Dependent Info by either clicking continue button or through other respective tabs. (See FIG. C-131)
        Step—11: Dependent Screen for COBRA is Display only screen. Click continue to navigate to COBRA Missing Info screen. (See FIG. C-132)
    
    


Field Explanation

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Group
Contains header information of the Group


Information



Header



Name of the 
Text for the Name of the Group


Group



Group ID
Text and Link for the Group ID to navigate to the



Group General Info screen


Group Type
Specifies the Type of the Group like Small Employer



Group


Proposed 
The text for Proposed Effective Date. Choose a date by


Effective
clicking calendar icon. Date accepts the format


Date
MM/DD/YYYY. Default effective date is first of the



following month. Effective date cannot be past date


Status
Text to specify the status of the group.


Pend Date



Date Finalized



Work Group
Text for Work Group. This specifies the internal work



group attached to the Group. Internal is based on the



writing agent's work group.


Tree Structure
Enrollment Missing Information is broken down into



tree structure. The tree can by expanded or collapsed.



The level of the tree is as per the example given below:



− Employee



 − Dependent



 − Dependent



Where (−) signifies expanded view and (+) signifies



collapsed view.


Group Missing
This identifies all the eligibility rules and the


Info
information that are incomplete on Group level for



completing the enrollment process.


Missing Entities
List the missing entities for the group. Provides a link



to go to the respective screen to fill in the relevant



information to complete all the required entries.


Message
List the message against each missing entities.


Employee
This identifies all the eligibility rules and the


Missing Info
information that are incomplete on Employee level for



completing the enrollment process.


Missing Entities
List the missing entities for the employee. Provides a



link to go to the respective screen to fill in the relevant



information to complete all the required entries.


Message
List the message against each missing entities.


Dependent
This identifies all the eligibility rules and the


Missing Info
information that are incomplete on dependent level for



completing the enrollment process.


Missing Entities
List the missing entities for the dependent. Provides a



link to go to the respective screen to fill in the relevant



information to complete all the required entries.


Message
List the message against each missing entities.


Enrollment 
Choose from the drop down list the action to be


Action
performed for enrollment. Enroll/Decline


Remarks
Text for remarks if any.


Reasons for 
Choose from the drop down list the reasons for decline.


Decline



Reasons for 
Text for other reason. If the reason for decline is other


Other
than the reasons available.









Button Functionality

    
    
        The following table provides explanation for each button in the screen.
    
    













Element
Description







Enroll
Saves the data if there are no missing information and



navigates to enrollment confirmation page.


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


<<, <, >, >>
The enrollment missing information shows record for 5



employees on single screen. If the employee size



increases more than 5. These buttons are used for



navigating to the next and previous records for



viewing.



<< - Show first record(s)



< - Show previous record(s)



> - Show next record(s)



>> - Show last record(s)


Group ID
Click Group ID to navigates to the Group's general info



screen.


Preview Invoice
Click Preview Invoice to pop up a new browser window



to preview the invoice for the group









    
    
        Step—12: On clicking enroll button, screen navigates to confirmation screen, for having created a group under COBRA Enrollment. Click search button to navigate back to Group Search screen. (See FIG. C-133)
    
    


Modify COBRA
The screen is to modify COBRA details for existing type. The screen provides functionality to save, edit or add new COBRA.
The sequential steps involved in modify COBRA are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Select the Existing COBRA and then select New COBRA. (See FIG. C-134)
        Step—2: The screen navigates to group search for adding COBRA. Enter group id or enter first letter of group name for search. Click Search button. (See FIG. C-135)
        Step—3: This pops up a screen with the search result.
        Step—4: Click on any group id for selection. Screen navigates to general info screen pertaining to group. The process and flow for modification are similar to that of creating a group, which are explained vide step 7 through step 11
    
    


Inactivate COBRA
The screen is to inactivate a COBRA details from its active in existing type. (See FIG. C-136)
The sequential steps involved in inactivating COBRA are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select New Business Enrollment. Select the Existing COBRA and then select Inactivate COBRA. (See FIG. C-137)
        Step—2: The screen navigates to group search for COBRA. Enter group id or enter first letter of group name for search. Click Search button. (See FIG. C-138)
        Step—3: This pops up a screen with the search result.
        Step—4: Click on any group id for selection. This navigates to a screen confirming for the selected group to make inactivate. Click Inactivate button. (See FIG. C-139)
        Step—5: Confirms the status. Click Search navigates employee search screen. (See FIG. C-140)
    
    


5 Termination
Termination is the transaction module that encompasses the process of terminating the group and member enrolled with PacAdvantage in the PX2 System. This process allows terminating Groups, Members and dependent from the PacAdvantage program.
Access
The application can be accessed from the main menu as follows:

    
    
        Enrollment→Termination→Group Termination
        
            →Employee Termination
            →Dependent Termination
            →Multiple Group Termination
        
        
    
    


Pre-Requisites
The groups and member must exist in the system for the termination process to occur.
Application Functions
This application has the following functions for termination:

    
    
        Group Termination—to terminate a group
        Employee Termination—to terminate an employee
        Dependent Termination—to terminate a dependent
        Multiple Group Termination—to terminate multiple groups
    
    


Group Termination
The screen is to terminate a group.
The sequential steps involved in terminating a group are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Termination. Then select Group Termination. (See FIG. C-141)
        Step—2: The screen navigates to group search to select a group. Enter value in any one of the field or simply click Search button to perform search operation. (See FIG. C-142)
        Step—3: This pops up a screen with search result. (See FIG. C-143)
        Step—4: Click on any group id for selection. The screen navigates to term request (See FIG. C-144)
        Step—5: Enter the fields with appropriate values as per the format briefed in field's explanation. Click continue.
        Step—6: Screen navigates to process term. Enter the details of effective term date and change term status and click Continue. (See FIG. C-145)
        Step—7: Confirms the termination of a group. (See FIG. C-146)
        Step—8: Click Search button to go back to Group Search screen.
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Request for Term








Mode of 
Choose a mode of request from the drop down list


Request
available. The field is mandatory.


Post Mark Date
The text for post mark date. Choose a date in the



format MM/DD/YYYY by clicking calendar icon. The



postmark date cannot be greater than system date.



The field is mandatory.


Date Received
The text for received date. Choose a date in the format



MM/DD/YYYY by clicking calendar icon. The received



date cannot be greater than system date. The field is



mandatory.


Request Term 
The text for request term date. Choose a date in the


Date
format MM/DD/YYYY by clicking calendar icon. The



request term date should be the last day of that



particular month except in case of death. The field is



mandatory.


Reason for
Choose a reason from the drop down list The field is


Term
mandatory.


Others
The text for narrating other info, provided the option



for reason for terms is others


Authorized
Choose Authorized contact from the list. The field is


contact
mandatory.







Process Term








Effective Term
The text for request term date. Choose a date in the


Date
format MM/DD/YYYY by clicking calendar icon.


Change Term
Choose a status from the drop down list for change


Status
term









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Search
Search is performed based on the input


Continue
Saves the data and navigates to next screen in the 



flow of termination.


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









Employee Termination
The screen is to terminate an employee.
The sequential steps involved in terminating an employee are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Termination. Then select Employee Termination. (See FIG. C-147)
        Step—2: The screen navigates to employee search to select a group. Enter value in any of the field or simply click Search button to perform. search operation. (See FIG. C-148)
        Step—3: This pops a screen with search result.
        Step—4: Click on any employee id for selection. The screen navigates to term request. (See FIG. C-149)
        Step—5: Enter the fields with appropriate values as per the format briefed in field's explanation. Click continue.
        Step—6: Screen navigates to process term. Enter the details of effective term date and change term status and click Continue. (See FIG. C-150)
        Step—7: Confirms the termination of a employee. (See FIG. C-151)
        Step—8: Clicking Search button leads to Employee search screen.
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Request for Term








Mode of Request
Choose a mode of request from the drop down list



available. This field is mandatory.


Post Mark Date
The text for post mark date. Choose a date in the



format MM/DD/YYYY by clicking calendar icon. The



postmark date cannot be greater than system date



This field is mandatory.


Date Received
The text for received date. Choose a date in the format



MM/DD/YYYY by clicking calendar icon. The Date



received cannot be greater than system date. This field



is mandatory.


Request Term
The text for request term date. Choose a date in the


Date
format MM/DD/YYYY by clicking calendar icon. The



request term date should be the last day of that



particular month. This field is mandatory.


Reason for Term
Choose a reason from the drop down list


Others
The text for narrating other info, provided the option



for reason for terms is others


Authorized 
The text for authorized contact. The field is


contact
mandatory.







Process Term








Effective Term 
The text for request term date. Choose a date in the


Date
format MM/DD/YYYY by clicking calendar icon.


Change Term
Choose a status from the drop down list for change


Status
term









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Search
Search is performed based on the input



Continue
Saves the data and navigates to next screen in the flow




of termination.



Clear
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes










Dependent Termination
The screen is to terminate a dependent.
The sequential steps involved in terminating a dependent are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Termination. Then select Dependent Termination. (See FIG. C-152)
        Step—2: The screen navigates to dependent search to select a group. Enter value in any one of the field or simply click Search button to perform search operation. (See FIG. C-153)
        Step—3: This pops a screen with search result. (See FIG. C-154)
        Step—4: Click on any dependent id for selection. The screen navigates to term request. (See FIG. C-155)
        Step—5: Enter the fields with appropriate values as per the format briefed in field's explanation. Click continue.
        Step—6: Screen navigates to process term. Enter the details of effective term date and change term status and click Continue. (See FIG. C-156)
        Step—7: Confirms the termination of a dependent. (See FIG. C-157)
        Step—8: Click Search button to navigate back to Dependent Search screen.
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Request for Term








Mode of Request
Choose a mode of request from the drop down list



available. The field is mandatory.


Post Mark Date
The text for postmark date. Choose a date in the



format MM/DD/YYYY by clicking calendar icon. The



postmark date cannot be greater than system date.



The field is mandatory.


Date Received
The text for received date. Choose a date in the format



MM/DD/YYYY by clicking calendar icon. The Date



Received cannot be greater than system date. The field



is mandatory.


Request Term 
The text for request term date. Choose a date in the


Date
format MM/DD/YYYY by clicking calendar icon. The



request term date should be the last day of that



particular month. The field is mandatory.


Reason for Term
Choose a reason from the drop down list. The field is



mandatory.


Others
The text for narrating other info, provided if the option



for reason for terms is others


Authorized 
The text for authorized contact. The field is


contact
mandatory.







Process Term








Effective Term 
The text for request term date. Choose a date in the


Date
format MM/DD/YYYY by clicking calendar icon.


Change Term
Choose a status from the drop down list for change


Status
term









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Search
Search is performed based on the input



Continue
Saves the data and navigates to next screen in the flow




of termination.



Clear
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes










Multiple Group Termination
The screen is to terminate multiple groups.
The sequential steps involved in terminating multiple groups are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Termination. Then select Multiple Group Termination. (See FIG. C-158)
        Step—2: The screen navigates to term request Enter the fields with appropriate values as per the format briefed in field's explanation. Click continue. (See FIG. C-159)
        Step—3: Confirms the termination of a groups. (See FIG. C-160)
        Step—4: Click search button to navigate back to Group Termination screen.
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Request for Term








Mode of Request
Choose a mode of request from the drop down list



available


Post Mark Date
The text for post mark date. Choose a date in the



format MM/DD/YYYY by clicking calendar icon. The



post mark date cannot be greater than system date


Date Received
The text for received date. Choose a date in the format



MM/DD/YYYY by clicking calendar icon. The post



mark date cannot be greater than system date


Request Term 
The text for request term date. Choose a date in the


Date
format MM/DD/YYYY by clicking calendar icon. The



request term date should be the last day of that



particular month


Reason for Term
Choose a reason from the drop down list


Others
The text for narrating other info, provided if the option



for reason for terms is others









Button Functionality
The following table provides explanation for each button in the screen.














Element 
Description









Search
Search is performed based on the input



Continue
Saves the data and navigates to next screen in the flow




of termination.



Clear
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes










6 Reinstatement
Reinstatement is the transaction module that encompasses the process of reinstating the group and member enrolled with PacAdvantage in the PX2 System. This process allows reinstating Groups, Members and dependent to the PacAdvantage program.
Access
The application can be accessed from the main menu as follows:

    
    
        Enrollment→Reinstatement→Group Reinstatement
        
            →Employee Reinstatement
            →Dependent Reinstatement
        
        
    
    


Pre-Requisites
The groups and member must exist in the system and also terminated for processing reinstatement.
Application Functions
This application has the following functions for reinstatement:

    
    
        Group Reinstatement—to reinstate a group
        Employee Reinstatement—to reinstate an employee
        Dependent Reinstatement—to reinstate a dependent
    
    


Group Reinstatement
The screen is to reinstate a group.
The sequential steps involved in reinstating a group are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Reinstatement. Then select Group Reinstatement. (See FIG. C-161)
        Step—2: The screen navigates to group search to select a group. Enter value in any one of the fields, or simply click search button to perform search operation. (See FIG. C-162)
        Step—3: This pops up a screen with search result. (See FIG. C-163)
        Step—4: Click on any group id for selection. The screen navigates to reinstate request. (See FIG. C-164)
        Step—5: Enter the fields with appropriate values as per the format briefed in field's explanation. Click continue
        Step—6: Screen navigates to process reinstate. Enter the details of effective term date and change term status and click Continue. (See FIG. C-165)
        Step—7: Confirms the reinstatement of a group. (See FIG. C-166)
        Step—8: Click Search button to go back to Group Search screen.
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Initiate Group Reinstatement








Mode of Request
Choose a mode of request from the drop down list



available. The field is mandatory.


Post Mark Date
The text for post mark date. Choose a date in the



format MM/DD/YYYY by clicking calendar icon. The



postmark date cannot be greater than system date.



The field is mandatory.


Date Received
The text for received date. Choose a date in the format



MM/DD/YYYY by clicking calendar icon. The Date



Received cannot be greater than system date. The field



is mandatory.


Request 
The text for request term date. Choose a date in the


Reinstate
format MM/DD/YYYY by clicking calendar icon. The


Date
request reinstate date should be the first day of next



month. The field is mandatory.


Reason for
Choose a reason from the drop down list. The field is


Reinstate
mandatory.


Others
The text for narrating other info, provided the option



for reason for reinstate is others


Authorized 
The text for authorized contact. The field is


contact
mandatory.







Process Reinstatement








Effective Term 
The text for request term date. Choose a date in the


Date
format MM/DD/YYYY by clicking calendar icon.


Change Reinstate
Choose a status from the drop down list for change


Status
reinstate









Button Functionality
The following table provides explanation for each button in the screen.














Element 
Description









Search
Search is performed based on the input



Continue
Saves the data and navigates to next screen in the flow




of reinstatement.



Clear
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes










Employee Reinstatement
The screen is to reinstate an employee.
The sequential steps involved in reinstating an employee are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Reinstatement. Then select Employee Reinstatement. (See FIG. C-167)
        Step—2: The screen navigates to employee search to select a group. Enter value in any one of the fields, or simply click search button to perform search operation. (See FIG. C-168)
        Step—3: This pops a screen with search result. (See FIG. C-169)
        Step—4: Click on any employee id for selection. The screen navigates to reinstate request. (See FIG. C-170)
        Step—5: Enter the fields with appropriate values as per the format briefed in field's explanation. Click continue.
        Step—6: Screen navigates to process reinstate. Enter the details of effective term date and change status and click Continue. (See FIG. C-171)
        Step—7: Confirms the reinstate of an employee. (See FIG. C-172)
        Step—8: Click Search button to navigate back to Employee Search screen.
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Initiate Employee Reinstatement








Reason for Term
Text for reason for term. The field is read only


Term Date
Text for termination date. Field is read only.


Mode of Request
Choose a mode of request from the drop down list



available. The field is mandatory.


Post Mark Date
The text for post mark date. Choose a date in the



format MM/DD/YYYY by clicking calendar icon. The



postmark date cannot be greater than system date.



The field is mandatory.


Date Received
The text for received date. Choose a date in the format



MM/DD/YYYY by clicking calendar icon. The Date



Received cannot be greater than system date. The field



is mandatory.


Request Reinstate
The text for request term date. Choose a date in the


Date
format MM/DD/YYYY by clicking calendar icon. The



request reinstate date should be the first day of next



month. The field is mandatory.


Reason for
Choose a reason from the drop down list. The field is


Reinstate
mandatory.


Others
The text for narrating other info, provided the option



for reason for reinstate is others


Authorized 
The text for authorized contact. The field is


contact
mandatory.







Process Reinstatement








Effective Term 
The text for request term date. Choose a date in the


Date
format MM/DD/YYYY by clicking calendar icon.


Change Reinstate
Choose a status from the drop down list for change


Status
reinstate









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Search
Search is performed based on the input



Continue
Saves the data and navigates to next screen in the flow




of termination.



Clear
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes










Dependent Reinstatement
The screen is to reinstate a dependent.
The sequential steps involved in reinstating a dependent are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Reinstatement. Then select Dependent Reinstatement. (See FIG. C-173)
        Step—2: The screen navigates to dependent search to select a group. Enter dependent id or enter first letter of dependent name for search. Click Search button. (See FIG. C-174)
        Step—3: This pops a screen with search result. (See FIG. 175)
        Step—4: Click on any dependent id for selection. The screen navigates to reinstate request. (See FIG. C-176)
        Step—5: Enter the fields with appropriate values as per the format briefed in field's explanation. Click continue.
        Step—6: Screen navigates to process reinstate. Enter the details of effective term date and change term status and click Continue. (See FIG. C-177)
        Step—7: Confirms the reinstatement of a dependent. (See FIG. C-178)
        Step—8: Click search button to go back to Dependent Search screen.
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Initiate Dependent Reinstatement








Mode of Request
Choose a mode of request from the drop down list



available. The field is mandatory.


Post Mark Date
The text for post mark date. Choose a date in the



format MM/DD/YYYY by clicking calendar icon. The



postmark date cannot be greater than system date.



The field is mandatory.


Date Received
The text for received date. Choose a date in the format



MM/DD/YYYY by clicking calendar icon. The Date



Received cannot be greater than system date. The field



is mandatory.


Request Reinstate
The text for request term date. Choose a date in the


Date
format MM/DD/YYYY by clicking calendar icon. The



request reinstate date should be the first day of next



month. The field is mandatory.


Reason for
Choose a reason from the drop down list. The field is


Reinstate
mandatory.


Others
The text for narrating other info, provided the option



for reason for reinstate is others


Authorized 
The text for authorized contact. The field is


contact
mandatory.







Process Reinstatement








Effective Term 
The text for request term date. Choose a date in the


Date 
format MM/DD/YYYY by clicking calendar icon.


Change Reinstate
Choose a status from the drop down list for change


Status
reinstate









Button Functionality
The following table provides explanation for each button in the screen.













Element
Description








Search
Search is performed based on the input



Continue
Saves the data and navigates to next screen in the flow




of termination.



Clear
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes









7 Appeals & Grievances
Appeals and grievance is the transaction module that encompasses the process for the groups and members enrolled with PacAdvantage in the PX2 System to raise appeals and grievance. Appeals and Grievance is the process of maintaining a status for all Appeals and Grievances received from the customer and follow up with the decision made either by PacAdvantage-Roseville or PacAdvantage-SF.
Access
The application can be accessed from the main menu as follows:

    
    
        Enrollment→Appeals and Grievances→Create
        
            →Modify
            →Close
        
        
    
    


Pre-Requisites
Group and member information must be available in the system for making an appeal or grievance.
Application Functions
This application has the following functions for reinstatement:

    
    
        Create—to create an appeal & grievance
        Modify—to modify an appeal & grievance
        Close—to close an appeal & grievance
    
    


Create
The screen is to create an appeal and grievance.
The sequential steps involved in creating an appeal & grievance are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Appeals & Grievances. Then select Create. (See FIG. C-179)
        Step—2: The screen navigates search to select a group or member. Based on the selection the information of group/member will be displayed. Enter value in any one of the fields, or simply click search button to perform search operation. (See FIG. C-180)
        Step—3: This pops a screen with search result. (See FIG. C-181)
        Step—4: Click on any group/member id for selection. The screen navigates to create grievance. (See FIG. C-182)
        Step—5: Enter the fields with appropriate values as per the format briefed in field's explanation. Click continue
        Step—6: Screen navigates to confirming create grievance. (See FIG. C-183)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Grievance Information








Post Mark Date
The text for post mark date. Choose a date in the



format MM/DD/YYYY by clicking calendar icon. The



post mark date cannot be greater than system date


Date Received
The text for received date. Choose a date in the format



MM/DD/YYYY by clicking calendar icon. The post



mark date cannot be greater than system date


Nature of
The text for nature of grievance. Choose a type from


Grievance
the drop down list available


Subject of
The text for subject of grievance. Choose a type from


Grievance
the drop down list available


Remarks
The text for remarks. Accepts alphabets, numeric and



special characters









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Search
Search is performed based on the input


Save
Saves the data and navigates to next screen in the flow



of creating a grievance


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









Modify
The screen is to modify an appeal and grievance.
The sequential steps involved in modifying an appeal & grievance are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Appeals & Grievances. Then select Modify. (See FIG. C-184)
        Step—2: The screen navigates search to select either by complainant or by grievance. Based on the selection the information of group/member with grievance details will be displayed. Enter group/member/grievance id o for search. Click Search button. (See FIG. C-185)
        Step—3: The screen navigates to process grievance Enter the fields with appropriate values as per the format briefed in field's explanation. (See FIG. C-186)
        Step—4: Click Save.
        Step—5: The screen confirms the modification of grievance. (See FIG. C-187)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Process Grievance








Search by
Choose the option to search by complainant or search



by grievance. Based on this option the Either



Grievance ID or Complainant ID field will be enabled.


Complainant 
Choose a type of complainant from either group or


Type
member


Complainant ID
The text for complainant id. Accepts numeric values.


Forward for
Click this option to have approval


approval



Forward To
The text for the person to whom it has to be forwarded


Forward Date
The text for forward date. Choose a date in the format



MM/DD/YYYY by clicking calendar icon


Batch Date
The text for batch date. Choose a date in the format



MM/DD/YYYY by clicking calendar icon


Additional 
The text for additional remarks. Accepts alphabets,


Remarks
numeric and special characters









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Search
Search is performed based on the input


Save
Saves the data and navigates to next screen in the flow



of creating a grievance


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









Close
The screen is to close an appeal and grievance.
The sequential steps involved in closing an appeal & grievance are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Appeals & Grievances. Then select Close. (See FIG. C-188)
        Step—2: The screen navigates search to select either by complainant or by grievance. Based on the selection the information of group/member with grievance details will be displayed. Enter group/member/grievance id o or enter first letter of group/member's name for search. Click Search. (See FIG. C-189)
        Step—3: The screen navigates to close grievance Enter the fields with appropriate values as per the format briefed in field's explanation. (See FIG. C-190)
        Step—4: Click Save.
        Step—5: The screen confirms the close of grievance. (See FIG. C-191)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Complainant Type
Choose a type of complainant from either group or



member


Complainant ID
The text for complainant id. Accepts numeric values


Conclusion
Choose a conclusion from the drop down list available


Reason
The text for reason. If the reason is others, it will



enable the field other reason for entry


Other Reason
The text for other reason. Field is enabled only if the



option under reasons is others


Batch Date
The text for batch date. Choose a date in the format



MM/DD/YYYY by clicking calendar icon









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Search
Search is performed based on the input


Save
Saves the data and navigates to next screen in the flow



of creating a grievance


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









8 Carrier Issues
Carrier Issues is the transaction module that encompasses the process for the groups and members enrolled with PacAdvantage in the PX2 System to raise issues with the carriers. Carrier Issues is the process of maintaining a status for all Carrier Issues received from the customer and follow up with the carrier for resolution and inform the customer of resolution.
Access
The application can be accessed from the main menu as follows:

    
    
        Enrollment→Carrier Issues→Create
        
            →Modify
            →Close
        
        
    
    


Pre-Requisites
There are no pre-requisites for using this application.
Application Functions
This application has the following functions for reinstatement:

    
    
        Create—to create carrier issue
        Modify—to modify carrier issue
        Close—to close carrier issue
    
    


Create
The screen is to create carrier issue.
The sequential steps involved in creating carrier issue are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Carrier Issues. Then select Create. (See FIG. C-192)
        Step—2: The screen navigates search to select a group or member. Based on the selection the information of group/member will be displayed. Enter value in any one of the field or simply click search button to perform search operation. (See FIG. C-193)
        Step—3: This pops a screen with search result. (See FIG. C-194)
        Step—4: Click on any group/member id for selection. The screen navigates to create carrier issue. (See FIG. C-195)
        Step—5: Enter the fields with appropriate values as per the format briefed in field's explanation.
        Step—6: Click Save
        Step—7: Screen navigates to confirming create carrier issues. (See FIG. C-196)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Carrier Issue Information








Received Date
The text for received date. Choose a date in the format



MM/DD/YYYY by clicking calendar icon.


Urgent
Click the check box, if it is urgent


Carrier
Choose a carrier from the drop down list available


Reported Issue
Choose a reported issue from the drop down list



available


Remarks
The text for remarks. Accepts alphabets, numeric and



special characters









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Search
Search is performed based on the input


Save
Saves the data and navigates to next screen in the flow



of creating carrier issue


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









Modify
The screen is to modify carrier issue.
The sequential steps involved in modifying a carrier issue are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Carrier Issues. Then select Modify. (See FIG. C-197)
        Step—2: The screen navigates search to select either by complainant or by carrier issue. Based on the selection the information of group/member with grievance details will be displayed. Enter the value for either customer id or carrier issue id. The field is mandatory. (See FIG. C-198)
        Step—3: Click search. The screen navigates to process carrier issue to modify. (See FIG. C-199)
        Step—4: Enter the fields with appropriate values as per the format briefed in field's explanation
        Step—5: Click Save.
        Step—6: The screen confirms the modification of carrier issues. (See FIG. C-200)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Search by
Select search either by client type or by carrier issue



type


Customer Type
Choose a Customer Type from either group or member.



The field is enabled only if the search is selected as



client type


Customer ID
The text for customer id. Accepts numeric values


Carrier Issue ID
The text for carrier issue id. Accepts numeric values.



The field is enabled only if the selected type is carrier



issue type


Notify carrier
Choose an option as yes or no for notifying a carrier


Mode of
Choose a mode from the drop down list available


Notification



Date Notified
The text for notification date. Choose a date in the



format MM/DD/YYYY by clicking calendar icon


Batch Date
The text for batch date. Choose a date in the format



MM/DD/YYYY by clicking calendar icon


Additional 
The text for remarks. Accepts alphabets, numeric and


Remarks
special characters









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Search
Search is performed based on the input


Save
Saves the data and navigates to next screen in the flow



of creating a grievance


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









Close
The screen is to close carrier issue.
The sequential steps involved in closing carrier issue are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Carrier Issues. Then select Close. (See FIG. C-201)
        Step—2: The screen navigates search to select either by customer or by carrier issue. Based on the selection the information of group/member with carrier issue details will be displayed. Enter group/member/carrier issue id for search. The field is mandatory. Click Search. (See FIG. C-202)
        Step—3: The screen navigates to close carrier issue Enter the fields with appropriate values as per the format briefed in field's explanation. (See FIG. C-203)
        Step—4: Click Save.
        Step—5: The screen confirms the close of carrier issue. (See FIG. C-204)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Search by
Select search either by client type or by carrier issue



type


Customer 
Choose a Customer Type from either group or member.


Type
The field is enabled only if the search is selected as



client type


Customer ID
The text for customer id. Accepts numeric values with



exactly 9 digits


Carrier Issue 
The text for carrier issue id. Accepts numeric values


ID
with exactly 9 digits. The field is enabled only if the



selected type is carrier issue type


Actual Issue
Choose an issue for actual issue from the drop down



list available


Resolution
Choose a resolution from the drop down list available


Retransmission
Click yes or no for retransmission


Date Carrier
The text for carrier received date. Choose a date in the


Received
format MM/DD/YYYY by clicking calendar icon


Notify 
Click yes or no for notifying originator


Originator



Batch Date
The text for batch date. Choose a date in the format



MM/DD/YYYY by clicking calendar icon


Resolution
The text for resolution comments. Accepts alphabets,


comments
numeric and special characters









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Search
Search is performed based on the input


Save
Saves the data and navigates to next screen in the flow



of creating a grievance


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









9 Add On
Add On is the transaction module that encompasses the process of Adding New Employee or Dependent to the group and or member enrolled with PacAdvantage in the PX2 System.
Access
The application can be accessed from the main menu as follows:

    
    
        Enrollment→Add On→Employee Add On
        
            →Dependent Add On
        
        
    
    


Pre-Requisites
Group and the member must be enroll and all their relevant information must be available in the system to Add On Employee and or dependent.
Application Functions
This application has the following functions for reinstatement:

    
    
        Add Employee—to add employee
        Add Dependent—to add dependent
        Modify Dependent—to modify employee
        Modify Dependent—to modify dependent
    
    


Add Employee
The screen is to add an employee.
The sequential steps involved in adding an employee are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Add On. Select Employee Add On. Then click Add Employee. (See FIG. C-205)
        Step—2: The screen navigates search to select a group. Enter value in any one of the fields, or simply click search button to perform search operation. (See FIG. C-206)
        Step—3: This pops up a screen with search result. (See FIG. C-207)
        Step—4: Click on any group id for selection. Screen navigates to change request screen for adding an employee.
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Group Information








Name of the 
Text for the Name of the Group. Read Only field


group



Effective Date
Text for Employee Effective date. Choose a date by



clicking calendar icon. Date accepts the format



MM/DD/YYYY. Defaults effective date of the Group.



Effective date cannot be past date Read only field


Group ID
Text for Group ID. Read only field.


Status
Text for status. Read only field


Group Type
Text for group type. Read only field.


Work Group
Text for work group. Read only field.


Mode of 
Choose a mode of request from the drop down list


Request
available


Post Mark Date
Text for post mark date. Choose a date by clicking



calendar icon. Accepts in the format MM/DD/YYYY



Entry to this field is mandatory


Received Date
Text for received date. Choose a date by clicking



calendar icon. Accepts in the format MM/DD/YYYY.



Entry to this field is mandatory.


Reasons for 
Choose a reason for add on from the drop down list


Add On
available


Others
Text for others. This field is enabled only if the option



for reasons for add on is others









Button Functionality
The following table provides explanation for each button in the screen.













Element
Description








Continue
Saves the entered information and navigates to next




screen Employee General Info.



Cancel
Clears or restores the content entered in the fields only




prior to saving the records









    
    
        Step—5: Enter the fields with appropriate values as per the format briefed in field's explanation
        Step—6: Screen navigates to add employee general information. First and Last name are mandatory other fields are optional. Enter the values in the respective fields, as per the format briefed in field's explanation section. (See FIG. C-209)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Employee Information








Salutation
Choose the salutation from the drop down list of



salutations available.


First Name
The text for first name. Accepts alphabets and special



character like hyphen and single quotes not exceeding



25 characters. First name is mandatory.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for last name Accepts alphabets and special



character like hyphen and single quotes not exceeding



35 characters. Last name is mandatory.


Suffix
Choose the suffix from the drop down list of suffixes



available.


Date of Birth
The text for date of birth. Choose a date by clicking



calendar icon. Date accepts the format MM/DD/YYYY.



Birth date cannot be later than the current date.


Social Security
The text for social security number for every


Number
individual. This can also be auto generated by clicking



auto generate link. Accepts numeric value of exactly 9



digits. Users with User Role as Level 2 and above can



only auto generate SSN.


Gender
Choose a gender from the drop down list available.







Address Information: Physical and Alternate Address - Note: Enter 


Alternate Address if different from the Physical Address.








Street Address
The text for address. Accepts alphanumeric and special



characters with values not exceeding 35 characters


Apt
The text for suite/apt # . . . Accepts alphanumeric and



special characters with values not exceeding 35



characters


Zip
The text for zip. Accepts numeric value of either 5 or 9



digits. City, State and County are populated



automatically on entering the correct zip code and



entering the tab key.


City
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters.


State
Choose the name of the state from the drop down list



of States available in United States of America


County
Choose the name of the county from the drop down list



of States available in United States of America


Mode of
Choose the mode of correspondence from the drop


Correspondence
down list available


Phone Number
The text for telephone number of the employee.



Accepts numeric values not exceeding 10 digits. The



format is (999) 999-9999


Extension
The text for extension number of the employee.



Accepts numeric values not exceeding 5 digits


Fax
The text for fax number of the employee. Accepts



numeric values not exceeding 10 digits. The format is



(999) 999-9999


Email
The text for email of the employee. Accepts alphabets,



numeric and special characters in the standard email



format of length not exceeding 100 characters









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Continue
Saves the data and navigates to coverage information



for employees.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Enrollment
Click enrollment summary refreshes the screen and


Summary
display the summary information entered for group



creation


Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


Group ID
Click Group ID to navigates to the Group's general info



screen.


Tab
General Info, Coverage Info, Add Dependent are the



tabs visible on this screen. The navigation between the



tabs is possible only if there is a valid Employee ID



generated and assigned to the employee. Also while



navigating through the tab the content that are



changed on the screen are not saved unless explicitly



saved by other operations on the screen









    
    
        Step—7: Screen navigates to coverage information. Even though the fields are optional, enter the values in the respective fields, as per the format briefed in field's explanation section and click Continue. (See FIG. C-210)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Employee Information








Hours worked 
The text for worked hours per week. Accepts numeric


per week
values not exceeding 2 digits.


Date of 
The text for date of employment. Choose a date by


employment
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Employee type
Choose an employee type from the drop down list



available


Pay Roll
Check box for Pay Roll verification. Check this if pay



roll is verified







Plan Information








Line of coverage
Choose a line of coverage from the drop down list



available


Medical waived
Click the check box for medical waive if the employee



is waiving medical.


Carrier selection
Choose a carrier selection from the drop down list


(Benefit level)
available


Coverage choice
Choose a coverage from the drop down list available


PCP ID/Medical
The text for PCP ID. Accepts alphabets and numeric


group ID
values not exceeding 10 characters.


Are you an 
Click the check box if you are an existing patient


existing patient



PCP last name
The text for PCP last name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 35 characters.


PCP first name
The text for PCP first name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 25 characters.


Prior plan type
Choose a plan type from the drop down list available


Prior plan name
Choose a plan name from the drop down list available


Prior insurance
The text for insurance start date. Choose a date by


start date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Prior insurance 
The text for insurance end date. Choose a date by


end date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Other coverage 
The text for other coverage. Accepts alphabets with


kept
values not exceeding 50 characters.


Employee 
Click the check box, to have employee signature


signature



Date signed
The text for date signed. Choose a date by clicking



calendar icon. Date accepts the format MM/DD/YYYY.



Date cannot accept future date.









Button Functionality
The following table provides explanation for each button in the screen.











Element 
Description







Add
Add the contents of employee coverage information. It



is only a temporary addition. Becomes permanent only



on saving the record.


Edit
Edit button will allow for editing a specific record in



the table.


Update
Update the contents of Plan Information. It is only a



temporary update. Becomes permanent only on saving



the record.


Cancel
Cancels the operation that was currently performed



prior to saving the record.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent only on saving the record.


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


Enrollment 
Click enrollment summary refreshes the screen and


Summary
display the summary of information entered for group



creation


Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


Group ID
Click Group ID to navigates to the Group's general info



screen.


Continue
Saves the data and navigates to Coverage Information



screen.


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tab
General Info, Coverage Info, Add Dependent are the



tabs visible on this screen. The navigation between the



tabs are possible only if there is a valid Employee ID



generated and assigned to the employee Also while



navigating through the tab the content that are



changed on the screen are not saved unless explicitly



saved by other operations on the screen









    
    
        Step—8: Screen navigates to add dependent information. First name and last name fields are mandatory and other fields are optional. Enter the values in the respective fields, as per the format briefed in field's explanation section and click either Enrollment Summary or Add dependent. (See FIG. C-211)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Dependent Information








First Name 
The text for first name. Accepts alphabets and special



character like hyphen and single quotes not exceeding



25 characters. First name is mandatory.


Middle 
The text for middle initial. Accepts alphabets not


Initial
exceeding 1 character.


Last Name
The text for last name. Accepts alphabets and special



characters like hyphen and single quotes not exceeding



35 characters. Last name is mandatory.


Suffix
Choose the suffix from the drop down list of suffixes



available.


Date of 
The text for date of birth. Choose a date by clicking


Birth
calendar icon. Date accepts the format



MM/DD/YYYY. Birth date cannot be later than the



current date.


Social 
The text for social security number for every


Security
individual. This can also be auto generated by clicking


Number
auto generate link. Accepts numeric value of exactly 9



digits. Users with User Role as Level 2 and above can



only auto generate SSN.


Gender
Choose a gender from the drop down list available.


Relationship
Choose the relationship from the drop down list



available.


Street 
The text for address. Accepts alphanumeric and special


Address
characters with values not exceeding 35 characters


Suite
The text for suite/apt # . . . Accepts alphanumeric and



special characters with values not exceeding 35



characters


Zip
The text for zip. Accepts numeric value of either 5 or 9



digits. City, and State are populated automatically on



entering the correct zip code and entering the tab key.


City
The text for city. Accepts alphabets not exceeding 30



characters.


State
Choose the name of the state from the drop down list



of States available in United States of America







Line of Coverage








Selected 
The text for selected carrier. It is a read only field


carrier



Coverage 
The text for coverage. It is a read only field


choice



Service area
The text for service area. It is a read only field


Prior plan 
Choose a plan type from the drop down list available


type



Prior plan
The text for plan name. Accepts alphabets


Waived
Click the check box if Line of Coverage is waived.


Start date
The text for insurance start date. Choose a date by



clicking calendar icon. Date accepts the format



MM/DD/YYYY.


End date
The text for insurance end date. Choose a date by



clicking calendar icon. Date accepts the format



MM/DD/YYYY.


PCP ID/
The text for PCP ID. Accepts alphabets and numeric



values not exceeding 10 characters.


PCP last 
The text for PCP last name. Accepts alphabets and


name
special character like hyphen and single quotes not



exceeding 35 characters.


PCP first 
The text for PCP first name. Accepts alphabets and


name
special character like hyphen and single quotes not



exceeding 25 characters.


Disabled 
Click the option of temporary or permanent. This is


dependent
enable if the relationship opted is child


Domestic 
Click the option for domestic partner. It depends on


partner
the value selected in relationship


Legal 
Click the option for legal guardian. It depends on the


guardian
value selected in relationship


Signature
Click the check box if the signature is opted









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add 
Saves the data and navigates to the screen for adding


Employee
employees.


Add 
Saves the data and navigates to the screen for adding


Dependent
dependent


Enrollment
Click enrollment summary refreshes the screen and


Summary
display the summary of information entered for group



creation


Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tab
General Info, Coverage Info, Add Dependent are the



tabs visible on this screen. The navigation between the



tabs are possible only if there is a valid Employee ID



generated and assigned to the employee Also while



navigating through the tab the content that are



changed on the screen are not saved unless explicitly



saved by other operations on the screen









    
    
        Step—9: Clicking enrollment summary button screen navigates to enrollment summary. This screen shows the overall information that is entered will be shown. (See FIG. C-212)
    
    


Field Explanation
The following table provides explanation for each element in the screen.











Element
Description







Group
Contains header information of the Group


Information



Header



Name of the Group
Text for the Name of the Group


Group ID
Text and Link for the Group ID to navigate to the



Group General Info screen


Group Type
Specifies the Type of the Group like Small Employer



Group


Status
Text to specify the status of the group.


Work Group
Text for Work Group. This specifies the internal work



group attached to the Group. This is based on the



writing agent's work group.


Enrollment
Enrollment Summary Information is broken down into


Summary
tree structure. The tree can by expanded or collapsed.


Information
The level of the tree is as per the example given below:



− Employee



 − Dependent



 − Dependent



Where (−) signifies expanded view and (+) signifies



collapsed view.


Employee ID
Text for Employee ID


Employee SSN
Text for Employee SSN


Employee Name
Text for employee Name (First Name and Last Name)


Effective Date
Text for Employee Effective date. Choose a date by



clicking calendar icon. Date accepts the format



MM/DD/YYYY. Defaults effective date of the



Employee. Effective date cannot be past date


Status
Text to specify the status of the employee.


Element
Description


Dependent ID
Text for Dependent ID


Dependent SSN 
Text for Dependent SSN


Dependent Name
Text for Dependent Name (First Name and Last



Name)


Effective Date
Text for Dependent Effective date. Choose a date by



clicking calendar icon. Date accepts the format



MM/DD/YYYY. Defaults effective date of the



Employee. Effective date cannot be past date


Status
Text to specify the status of the Dependent.









Button Functionality
The following table provides explanation for each button in the screen.













Element
Description








Pre 
Saves the data and performs validation and eligibility



Enrollment
checks against the information required for enrollment




and navigates to the screen Missing Information.



Cancel
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes









    
    
        Step—10: Clicking pre enrollment navigates to missing info screen. It gives the information that is left out while entering input for creating a group. For a successful creation of a group the missing information should be empty. (See FIG. C-213)
    
    


Field Explanation
The following table provides explanation for each element in the screen.











Element
Description







Group
Contains header information of the Group


Information



Header



Name of 
Text for the Name of the Group


the Group



Group ID
Text and Link for the Group ID to navigate to the



Group General Info screen


Group Type
Specifies the Type of the Group like Small Employer



Group


Effective 
The text for Effective Date.


Date



Status
Text to specify the status of the group.


Work 
Text for Work Group. This specifies the internal work


Group
group attached to the Group. Internal is based on the



writing agent's work group.


Tree 
Enrollment Missing Information is broken down into


Structure
tree structure. The tree can by expanded or collapsed.



The level of the tree is as per the example given below:



− Employee



 − Dependent



 − Dependent



Where (−) signifies expanded view and (+) signifies



collapsed view.


Employee
This identifies all the eligibility rules and the


Missing 
information that are incomplete on Employee level for


Info
completing the enrollment process.


Missing 
List the missing entities for the employee. Provides a


Entities
link to go to the respective screen to fill in the relevant



information to complete all the required entries.


Message
List the message against each missing entities.


Dependent
This identifies all the eligibility rules and the


Missing 
information that are incomplete on dependent level for


Info
completing the enrollment process.


Missing 
List the missing entities for the dependent. Provides a


Entities
link to go to the respective screen to fill in the relevant



information to complete all the required entries.


Message
List the message against each missing entities.


Enrollment 
Choose from the drop down list the action to be


Action
performed for enrollment. Enroll/Decline


Remarks
Text for remarks if any.


Reasons 
Choose from the drop down list the reasons for decline.


for Decline



Reasons 
Text for other reason. If the reason for decline is other


for Other
than the reasons available.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Send 
Click this link to send missing information to the


mail
Internal Work Group (GMS representatives) attached



to this Group.


Preview 
Click this Link to preview the Invoice details prior to


Invoice
generation of invoice.


Enroll
Saves the data if there are no missing information and



navigates to enrollment confirmation page.


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


<<, <, >, >>
The enrollment missing information shows record for 5



employees on single screen. If the employee size



increases more than 5. These buttons are used for



navigating to the next and previous records for



viewing.



<< - Show first record (s)



< - Show previous record (s)



> - Show next record (s)



>> - Show last record (s)


Employee 
Click Employee ID to navigates to the Employee's


ID
general info screen.


Preview 
Click Preview Invoice to pop up a new browser window


Invoice
to preview the invoice for the group









    
    
        Step—11: On completing all the relevant information that is required for a successful addition of an employee, the following is the sample screen for a successful creation. (See FIG. C-214)
        Step—12: Click Search employee to navigate back to Search Employee screen.
    
    


Modify Employee
The screen is to modify an employee.
The sequential steps involved in modifying an employee are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Add On. Select Employee Add On. Then click Modify Employee. (See FIG. C-215)
        Step—2: The screen navigates search to select a group. Enter value in any one of the field or simply click Search button to perform search operation. (See FIG. C-216)
        Step—3: This pops up a screen with search result. (See FIG. C-217)
        Step—4: Click on any employee id for selection. This navigates to General info of employees. The flow and method of modifying are similar to that of creation, which is explained in Add Employee, vide step 6 through step 11.
    
    


Modify Dependent
The screen is to modify a dependent. Here an employee can be added to a group and a dependent to that employee can be modified.
The sequential steps involved in modifying dependent are listed below.


    
    
        Step—1: After successful logon, click the menu Enrollment and select Add On. Select Employee Add On. Then click Modify Dependent. (See FIG. C-218)
        Step—2: The screen navigates search to select a dependent Enter value in any one of the field or simply click Search button to perform search operation. (See FIG. C-219)
        Step—3: This pops up a screen with search result. (See FIG. C-220)
        Step—4: Click on any employee id for selection. This navigates to Add Dependent of an employee. The flow and method of modifying are similar to that of creation, which is explained in Add Employee, vide step 8 through step 11.
    
    


Inactivate Dependent
The screen is to inactivate a dependent.
The sequential steps involved in inactivating dependent are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Add On. Select Employee Add On. Then click Inactivate Dependent. (See FIG. C-221)
        Step—2: The screen navigates search to select a dependent. Enter value in any one of the field or simply click search button to perform search operation. (See FIG. C-222)
        Step—3: This pops up a screen with search result. (See FIG. C-223)
        Step—4: Click on any Dependent ID for selection. Screen navigates to Inactivate. (See FIG. C-224)
        Step—5 Click Inactivate button, leads to confirmation screen. (See FIG. C-225)
    
    


Add Dependent
The screen is to add a dependent.
The sequential steps involved in adding a dependent are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Add On. Select Dependent Add On. Then click Add Dependent. (See FIG. C-226)
        Step—2: The screen navigates search to select a group/employee Enter value in any one of the field, or simply click search button, to perform search operation. (See FIG. C-227)
        Step—3: This pops up a screen with search result. (See FIG. C-228)
        Step—4: Click on any employee id for selection. This navigates to change request for add on dependent screen. Enter the fields with appropriate values as per the format briefed in field's explanation. Click Continue. (See FIG. C-229)
        Step—5: Screen navigates to Add on Dependent screen. Enter the fields with appropriate values as per the format briefed in field's explanation. Click Enrollment summary. Enrollment summary and missing information are similar to Add Dependent and it is explained under Add Employee vide step 8 through step 11. (See FIG. C-230)
    
    


Field Explanation
Refer for field explanations explained in Add Employee
Button Functionality
Refer for field explanations explained in Add Employee
Modify Dependent
The screen is to modify a dependent, where a dependent is added to an already enrolled employee. The process and flow are similar to that of modify dependent under Employee Add on.
The sequential steps involved in modifying dependent are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Add On. Select Employee Add On. Then click Modify Dependent. (See FIG. C-231)
        Step—2: The screen navigates search to select a dependent Enter value in any one of the field or simply click Search button to perform search operation. (See FIG. C-232)
        Step—3: This pops up a screen with search result. (See FIG. C-233)
        Step—4: Click on any employee id for selection. This navigates to Add Dependent of an employee. The flow and method of modifying are similar to that of creation, which is explained in Add Employee, vide step 8 through step 11.
    
    


10 En-Operations
Enrollment Operation is a utility process for generation various file in the specified output format for transmission to the Carrier, PacAdvantage and Mail House. These operations are Export Membership Data, Export PacAdvantage Data, Export Transmission Data, ROE Process, and ROE Packet Generation.
Access
The application can be accessed from the main menu as follows:

    
    
        Enrollment→En-Operations→Export Membership Data
        
            →Export PacAdvantage Data
            →Export Transmission Data
            →ROE Process
            →ROE Packet Generation
        
        
    
    


Pre-Requisites
All master and transaction records must be available in the system for Enrollment Operation.
Output file format and information for each carrier must be available in the system. Refer “User Manual for Carrier Maintenance” for further information on the output file formats for Carriers (Enrollment Transmission)
Application Functions
This application has the following functions for reinstatement:

    
    
        Export Membership Data
        Export PacAdvantage Data
        Export Transmission Data
        ROE Process
        ROE Packet Generation
    
    


Export Membership Data
The screen is to export membership data.
The sequential steps involved in exporting membership data are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select EN-Operations. Select Export Membership Data. (See FIG. C-234)
        Step—2: The screen navigates to Export Membership Data. (See FIG. C-235)
        Step—3: Choose the option of carrier or plan, member status, term effective date and file format and click Export
        Step—4: Initially the status will be not exported. Once the export button is clicked after filling necessary fields, a new browser window open for downloading the file. (See FIG. C-236)
        Step—5: Click “Click here to download” link and then click Ok to download the file
        Step—6: Click on the Search button navigates to the screen shown below. Enter Export ID and search for the export status. Click on the Export ID link to show the screen with export details or Click back to go back to the export screen. (See FIG. C-237)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Export ID
Read only field to display export id value


Status
Read only field to display the status of export.


Exported 
Read only field to display the user who exported the


By
files


Export 
Read only field to display the export date


Date



Carrier
Choose this option and select from the list if the data



export is based on the Carrier


Plan
Choose this option and select from the list if the data



export is based on the Plan


Member 
Choose from the List the Member status. Member


Status
Status can be Active, Termed or Both. The field is



mandatory


Term 
Enter the date for Term Effective Date or select a date


Effective 
by clicking calendar icon. The field is mandatory if the


Date
Member status option is Termed or Both.


File Format
Choose a format from drop down list for output format



that should be generated. The field is mandatory









Button Functionality
The following table provides explanation for each button in the screen.













Element
Description








New
Click on new button enables to have a new Export of




files.



Export
Click on Export button will perform the action of




exporting the files based on selection criteria



Search
Click on search button navigates to a screen to have a




search on entering Export ID.



View 
Click on view export log to have a pop up display



Export Log
showing the status of exported files



Hide 
Click on hide export log to hide the pop up display



Export Log
message.



Clear
Clears the content and restore the operation that was




currently performed prior to saving the record



Back
Goes back to Export screen.









Export PacAdvantage Data
The screen is to export PacAdvantage Data.
The sequential steps involved in exporting PacAdvantage data are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select EN-Operations. Select Export PacAdvantage Data. (See FIG. C-238)
        Step—2: The screen navigates to Export PacAdvantage Data. (See FIG. C-239)
        Step—3: Click Export
        Step—4: Initially the status will be not exported. Once the export button is clicked, the user has an option to view the status of export process by clicking Search.
        Step—5: Click back button to go back to Export. PacAdvantage Data Screen. (See FIG. C-240)
    
    


Field Explanation
The following table provides explanation for each button in the screen.













Element
Description








Export ID
Read only field to display export id value



Status
Read only field to display the status of export.



Exported 
Read only field to display the user who 



By
exported the files



Export 
Read only field to display the export date



Date









Button Functionality
The following table provides explanation for each button in the screen.













Element
Description








New
Click on new button enables to have a new Export of




files.



Export
Click on Export button will perform the action of




exporting the files based on selection criteria



Search
Click on search button navigates to a screen to have a




search on entering Export ID.



View 
Click on view export log to have a pop up display



Export Log
showing the status of exported files



Hide 
Click on hide export log to hide the pop up display



Export Log
message.



Clear
Clears the content and restore the operation that was




currently performed prior to saving the record



Back
Goes back to Export PacAdvantage Data screen.









Export Transmission Data
The screen is to export transmission data.
The sequential steps involved in exporting transmission data are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select EN-Operations. Select Export Transmission Data. (See FIG. C-241)
        Step—2: The screen navigates to Export Transmission Data. (See FIG. C-242)
        Step—3: Click Export
        Step—4: Initially the status will be not exported. Once the export button is clicked after filling necessary fields, the user has an option to view the status of export process by clicking Search. (See FIG. C-243)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Export ID
Read only field to display export id value


Status
Read only field to display the status of export.


Exported By
Read only field to display the user who exported the



files


Export Date
Read only field to display the export date


Transmit for the 
Enter the date for Transmit for the following Date


following Date
From or select a date by clicking calendar icon. The


From
field is mandatory.


Transmit for the 
Enter the date for Transmit for the following Date To


following Date 
or select a date by clicking calendar icon. The field is


To 
mandatory.


Comments
Text to enter Comments if any.









Button Functionality
The following table provides explanation for each button in the screen.











Element 
Description







New
Click on new button enables to have a new Export of



files.


Export
Click on Export button will perform the action of



exporting the files based on selection criteria


Search
Click on search button navigates to a screen to have a



search on entering Export ID.


Back
Goes back to Export Transmission Data screen.









ROE Process
The screen is to process ROE data.
The sequential steps involved in processing ROE are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select EN-Operations. Select ROE Process. (See FIG. C-244)
        Step—2: The screen navigates to ROE Process. (See FIG. C-245)
        Step—3: Click Generate
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Run ID
The text for sequential number of Run ID. It is a read



only field and is auto generated


Renewal Date
The text for Renewal Date during which the ROE/OE



process is to be initiated.


Run By
The text for name of the user who initiates ROE



process. It is a read only field.









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









New
Click on New button to start new ROE Process.



Generate
Click Generate to Initiate ROE Process. ROE process




once initiated for a specific period cannot be re




initiated once again.



Cancel
Click cancel to reset the fields.










ROE Packet Generation
The screen is to process ROE Packet Generation.
The sequential steps involved in generating ROE Packets are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select EN-Operations. Select ROE Packet Generation. (See FIG. C-246)
        Step—2: The screen navigates to ROE Packet Generation. Select ROE cycle period and apply filter conditions for Generating ROE/OE packets. (See FIG. C-247)
        Step—3: Click Generate
        Step—4: Initially the status will be not imported. Once the export button is clicked after filling necessary fields, the user has an option to view the status of export process by clicking Search. (See FIG. C-248) Step 5: Click Back button to go back to ROE
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Export ID
The text for Export ID. This is auto generated by the



system


Status
The text for Export Status. This is a read only field.



The system shows the Export status based on data



exported


Exported By
The text for Exported By. This is a read only field.


Export Date
The text for Export date. This is a read only field.


ROE Cycle
Choose the ROE Cycle period for which the ROE/OE



packet are to be generated.


Post Mark Date
The text for post mark date. Choose a date in the



format MM/DD/YYYY by clicking calendar icon. The



postmark date cannot be greater than system date.



The field is mandatory.


Comments
Text to specify comments if any.


Selected Groups
The text displays the selected group count based on 



the ROE Cycle period. Example 0 to 100. It is a 



read only field


Group ID
The text for Group ID. Accepts numeric values only.


Group Name
The text for group name. Accepts any characters.


Group Type
Choose the group type from the list.


Group Size From
The text for group size and specifies the starting



range. Accepts numeric values only.


Group Size To
The text for group size and specifies the ending range.



Accepts numeric values only.


View Selected
Check the View Selected Check Box to view only



selected groups.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Filter
Click the Filter to display the Group based on the



search criteria/filter conditions provided.


Clear Filter
Clear the Content of the fields.


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


Check All on this
The “Check All on this Page” Link will check all the


Page
records in the table on this Page


Clear All on this
The “Clear All on this Page” Link will uncheck all the


Page
records in the table that are checked on this Page.


Invert Selection
The Invert Selection Link will invert the selection



criteria for the check boxes. I.e. All Check Groups



would be unchecked and vice versa.


<<, <, >, >>
These buttons are used for navigating to the next and



previous records for viewing.



<< - Show first record(s)



< - Show previous record(s)



> - Show next record(s)



>> - Show last record(s)


New
Click New to start new operation on this screen


Generate
Click Generate to generate ROE/OE packets for Mail



House Transmission.


Search
Click Search Button to search the Status of the 



ROE/OE Packet generation


Cancel
Cancels the operation that was currently performed



prior to saving the record.


Back
Goes back to ROE Transmission screen.









11 Change
Changes is the transaction module that encompasses the process of accommodating and maintaining all information that is required for Groups ad Members. Change can be done for Groups, COBRA Members, Individual Member, Employee and Dependent.
Access
The application can be accessed from the main menu as follows:

    
    
        Enrollment→En-Operations→Group Change
        
            →COBRA Change
            →Individual Employee Change
            →Employee Change
            →Dependent Change
        
        
    
    


Pre-Requisites
Groups and Members must be enrolled and all the relevant information must be available in the system for making changes.
Application Functions
This application has the following functions for reinstatement:
Create New Change Request
Modify Change Request
Group Change Create New Request
The screen is to have an request for any change in Group
The sequential steps involved in change request for group are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Change. Select Group change and Create Change Request. (See FIG. C-249)
        Step—2: The screen navigates to Group Search screen. Enter any value in one of the field to perform search operation. (See FIG. C-250)
        Step—3: This pops up a screen with search result. (See FIG. C-251)
        Step—4: Click on any group id for selection the screen navigates to Group Change Request. (See FIG. C-252)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Group Information








Name of the 
Text for the Name of the Group. This is read only field.


group



Effective Date
Text for Effective date. This is read only field.


Group ID
Text for Group ID. This is read only field..


Status
Text for status. This is read only field.


Group Type
Text for group type. This is read only field..


Work Group
Text for work group. This is read only field..







General Information








Mode of Request
Choose a mode of request from the drop down list



available


Post Mark Date
Text for post mark date. Choose a date by clicking



calendar icon. Accepts in the format MM/DD/YYYY



Entry to this field is mandatory


Received Date
Text for received date. Choose a date by clicking



calendar icon. Accepts in the format MM/DD/YYYY.



Entry to this field is mandatory.


Reasons for 
Choose a reason for change from the drop down list


Change
available


Others
Text for others. This field is enabled only if the 



option for reasons for change is others









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Continue
Saves the entered information and navigates to next




level, which show the pick list for the changes that are




sought.



Clear
Clears or restores the content entered in the fields as




was prior to saving the records.










    
    
        Step—5: Choose mode of request, Post mark date, date received and reason for change. Clicks continue. This screen would be available only if there are no change requests pending for the group.
        Step—6: Navigates to group changes, which allows the option to pick the changes sought. Check the items that need to be change and click on continue button. This screen is dynamically built to display only those changes that can be performed on the specific group selected. (See FIG. C-253)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Group Information








Name of the group
Text for the Name of the Group. Read Only field


Effective Date
Text for Effective date. This is read only field.


Group ID
Text for Group ID. This is read only field.


Status
Text for status. This is read only field.


Group Type
Text for group type. This is read only field.


Work Group
Text for work group. This is read only field.







General Information








Contact
Selecting this option will enable to allow


Information1
for any modifications


Contact
Selecting this option will enable to allow


Information2
for any modifications


Physical Address
Selecting this option will enable to allow



for any modifications


Billing Address
Selecting this option will enable to allow



for any modifications


Tax Identification
Selecting this option will enable to allow



for any modifications


Billing Address
Selecting this option will enable to allow



for any modifications







Billing Information








Payment
Selecting this option will enable to allow


information
for any modifications







Agent Information








Writing Agent
Selecting this option will enable to allow



for any modifications


Agent of Record
Selecting this option will enable to allow



for any modifications


General Agency
Selecting this option will enable to allow



for any modifications







Coverage Information








RAF
Selecting this option will enable to allow



for any modifications


Waiting Period
Selecting this option will enable to allow



for any modifications


Medical LOC
Selecting this option will enable to allow



for any modifications


Vision LOC
Selecting this option will enable to allow



for any modifications


Dental LOC
Selecting this option will enable to allow



for any modifications


CAM LOC
Selecting this option will enable to allow



for any modifications


Others
Selecting this option will enable to allow



for any modifications









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Continue
Saves the data and navigates to General information for groups.


Clear
Clears the contents entered in the fields or restore to the 



previous state as was before saving the changes









    
    
        Step—7: On clicking continue, navigates to General Information of group Respective tabs can also clicked to navigate to corresponding screens. Continue would be enabled only if the changes are sought on this screen, else use tab to navigate to the next screen. (See FIG. C-254)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Company Information








Legal Name
The text for name of the group. Accepts alphanumeric



and special characters not exceeding 60 characters.



Field is mandatory


Doing Business
The text for business nature. Accepts alphanumeric


As
and special characters not exceeding 60 characters.



Field is optional


Type of Business
Choose the type of business from the drop down list



available


Tax Identification
The text for tax identification. Accepts numeric values



of exactly 9 digits







Address Information: Physical and Billing Address - Note: Enter Billing


Address if different from the Physical Address.








Street Address
The text for company address. Accepts alphanumeric



and special characters not exceeding 35 characters


Suite
The text for company suite/apt # Accepts



alphanumeric and special characters not exceeding 35



characters


Zip
The text for zip. Accepts numeric value of either 5 or 9



digits. City, State and County are populated



automatically on entering the correct zip code and



entering the tab key.


City
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters.


State
Choose the name of the state from the drop down list



of States available in United States of America


County
Choose the name of the county from the drop down list



of counties available for the ZIP Code entered.







Contact Information








Mode of
Choose the mode of correspondence from the drop


Correspondence
down list available.







Contact 1 and Contact 2 - Fill in the relevant for Contact 1 and 2.








Salutation
Choose the salutation from the drop down list of



salutations available.


First Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 25 characters.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 35 characters.


Suffix
Choose the suffix from the drop down list of suffixes



available.


Phone Number
The text for telephone number of the contact person.



Accepts numeric values of exactly 10 digits. The format



is (999) 999-9999


Extension
The text for extension number of the contact person.



Accepts numeric values not exceeding 5 digits.


Fax
The text for fax number of the contact person. Accepts



numeric values of exactly 10 digits. The format is



(999) 999-9999


Email
The text for email of the contact person. Accepts



alphabets, numeric and special characters in the



standard email format of length not exceeding 100



characters


Contact 
The text for comments. Accepts alphabets, numeric


Comments
and special characters. Field is optional









Button Functionality
The following table provides explanation for each button in the screen.














Element 
Description









Continue
Saves the data and navigates to Billing Information




screen and the system generates Group ID. This is




enabled only if changes are sought on this screen.



Cancel
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes



Tabs
General Info, Billing Info, Agent Info, Coverage Info




are the tabs visible on this screen. Navigation to the




next screen is also possible by using tabs If continue




button is disabled use this tab to navigate to the next




screen. Also while navigating through the tab the




content that are changed on the screen are not saved




unless explicitly saved by other operations on the




screen.










    
    
        Step—8: On clicking continue, navigates to Billing Information Respective tabs can also clicked to navigate corresponding screens. (See FIG. C-255)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Mode of payment 
Choose a mode of payment from the drop down list



available. Based on selection corresponding fields will



enable to enter the values. For e.g. if the value selected



is card payment, EFT will be disabled and allows only



entering card details and vice versa.







Credit Card Information








Cardholder's
The text for cardholder's name. Accepts alphabets and


Names
space between two words.


Credit Card Type
Choose the type of credit card from the drop down list



available.


Credit Card No
The text for credit card number. Accepts numeric



values not exceeding 30 digits


Expiration Date
Choose a month of expiration from the drop down list



available


Expiration Year
The text for expiration year. Accepts numeric values



of exactly 4. Example 2002.


Billing Address 
As it appears on the credit Card


Street Address
The text for company address. Accepts alphanumeric



and special characters not exceeding 35 characters.


ZIP
The text for zip. Accepts numeric value of either 5 or 9



digits.


State
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters.


City
Choose the name of the state from the drop down list



of States available in United States of America







EFT Information








Bank Name
The text for bank name. Accepts alphabets and space



between two words.


Routing Number
The text for routing number. Accepts numeric values



not exceeding 9 digits.


Account Number
The text for account number. Accepts numeric values



not exceeding 9 digits.


Account Type
Choose the type of account from the drop down list



available.


Depositor's Name
The text for depositor's name. Accepts alphabets and



space between two words.







Initial Payment Information








Amount Received
The text for amount received. Accepts only numeric



values in the format 999999999.99


Date Receive
The text for date received. Choose from the calendar



icon in the format MM/DD/YYYY.


Check #
The text for check number. Accepts numeric values not



exceeding 9 digits.


No Check
Check the option of no checks received for any non-


Received
receipt of checks.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Continue
Saves the data and Navigates to Agent Information



screen.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Missing
Click missing information refreshes the screen and


Information
displays the missed information for the group.


Tabs
General Info, Billing Info, Agent Info, Coverage Info



are the tabs visible on this screen. Navigation to the



next screen is also possible by using tabs If continue



button is disabled use this tab to navigate to the next



screen. Also while navigating through the tab the



content that are changed on the screen are not saved



unless explicitly saved by other operations on the



screen.









    
    
        Step—9: On clicking continue, navigates to Agent Information. Respective tabs can also clicked to navigate corresponding screens. (See FIG. C-256)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Agent ID
Choose an agent id by clicking search icon


Agent Type
Choose an agent type from the drop down list



available. Based on the selection of the agent type the



percent commission split entry and the Receive ROE



packets option would be available.


Percent 
The text for percent commission. Accepts numeric


commission 
values in the range of 1-100 (Example 100.00). This


split
will be enabled only if the Agent type selected is “Agent



Of Record”



Sum of the percentage for all the Agent of Record



added should be equal to 100.00.


Receive
Click the check box to receive ROE/OE packets for


ROE/OE
agent. This option will not be available for Agent Type


packets
“General Agent”.


Agent 
The text for agent commission. Defaults the value


Commission
defined in CM - rate Administration for Agent



Commission. Accepts numeric values less than or



equal to the defaulted value in the in the range of



1-100 (Example 4.45)


Check the box
Click the check box for a group with out an agent. This


if the group 
option will be available only for the Agent Type, “Agent


is without an 
of Record and Writing Agent”.


agent









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add
Add the contents of agent information. It is only a



temporary addition. Becomes permanent only on



saving the record.


Edit
Edit button will allow for editing a specific record in



the table.


Clear
Clears the contents entered in the fields


Update
Update the contents of agent information. It is only a



temporary update. Becomes permanent only on saving



the record


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent only on saving the record


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


Continue
Saves the data and navigates to Coverage Information



screen.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tab
General Info, Billing Info, Agent Info, Coverage Info



are the tabs visible on this screen. Navigation to the



next screen is also possible by using tabs If continue



button is disabled use this tab to navigate to the next



screen. Also while navigating through the tab the



content that are changed on the screen are not saved



unless explicitly saved by other operations on the



screen









    
    
        Step—10: On clicking continue, navigates to Coverage Information. Respective tabs can also clicked to navigate corresponding screens. (See FIG. C-257)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Hours worked
The text for worked hours per week. Accepts numeric


per week
values.


Date of 
The text for date of employment. Choose a date by


employment
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Employee type
Choose an employee type from the drop down list



available


Line of coverage
Choose a line of coverage from the drop down list



available


Medical waived
Click the check box for medical waive if the employee



is waiving medical.


Carrier selection
Choose a carrier selection from the drop down list


(Benefit level)
available


Coverage choice
Choose a coverage from the drop down list available


PCP ID/Medical
The text for PCP ID. Accepts alphabets and numeric


group ID
values not exceeding 10 characters.


Are you an 
Click the check box if you are an existing patient


existing patient



PCP last name
The text for PCP last name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 35 characters.


PCP first name
The text for PCP first name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 25 characters.


Prior plan type
Choose a plan type from the drop down list available


Prior plan name
Choose a plan name from the drop down list available


Prior insurance
The text for insurance start date. Choose a date by


start date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Prior insurance 
The text for insurance end date. Choose a date by


end date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Other coverage
The text for other coverage. Accepts alphabets with


kept
values not exceeding 50 characters.


RAF
Text to display the RAF applicable for the Individual



Association Member.


Employee
Click the check box, to have employee signature


signature 



Date signed
The text for date signed. Choose a date by clicking



calendar icon. Date accepts the format MM/DD/YYYY.



Date cannot accept future date.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add
Add the contents of employee coverage information. 



It is only a temporary addition. Becomes permanent 



only on saving.


Edit
Edit button will allow for editing a specific record in



the table.


Update
Update the contents of Plan Information. It is only a



temporary update. Becomes permanent only on saving.


Cancel
Cancels the operation that was currently performed



prior to saving the record.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent only on saving.


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in 



the table that are checked.


Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


Group ID
Click Group ID to navigates to the Group's general 



info screen.


Continue
Saves the data and navigates to Missing Information



screen.


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tab
General Info, Billing Info, Agent Info, Coverage Info



are the tabs visible on this screen. Navigation to the



next screen is also possible by using tabs If continue



button is disabled use this tab to navigate to the next



screen. Also while navigating through the tab the



content that are changed on the screen are not saved



unless explicitly saved by other operations on the



screen









    
    
        Step—11: Clicking change summary button screen navigates to missing info screen. This screen shows the overall information that is entered will be shown. (See FIG. C-258)
    
    


Field Explanation
The following table provides explanation for each button in the screen.














Element
Description
















Group Missing Information










Missing Entity
List the missing entities for the group 




change 



Message
Provides a message for the missing entities







Change Information










Change Rule
Specifies the pick list for the changes



Change status
Show the change status as incomplete, 




complete



Change
Choose from the list change status



confirmation




Change Action
Choose from the list of change action



Remarks
Text for briefing the change action










Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Confirm 
Navigates to confirmation screen by incorporating all



the changes made


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









    
    
        Step—12: Confirms the changes incorporated in-group request. Click Group Change Search to go back to Group Search screen. (See FIG. C-259)
    
    


Group Modify Pending Change
The screen is to have an request for any change in Group
The sequential steps involved in change request for group are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Change. Select Group change and Modify Pending Change. (See FIG. C-260)
        Step—2: The screen navigates to Group Search screen. Enter any value in one of the field to perform search operation. (See FIG. C-261)
        Step—3: This pops up a screen with search result. (See FIG. C-262)
        Step—4: Navigates to group changes, which allows the option to have changes required. If no option is selected the continue button in respective pages will be disabled and changes cannot be performed. (See FIG. C-263)
    
    


Field Explanation
Refer field explanations explained in Create New Change Request under Group Change
Button Functionality
Refer button functionality explained in Create New Change Request under Group Change.

    
    
        Step—5: On clicking continue, navigates to General Information of group Respective tabs can also clicked to navigate to corresponding screens. The process and flow for modifying change request is similar to that of create new change request. (See FIG. C-264)
    
    


Field Explanation
Refer field explanations explained in Create New Change Request.
Button Functionality
Refer button functionality explained in Create New Change Request.
COBRA Change Create New Request
The screen is to have an request for any change in COBRA
The sequential steps involved in change request for COBRA are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Change. Select COBRA change and Create Change Request. (See FIG. C-265)
        Step—2: The screen navigates to Employee Search screen. Enter any value in one of the field to perform search operation. (See FIG. C-266)
        Step—3: This pops up a screen with search result. (See FIG. C-267)
        Step—4: Click on any employee id for selection the screen navigates to Employee change Request. (See FIG. C-268)
    
    


Field Explanation
Refer field explanations explained in Create New Change Request
Button Functionality
Refer button functionality explained in Create New Change Request.

    
    
        Step—5: Screen navigates to employee change (pick list). Select the options to have any modifications, so that the selected screen will enable the continue button. This screen is dynamically built to display only those changes that can be performed on the specific group selected. (See FIG. C-269)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Group Information








Name of the group
Text for the Name of the Group. This is read 



only field.


Effective Date
Text for Effective date. This is read only field.


Group ID
Text for Group ID. This is read only field.


Status
Text for status. This is read only field.


Group Type
Text for group type. This is read only field.


Work Group
Text for work group. This is read only field.


Employee ID
Text for employee ID This is read only field.


Employee Name
Text for employee name. This is read 



only field







General Information








Change in employee
Selecting this option will enable to allow 


address
for any modifications


Change SSN
Selecting this option will enable to allow for 


information
any modifications


Employee Date 
Selecting this option will enable to allow for 


of birth
any modifications


Change in employee 
Selecting this option will enable to allow for 


demographic
any modifications


location








Billing Information








Payment
Selecting this option will enable to allow for


Instruction
any modifications







Coverage Information








Medical LOC
Selecting this option will enable to allow for 



any modifications


Vision LOC
Selecting this option will enable to allow for 



any modifications


Dental LOC
Selecting this option will enable to allow for 



any modifications


CAM LOC
Selecting this option will enable to allow for 



any modifications


Hours worked
Selecting this option will enable to allow for 



any modifications


Employee Type
Selecting this option will enable to allow for 



any modifications


Date of employment
Selecting this option will enable to allow for 



any modifications









    
    
        Step—6: On clicking continue, screen navigates to General Info screen. Make any corrections if previously opted in change request, then only continue button will be enabled. Otherwise navigate screens through tabs. (See FIG. C-270)
    
    


Field Explanation
The following table provides explanation for each element in the screen.











Element
Description







Group
Contains header information of the Group


Information Header



Name of the group
Text for the Name of the Group. This is read 



only field.


Effective Date
Text for Effective date. This is read only field.


Group ID
Text for Group ID. This is read only field.


Status
Text for status. This is read only field.


Group Type
Text for group type. This is read only field.


Work Group
Text for work group. This is read only field.


Employee ID
Text for employee ID This is read only field.


Employee Name
Text for employee name. This is read only field







Employee Information








Salutation
Choose the salutation from the drop down list of



salutations available. This is read only field


First Name
The text for first name. Accepts alphabets and 



special character like hyphen and single quotes 



not exceeding 25 characters. First name is 



mandatory. This is read only field


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character. This is read only field


Last Name
The text for last name. Accepts alphabets and 



special characters like hyphen and single quotes 



not exceeding 35 characters. Last name is 



mandatory. This is read only field


Suffix
Choose the Suffix from the drop down list of



salutations available This is read only field.


Date of Birth
The text for date of birth. Choose a date by 



clicking calendar icon Allows for modification, 



as it has been opted for change from the pick 



up list.


Social Security
The text for social security number for every


Number
individual. This can also be auto generated by 



clicking auto generate link. Accepts numeric 



value of exactly 9 digits. Users with User Role as 



Level 2 and above can only auto generate SSN. 



This is read only field


Gender
Choose a gender from the drop down list 



available. This is read only field







Address Information








Street Address
The text for address. Accepts alphanumeric and 



special characters with values not exceeding 35 



characters


Apt
The text for suite/apt #. Accepts alphanumeric and



special characters with values not exceeding 35



characters This is read only field


Zip
The text for zip. Accepts numeric value of either 



5 or 9 digits. City, State and County are populated



automatically on entering the correct zip code and



entering the tab key. This is read only field


City
The text for city. Accepts alphabets and space 



between two words not exceeding 30 characters. 



This is read only field


State
Choose the name of the state from the drop 



down list of States available in United States of 



America This is read only field


County
Choose the name of the county from the drop 



down list of States available in United States of 



America This is read only field


Mode of
Choose the mode of correspondence from the 


Correspondence
drop down list available This is read only field


Phone Number
The text for telephone number of the employee.



Accepts numeric values not exceeding 10 digits. 



The format is (999) 999-9999 This is read 



only field


Extension
The text for extension number of the employee.



Accepts numeric values not exceeding 5 digits 



This is read only field


Fax
The text for fax number of the employee. 



Accepts numeric values not exceeding 10 digits. 



The format is (999) 999-9999 This is read 



only field


Email
The text for email of the employee. Accepts 



alphabets, numeric and special characters in the 



standard email format of length not exceeding 



100 characters This is read only field









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Continue
Saves the data and Navigates to Billing Information



screen. This is enabled only if changes are sought on



this screen


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Missing
Click missing information refreshes the screen and


Information
displays the missed information for the group.


Tabs
General Info, Billing Info, Coverage Info are the tabs



visible on this screen. Navigation to the next screen 



is also possible by using tabs If continue button is



disabled use this tab to navigate to the next screen.



Also while navigating through the tab the content 



that are changed on the screen are not saved unless



explicitly saved by other operations on the screen.









    
    
        Step—7: On clicking continue, screen navigates to Billing Info. Make any corrections if previously opted in change request, then only continue button will be enabled. Otherwise navigate screens through tabs. (See FIG. C-271)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Mode of payment 
Choose a mode of payment from the drop down 



list available. Based on selection corresponding 



fields will enable to enter the values. For e.g. if 



the value selected is card payment, EFT will be 



disabled and allows only entering card details 



and vice versa.







Credit Card Information








Cardholder's
The text for cardholder's name. Accepts 


Names
alphabets and space between two words. 



This is read only field


Credit Card Type
Choose the type of credit card from the drop 



down list available.


Credit Card No
The text for credit card number. Accepts 



numeric values not exceeding 30 digits


Expiration Date
Choose a month of expiration from the drop 



down list available


Expiration Year
The text for expiration year. Accepts numeric 



values of exactly 4. Example 2002.


Billing Address 
As it appears on the credit Card


Street Address
The text for company address. Accepts 



alphanumeric and special characters not 



exceeding 35 characters.


ZIP
The text for zip. Accepts numeric value of 



either 5 or 9 digits.


State
The text for city. Accepts alphabets and 



space between two words not exceeding 30 



characters.


City
Choose the name of the state from the drop 



down list of States available in United States 



of America







EFT Information








Bank Name
The text for bank name Accepts alphabets 



and space between two words.


Routing Number
The text for routing number. Accepts numeric 



values not exceeding 9 digits.


Account Number
The text for account number. Accepts numeric 



values not exceeding 9 digits.


Account Type
Choose the type of account from the drop down 



list available.


Depositor's Name 
The text for depositor's name. Accepts alphabets 



and space between two words.







COBRA Billing Information








Send Bills to
Choose the option to send the bills to Group or Sel.









Button Functionality
The following table provides explanation for each button in the screen.











Element 
Description







Continue
Saves the data and Navigates to Coverage Information



screen. This is enabled only if changes are sought on



this screen


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Missing
Click missing information refreshes the screen and


Information
displays the missed information for the group.


Tabs
General Info, Billing Info, Coverage Info are the tabs



visible on this screen. Navigation to the next screen is



also possible by using tabs If continue button is



disabled use this tab to navigate to the next screen.



Also while navigating through the tab the content that



are changed on the screen are not saved unless



explicitly saved by other operations on the screen.









    
    
        Step—8: On clicking continue, screen navigates to Coverage Info. Make any corrections if previously opted in change request, then only continue button will be enabled. Otherwise navigate screens through tabs. (See FIG. C-272)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Plan Information








Line of coverage
Choose a line of coverage from the drop down 



list available


Medical waived
Click the check box for medical waive if the 



employee is waiving medical.


Carrier selection
Choose a carrier selection from the drop down 


(Benefit level)
list available


Coverage choice
Choose a coverage from the drop down list 



available


PCP ID/Medical
The text for PCP ID. Accepts alphabets and 


group ID
numeric values not exceeding 10 characters.


Are you an 
Click the check box if you are an existing patient


existing patient



PCP last name
The text for PCP last name. Accepts alphabets 



and special character like hyphen and single 



quotes not exceeding 35 characters.


PCP first name
The text for PCP first name. Accepts alphabets 



and special character like hyphen and single 



quotes not exceeding 25 characters.


Prior plan type
Choose a plan type from the drop down list 



available


Prior plan name
Choose a plan name from the drop down list 



available


Prior insurance
The text for insurance start date. Choose a date by


start date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Prior insurance 
The text for insurance end date. Choose a date by


end date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Additional
The text for additional coverage. Accepts 


Coverage
alphabets with values not exceeding 50 



characters.


Date signed
The text for date signed. Choose a date by 



clicking calendar icon. Date accepts the format 



MM/DD/YYYY. Date cannot accept future date.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add
Add the contents of employee coverage information. It



is only a temporary addition. Becomes permanent only



on saving the record.


Edit
Edit button will allow for editing a specific record in



the table.


Update
Update the contents of Plan Information. It is only a



temporary update. Becomes permanent only on saving



the record.


Cancel
Cancels the operation that was currently performed



prior to saving the record.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent only on saving the record.


Check All
The “Check All” Link will check all the records in 



the table


Clear All
The “Clear All” Link will uncheck all the records in 



the table that are checked.


Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a 



successful creation of a group, there should be no 



missing information


Group ID
Click Group ID to navigates to the Group's general 



info screen.


Continue
Saves the data and navigates to Missing Information



screen, if it is enabled . . .


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tab
General Info, Billing Info, Coverage Info, are the tabs



visible on this screen. Navigation to the next screen is



also possible by using tabs If continue button is



disabled use this tab to navigate to the next screen



Also while navigating through the tab the content that



are changed on the screen are not saved unless



explicitly saved by other operations on the screen









    
    
        Step—9: On clicking continue, screen navigates to Missing Info. (See FIG. C-273)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Employee Missing Information








Missing Entity
List the missing entities for the group change


Message
Provides a message for the missing entities


Enrollment
Lists all the changes sought in the pick list


Information



Status
Displaying the status of change.







Change Information








Change Rule
Specifies the pick list for the changes


Change status
Show the change status as incomplete, 



complete


Change
Choose from the list change status


confirmation



Change Action
Choose from the list of change action


Remarks
Text for briefing the change action









Button Functionality
The following table provides explanation for each button in the screen.













Element
Description








Confirm 
Navigates to confirmation screen by incorporating 




all the corrections made



Clear
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes









    
    
        Step—10: After entering the respective fields, click continues, which navigates to confirmation screen. (See FIG. C-274)
    
    


COBRA Modify Pending Change
The screen is to have an request for any change in COBRA
The sequential steps involved in change request for COBRA are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Change. Select COBRA change and Modify Pending Change. (See FIG. C-275)
        Step—2: The screen navigates to Employee Search screen. Enter any value in one of the field to perform search operation. (See FIG. C-276)
        Step—3: This pops up a screen with search result. (See FIG. C-277)
        Step—4: Navigates to employee changes, which allows the option to have changes required. If no option is selected the continue button in respective pages will be disabled and changes cannot be performed. (See FIG. C-278)
    
    


Field Explanation
Refer field explanations explained in Create New Change Request under COBRA Change
Button Functionality
Refer button functionality explained in Create New Change Request under COBRA Change

    
    
        Step—5: On clicking continue, navigates to General Information of group Respective tabs can also clicked to navigate to corresponding screens. The process and flow for modifying change request is similar to that of create new change request. (See FIG. C-279)
    
    


Field Explanation
Refer field explanations explained in Create New Change Request, under COBRA Change
Button Functionality
Refer button functionality explained in Create New Change Request, under COBRA Change.
Individual Member Change Create New Request
The screen is to have a request for any change in Individual Member
The sequential steps involved in change request for Individual Member are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Change. Select Individual Member change and Create Change Request. (See FIG. C-280)
        Step—2: The screen navigates to Employee Search screen. Enter any value in one of the field to perform search operation. (See FIG. C-281)
        Step—3: This pops up a screen with search result. (See FIG. C-282)
        Step—4: Click on any employee id for selection the screen navigates to Employee change Request. (See FIG. C-283)
    
    


Field Explanation
Refer field explanations explained in Create New Change Request
Button Functionality
Refer button functionality explained in Create New Change Request.

    
    
        Step—5: Screen navigates to employee change (pick list). Select the options to have any modifications, so that the selected screen will enable the continue button. (See FIG. C-284)
    
    


Field Explanation
The following table provides explanation for each button in the screen.














Element
Description
















Group Information










Name of the group
Text for the Name of the Group. This is 




read only field.



Effective Date
Text for Effective date. This is read only 




field.



Group ID
Text for Group ID. This is read only field.



Status
Text for status. This is read only field.



Group Type
Text for group type. This is read only field.



Work Group
Text for work group. This is read only field.



Employee ID
Text for employee ID This is read only field.



Employee Name
Text for employee name. This is read only 




field







General Information










Change in employee 
Selecting this option will enable to allow 



address
for any modifications



Change SSN
Selecting this option will enable to allow 



information
for any modifications



Employee Date of
Selecting this option will enable to allow 



birth
for any modifications



Change in employee
Selecting this option will enable to allow 



demographic
for any modifications



location








Billing Information










Payment
Selecting this option will enable to allow 



Instruction
for any modifications







Coverage Information










Medical LOC
Selecting this option will enable to allow 




for any modifications



Vision LOC
Selecting this option will enable to allow 




for any modifications



Dental LOC
Selecting this option will enable to allow 




for any modifications



CAM LOC
Selecting this option will enable to allow 




for any modifications



Hours worked
Selecting this option will enable to allow 




for any modifications



Employee Type
Selecting this option will enable to allow 




for any modifications



Date of employment
Selecting this option will enable to allow 




for any modifications










    
    
        Step—6: On clicking continue, screen navigates to General Info screen. Make any corrections if previously opted in change request, then only continue button will be enabled. Otherwise navigate screens through tabs. (See FIG. C-285)
    
    


Field Explanation
The following table provides explanation for each element in the screen.











Element
Description







Group
Contains header information of the Group


Information 



Header



Name of the 
Text for the Name of the Group. This is read 


group
only field.


Effective Date
Text for Effective date. This is read only field.


Group ID
Text for Group ID. This is read only field.


Status
Text for status. This is read only field.


Group Type
Text for group type. This is read only field.


Work Group
Text for work group. This is read only field.


Employee ID
Text for employee ID This is read only field.


Employee Name
Text for employee name. This is read only field







Employee Information








Salutation
Choose the salutation from the drop down list of



salutations available. This is read only field


First Name
The text for first name. Accepts alphabets and special



character like hyphen and single quotes not exceeding



25 characters. First name is mandatory. This is read



only field


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character. This is read only field


Last Name
The text for last name. Accepts alphabets and special



characters like hyphen and single quotes not exceeding



35 characters. Last name is mandatory. This is read



only field


Suffix
Choose the Suffix from the drop down list of



salutations available This is read only field.


Date of Birth
The text for date of birth. Choose a date by clicking



calendar icon Allows for modification, as it has



been opted for change from the pick up list.


Social Security 
The text for social security number for every


Number
individual. This can also be auto generated by clicking



auto generate link. Accepts numeric value of exactly 9



digits. Users with User Role as Level 2 and above can



only auto generate SSN. This is read only field


Gender
Choose a gender from the drop down list available.



This is read only field







Address Information








Street Address
The text for address. Accepts alphanumeric and special



characters with values not exceeding 35 characters


Apt
The text for suite/apt #. Accept alphanumeric and 



special characters with values not exceeding 35



characters This is read only field


Zip
The text for zip. Accepts numeric value of either 5 or 9



digits. City, State and County are populated



automatically on entering the correct zip code and



entering the tab key. This is read only field


City
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters. This is read



only field


State
Choose the name of the state from the drop down list



of States available in United States of America This is



read only field


County
Choose the name of the county from the drop down 



list of States available in United States of America 



This is read only field


Mode of
Choose the mode of correspondence from the drop


Correspondence
down list available This is read only field


Phone Number
The text for telephone number of the employee.



Accepts numeric values not exceeding 10 digits. The



format is (999) 999-9999 This is read only field


Extension
The text for extension number of the employee.



Accepts numeric values not exceeding 5 digits This is



read only field


Fax
The text for fax number of the employee. Accepts



numeric values not exceeding 10 digits. The format is



(999) 999-9999 This is read only field


Email
The text for email of the employee. Accepts alphabets,



numeric and special characters in the standard email



format of length not exceeding 100 characters This is



read only field









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Continue
Saves the data and Navigates to Billing Information



screen. This is enabled only if changes are sought on



this screen


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Missing
Click missing information refreshes the screen and


Information
displays the missed information for the group.


Tabs
General Info, Billing Info, Coverage Info are the tabs



visible on this screen. Navigation to the next screen is



also possible by using tabs If continue button is



disabled use this tab to navigate to the next screen.



Also while navigating through the tab the content that



are changed on the screen are not saved unless



explicitly saved by other operations on the screen.









    
    
        Step—7: On clicking continue, screen navigates to Billing Info. Make any corrections if previously opted in change request, then only continue button will be enabled. Otherwise navigate screens through tabs. (See FIG. C-286)
    
    


Field Explanation
The following table provides explanation for each button in the screen.














Element
Description









Mode of payment
Choose a mode of payment 




from the drop down list




available. Based on selection 




corresponding fields will




enable to enter the values. For 




e.g. if the value selected




is card payment, EFT will be 




disabled and allows only




entering card details and 




vice versa.







Credit Card Information










Cardholder's
The text for cardholder's name. 



Names
Accepts alphabets and




space between two words. 




This is read only field



Credit Card Type 
Choose the type of credit 




card from the drop down list




available.



Credit Card No
The text for credit card 




number. Accepts numeric




values not exceeding 30 digits



Expiration Date
Choose a month of expiration 




from the drop down list




available



Expiration Year
The text for expiration year. 




Accepts numeric values




of exactly 4. Example 2002.



Billing Address 
As it appears on the credit Card



Street Address
The text for company address. 




Accepts alphanumeric




and special characters not 




exceeding 35 characters.



ZIP
The text for zip. Accepts 




numeric value of either 5 or 9




digits.



State
The text for city. Accepts 




alphabets and space between




two words not exceeding 




30 characters.



City
Choose the name of the 




state from the drop down list




of States available in United 




States of America







EFT Information










Bank Name
The text for bank name. 




Accepts alphabets and space




between two words.



Routing Number
The text for routing number. 




Accepts numeric values




not exceeding 9 digits.



Account Number
The text for account number. 




Accepts numeric values




not exceeding 9 digits.



Account Type
Choose the type of account 




from the drop down list




available.



Depositor's Name 
The text for depositor's name. 




Accepts alphabets and




space between two words.










Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Continue
Saves the data and Navigates to Coverage Information



screen. This is enabled only if changes are sought on



this screen


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Missing
Click missing information refreshes the screen and


Information
displays the missed information for the group.


Tabs
General Info, Billing Info, Coverage Info are the tabs



visible on this screen. Navigation to the next screen is



also possible by using tabs If continue button is



disabled use this tab to navigate to the next screen.



Also while navigating through the tab the content that



are changed on the screen are not saved unless



explicitly saved by other operations on the screen.









    
    
        Step—8: On clicking continue, screen navigates to Coverage Info. Make any corrections if previously opted in change request, then only continue button will be enabled. Otherwise navigate screens through tabs. (See FIG. C-287)
    
    


Field Explanation
The following table provides explanation for each button in the screen.














Element
Description
















Employee Information










Hours worked per
The text for worked hours 



week
per week. Accepts numeric




values not exceeding 2 digits.



Date of employment
The text for date of employment. 




Choose a date by




clicking calendar icon. 




Date accepts the format




MM/DD/YYYY.



Employee Type
Choose an Employee Type 




from the drop down list




available







RAF Discounting










RAF
List the RAF tier applicable 




for the group based on the




RAF tier available on 




group's effective date.







Plan Information










Line of coverage
Choose a line of coverage 




from the drop down list




available



Medical waived
Click the check box for 




medical waive if the employee




is waiving medical.



Element
Description



Carrier selection
Choose a carrier selection 



(Benefit level)
from the drop down list




available



Coverage choice
Choose a coverage from 




the drop down list available



PCP ID/Medical
The text for PCP ID. 



group ID
Accepts alphabets and numeric




values not exceeding 




10 characters.



Are you an existing 
Click the check box if you 



patient
are an existing patient



PCP last name
The text for PCP last name. 




Accepts alphabets and




special character like hyphen 




and single quotes not




exceeding 35 characters.



PCP first name
The text for PCP first name. 




Accepts alphabets and




special character like 




hyphen and single quotes not




exceeding 25 characters.



Prior plan type
Choose a plan type from the 




drop down list available



Prior plan name
Choose a plan name from the 




drop down list available



Prior insurance
The text for insurance 



start date
start date. Choose a date by




clicking calendar icon. 




Date accepts the format




MM/DD/YYYY.



Prior 
The text for insurance end 



insurance end 
date. Choose a date by



date
clicking calendar icon. 




Date accepts the format




MM/DD/YYYY.



Additional
The text for additional 



Coverage
coverage. Accepts alphabets




with values not 




exceeding 50 characters.



Date signed
The text for date signed. 




Choose a date by clicking




calendar icon. Date accepts 




the format MM/DD/YYYY.




Date cannot accept future date.










Button Functionality
The following table provides explanation for each button in the screen.











Element 
Description







Add
Add the contents of employee coverage information. It



is only a temporary addition. Becomes permanent only



on saving the record.


Edit
Edit button will allow for editing a specific record in



the table.


Update
Update the contents of Plan Information. It is only a



temporary update. Becomes permanent only on saving



the record.


Cancel
Cancels the operation that was currently performed



prior to saving the record.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent only on saving the record.


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


Group ID
Click Group ID to navigates to the Group's general info



screen.


Continue
Saves the data and navigates to Missing Information



screen, if it is enabled . . .


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tab
General Info, Billing Info, Coverage Info, are the tabs



visible on this screen. Navigation to the next screen is



also possible by using tabs If continue button is



disabled use this tab to navigate to the next screen



Also while navigating through the tab the content that



are changed on the screen are not saved unless



explicitly saved by other operations on the screen









    
    
        Step—9: On clicking continue, screen navigates to Missing Info. (See FIG. C-288)
    
    


Field Explanation
The following table provides explanation for each button in the screen.














Element
Description
















Employee Missing Information










Missing Entity 
List the missing entities for the group change



Message
Provides a message for the missing entities



Enrollment
Lists all the changes sought in the pick list



Information




Status
Displaying the status of change.







Change Information










Change Rule
Specifies the pick list for the changes



Change status
Show the change status as incomplete, complete



Element
Description



Change
Choose from the list change status



confirmation




Change Action
Choose from the list of change action



Remarks
Text for briefing the change action










Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Confirm
Navigates to confirmation screen by incorporating all



the corrections made


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









    
    
        Step—10: After entering the respective fields, click continues, which navigates to confirmation screen. (See FIG. C-289)
    
    


Individual Member Modify Pending Change
The screen is to have a request for any change in Individual Member
The sequential steps involved in change request for Individual Member are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Change. Select Individual Member change and Modify Pending Change. (See FIG. C-290)
        Step—2: The screen navigates to Employee Search screen. Enter any value in one of the field to perform search operation. (See FIG. C-291)
        Step—3: This pops up a screen with search result. (See FIG. C-292)
        Step—4: Navigates to employee changes, which allows the option to have changes required. If no option is selected the continue button in respective pages will be disabled and changes cannot be performed. (See FIG. C-293)
    
    


Field Explanation
Refer field explanations explained in Create New Change Request under Individual Change
Button Functionality
Refer button functionality explained in Create New Change Request under Individual Change

    
    
        Step—5: On clicking continue, navigates to General Information of group Respective tabs can also clicked to navigate to corresponding screens. The process and flow for modifying change request is similar to that of create new change request. (See FIG. C-294)
    
    


Field Explanation
Refer field explanations explained in Create New Change Request, under Individual Member Change
Button Functionality
Refer button functionality explained in Create New Change Request, under Individual Member Change.
Employee Change Create New Request
The screen is to have a request for any change in Employee
The sequential steps involved in change request for Employee are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Change. Select Employee change and Create Change Request. (See FIG. C-295)
        Step—2: The screen navigates to Employee Search screen. Enter any value in one of the field to perform search operation. (See FIG. C-296)
        Step—3: This pops up a screen with search result. (See FIG. C-297)
        Step—4: Click on any employee id for selection screen navigates to Employee change Request. (See FIG. C-298)
    
    


Field Explanation
Refer field explanations explained in Create New Change Request
Button Functionality
Refer button functionality explained in Create New Change Request.

    
    
        Step—5: Screen navigates to employee change (pick list). Select the options to have any modifications, so that the selected screen will enable the continue button. (See FIG. C-299)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Group Information








Name of the group
Text for the Name of the Group. 



This is read only field.


Effective Date
Text for Effective date. This is read only field.


Group ID
Text for Group ID. This is read only field.


Status
Text for status. This is read only field.


Group Type
Text for group type. This is read only field.


Work Group
Text for work group. This is read only field.


Employee ID
Text for employee ID This is read only field.


Employee Name
Text for employee name. This is read only field







General Information








Change in employee 
Selecting this option will enable to allow for any


address
modifications


Change SSN
Selecting this option will enable to allow 


information
for any modifications


Employee Date of
Selecting this option will enable to allow 


birth
for any modifications


Change in employee 
Selecting this option will enable to allow 


demographic
for any modifications


location








Billing Information








Payment
Selecting this option will enable to allow for any


Instruction
modifications







Coverage Information








Medical LOC
Selecting this option will enable 



to allow for any modifications


Vision LOC
Selecting this option will enable 



to allow for any modifications


Dental LOC
Selecting this option will enable 



to allow for any modifications


CAM LOC
Selecting this option will enable 



to allow for any modifications


Hours worked
Selecting this option will enable 



to allow for any modifications


Employee Type
Selecting this option will enable 



to allow for any modifications


Date of employment 
Selecting this option will enable 



to allow for any modifications









    
    
        Step—6: On clicking continue, screen navigates to General Info screen. Make any corrections if previously opted in change request, then only continue button will be enabled. Otherwise navigate screens through tabs. (See FIG. C-300)
    
    


Field Explanation
The following table provides explanation for each element in the screen.











Element
Description







Group
Contains header information of the Group


Information



Header



Name of 
Text for the Name of the Group. This is read only field.


the group 



Effective 
Text for Effective date. This is read only field.


Date



Group ID
Text for Group ID. This is read only field.


Status
Text for status. This is read only field.


Group Type
Text for group type. This is read only field.


Work Group
Text for work group. This is read only field.


Employee ID
Text for employee ID This is read only field.


Employee 
Text for employee name. This is read only field


Name








Employee Information








Salutation
Choose the salutation from the drop down list of



salutations available. This is read only field


First Name
The text for first name. Accepts alphabets and special



character like hyphen and single quotes not exceeding



25 characters. First name is mandatory. This is read



only field


Middle 
The text for middle initial. Accepts alphabets not


Initial
exceeding 1 character. This is read only field


Last 
The text for last name. Accepts alphabets and special


Name
characters like hyphen and single quotes not exceeding



35 characters. Last name is mandatory. This is read



only field


Suffix
Choose the Suffix from the drop down list of



salutations available This is read only field.


Date of 
The text for date of birth. Choose a date by clicking


Birth
calendar icon Allows for modification, as it has



been opted for change from the pick up list.


Social 
The text for social security number for every


Security
individual. This can also be auto generated by clicking


Number
auto generate link. Accepts numeric value of exactly 9



digits. Users with User Role as Level 2 and above can



only auto generate SSN. This is read only field


Gender
Choose a gender from the drop down list available.



This is read only field







Address Information








Street 
The text for address. Accepts alphanumeric and special


Address
characters with values not exceeding 35 characters


Apt
The text for suite/apt # . . . Accepts alphanumeric and



special characters with values not exceeding 35



characters This is read only field


Zip
The text for zip. Accepts numeric value of either 5 or 9



digits. City, State and County are populated



automatically on entering the correct zip code and



entering the tab key. This is read only field


City
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters. This is read



only field


State
Choose the name of the state from the drop down list



of States available in United States of America This is



read only field


County
Choose the name of the county from the drop down list



of States available in United States of America This is



read only field


Mode of
Choose the mode of correspondence from the drop


Corre-
down list available This is read only field


spondence



Phone 
The text for telephone number of the employee.


Number
Accepts numeric values not exceeding 10 digits. The



format is (999) 999-9999 This is read only field


Extension
The text for extension number of the employee.



Accepts numeric values not exceeding 5 digits This is



read only field


Fax
The text for fax number of the employee. Accepts



numeric values not exceeding 10 digits. The format is



(999) 999-9999 This is read only field


Email
The text for email of the employee. Accepts alphabets,



numeric and special characters in the standard email



format of length not exceeding 100 characters This is



read only field









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Continue
Saves the data and Navigates to Coverage Information



screen. This is enabled only if changes are sought on



this screen


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Missing
Click missing information refreshes the screen and


Information
displays the missed information for the group.


Tabs
General Info, Billing Info, Coverage Info are the tabs



visible on this screen. Navigation to the next screen is



also possible by using tabs If continue button is



disabled use this tab to navigate to the next screen.



Also while navigating through the tab the content that



are changed on the screen are not saved unless



explicitly saved by other operations on the screen.









    
    
        Step—7: On clicking continue, screen navigates to Coverage Info. Make any corrections if previously opted in change request, then only continue button will be enabled. Otherwise navigate screens through tabs. (See FIG. C-301)
    
    


Field Explanation
The following table provides explanation for each button in the screen.














Element
Description
















Employee Information










Hours worked per
The text for worked hours 



week
per week. Accepts numeric




values not exceeding 2 digits.



Date of employment
The text for date of 




employment. Choose a date by




clicking calendar icon. 




Date accepts the format




MM/DD/YYYY.



Employee Type
Choose an Employee Type from 




the drop down list available







Plan Information










Line of coverage
Choose a line of coverage 




from the drop down list available



Medical waived
Click the check box for 




medical waive if the employee




is waiving medical.



Carrier selection
Choose a carrier selection 



(Benefit level)
from the drop down list available



Coverage choice
Choose a coverage from the 




drop down list available



PCP ID/Medical
The text for PCP ID. 



group ID
Accepts alphabets and numeric




values not exceeding 10 characters.



Are you an existing 
Click the check box if 



patient
you are an existing patient



PCP last name
The text for PCP last name. 




Accepts alphabets and




special character like 




hyphen and single quotes not




exceeding 35 characters.



PCP first name
The text for PCP first name. 




Accepts alphabets and




special character like 




hyphen and single quotes not




exceeding 25 characters.



Prior plan type
Choose a plan type from 




the drop down list available



Prior plan name
Choose a plan name from 




the drop down list available



Prior insurance
The text for insurance 



start date
start date. Choose a date by




clicking calendar icon. 




Date accepts the format




MM/DD/YYYY.



Prior insurance end
The text for insurance end 



date
date. Choose a date by




clicking calendar icon. 




Date accepts the format




MM/DD/YYYY.



Additional
The text for additional 



Coverage
coverage. Accepts alphabets




with values not 




exceeding 50 characters.



Date signed
The text for date signed. 




Choose a date by clicking




calendar icon. Date accepts 




the format MM/DD/YYYY.




Date cannot accept future date.










Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add
Add the contents of employee coverage information. It



is only a temporary addition. Becomes permanent only



on saving the record.


Edit
Edit button will allow for editing a specific record in



the table.


Update
Update the contents of Plan Information. It is only a



temporary update. Becomes permanent only on saving



the record.


Cancel
Cancels the operation that was currently performed



prior to saving the record.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent only on saving the record.


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


Group ID
Click Group ID to navigates to the Group's general info



screen.


Continue
Saves the data and navigates to Missing Information



screen, if it is enabled . . .


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tab
General Info, Billing Info, Coverage Info, are the tabs



visible on this screen. Navigation to the next screen is



also possible by using tabs If continue button is



disabled use this tab to navigate to the next screen



Also while navigating through the tab the content that



are changed on the screen are not saved unless



explicitly saved by other operations on the screen









    
    
        Step—8: On clicking continue, screen navigates to Missing Info. (See FIG. C-302)
    
    


Field Explanation
The following table provides explanation for each button in the screen.














Element
Description
















Employee Missing Information










Missing Entity 
List the missing entities for the group change



Message
Provides a message for the missing entities



Enrollment
Lists all the changes sought in the pick list



Information




Status
Displaying the status of change.







Change Information










Change Rule
Specifies the pick list for the changes



Change status
Show the change status as incomplete, complete



Change
Choose from the list change status



confirmation




Change Action
Choose from the list of change action



Remarks
Text for briefing the change action










Button Functionality
The following table provides explanation for each button in the screen.











Element 
Description







Confirm 
Navigates to confirmation screen by incorporating all



the corrections made


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









    
    
        Step—9: After entering the respective fields, click continues, which navigates to confirmation screen. (See FIG. C-303)
    
    


Employee Modify Pending Change
The screen is to have a request for any change in Employee
The sequential steps involved in change request for Employee are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Change. Select Employee change and Modify Pending Change. (See FIG. C-304)
        Step—2: The screen navigates to Employee Search screen. Enter any value in one of the field to perform search operation. (See FIG. C-305)
        Step—3: This pops up a screen with search result. (See FIG. C-306)
        Step—4: Navigates to employee changes, which allows the option to have changes required. If no option is selected the continue button in respective pages will be disabled and changes cannot be performed. (See FIG. C-307)
    
    


Field Explanation
Refer field explanations explained in Create New Change Request under Employee Change
Button Functionality
Refer button functionality explained in Create New Change Request under Employee Change

    
    
        Step—5: On clicking continue, navigates to General Information of group Respective tabs can also clicked to navigate to corresponding screens. The process and flow for modifying change request is similar to that of create new change request. (See FIG. C-308)
    
    


Field Explanation
Refer field explanations explained in Create New Change Request, under Employee Change
Button Functionality
Refer button functionality explained in Create New Change Request, under Employee Change.
Dependent Change Create New Request
The screen is to have a request for any change in Dependent
The sequential steps involved in change request for Dependent are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Change. Select Dependent change and Create Change Request. (See FIG. C-309)
        Step—2: The screen navigates to Dependent Search screen. Enter any value in one of the field to perform search operation. (See FIG. C-310)
        Step—3: This pops up a screen with search result. (See FIG. C-311)
        Step—4: Click on any dependent id for selection the screen navigates to Dependent change Request. (See FIG. C-312)
    
    


Field Explanation
Refer field explanations explained in Create New Change Request
Button Functionality
Refer button functionality explained in Create New Change Request.

    
    
        Step—5: Screen navigates to employee change (pick list). Select the options to have any modifications, so that the selected screen will enable the continue button. (See FIG. C-313)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Group Information








Name of the group 
Text for the Name of the Group. 



This is read only field.


Effective Date
Text for Effective date. This is read only field.


Group ID
Text for Group ID. This is read only field..


Status
Text for status. This is read only field.


Group Type
Text for group type. This is read only field.


Work Group
Text for work group. This is read only field.


Dependent ID
Text for Dependent ID This is read only field.


Dependent Name
Text for Dependent name. This is read only field







General Information








Change in
Selecting this option will enable to allow for any


Dependent address 
modifications


Change SSN
Selecting this option will enable 


information
to allow for any modifications


Dependent Date of 
Selecting this option will enable 


birth
to allow for any modifications


Change in
Selecting this option will enable 


Dependent
to allow for any modifications


demographic



location



Dependent
Selecting this option will enable 


Relationship
to allow for any modifications







Coverage Information








Change in Plan 
Selecting this option will enable to allow 


information
for any modifications









    
    
        Step—6: On clicking continue, screen navigates to Dependent Change screen. Make any corrections if previously opted in change request, then only continue button will be enabled. Otherwise navigate screens through tabs. (See FIG. C-314)
    
    


Field Explanation
The following table provides explanation for each element in the screen.











Element
Description







Group
Contains header information of the Group


Information



Header



Name of the group 
Text for the Name of the Group. This is read only field.


Effective Date
Text for Effective date. This is read only field.


Group ID
Text for Group ID. This is read only field..


Status
Text for status. This is read only field.


Group Type
Text for group type. This is read only field.


Work Group
Text for work group. This is read only field.


Dependent ID
Text for Dependent ID This is read only field.


Dependent Name
Text for Dependent name. This is read only field







Dependent Information








First Name
The text for first name. Accepts alphabets and special



character like hyphen and single quotes not exceeding



25 characters. First name is mandatory. This is read



only field


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character. This is read only field


Last Name
The text for last name. Accepts alphabets and special



characters like hyphen and single quotes not exceeding



35 characters. Last name is mandatory. This is read



only field


Suffix
Choose the Suffix from the drop down list of



salutations available This is read only field.


Date of Birth
The text for date of birth. Choose a date by clicking



calendar icon Allows for modification, as it has



been opted for change from the pick up list.


Social Security
The text for social security number for every


Number
individual. This can also be auto generated by clicking



auto generate link. Accepts numeric value of exactly 9



digits. Users with User Role as Level 2 and above can



only auto generate SSN. This is read only field


Gender
Choose a gender from the drop down list available.



This is read only field


Street Address 
The text for address. Accepts alphanumeric and special



characters with values not exceeding 35 characters


Apt
The text for suite/apt # . . . Accepts alphanumeric and 



special characters with values not exceeding 35



characters This is read only field


Zip
The text for zip. Accepts numeric value of either 5 or 9



digits. City, State and County are populated



automatically on entering the correct zip code and



entering the tab key. This is read only field


City
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters. This is read



only field


State
Choose the name of the state from the drop down list



of States available in United States of America This is



read only field


Relationship
Choose the relationship from the drop down list



available. This is read only field









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Change Summary
Saves the data and Navigates to Change Summary



Information screen.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Missing
Click missing information refreshes the screen and


Information
displays the missed information for the group.









    
    
        Step—7: On clicking continue, screen navigates to Missing Info. (See FIG. C-315)
    
    


Field Explanation
The following table provides explanation for each button in the screen.














Element
Description
















Dependent Missing Information










Missing Entity
List the missing entities for the group change



Message
Provides a message for the missing entities



Enrollment
Lists all the changes sought in the pick list



Information




Status
Displaying the status of change.







Change Information










Change Rule
Specifies the pick list for the changes



Change status
Show the change status as incomplete, complete



Change
Choose from the list change status



confirmation




Change Action
Choose from the list of change action



Remarks
Text for briefing the change action










Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Confirm
Navigates to confirmation screen by incorporating all



the corrections made


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









    
    
        Step—8: after entering the respective fields, click continues, which navigates to confirmation screen. (See FIG. C-316)
        Step—9: Click Dependent Search to navigate back to Dependent Search screen.
    
    


Dependent Modify Request Change
The screen is to have a request for any change in Dependent
The sequential steps involved in change request for Dependent are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select Change. Select Dependent change and Modify Change Request. (See FIG. C-317)
        Step—2: The screen navigates to Dependent Search screen. Enter any value in one of the field to perform search operation. (See FIG. C-318)
        Step—3: This pops up a screen with search result. (See FIG. C-319)
        Step—4: Navigates to Dependent changes, which allows the option to have changes required. If no option is selected the continue button in respective pages will be disabled and changes cannot be performed. (See FIG. C-320)
        Step—5: On clicking continue, navigates to Dependent Change. The process and flow for modifying change request is similar to that of create new change request. (See FIG. C-321)
        Step—6: On clicking continue, screen navigates to Missing Info. (See FIG. C-322)
    
    


Field Explanation
The following table provides explanation for each button in the screen.














Element
Description
















Dependent Missing Information










Missing Entity
List the missing entities for the group change



Message
Provides a message for the missing entities



Enrollment
Lists all the changes sought in the pick list



Information




Status
Displaying the status of change.







Change Information










Change Rule
Specifies the pick list for the changes



Change status
Show the change status as incomplete, complete



Change
Choose from the list change status



confirmation




Change Action
Choose from the list of change action



Remarks
Text for briefing the change action










Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Confirm
Navigates to confirmation screen by incorporating all



the corrections made


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









    
    
        Step—7: After entering the respective fields, click continues, which navigates to confirmation screen. (See FIG. C-323)
        Step—8: Click Dependent Search to navigate back to Dependent Search screen.
    
    


Field Explanation
Refer field explanations explained in Create New Change Request, under Dependent Change
Button Functionality
Refer button functionality explained in Create New Change Request, under Dependent Change
12 ROE/OE
ROE is the transaction module that encompasses the process of Re-qualification and open enrollment for Group and Members enrolled with PacAdvantage in the PX2 System. ROE (Re-qualification and open enrollment) is the process of Re-qualifying the Group and Members on their anniversary. Once a year, on the anniversary date of a group's enrollment in PacAdvantage, the group's participation, contribution and qualification is reviewed. This review is to ensure that the group meets the qualification requirement.
OE (Open Enrollment) is the process during the anniversary of the group wherein the group has the privilege to make the changes to the plan, waiting period etc that were earlier not open for changes.
Access
The application can be accessed from the main menu as follows:

    
    
        Enrollment→ROE→Group Enrollment
        
            →Employee Enrollment
            →Dependent Enrollment
            →Individual Member
            →COBRA
            →Manual ROE
        
        
    
    


Pre-Requisites
The Process ROE operation should be initiated prior to making the ROE/OE changes to the Groups and Members.
Group and the member must be enroll and all their relevant information must be available in the system in order to accomplish the task for ROE/OE.
Application Functions
This application has the following functions for reinstatement:

    
    
        Modify—to modify group, employee, dependent, individual enrollment entries
    
    


Group Enrollment
The screen is to modify group enrollment
The sequential steps involved in modifying group enrollment are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select ROE. Select Group Enrollment. Then click Process Group. (See FIG. C-324)
        Step—2: The screen navigates search to select a group. Enter value in any one of the field, or simply click search button to perform search operation. (See FIG. C-325)
        Step—3: This pops up a screen with search result. (See FIG. C-326)
        Step—4: Click on any Group ID for selection. Screen navigates to change request screen for making ROE/OE changes for a group. (See FIG. C-327)
    
    


Field Explanation
The following table provides explanation for each button in the screen.














Element
Description
















Group General Information










Contact
Selecting this option will enable to 



Information
allow for any modifications



Address
Selecting this option will enable to 



Information
allow for any modifications



Tax Identification
Selecting this option will enable to 




allow for any modifications



Demographic
Selecting this option will enable to 



location
allow for any modifications







Billing Information










Billing Information
Selecting this option will enable to 




allow for any modifications







Agent Information










Agent Information
Selecting this option will enable to 




allow for any modifications







Coverage Information










RAF Discounting
Selecting this option will enable to 




allow for any modifications



Workers
Selecting this option will enable to



Compensation Flag
allow for any modifications



TEFRA flag
Selecting this option will enable to 




allow for any modifications



1099 Flag
Selecting this option will enable to 




allow for any modifications



Domestic Partner
Selecting this option will enable to 



Support flag
allow for any modifications



COBRA Support
Selecting this option will enable to 



flag
allow for any modifications



Part time support
Selecting this option will enable to 



flag
allow for any modifications



Waiting period
Selecting this option will enable to 



information
allow for any modifications



Medical LOC
Selecting this option will enable to 




allow for any modifications



Vision LOC
Selecting this option will enable to 




allow for any modifications



Dental LOC
Selecting this option will enable to




allow for any modifications



CAM LOC
Selecting this option will enable to 




allow for any modifications










Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Continue
Saves the data and navigates to General information



for groups.


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









    
    
        Step—5: On clicking continue, navigates to General Information of group Respective tabs can also clicked to navigate to corresponding screens. Continue would be enabled only if the changes are sought on this screen, else use tab to navigate to the next screen. (See FIG. C-328)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Company Information








Legal Name
The text for name of the group. Accepts alphanumeric



and special characters not exceeding 60 characters.



Field is mandatory


Doing Business As
The text for business nature. Accepts alphanumeric



and special characters not exceeding 60 characters.



Field is optional


Type of Business
Choose the type of business from the drop down list



available


Tax Identification
The text for tax identification. Accepts numeric values



of exactly 9 digits







Address Information: Physical and Billing Address - Note: Enter Billing


Address if different from the Physical Address.








Street Address
The text for company address. Accepts alphanumeric



and special characters not exceeding 35 characters


Suite
The text for company suite/apt # Accepts



alphanumeric and special characters not exceeding 35



characters


Zip
The text for zip. Accepts numeric value of either 5 or 9



digits. City, State and County are populated



automatically on entering the correct zip code and



entering the tab key.


City
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters.


State
Choose the name of the state from the drop down list



of States available in United States of America


County
Choose the name of the county from the drop down list



of counties available for the ZIP Code entered.







Contact Information








Mode of
Choose the mode of correspondence from the drop


Correspondence
down list available.







Contact 1 and Contact 2 - Fill in the relevant for Contact 1 and 2.








Salutation
Choose the salutation from the drop down list of



salutations available.


First Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 25 characters.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 35 characters.


Suffix
Choose the suffix from the drop down list of suffixes



available.


Phone Number
The text for telephone number of the contact person.



Accepts numeric values of exactly 10 digits. The format



is (999) 999-9999


Extension
The text for extension number of the contact person.



Accepts numeric values not exceeding 5 digits.


Fax
The text for fax number of the contact person. Accepts



numeric values of exactly 10 digits. The format is



(999) 999 - 9999


Email
The text for email of the contact person. Accepts



alphabets, numeric and special characters in the



standard email format of length not exceeding 100



characters


Contact Comments
The text for comments. Accepts alphabets, numeric



and special characters. Field is optional









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Continue
Saves the data and navigates to Billing Information




screen and the system generates Group ID. This is




enabled only if changes are sought on this screen



Cancel
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes



Tabs
General Info, Billing Info, Agent Info, Coverage Info




are the tabs visible on this screen. Navigation to the




next screen is also possible by using tabs If continue




button is disabled use this tab to navigate to the next




screen. Also while navigating through the tab the




content that are changed on the screen are not saved




unless explicitly saved by other operations on the




screen.










    
    
        Step—6: On clicking continue, navigates to Group Billing Information of group Respective tabs can also clicked to navigate to corresponding screens. Continue would be enabled only if the changes are sought on this screen, else use tab to navigate to the next screen. Enter the values in the respective fields, as per the format briefed in field's explanation section and click Continue. (See FIG. C-329)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Mode of payment
Choose a mode of payment from the drop down list



available. Based on selection corresponding fields will



enable to enter the values. For e.g. if the value selected



is card payment, EFT will be disabled and allows only



entering card details and vice versa.







Credit Card Information








Cardholder's
The text for cardholder's name. Accepts alphabets and


Names
space between two words.


Credit Card Type
Choose the type of credit card from the drop down list



available.


Credit Card No
The text for credit card number. Accepts numeric



values not exceeding 30 digits


Expiration Date
Choose a month of expiration from the drop down list



available


Expiration Year
The text for expiration year. Accepts numeric values



of exactly 4. Example 2002.







Billing Address As it appears on the credit Card








Street Address
The text for company address. Accepts alphanumeric



and special characters not exceeding 35 characters.


ZIP
The text for zip. Accepts numeric value of either 5 or 9



digits.


State
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters.


City
Choose the name of the state from the drop down list



of States available in United States of America







EFT Information








Bank Name
The text for bank name. Accepts alphabets and space



between two words.


Routing Number
The text for routing number. Accepts numeric values



not exceeding 9 digits.


Account Number
The text for account number. Accepts numeric values



not exceeding 9 digits.


Account Type
Choose the type of account from the drop down list



available.


Depositor's Name
The text for depositor's name. Accepts alphabets and



space between two words.







Initial Payment Information








Amount Received
The text for amount received. Accepts only numeric



values in the format 999999999.99


Date Receive
The text for date received. Choose from the calendar



icon in the format MM/DD/YYYY.


Check #
The text for check number. Accepts numeric 



values not exceeding 9 digits.


No Check Received
Check the option of no checks received for any non-



receipt of checks.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Continue
Saves the data and Navigates to Agent Information



screen. This is enabled only if changes are sought on



this screen


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Enrollment
Click enrollment summary refreshes the screen and


Summary
display the summary of information entered for group.


Missing
Click missing information refreshes the screen and


Information
displays the missed information for the group.


Tabs
General Info, Billing Info, Agent Info, Coverage Info



are the tabs visible on this screen. Navigation to the



next screen is also possible by using tabs If continue



button is disabled use this tab to navigate to the next



screen. Also while navigating through the tab the



content that are changed on the screen are not saved



unless explicitly saved by other operations on the



screen.









    
    
        Step—7: On clicking continue, navigates to Group Agent Information of group Respective tabs can also clicked to navigate to corresponding screens. Continue would be enabled only if the changes are sought on this screen, else use tab to navigate to the next screen. (See FIG. C-330)
    
    


Field Explanation
The following table provides explanation for each element in the screen.











Element
Description







Agent ID
Choose an agent id by clicking search icon


Agent Type
Choose an agent type from the drop down list



available. Based on the selection of the agent type the



percent commission split entry and the Receive ROE



packets option would be available.


Percent commission
The text for percent commission. Accepts numeric


split
values in the range of 1-100 (Example 100.00). This



will be enabled only if the Agent type selected is 



“Agent Of Record”



Sum of the percentage for all the Agent of Record



added should be equal to 100.00.


Receive ROE/OE
Click the check box to receive ROE/OE packets for


packets
agent. This option will not be available for Agent Type



“General Agent”.


Agent Commission
The text for agent commission. Defaults the value



defined in CM − rate Administration for Agent



Commission. Accepts numeric values less than or



equal to the defaulted value in the in the range of 1-100



(Example 4.45)


Check the box if the
Click the check box for a group with out an agent. 


group is without an
This option will be available only for the Agent 


agent
Type, “Agent of Record and Writing Agent”.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add
Add the contents of agent information. It is only a



temporary addition. Becomes permanent only on



saving the record.


Edit
Edit button will allow for editing a specific record in



the table.


Update
Update the contents of agent information. It is only a



temporary update. Becomes permanent only on saving



the record


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent only on saving the record


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


Enrollment
Click enrollment summary refreshes the screen and


Summary
display the summary of information entered for group



creation


Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


Continue
Saves the data and navigates to Coverage Information



screen. This is enabled only if changes are sought on



this screen


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tab
General Info, Billing Info, Agent Info, Coverage Info



are the tabs visible on this screen. Navigation to the



next screen is also possible by using tabs If continue



button is disabled use this tab to navigate to the next



screen.. Also while navigating through the tab the



content that are changed on the screen are not saved



unless explicitly saved by other operations on the



screen









    
    
        Step—8: On clicking continue, navigates to Group Coverage Information of group Respective tabs can also clicked to navigate to corresponding screens. Continue would be enabled only if the changes are sought on this screen, else use tab to navigate to the next screen. (See FIG. C-331)
    
    


Field Explanation
The following table provides explanation for each button in the screen











Element
Description















Waiting Period Information








Employee Type
Choose an Employee Type from the drop down list



available


Waiting Period
Choose a waiting period from the drop down list



available







RAF Discounting








RAF
List the RAF tier applicable for the group based on the



RAF tier available on group's effective date.







Contribution








Line of Coverage
Choose a line of coverage from the drop down list


elected
available


Contribution For
Choose a contribution for from the drop down list



available. Contribution can be for an employee or



dependent.


Contribution Type
Choose a contribution type from the drop down list



available. List the contribution type “% Lowest Cost



HMO”, “% Lowest Cost Plan”, “% Specified Plan”, 



“Flat $ Amount”. On Selecting % Specified Plan 



the page would get refreshed and the Plan Name 



for the Specified LOC would be populated in 



the Drop Down List “Plan Name”


Contribution
The text for contribution amount. Accepts numeric


Amount
values in the format 99999999.99 for flat $ amount



and for the rest of the option it accepts as % value say



100.00


Plan Name
Choose a plan name from the drop down list available



if the Contribution Type selected is “% Specified Plan”.


Current Group
Choose a group insurer from the drop down list


Insurer
available


Whether group
Click the option yes or no


legally required to



provide workers



compensation



coverage



Workers
Choose a compensation carrier name from the drop


compensation
down list available


carrier name



Number of
The text for total number of employees including full


Employees (Full
time and part time. Accepts numeric values


time and part time)



Number of full time
The text for number of full time employees at the time


employees at the
of applying. Accepts numeric values


time of application



Number of eligible
The text for number of eligible employees at the time


employees at the
of applying. Accepts numeric values


time of application



Number of
The text for number of employees at the time of


employee applying
applying. Accepts numeric values


Have you employed
Click the option yes or no


20 or more



employees for 20 or



more weeks during



the current or



preceding year



(TEFRA)



Have you employed
Click the option yes or no


20 or more



employees during



at least 50% of the



preceding calendar



year (COBRA)



Are you offering
Click the option yes or no


coverage to



employees working



more 20-29 hours



per week



Are you offering
Click the option yes or no


coverage to



domestic partners









Button Functionality
The following table provides explanation for each button in the screen











Element
Description







Add (Waiting
Add the contents of Waiting Period information. It is


Period Information)
only a temporary addition. Becomes permanent only



on saving the record.


Add (Contribution)
Add the contents of Contribution and Coverage 



elected. It is only a temporary addition. Becomes 



permanent only on saving the record.


Update (Waiting
Updates the contents of Waiting Period information. It


Period Information)
is only a temporary update. Becomes permanent only



on saving the record.


Update
Update the contents of Contribution and Coverage


(Contribution)
elected. It is only a temporary update. Becomes



permanent only on saving the record.


Edit
Edit button will allow for editing a specific record in



the table.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent only on saving the record.


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records 



in the table that are checked.


Enrollment
Click enrollment summary refreshes the screen and


Summary
display the summary information entered for group



creation


Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


View Missing Info
Saves the data and navigates to Missing Information



Page


Save & Create New
Saves the data entered and navigates to the screen


Group
Group Hierarchy for creating New Group.


Cancel
Clears or restores the content entered in the fields only



prior to saving the records.


Tab
General Info, Billing Info, Agent Info, Coverage Info



are the tabs visible on this screen. The navigation



between tabs is possible only if there is a valid group



ID generated and assigned to the group. Also while



navigating through the tab the content that are



changed on the screen are not saved unless explicitly



saved by other operations on the screen









    
    
        Step—9: On clicking Enrollment Summary, screen navigates to Summary screen. (See FIG. C-332)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Total Full Time
Value is shown based on the actual full time 


Applied (A)
employee applied (System Identified)


Total part Time
Value is shown based on the actual part time 


Applied (B)
employee applied (System Identified)


Employee Waived
Text to enter Employee Waived. Contains 


(C)
only whole number. Accepts numbers not 



exceeding 5 digits. Manually entered based



on verification.


Employee Declined 
Text to enter Employee Declined. Contains 


(D)
only whole number. Accepts numbers not 



exceeding 5 digits. Manually entered based 



on verification.


Total Eligible
Text to display total eligible employee. 


Employee (E) =
Employee Applying is sum total of A + B + D.


Total Employee
Text to display total employee applying. 


Applying (F)
Employee Applying is sum total of A + B.


% Participation
Test to display % participation. Participation 


Based on Info Provided
is % of E/F


Total Full Time
Text for Total Full Time Applied. Based on 


Applied (A)
the information provide on the Coverage Info 



screen


Total part Time
Text for Total Part Time Applied. Based on 


Applied (B)
the information provide on the Coverage Info 



screen


Total Employees
Text to display total employee applied. 


Applied
Employee Applied is sum total of A + B


Total Full Time
Value is shown based on the actual full time 


Applied (A)
employee applied (System Identified)









    
    
        Step—10: On clicking continue, navigates to Missing Info screen. (See FIG. C-333)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Employee Missing Information








Missing Entity 
List the missing entities for the group change


Message
Provides a message for the missing entities


Enrollment
Lists all the changes sought in the pick list


Information



Status
Displaying the status of change.







Dependent Missing Information








Missing Entity
List the missing entities for the group change


Message
Provides a message for the missing entities


Enrollment
Lists all the changes sought in the pick list


Information



Status
Displaying the status of change.







Change Information








ROE/OE Status
Specifies the pick list for the changes


Remarks
Text for briefing the change action


Reason for Decline 
Choose from the list of reasons for decline. 



This field is enabled only if the status of 



ROE/OE is opted as decline


Others
Text for briefing the other status and 



description









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Finalize
Navigates to confirmation screen by incorporating 




all the corrections made



Clear
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes










    
    
        Step—11: On clicking Finalize, navigates to confirmation screen. (See FIG. C-334)
    
    


Employee Enrollment
The screen is to modify employee enrollment
The sequential steps involved in modifying employee enrollment are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select ROE/OE Select Employee Enrollment. Then click Process Employee. (See FIG. C-335)
        Step—2: The screen navigates search to select an employee. Enter value in any one of the field or simply click Search button to perform search operation. (See FIG. C-336)
        Step—3: This pops up a screen with search result. (See FIG. C-337)
        Step—4: Click on any Employee ID for selection. Screen navigates to change request screen for making ROE/OE changes for an employee. (See FIG. C-338)
    
    


Field Explanation
The following table provides explanation for each button in the screen.














Element
Description
















Group Information










Name of the group
Text for the Name of the Group. Read 




Only field



Effective Date
Text for Employee Effective date. 




This is read only field.



Group ID
Text for Group ID. This is read 




only field.



Status
Text for status. This is read only field.



Group Type
Text for group type. This is read only 




field.



Work Group
Text for work group. This is read only 




field.



Employee ID
Text for Employee ID. This is read only 




field.



Employee Name
Text for Employee Name. This is read 




only field.







Employee General Information Changes










Employee Date 
Selecting this option will enable to allow 



of Birth
for any modifications.



Employee Address
Selecting this option will enable to allow 




for any modifications



Employee SSN
Selecting this option will enable to allow 




for any modifications



Employee
Selecting this option will enable to allow 



Demographic
for any modifications



Information








Employee Coverage Information Changes










Payroll
Selecting this option will enable to allow 




for any modifications



Employee Type
Selecting this option will enable to allow 




for any modifications



Medical LOC
Selecting this option will enable to allow 




for any modifications



Vision LOC
Selecting this option will enable to allow 




for any modifications



Dental LOC
Selecting this option will enable to allow 




for any modifications



CAM LOC
Selecting this option will enable to allow 




for any modifications










Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Continue
Saves the data and navigates to General information




for employees. This is enabled only if changes are




sought on this screen



Cancel
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes










    
    
        Step—5: On selecting the options for changes click Continue. Screen navigates to Employee General Information screen. (See FIG. C-339)
    
    


Field Explanation
The following table provides explanation for each button in the screen.














Element
Description
















Employee Information










Salutation
Choose the salutation from the drop down 




list of salutations available.



First Name
The text for contact name. Accepts alphabets 




and special characters like hyphen and single 




quotes not exceeding 25 characters.



Middle Initial
The text for middle initial. Accepts alphabets 




not exceeding 1 character.



Last Name
The text for contact name. Accepts alphabets 




and special characters like hyphen and single 




quotes not exceeding 35 characters.



Suffix
Choose the suffix from the drop down list of 




suffixes available.



Date of Birth
The text for date of birth. Choose a date by 




clicking calendar icon. Date accepts the format 




MM/DD/YYYY. Birth date cannot be later 




than the current date.



Social Security 
The text for social security number for every



Number
individual. This can also be auto generated by 




clicking auto generate link. Accepts numeric 




value of exactly 9 digits. Users with User Role 




as Level 2 and above can only auto generate 




SSN.



Gender
Choose a gender from the drop down list 




available.







Address Information










Street Address
The text for address. Accepts alphanumeric 




and special characters with values not exceeding 




35 characters



Apt
The text for suite/apt #. Accepts alphanumeric 




and special characters with values not exceeding 




35 characters



Zip
The text for zip. Accepts numeric value of 




either 5 or 9 digits. City, State and County are 




populated automatically on entering the correct 




zip code and entering the tab key.



City
The text for city. Accepts alphabets and space 




between two words not exceeding 30 characters.



State
Choose the name of the state from the drop 




down list of States available in United States 




of America



County
Choose the name of the county from the drop 




down list of States available in United States 




of America



Mode of
Choose the mode of correspondence from the 



Correspondence
drop down list available



Phone Number
The text for telephone number of the employee.




Accepts numeric values not exceeding 10 digits. 




The format is (999) 999-9999



Extension
The text for extension number of the employee.




Accepts numeric values not exceeding 5 digits



Fax
The text for fax number of the employee. 




Accepts numeric values not exceeding 10 digits. 




The format is (999) 999-9999



Email
The text for email of the employee. Accepts 




alphabets, numeric and special characters in the 




standard email format of length not exceeding 




100 characters










Button Functionality
The following table provides explanation for each button in the screen.











Element 
Description







Continue
Saves the data and navigates to Coverage information



for employees. This is enabled only if changes are



sought on this screen


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tab
General Info, Coverage Info, are the tabs visible on



this screen. Navigation to the next screen is also



possible by using tabs If continue button is disabled



use this tab to navigate to the next screen. Also while



navigating through the tab the content that are



changed on the screen are not saved unless explicitly



saved by other operations on the screen









    
    
        Step—6: After making any changes in the fields as explained in the field explanation, click Continue. Screen navigates to employee Coverage Info screen. (See FIG. C-340)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Employee Information








Hours worked per
The text for worked hours per week. 


week
Accepts numeric values not exceeding 



2 digits.


Date of employment
The text for date of employment. Choose 



a date by clicking calendar icon. Date 



accepts the format MM/DD/YYYY.


Employee type
Choose an employee type from the drop 



down list available







Plan Information








Line of coverage
Choose a line of coverage from the drop 



down list available


Medical waived
Click the check box for medical waive if 



the employee is waiving medical.


Carrier selection 
Choose a carrier selection from the drop 


(Benefit level)
down list available


Coverage choice
Choose a coverage from the drop down 



list available


PCP ID/Medical
The text for PCP ID. Accepts alphabets 


group ID
and numeric values not exceeding 10 



characters.


Are you an existing 
Click the check box if you are an existing 


patient
patient


PCP last name
The text for PCP last name. Accepts 



alphabets and special character like hyphen 



and single quotes not exceeding 35 



characters.


PCP first name
The text for PCP first name. Accepts 



alphabets and special character like hyphen 



and single quotes not exceeding 25 



characters.


Prior plan type
Choose a plan type from the drop down 



list available


Prior plan name
Choose a plan name from the drop down 



list available


Prior insurance
The text for insurance start date. Choose a 


start date
date by clicking calendar icon. Date accepts 



the format MM/DD/YYYY.


Prior insurance end 
The text for insurance end date. Choose a 


date
date by clicking calendar icon. Date accepts 



the format MM/DD/YYYY.


Other coverage kept
The text for other coverage. Accepts alphabets 



with values not exceeding 50 characters.


Employee signature
Click the check box, to have employee 



signature


Date signed
The text for date signed. Choose a date by 



clicking calendar icon. Date accepts the 



format MM/DD/YYYY.



Date cannot accept future date.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add
Add the contents of employee coverage information. 



It is only a temporary addition. Becomes permanent 



only on saving the record.


Edit
Edit button will allow for editing a specific record in



the table.


Update
Update the contents of Plan Information. It is only a



temporary update. Becomes permanent only on 



saving the record.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent only on saving the record.


Check All
The “Check All” Link will check all the records in 



the table


Clear All
The “Clear All” Link will uncheck all the records in 



the table that are checked.


Enrollment 
Click enrollment summary refreshes the screen and


Summary
display the summary of information entered for 



group creation


Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


Group ID
Click Group ID to navigates to the Group's general 



info screen.


Continue
Saves the data and navigates to Missing Information



screen, if it is enabled.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tab
General Info, Coverage Info, are the tabs visible on



this screen. Navigation to the next screen is also



possible by using tabs If continue button is disabled



use this tab to navigate to the next screen. Also while



navigating through the tab the content that are



changed on the screen are not saved unless explicitly



saved by other operations on the screen









    
    
        Step—7: After entering the fields as per the field details explained in field explanation. Click Continue. Screen navigates to Enrollment Summary. (See FIG. C-341)
    
    


Field Explanation
The following table provides explanation for each element in the screen.











Element
Description







Group 
Contains header information of the Group


Information Header



Name of the Group
Text for the Name of the Group


Group ID
Text and Link for the Group ID to navigate 



to the Group General Info screen


Group Type
Specifies the Type of the Group like Small 



Employer Group


Proposed Effective
The text for Proposed Effective Date. Choose 


Date
a date by clicking calendar icon. Date accepts 



the format MM/DD/YYYY. Default effective 



date is first of the following month. Effective 



date cannot be past date


Status
Text to specify the status of the group.


Work Group
Text for Work Group. This specifies the 



internal work group attached to the Group. 



This is based on the writing agent's work 



group.


Enrollment
Enrollment Summary Information is broken 


Summary
down into tree structure. The tree can by 


Information
expanded or collapsed. The level of the tree 



is as per the example given below:



− Employee



 − Dependent



 − Dependent



− Employee



 − Dependent



− Employee



+ Employee



− Employee



 + Dependent



+− Employee



Where (−) signifies expanded view and 



(+) signifies collapsed view.


Employee ID
Text for Employee ID


Employee SSN
Text for Employee SSN


Employee Name
Text for employee Name (First Name 



and Last Name)


Effective Date
Text for Employee Effective date. Choose a 



date by clicking calendar icon. Date accepts 



the format MM/DD/YYYY. Defaults effective 



date of the Group. Effective date cannot be 



past date


Status
Text to specify the status of the employee.


Enrollment
There are two part of this information:


Information
3) Entered based on verification


Entered
4) Based on the information provide on the


based on verification
 Coverage Info screen


Total Full Time
Value is shown based on the actual full 


Applied (A)
time employee applied (System Identified)


Total part Time
Value is shown based on the actual part time 


Applied (B)
employee applied (System Identified)


Employee Waived
Text to enter Employee Waived. Contains 


(C)
only whole number. Accepts numbers not 



exceeding 5 digits. Manually entered based 



on verification.


Employee Declined
Text to enter Employee Declined. Contains 


(D)
only whole number. Accepts numbers not 



exceeding 5 digits. Manually entered based 



on verification.


Total Eligible
Text to display total eligible employee. 


Employee (E) =
Employee Applying is sum total of A + B + D.


Total Employee
Text to display total employee applying. 


Applying (F)
Employee Applying is sum total of A + B.


% Participation
Test to display % participation. Participation 


Based on Info
is % of E/F


Provided



Total Full Time
Text for Total Full Time Applied. Based on 


Applied (A)
the information provide on the Coverage 



Info screen


Total part Time
Text for Total Part Time Applied. Based on 


Applied (B)
the information provide on the Coverage 



Info screen


Total Employees
Text to display total employee applied. 


Applied
Employee Applied is sum total of A + B









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Pre Enrollment
Saves the data and performs validation and 




eligibility checks against the information 




required for enrollment and navigates to the 




screen Missing Information.



Clear
Clears the contents entered in the fields or 




restore to the previous state as was before saving 




the changes



<<, <. >, >>
The enrollment summary shows record for 5 




employees on single screen. If the employee size 




increases more than 5. These buttons are used for 




navigating to the next and previous records for 




viewing.




<< - Show first record(s)




< - Show previous record(s)




> - Show next record(s)




>> - Show last record(s)



Group ID
Click Group ID to navigates to the Group's 




general info screen.










    
    
        Step—8: On clicking Pre-Enrollment, screen navigates to missing info. (See FIG. C-342)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Employee Missing Information








Missing Entity
List the missing entities for the group change


Message
Provides a message for the missing entities


Enrollment
Lists all the changes sought in the pick list


Information



Status
Displaying the status of change.







Dependent Missing Information








Missing Entity
List the missing entities for the group change


Message
Provides a message for the missing entities


Enrollment
Lists all the changes sought in the pick list


Information



Status
Displaying the status of change.







Change Information








ROE/OE Status
Specifies the pick list for the changes


Remarks
Text for briefing the change action


Reason for Decline 
Choose from the list of reasons for decline. 



This field is enabled only if the status of 



ROE/OE is opted as decline


Others
Text for briefing the other status and 



description









Button Functionality
The following table provides explanation for each button in the screen.











Element 
Description







Finalize
Navigates to confirmation screen by incorporating 



all the corrections made


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









    
    
        Step—9: On clicking Finalize, navigates to confirmation screen. Click continue to navigate back to Group search irrespective of process, as the process is being carried out for a group. (See FIG. C-343)
    
    


Dependent Enrollment
The screen is to modify dependent enrollment
The sequential steps involved in modifying dependent enrollment are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select ROE. Select Dependent Enrollment. Then click Modify. (See FIG. C-344)
        Step—2: The screen navigates search to select an dependent. Enter the search criteria for Searching for the dependent. (See FIG. C-345)
        Step—3: This pops up a screen with search result. (See FIG. C-346)
        Step—4: Click on any Dependent ID for selection. Screen navigates to change request screen for making ROE/OE changes for an employee. (See FIG. C-347)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Group Information








Name of the group 
Text for the Name of the Group. 



Read Only field


Effective Date
Text for Employee Effective date. 



This is read only field.


Group ID
Text for Group ID. This is read 



only field.


Status
Text for status. This is read only 



field.


Group Type
Text for group type. This is read only 



field.


Work Group
Text for work group. This is read only 



field.


Employee ID
Text for Employee ID. This is read 



only field.


Employee Name
Text for Employee Name. This is read 



only field.


Dependent ID
Text for Dependent ID. This is read 



only field.


Dependent Name
Text for Dependent Name. This is read 



only field.







Dependent General Information Changes








Dependent to waive
Selecting this option will enable to allow 


Vision Plan
for any modifications.


Information



Dependent to waive
Selecting this option will enable to allow 


Dental Plan
for any modifications


Information



Dependent to waive
Selecting this option will enable to allow 


Medical Plan
for any modifications


Information



Prior Plan
Selecting this option will enable to allow 


Information
for any modifications


Dependent Address
Selecting this option will enable to allow 


Information
for any modifications


Dependent SSN
Selecting this option will enable to allow 



for any modifications


Dependent
Selecting this option will enable to allow 


Relationship
for any modifications


Dependent Date 
Selecting this option will enable to allow 


of Birth
for any modifications


Dependent
Selecting this option will enable to allow 


Personal
for any modifications


Information









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Continue
Saves the data and navigates to Dependent General




information for employees.



Cancel
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes










    
    
        Step—5: On clicking continue, navigates to Dependent General Information screen. Respective tabs can also clicked to navigate to corresponding screens. If any other tabs like Coverage or General Info, or if Enrollment summary, Cancel is disabled, due to non-selection of changes sought, use missing information link to navigate to the missing info screen. (See FIG. C-348)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Dependent Information








Salutation
Choose the salutation from the drop down list of



salutations available.


First Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 25 characters.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 35 characters.


Suffix
Choose the suffix from the drop down list of suffixes



available.


Date of Birth
The text for date of birth. Choose a date by 



clicking calendar icon. Date accepts the format 



MM/DD/YYYY. Birth date cannot be later than 



the current date.


Social Security
The text for social security number for every


Number
individual. This can also be auto generated by clicking



auto generate link. Accepts numeric value of exactly 9



digits. Users with User Role as Level 2 and above can



only auto generate SSN.


Gender
Choose a gender from the drop down list available.







Address Information








Street Address
The text for address. Accepts alphanumeric and 



special characters with values not exceeding 35 



characters


Apt
The text for suite/apt #. Accepts alphanumeric and 



special characters with values not exceeding 35



characters


Zip
The text for zip. Accepts numeric value of either 5 or 9



digits. City, State and County are populated



automatically on entering the correct zip code and



entering the tab key.


City
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters.


State
Choose the name of the state from the drop down list



of States available in United States of America







Line of Coverage Information [For Medical, Vision, Dental]








Selected Product
Text for the product selected. It is a read only field.


Coverage Choice
Choose a coverage from the drop down list available


Waived
Click the check box for any waive.


Service Area
The text for service area.


PCP ID/Medical
The text for PCP ID. Accepts alphabets and numeric


group ID
values not exceeding 10 characters.


PCP last name
The text for PCP last name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 35 characters.


PCP first name
The text for PCP first name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 25 characters.


Prior insurance
The text for insurance start date. Choose a date by


start date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Prior insurance end
The text for insurance end date. Choose a date by


date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Other coverage kept
The text for other coverage. Accepts alphabets with



values not exceeding 50 characters.


Additional
The text for additional coverage. Accepts alphabets


Coverage
with values not exceeding 50 characters.


Disabled dependent
Click the option of temporary or permanent. This is



enable if the relationship opted is child


Domestic partner
Click the option for domestic partner. It depends on



the value selected in relationship


Legal guardian
Click the option for legal guardian. It depends on the



value selected in relationship


Signature
Click the check box if the signature is opted









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Enrollment
Saves the data and navigates to Summary screen. This


Summary
is enabled only if changes are sought on this screen.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tab
General Info, Coverage Info, are the tabs visible on



this screen. If any other tabs like Coverage or General



Info, or if Enrollment summary, Cancel is disabled,



due to non-selection of changes sought, use missing



information link to navigate to the missing info screen.









    
    
        Step—6: After entering the fields as per the field details explained in field explanation. Click Continue. Screen navigates to Enrollment Summary. (See FIG. C-349)
    
    


Field Explanation
The following table provides explanation for each element in the screen.











Element
Description







Group
Contains header information of the Group


Information Header



Name of the Group
Text for the Name of the Group


Group ID
Text and Link for the Group ID to navigate 



to the Group General Info screen


Group Type
Specifies the Type of the Group like Small 



Employer Group


Proposed Effective
The text for Proposed Effective Date. Choose 


Date
a date by clicking calendar icon. Date accepts 



the format MM/DD/YYYY. Default effective 



date is first of the following month. Effective 



date cannot be past date


Status
Text to specify the status of the group.


Work Group
Text for Work Group. This specifies the 



internal work group attached to the Group. 



This is based on the writing agent's work 



group.


Enrollment
Enrollment Summary Information is broken 


Summary
down into tree structure. The tree can by 


Information
expanded or collapsed. The level of the tree 



is as per the example given below:



− Employee



 − Dependent



 − Dependent



− Employee



 − Dependent



− Employee



+ Employee



− Employee



 + Dependent



+− Employee



Where (−) signifies expanded view and 



(+) signifies collapsed view.


Employee ID
Text for Employee ID


Employee SSN
Text for Employee SSN


Employee Name
Text for employee Name (First Name



and Last Name)


Effective Date
Text for Employee Effective date. Choose a 



date by clicking calendar icon. Date accepts 



the format MM/DD/YYYY. Defaults effective 



date of the Group. Effective date cannot be 



past date


Status
Text to specify the status of the employee.


Enrollment
There are two part of this information:


Information
 5) Entered based on verification



 6) Based on the information provide on the



  Coverage Info screen







Entered based on verification








Total Full Time
Value is shown based on the actual full 


Applied (A)
time employee applied (System Identified)


Total part Time
Value is shown based on the actual part time 


Applied (B)
employee applied (System Identified)


Employee Waived
Text to enter Employee Waived. Contains 


(C)
only whole number. Accepts numbers not 



exceeding 5 digits. Manually entered based 



on verification.


Employee Declined
Text to enter Employee Declined. Contains 


(D)
only whole number. Accepts numbers not 



exceeding 5 digits. Manually entered based 



on verification.


Total Eligible
Text to display total eligible employee.


Employee (E) =
Employee Applying is sum total of A + B + D.


Total Employee
Text to display total employee applying. 


Applying (F)
Employee Applying is sum total of A + B.


% Participation
Test to display % participation. Participation 



is % of E/F







Based on Info Provided








Total Full Time
Text for Total Full Time Applied. Based on 


Applied (A)
the information provide on the Coverage 



Info screen


Total part Time
Text for Total Part Time Applied. Based on


Applied (B)
the information provide on the Coverage 



Info screen


Total Employees
Text to display total employee applied. 


Applied
Employee Applied is sum total of A + B









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Pre Enrollment
Saves the data and performs validation and eligibility



checks against the information required for enrollment



and navigates to the screen Missing Information.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


<<, <, >, >>
The enrollment summary shows record for 5 employees



on single screen. If the employee size increases more



than 5. These buttons are used for navigating to the



next and previous records for viewing.



<< - Show first record (s)



< - Show previous record (s)



> - Show next record (s)



>> - Show last record (s)


Group ID
Click Group ID to navigates to the Group's general info



screen.









    
    
        Step—7: On clicking Pre-Enrollment, screen navigates to missing info. (See FIG. C-350)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Employee Missing Information








Missing Entity
List the missing entities for the group change


Message
Provides a message for the missing entities


Enrollment
Lists all the changes sought in the pick list


Information



Status
Displaying the status of change.







Dependent Missing Information








Missing Entity
List the missing entities for the group change


Message
Provides a message for the missing entities


Enrollment
Lists all the changes sought in the pick list


Information



Status
Displaying the status of change.







Change Information








ROE/OE Status
Specifies the pick list for the changes


Remarks
Text for briefing the change action


Reason for Decline 
Choose from the list of reasons for decline. This 



field is enabled only if the status of ROE/OE



is opted as decline


Others
Text for briefing the other status and description









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Finalize
Navigates to confirmation screen by incorporating all



the corrections made


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









    
    
        Step—8: On clicking Finalize, navigates to confirmation screen. Click continue to go back to Group search. (See FIG. C-351)
    
    


COBRA
The screen is to modify COBRA
The sequential steps involved in modifying COBRA are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select ROE. Select COBRA. (See FIG. C-352)
        Step—2: he screen navigates search to select a group. Enter the search criteria for Searching for the group. (See FIG. C-353)
        Step—3: his pops up a screen with search result. (See FIG. C-354)
        Step—4: lick on any Group ID for selection. Screen navigates to change request screen for making ROE/OE changes for a group. (See FIG. C-355)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Group Information








Parent Group ID
Text to display the Parent Group ID. This is a read



only field


Parent Group
Text to display the Parent Group Name. This is a


Name
read only field


COBRA Group ID
Text to display the COBRA Group ID. This is a read



only field


COBRA Type
Text to display the COBRA Group Type whether Cal



COBRA or Federal COBRA. This is a read only field


Group Effective
Text to display effective date of the parent group. This


Date
is a read only field


Work Group
Text to Display the internal Work group associated



with the Parent Group This is a read only field


Status
Text to display status of the group. This is a read only



field


Mode of Request
Choose a mode of request from the drop down list



available. The field is mandatory.


Post Mark Date
The text for post mark date. Choose a date in the



format MM/DD/YYYY by clicking calendar icon. The



postmark date cannot be greater than system date.



The field is mandatory.


Date Received
The text for received date. Choose a date in the 



format MM/DD/YYYY by clicking calendar icon. 



The received date cannot be greater than system 



date. The field is mandatory.


Reason for Change
Choose a reason from the drop down list The field is



mandatory.


Others
The text for narrating other info, provided the option



for reason for terms is others









Button Functionality
The following table provides explanation for each button in the screen.













Element
Description








Continue
Saves the data and navigates to General information




for groups.



Clear
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes









    
    
        Step—5: On clicking continue, navigates to Group General Information of group Respective tabs can also clicked to navigate to corresponding screens. Continue would be enabled only if the changes are sought on this screen, else use tab to navigate to the next screen. (See FIG. C-356)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Parent Group ID
Text to display the Parent Group ID.


Parent Group
Text to display the Parent Group Name.


Name



COBRA 
Text to display the COBRA Group ID.


Group ID



COBRA Type
Text to display the COBRA Group Type whether Cal



COBRA or Federal COBRA.


Group Effective
Text to display effective date of the parent group.


Date



Work Group
Text to Display the internal Work group associated



with the Parent Group


Status
Text to display status of the group.


Post Mark Date
Text for post mark date. Choose a date by clicking



calendar icon. Accepts in the format MM/DD/YYYY


Received Date
Text for received date. Choose a date by clicking



calendar icon. Accepts in the format MM/DD/YYYY


Salutation
Choose the salutation from the drop down list of



salutations available.


First Name
The text for first name. Accepts alphabets and special



character like hyphen and single quotes not exceeding



25 characters. First name is mandatory.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for last name. Accepts alphabets and special



characters like hyphen and single quotes not exceeding



35 characters. Last name is mandatory.


Suffix
Choose the Suffix from the drop down list of



salutations available.


Date of Birth
The text for date of birth. Choose a date by clicking



calendar icon


Social Security
The text for social security number for every


Number
individual. This can also be auto generated by clicking



auto generate link. Accepts numeric value of exactly 9



digits. Users with User Role as Level 2 and above can



only auto generate SSN.


Gender
Choose a gender from the drop down list available.







Address Information: Physical Home Address or Mailing Address








Address
The text for company address. Accepts alphabets and



numeric values not exceeding 35 characters


Apt
The text for company suite/apt # Accepts alphabets



and numeric values of not exceeding 35 characters


Zip
The text for zip. Accepts numeric of either 5 or 9



digits. City, State and County are populated



automatically for the correct zip code.


City
The text for city. Accepts alphabets of not exceeding



30 characters.


State
Choose the name of the state from the drop down list



of States available in United States of America


County
Choose the name of the county from the drop down list



of States available in United States of America


Mode of
Choose the mode of correspondence from the drop


Correspondence
down list available


Phone Number
The text for telephone number of the contact person.



Accepts numeric values of not exceeding 10 digits. The



format is (999) 999-9999


Extension
The text for telephone number of the contact person.



Accepts numeric values of not exceeding 5 digits. The



format is (999) 999-9999


Fax
The text for fax number of the contact person. Accepts



numeric values of not exceeding 10 digits. The format



is 9999


Email
The text for email of the contact person. Accepts



alphabets, numeric and special characters in the



standard email format of length not exceeding 100



characters









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Continue
Saves the data and navigates to Billing Information



screen and the system generates Group ID. This is



enabled only if changes are sought on this screen


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tabs
General Info, Billing Info, Coverage Info and Add



Employees are the tabs visible on this screen.



Navigation to the next screen is also possible by using



tabs If continue button is disabled use this tab to



navigate to the next screen Also while navigating



through the tab the content that are changed on the



screen are not saved unless explicitly saved by other



operations on the screen.









    
    
        Step—6: On clicking continue, navigates to Group Billing Information of group Respective tabs can also clicked to navigate to corresponding screens. Continue would be enabled only if the changes are sought on this screen, else use tab to navigate to the next screen. Enter the values in the respective fields, as per the format briefed in field's explanation section and click Continue. (See FIG. C-357)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Mode of payment
Choose a mode of payment from the drop down list



available. Based on selection corresponding fields will



enable to enter the values. For e.g. if the value selected



is card payment, EFT will be disabled and allows only



entering card details and vice versa.







Credit Card Information








Cardholder's
The text for cardholder's name. Accepts alphabets and


Names
space between two words.


Credit Card Type
Choose the type of credit card from the drop down list



available.


Credit Card No
The text for credit card number. Accepts numeric



values not exceeding 30 digits


Expiration Date
Choose a month of expiration from the drop down list



available


Expiration Year
The text for expiration year. Accepts numeric values



of exactly 4. Example 2002.


Billing Address 
As itappears on the credit Card


Street Address
The text for company address. Accepts alphanumeric



and special characters not exceeding 35 characters.


ZIP
The text for zip. Accepts numeric value of either 5 or 9



digits.


State
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters.


City
Choose the name of the state from the drop down list



of States available in United States of America







EFT Information








Bank Name
The text for bank name. Accepts alphabets and space



between two words.


Routing Number
The text for routing number. Accepts numeric values



not exceeding 9 digits.


Account Number
The text for account number. Accepts numeric values



not exceeding 9 digits.


Account Type
Choose the type of account from the drop down list



available.


Depositor's Name
The text for depositor's name. Accepts alphabets and



space between two words.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Continue
Saves the data and Navigates to coverage Information



screen. This is enabled only if changes are sought on



this screen


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tabs
General Info, Billing Info, Coverage Info and Add



Employees are the tabs visible on this screen.



Navigation to the next screen is also possible by using



tabs If continue button is disabled use this tab to



navigate to the next screen. Also while navigating



through the tab the content that are changed on the



screen are not saved unless explicitly saved by other



operations on the screen.









    
    
        Step—7: On clicking continue, navigates to Group Coverage Information of group Respective tabs can also clicked to navigate to corresponding screens. Continue would be enabled only if the changes are sought on this screen, else use tab to navigate to the next screen. (See FIG. C-358)
    
    


Field Explanation
The following table provides explanation for each button in the screen











Element
Description







COBRA effective
The text for COBRA effective date. Choose a date 


date
by clicking calendar icon


Qualifying event
Choose a qualifying even from the drop down list



available


COBRA end date
The text for COBRA end date. Choose a date by



clicking calendar icon


Send bill to
Choose the option of sending the bills either to group



or self (individual)







Plan Information








Line of coverage
Choose a line of coverage from the drop down list



available


Medical waived
Click the check box for medical waive if the



employee is waiving medical.


Carrier selection
Choose a carrier selection from the drop down list


(Benefit level)
available


Coverage choice
Choose a coverage from the drop down list available


PCP ID/Medical
The text for PCP ID. Accepts alphabets and numeric


group ID
values not exceeding 10 characters.


Are you an existing
Click the check box if you are an existing patient


patient



PCP last name
The text for PCP last name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 35 characters.


PCP first name
The text for PCP first name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 25 characters.


Prior plan type
Choose a plan type from the drop down list available


Prior plan name
Choose a plan name from the drop down list available


Prior insurance
The text for insurance start date. Choose a date by


start date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Prior insurance end
The text for insurance end date. Choose a date by


date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Other coverage kept
The text for other coverage. Accepts alphabets with



values not exceeding 50 characters.


RAF
The text to display RAF applicable for the Primary



Group.


Employee signature
Click the check box, to have employee signature


Date signed
The text for date signed. Choose a date by clicking



calendar icon. Date accepts the format 



MM/DD/YYYY. Date cannot accept future date.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add
Add the contents of employee coverage information. 



It is only a temporary addition. Becomes permanent 



only on saving the record.


Edit
Edit button will allow for editing a specific record in



the table.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent only on saving the record.


Check All
The “Check All” Link will check all the records in



the table


Clear All
The “Clear All” Link will uncheck all the records in 



the table that are checked.


COBRA Summary
Click COBRA summary refreshes the screen and



display the summary of information entered for



COBRA creation


Continue
Navigates add dependent screen.


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tabs
General Info, Billing Info, Coverage Info and Add



Employees are the tabs visible on this screen. The



navigation between is tabs are possible only if there is



a valid group ID generated and assigned to the group.



Also while navigating through the tab the content that



are changed on the screen are not saved unless



explicitly saved by other operations on the screen.









    
    
        Step—8: On clicking continue, navigates to Dependent Information of group Respective tabs can also clicked to navigate to corresponding screens. Continue would be enabled only if the changes are sought on this screen, else use tab to navigate to the next screen. (See FIG. C-359)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







First Name
The text for first name. Accepts alphabets and 



special character like hyphen and single quotes not 



exceeding 25 characters. First name is mandatory.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for last name. Accepts alphabets and special



characters like hyphen and single quotes not exceeding



35 characters. Last name is mandatory.


Suffix
Choose the suffix from the drop down list of suffixes



available.


Date of Birth
The text for date of birth. Choose a date by clicking



calendar icon. Date accepts the format



MM/DD/YYYY. Birth date cannot be later than the



current date.


Social Security
The text for social security number for every


Number
individual. This can also be auto generated by clicking



auto generate link. Accepts numeric value of exactly 9



digits. Users with User Role as Level 2 and above can



only auto generate SSN.


Gender
Choose a gender from the drop down list available.


Relationship
Choose the relationship from the drop down list



available.


Street Address
The text for address. Accepts alphanumeric and 



special characters with values not exceeding 35 



characters


Suite
The text for suite/apt #. Accepts alphanumeric and



special characters with values not exceeding 35



characters


Zip
The text for zip. Accepts numeric value of either 5 or 9



digits. City, and State are populated automatically on



entering the correct zip code and entering the tab key.


City
The text for city. Accepts alphabets not exceeding 30



characters.


State
Choose the name of the state from the drop down list



of States available in United States of America


Selected carrier
The text for selected carrier. It is a read only field


Coverage choice
The text for coverage. It is a read only field


Service area
The text for service area. It is a read only field


Prior plan type
Choose a plan type from the drop down list available


Prior plan
The text for plan name. Accepts alphabets


Waived
Click the check box if medical is waived


Start date
The text for start date. Choose a date by clicking



calendar icon


End date
The text for end date. Choose a date by clicking



calendar icon


PCP ID/
The text for PCP ID. Accepts alphabets


PCP last name
The text for PCP last name. Accepts alphabets and



special character like hyphen and single quotes


PCP first name
The text for PCP first name. Accepts alphabets and



special character like hyphen and single quotes


Disabled dependent
Click the option of temporary or permanent. This is



enable if the relationship opted is child


Domestic partner
Click the option for domestic partner. It depends on



the value selected in relationship


Legal guardian
Click the option for legal guardian. It depends on the



value selected in relationship


Signature
Click the check box if the signature is opted









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add
Add the contents of dependent information. It is only a



temporary addition.


Edit
Edit button will allow for editing a specific record in



the table.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


Clear
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Continue
Screen navigates to Missing info.


Tabs
General Info, Billing Info, Coverage Info and Add



Employees are the tabs visible on this screen. The



navigation between is tabs are possible only if there is



a valid group ID generated and assigned to the group.



Also while navigating through the tab the content that



are changed on the screen are not saved unless



explicitly saved by other operations on the screen.









    
    
        Step—9: On clicking continue, navigates to Missing Info screen. (See FIG. C-360)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Employee Missing Information








Missing Entity
List the missing entities for the group change


Element
Description


Message
Provides a message for the missing entities


Enrollment
Lists all the changes sought in the pick list


Information



Status
Displaying the status of change.







Dependent Missing Information








Missing Entity
List the missing entities for the group change


Message
Provides a message for the missing entities


Enrollment
Lists all the changes sought in the pick list


Information



Status
Displaying the status of change.







Change Information








ROE/OE Status
Specifies the pick list for the changes


Remarks
Text for briefing the change action


Reason for Decline
Choose from the list of reasons for decline. This field 



is enabled only if the status of ROE/OE is opted as



decline


Others
Text for briefing the other status and description









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Finalize
Navigates to confirmation screen by incorporating all



the corrections made


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









    
    
        Step—10: On clicking Finalize, navigates to confirmation screen. (See FIG. C-361)
    
    


Manual ROE
The screen is to have manual ROE
The sequential steps involved in having manual ROE are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select ROE. Select Manual ROE. (See FIG. C-362)
        Step—2: The screen navigates search to select a process. Entries to the fields are mandatory. Click Search. (See FIG. C-363)
        Step—3: This pops up a screen with search result. (See FIG. C-364)
        Step—4: Choose a employee id and click Process Manual. Click Search to navigate back to group search screen. (See FIG. C-365)
    
    


Individual Member Modify
The screen is to modify Individual Member
The sequential steps involved in modifying Individual Member are listed below.


    
    
        Step—1: After successful logon, click the menu Enrollment and select ROE. Select Individual Member and then Modify Individual Member. (See FIG. C-366)
        Step—2: The screen navigates search to select an employee. Enter the search criteria for Searching for the Employee. (See FIG. C-367)
        Step—3: This pops up a screen with search result. (See FIG. C-368)
        Step—4: Click on any employee id for selection the screen navigates to Individual Employee Change (pick list). (See FIG. C-369)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Group Information








Name of the group
Text for the Name of the Group. 



This is read only field.


Effective Date
Text for Effective date. This is read only field.


Group ID
Text for Group ID. This is read only field.


Element
Description


Status
Text for status. This is read only field.


Group Type
Text for group type. This is read only field.


Work Group
Text for work group. This is read only field.


Employee ID
Text for employee ID This is read only field.


Employee Name
Text for employee name. This is read only field


Association ID
Text for Association ID This is read only field.


Association Name
Text for Association name. This is read only field







Employee General Information








Employee address
Selecting this option will enable to allow for any



modifications


SSN information
Selecting this option will enable to allow for 



any modifications


Employee Date of
Selecting this option will enable to allow for 


birth
any modifications


Employee
Selecting this option will enable to allow for 


demographic
any modifications


location








Employee Billing Information








Billing Information
Selecting this option will enable to 



allow for any modifications







Employee Agent Information








Agent Information
Selecting this option will enable to allow for any



modifications







Coverage Information








RAF Discounting
Selecting this option will enable to allow 



for any modifications


Employee Type
Selecting this option will enable to allow 



for any modifications


Payroll
Selecting this option will enable to allow 



for any modifications


Medical LOC
Selecting this option will enable to allow 



for any modifications


Vision LOC
Selecting this option will enable to allow 



for any modifications


Dental LOC
Selecting this option will enable to allow 



for any modifications


CAM LOC
Selecting this option will enable to allow 



for any modifications


Hours worked
Selecting this option will enable to allow 



for any modifications


Employee Type
Selecting this option will enable to allow 



for any modifications


Date of employment
Selecting this option will enable to allow 



for any modifications









Button Functionality
The following table provides explanation for each button in the screen.













Element
Description








Continue
Saves the data and navigates to General information




for groups.



Cancel
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes









    
    
        Step—5: On clicking continue, navigates to General Information of group Respective tabs can also clicked to navigate to corresponding screens. Continue would be enabled only if the changes are sought on this screen, else use tab to navigate to the next screen. (See FIG. C-370)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Group Information








Name of the group
Text for the Name of the Group. This is read only field.


Effective Date
Text for Effective date. This is read only field.


Group ID
Text for Group ID. This is read only field.


Status
Text for status. This is read only field.


Group Type
Text for group type. This is read only field.


Work Group
Text for work group. This is read only field.


Employee ID
Text for employee ID This is read only field.


Employee Name
Text for employee name. This is read only field


Association ID
Text for Association ID This is read only field.


Association Name
Text for Association name. This is read only field







Employee Information








Salutation
Choose the salutation from the drop down list of



salutations available.


First Name
The text for first name. Accepts alphabets and special



character like hyphen and single quotes not exceeding



25 characters. First name is mandatory.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for contact name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 35 characters. Last name is mandatory


Suffix
Choose the suffix from the drop down list of suffixes



available.


Date of Birth
The text for date of birth. Choose a date by clicking



calendar icon


Social Security
The text for social security number for every


Number
individual. This can also be auto generated by clicking



auto generate link. Accepts numeric value of exactly 9



digits. Users with User Role as Level 2 and above can



only auto generate SSN.


Gender
Choose a gender from the drop down list available.







Address Information; Physical and Alternate Address - Note: Enter


Alternate Address if different from the Physical Address.








Street Address
The text for address. Accepts alphanumeric and special



characters not exceeding 35 characters


Suite
The text for suite/apt # Accepts alphanumeric and



special characters not exceeding 35 characters


Zip
The text for zip. Accepts numeric value of either 5 or 9



digits. City, State and County are populated



automatically on entering the correct zip code and



entering the tab key.


City
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters.


State
Choose the name of the state from the drop down list



of States available in United States of America


County
Choose the name of the county from the drop down list



of counties available for the ZIP Code entered.


Mode of
Choose the mode of correspondence from the drop


Correspondence
down list available.


Phone Number
The text for telephone number of the contact person.



Accepts numeric values not exceeding 10 digits. The



format is (999) 999-9999


Extension
The text for extension number of the contact person.



Accepts numeric values not exceeding 5 digits.


Fax
The text for fax number of the contact person Accepts



numeric values not exceeding 10 digits. The format is



(999) 999-9999


Email
The text for email of the contact person. Accepts



alphabets, numeric and special characters in the



standard email format of length not exceeding 100



characters









Button Functionality
The following table provides explanation for each button in the screen.













Element
Description








Continue
Navigates to Billing Information screen. This is




enabled only if changes are sought on this screen



Cancel
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes



Tabs
General Info, Billing Info, Agent Info, Coverage Info




are the tabs visible on this screen. Navigation to the




next screen is also possible by using tabs If continue




button is disabled use this tab to navigate to the next




screen. Also while navigating through the tab the




content that are changed on the screen are not saved




unless explicitly saved by other operations on the




screen.









    
    
        Step—6: On clicking continue, navigates to Billing Information of group Respective tabs can also clicked to navigate to corresponding screens. Continue would be enabled only if the changes are sought on this screen, else use tab to navigate to the next screen. (See FIG. C-371)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Mode of payment
Choose a mode of payment from the drop down list



available. Based on selection corresponding fields will



enable to enter the values. For e.g. if the value selected



is card payment, EFT will be disabled and allows only



entering card details and vice versa.







Credit Card Information








Cardholder's
The text for cardholder's name. Accepts alphabets and


Names
space between two words.


Credit Card Type
Choose the type of credit card from the drop down list



available.


Credit Card No
The text for credit card number. Accepts numeric



values not exceeding 30 digits


Expiration Date
Choose a month of expiration from the drop down list



available


Expiration Year
The text for expiration year. Accepts numeric values



of exactly 4. Example 2002.


Billing Address 
As it appears on the credit Card


Street Address
The text for company address. Accepts alphanumeric



and special characters not exceeding 35 characters.


ZIP
The text for zip. Accepts numeric value of either 5 or 



9 digits.


State
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters.


City
Choose the name of the state from the drop down list



of States available in United States of America







EFT Information








Bank Name
The text for bank name. Accepts alphabets and space



between two words.


Routing Number
The text for routing number. Accepts numeric values



not exceeding 9 digits.


Account Number
The text for account number. Accepts numeric values



not exceeding 9 digits.


Account Type
Choose the type of account from the drop down list



available.


Depositor's Name
The text for depositor's name. Accepts alphabets and



space between two words.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Continue
Saves the data and Navigates to Agent Information



screen. This is enabled only if changes are sought on



this screen


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Enrollment
Click enrollment summary refreshes the screen and


Summary
display the summary of information entered for group.


Missing
Click missing information refreshes the screen and


Information
displays the missed information for the group.


Tabs
General Info, Billing Info, Agent Info, Coverage Info



are the tabs visible on this screen. Navigation to the



next screen is also possible by using tabs If continue



button is disabled use this tab to navigate to the next



screen. Also while navigating through the tab the



content that are changed on the screen are not saved



unless explicitly saved by other operations on the



screen.









    
    
        Step—7: On clicking continue, navigates to Agent Information of group Respective tabs can also clicked to navigate to corresponding screens. Continue would be enabled only if the changes are sought on this screen, else use tab to navigate to the next screen. (See FIG. C-372)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description







Agent ID
Choose an agent id by clicking search icon


Agent Type
Choose an agent type from the drop down list



available. Based on the selection of the agent type the



percent commission split entry and the Receive ROE



packets option would be available.


Percent 
The text for percent commission. Accepts numeric


commission 
values in the range of 1-100 (Example 100.00). This


split
will be enabled only if the Agent type selected is 



“Agent Of Record”



Sum of the percentage for all the Agent of Record



added should be equal to 100.00.


Receive ROE/OE
Click the check box to receive ROE/OE packets for


packets
agent. This option will not be available for Agent 



Type “General Agent”.


Agent Commission
The text for agent commission. Defaults the value



defined in CM - rate Administration for Agent



Commission. Accepts numeric values less than or



equal to the defaulted value in the in the range of 



1-100 (Example 4.45)


Check the box if 
Click the check box for a group with out an agent. 


the group is 
This option will be available only for the Agent 


without an agent
Type, “Agent of Record and Writing Agent”.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add
Add the contents of agent information. It is only a



temporary addition. Becomes permanent only on



saving the record.


Edit
Edit button will allow for editing a specific record in



the table.


Update
Update the contents of agent information. It is only a



temporary update. Becomes permanent only on saving



the record


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent only on saving the record


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


Enrollment
Click enrollment summary refreshes the screen and


Summary
display the summary of information entered for group



creation


Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


Continue
Saves the data and navigates to Coverage Information



screen. This is enabled only if changes are sought on



this screen


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tab
General Info, Billing Info, Agent Info, Coverage Info



are the tabs visible on this screen. Navigation to the



next screen is also possible by using tabs If continue



button is disabled use this tab to navigate to the next



screen. Also while navigating through the tab the



content that are changed on the screen are not saved



unless explicitly saved by other operations on the



screen









    
    
        Step—8: On clicking continue, navigates to Coverage Information of group Respective tabs can also clicked to navigate to corresponding screens. Continue would be enabled only if the changes are sought on this screen, else use tab to navigate to the next screen. (See FIG. C-373)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Employee Information








Hours worked per
The text for worked hours per week. Accepts


week
numeric values not exceeding 2 digits.


Date of hire
The text for date of hire. Choose a date by clicking



calendar icon. Date accepts the format 



MM/DD/YYYY.


Employee type
Choose an employee type from the drop down list



available


Pay Roll
Check box for Pay Roll verification. Check this if pay



roll is verified.







RAF Discounting








RAF
List the RAF tier applicable for the group based on the



RAF tier available on group's effective date.







Plan Information








Line of coverage
Choose a line of coverage from the drop down list



available


Medical waived
Click the check box for medical waive if the employee



is waiving medical.


Carrier selection
Choose a carrier selection from the drop down list


(Benefit level)
available


Coverage choice
Choose a coverage from the drop down list available


PCP ID/Medical
The text for PCP ID. Accepts alphabets and numeric


group ID
values not exceeding 10 characters.


Are you an existing
Click the check box if you are an existing patient


patient



PCP last name
The text for PCP last name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 35 characters.


PCP first name
The text for PCP first name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 25 characters.


Prior plan type
Choose a plan type from the drop down list available


Prior plan name
Choose a plan name from the drop down list available


Prior insurance
The text for insurance start date. Choose a date by


start date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Prior insurance end 
The text for insurance end date. Choose a date by


date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Additional
The text for additional coverage. Accepts alphabets


Coverage
with values not exceeding 50 characters.


Date signed
The text for date signed. Choose a date by clicking



calendar icon. Date accepts the format 



MM/DD/YYYY. Date cannot accept future date.









Button Functionality
The following table provides explanation for each button in the screen











Element
Description







Add (Waiting
Add the contents of Waiting Period information. It is


Period 
only a temporary addition. Becomes permanent only


Information)
on saving the record.


Add 
Add the contents of Contribution and Coverage elected.


(Contribution)
It is only a temporary addition. Becomes permanent



only on saving the record.


Update 
Updates the contents of Waiting Period information. It


(Waiting
is only a temporary update. Becomes permanent only


Period 
on saving the record.


Information)



Update
Update the contents of Contribution and Coverage


(Contribution)
elected. It is only a temporary update. Becomes



permanent only on saving the record.


Cancel
Cancels the operation that was currently performed



prior to saving the record.


Edit
Edit button will allow for editing a specific record in



the table.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent only on saving the record.


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


Enrollment
Click enrollment summary refreshes the screen and


Summary
display the summary information entered for group



creation


Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


View 
Saves the data and navigates to Missing Information


Missing Info
Page


Save & Create
Saves the data entered and navigates to the screen


New Group
Group Hierarchy for creating New Group.


Cancel
Clears or restores the content entered in the fields only



prior to saving the records.


Tab
General Info, Billing Info, Agent Info, Coverage Info



are the tabs visible on this screen. Navigation to the



next screen is also possible by using tabs If continue



button is disabled use this tab to navigate to the next



screen. Also while navigating through the tab the



content that are changed on the screen are not saved



unless explicitly saved by other operations on the



screen









    
    
        Step—9: Click Enrollment Summary link to have a summary detail. Click Pre Enrollment, which also leads to Missing Info screen. (See FIG. C-374)
        Step—10: Clicking change summary button screen navigates to missing info screen. This screen shows the overall information that are entered will be shown. (See FIG. C-375)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Employee Missing Information








Missing Entity
List the missing entities for the group change


Message
Provides a message for the missing entities


Enrollment
Lists all the changes sought in the pick list


Information



Status
Displaying the status of change.







Change Information








ROE/OE Status
Specifies the pick list for the changes


Remarks
Text for briefing the change action


Reason for Decline 
Choose from the list of reasons for decline. This 



field is enabled only if the status of ROE/OE is 



opted as decline


Others
Text for briefing the other status and description









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Finalize
Navigates to confirmation screen by incorporating all



the corrections made


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









    
    
        Step—11: On clicking Finalize, navigates to confirmation screen. Click Continue to go back to Group search screen. (See FIG. C-376)
    
    


Individual Dependent Modify
The screen is to modify Individual Member Dependent
The sequential steps involved in modifying Individual Member Dependent are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select ROE. Select Individual Member and then Modify Dependent. (See FIG. C-377)
        Step—2: The screen navigates search to select an dependent. Enter the search criteria for Searching for the Dependent. (See FIG. C-378)
        Step—3: This pops up a screen with search result. (See FIG. C-379)
        Step—4: Click on any employee id for selection the screen navigates to Individual Employee Change (pick list). (See FIG. C-380)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Group Information








Name of the group
Text for the Name of the Group. Read Only field


Effective Date
Text for Employee Effective date. This is read only



field.


Group ID
Text for Group ID. This is read only field.


Status
Text for status. This is read only field.


Group Type
Text for group type. This is read only field.


Work Group
Text for work group. This is read only field.


Employee ID
Text for Employee ID. This is read only field.


Employee Name
Text for Employee Name. This is read only field.


Dependent ID
Text for Dependent ID. This is read only field.


Dependent Name
Text for Dependent Name. This is read only field.







Dependent General Information Changes








Dependent to waive 
Selecting this option will enable to allow for any


Vision Plan
modifications.


Information



Dependent to waive 
Selecting this option will enable to allow for any


Dental Plan
modifications


Information



Dependent to waive 
Selecting this option will enable to allow for any


CAM Plan
modifications


Information



Dependent to waive 
Selecting this option will enable to allow for any


Medical Plan
modifications


Information



Prior Plan
Selecting this option will enable to allow for any


Information
modifications


Dependent Address
Selecting this option will enable to allow for any


Information
modifications


Dependent SSN
Selecting this option will enable to allow for any



modifications


Dependent
Selecting this option will enable to allow for any


Relationship
modifications


Dependent Date of
Selecting this option will enable to allow for any


Birth
modifications


Dependent
Selecting this option will enable to allow for any


Personal
modifications


Information









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Continue
Saves the data and navigates to Dependent General



information for employees.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









    
    
        Step—5: n clicking continue, navigates to Dependent General Information screen. Respective tabs can also clicked to navigate to corresponding screens. If any other tabs like Coverage or General Info, or if Enrollment summary, Cancel is disabled, due to non-selection of changes sought, use missing information link to navigate to the missing info screen. (See FIG. C-381)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Dependent Information








First Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 25 characters.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 35 characters.


Suffix
Choose the suffix from the drop down list of suffixes



available.


Date of Birth
The text for date of birth. Choose a date by clicking



calendar icon. Date accepts the format MM/DD/YYYY.



Birth date cannot be later than the current date.


Social Security
The text for social security number for every


Number
individual. This can also be auto generated by clicking



auto generate link. Accepts numeric value of exactly 9



digits. Users with User Role as Level 2 and above can



only auto generate SSN.


Gender
Choose a gender from the drop down list available.







Address Information








Street Address
The text for address. Accepts alphanumeric and special



characters with values not exceeding 35 characters


Apt
The text for suite/apt #. Accepts alphanumeric and



special characters with values not exceeding 35



characters


Zip
The text for zip. Accepts numeric value of either 5 or 9



digits. City, State and County are populated



automatically on entering the correct zip code and



entering the tab key.


City
The text for city. Accepts alphabets and space between



two words not exceeding 30 characters.


State
Choose the name of the state from the drop down list



of States available in United States of America







Line of Coverage Information [For Medical, Vision, Dental]








Selected Product
Text for the product selected. It is a read only field.


Coverage Choice
Choose a coverage from the drop down list available


Waived
Click the check box for any waive.


Service Area
The text for service area.


PCP ID/Medical
The text for PCP ID. Accepts alphabets and numeric


group ID
values not exceeding 10 characters.


PCP last name
The text for PCP last name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 35 characters.


PCP first name
The text for PCP first name. Accepts alphabets and



special character like hyphen and single quotes not



exceeding 25 characters.


Prior insurance
The text for insurance start date. Choose a date by


start date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Prior insurance 
The text for insurance end date. Choose a date by


end date
clicking calendar icon. Date accepts the format



MM/DD/YYYY.


Other coverage
The text for other coverage. Accepts alphabets with


kept
values not exceeding 50 characters.


Additional
The text for additional coverage. Accepts alphabets


Coverage
with values not exceeding 50 characters.


Disabled 
Click the option of temporary or permanent. This is


dependent
enable if the relationship opted is child


Domestic partner
Click the option for domestic partner. It depends on



the value selected in relationship


Legal guardian
Click the option for legal guardian. It depends on the



value selected in relationship


Signature
Click the check box if the signature is opted









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Enrollment
Saves the data and navigates to Summary screen. This


Summary
is enabled only if changes are sought on this screen.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


Tab
General Info, Coverage Info, are the tabs visible on



this screen. If any other tabs like Coverage or General



Info, or if Enrollment summary, Cancel is disabled,



due to non-selection of changes sought, use missing



information link to navigate to the missing info screen.









    
    
        Step—6: After entering the fields as per the field details explained in field explanation. Click Continue. Screen navigates to Enrollment Summary. (See FIG. C-382)
    
    


Field Explanation
The following table provides explanation for each element in the screen.











Element
Description







Group
Contains header information of the Group


Information



Header



Name of the Group
Text for the Name of the Group


Group ID
Text and Link for the Group ID to navigate to the



Group General Info screen


Group Type
Specifies the Type of the Group like Small Employer



Group


Proposed Effective
The text for Proposed Effective Date. Choose a date by


Date
clicking calendar icon. Date accepts the format



MM/DD/YYYY. Default effective date is first of the



following month. Effective date cannot be past date


Status
Text to specify the status of the group.


Work Group
Text for Work Group. This specifies the internal work



group attached to the Group. This is based on the



writing agent's work group.


Enrollment
Enrollment Summary Information is broken down into


Summary
tree structure. The tree can by expanded or collapsed.


Information
The level of the tree is as per the example given below:



− Employee



 − Dependent



 − Dependent



− Employee



 − Dependent



− Employee



+ Employee



− Employee



 + Dependent



+− Employee



Where (−) signifies expanded view and (+) signifies



collapsed view.


Employee ID
Text for Employee ID


Employee SSN
Text for Employee SSN


Employee Name
Text for employee Name (First Name and Last Name)


Effective Date
Text for Employee Effective date. Choose a date by



clicking calendar icon. Date accepts the format



MM/DD/YYYY. Defaults effective date of the Group.



Effective date cannot be past date


Status
Text to specify the status of the employee.


Dependent ID
Text for Dependent ID


Dependent SSN
Text for Dependent SSN


Dependent Name
Text for Dependent Name (First Name and Last



Name)


Effective Date
Text for Dependent Effective date. Choose a date by



clicking calendar icon. Date accepts the format



MM/DD/YYYY. Defaults effective date of the Group.



Effective date cannot be past date


Status
Text to specify the status of the Dependent.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Missing
Click missing information refreshes the screen and


Information
displays the missed information. For a successful



creation of a group, there should be no missing



information


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes


<<, <, >, >>
The enrollment summary shows record for 5 employees



on single screen. If the employee size increases more



than 5. These buttons are used for navigating to the



next and previous records for viewing.



<< - Show first record (s)



< - Show previous record (s)



> - Show next record (s)



>> - Show last record (s)


Group ID
Click Group ID to navigates to the Group's general info



screen.









    
    
        Step—7: On clicking Pre-Enrollment, screen navigates to missing info. (See FIG. C-383)
    
    


Field Explanation
The following table provides explanation for each button in the screen.











Element
Description















Employee Missing Information








Missing Entity
List the missing entities for the group change


Message
Provides a message for the missing entities


Enrollment
Lists all the changes sought in the pick list


Information



Status
Displaying the status of change.







Dependent Missing Information








Missing Entity
List the missing entities for the group change


Message
Provides a message for the missing entities


Enrollment
Lists all the changes sought in the pick list


Information



Status
Displaying the status of change.







Change Information








ROE/OE Status
Specifies the pick list for the changes


Remarks
Text for briefing the change action


Reason for Decline
Choose from the list of reasons for decline. This field is



enabled only if the status of ROE/OE is opted as



decline


Others
Text for briefing the other status and description









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Finalize
Navigates to confirmation screen by incorporating all



the corrections made


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes









    
    
        Step—8: On clicking Finalize, navigates to confirmation screen. (See FIG. C-384)
    
    


13 View
View option is to facilitate to have any change, or to view the contents of Group, Employee and Dependent.
Access
The application can be accessed from the main menu as follows:

    
    
        Enrollment→View→View Group
        Enrollment→View→View Employee
        Enrollment→View→View Dependent
    
    


Pre-Requisites
The groups, employees and dependents must exist in the system.
Application Functions
This application has the following functions for reinstatement:

    
    
        View Group—to view the contents of group
        View Employee—to view the contents of employee
        View Dependent—to view the contents of dependents
    
    


View Group
The screen is to view the contents of a group, for further process like to change, only to view the contents or to create a new group.
The sequential steps involved in viewing the details of a group are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select View. Then select View Group. (See FIG. C-385)
        Step—2: The screen navigates to group search to select a group. Enter value in any one of the fields, or simply click search button to perform search operation. (See FIG. C-386)
        Step—3: This pops up a screen with search result. (See FIG. C-387)
        Step—4: Choose a group id for selection. On clicking Change button, screen navigates to group change request screen, which is similar to change request for Group explained under CHANGE. The flow and process are same based on the type of group selected. (See FIG. C-388)
    
    


On clicking View button, screen navigates to group view screen. The screen is to only to have view option. Click Search Group to navigate back to Group search screen (See FIG. C-389)
On clicking Create New button, screen navigates to group hierarchy screen which is explained under NEW BUSINESS, to create a new group.
View Employee
The screen is to view the contents of an employee, for further process like to change, only to view the contents or to create a new employee
The sequential steps involved in viewing details of an employee are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select View. Then select View Employee. (See FIG. C-390)
        Step—2: The screen navigates to employee search to select an employee. Enter value in any one of the fields, or simply click search button to perform search operation. (See FIG. C-391)
        Step—3: This pops up a screen with search result. (See FIG. C-392)
        Step—4: Choose an employee id for selection.
    
    


On clicking Change button, screen navigates to employee change request screen, which is similar to change request for Employee explained under CHANGE. The flow and process are same as explained under CHANGE. (See FIG. C-FIG. 393)
On clicking View button, screen navigates to employee view screen. The screen is to only to have view option. Click Search employee to navigate back to Employee search screen. (See FIG. C-394)
On clicking Create New button, screen navigates to Change request for employee add on screen to add new employees.
View Dependent
The screen is to view the contents of an dependent, for further process like to change, only to view the contents or to create a new dependent
The sequential steps involved in viewing details of a dependent are listed below.

    
    
        Step—1: After successful logon, click the menu Enrollment and select View. Then select View Dependent. (See FIG. C-395)
        Step—2: The screen navigates to employee search to select an employee. Enter value in any one of the fields, or simply click search button to perform search operation. (See FIG. C-396)
        Step—3: This pops up a screen with search result. (See FIG. C-397)
        Step—4: Choose an dependent id for selection.
    
    


On clicking Change button, screen navigates to dependent change request screen, which is similar to change request for Dependent explained under CHANGE. The flow and process are same as explained under CHANGE. (See FIG. C-398)
On clicking View button, screen navigates to dependent view screen. The screen is to only to have view option. Click Search employee to navigate back to Dependent search screen. (See FIG. C-399)
On clicking Create New button, screen navigates to Change request for dependent add on screen to add new dependents.
PX2 User Manual
Finance
1 Introduction
Finance is the transaction module that encompasses the process of Billing, Cash Receipts, Cash Reconciliation and other Finance Operations like Premium Transmission Data Output, Mail House Billing Data Output, Lockbox and EFT Imports, Credit Card Import and export, Commission Check Run and Import Risk Adjustment Factors. These operations are for the various group and members participating in the PacAdvantage program.
The Applications
The above-mentioned processes are accomplished in several applications embedded into the Finance Module. These applications steer the tasks of creating, and maintaining operational information relevant for financial transactions within PX2 entities, thereby helping achieve the goals of the Finance Module.

    
    
        Billing—Billing is the process of creating invoice for the customers enrolled in the PacAdvantage program. The Invoice on a broad base is classified into two types—First Time Invoice (invoice to the group/member that has enrolled as new business) and Running invoice or periodic invoice (To the existing Group/Members).
        Cash Receipts—Cash Receipt is the process of entering the cash received by BPI into the system. The cash receipt can be received in various modes as defined by the business process. Cash Receipt includes Lock Box receipts, Check, Credit Card, EFT and Transfer.
        Cash Reconciliation—Cash Reconciliation is the process of reconciling the cash receipts and adjustments to individual invoices and reconciling the amount paid by the group.
        Cash Disbursement—Cash Disbursement is the process of handling commission. It deals with both commission disbursement as well as commission adjustments.
        Finance Operations—Finance Operation consists of the utility operations within the finance module for various processes like Premium Transmission Data Output, Mail House Billing Data Output, Lockbox and EFT Imports, Credit Card Import and export, Commission Check Run and Import Risk Adjustment Factors.
    
    


2 Billing
Billing is the transaction module that encompasses the process of creating and maintaining invoices for the group and member enrolled with PacAdvantage in the PX2 System. Billing mainly can be categorized in to two.
First Time invoice, generate first time invoice for the groups/members who have enrolled as new business and Periodic invoice.
Generate running invoice to the existing groups/members.
Billing also has other utility as a support to the billing process viz. Suppress Batch Billing, Batch Bill, Batch Billing Adjustments, Manual Bill and Dynamic Text.
Access

    
    
        The application can be accessed from the main menu as follows:
        
            Finance→Billing→Suppress Batch Billing
            
                →Batch Billing
                →Manual Billing
                →Billing Adjustments
                →Dynamic Text
            
            
        
        
    
    


Pre-Requisites
All relevant master and transaction records must be available in the system for a successful billing. Master and transaction records are as follows:

    
    
        Carrier Maintenance—Refer “User Manual for Carrier Maintenance” for further information on the master records.
        Agent/Agency—Refer “User Manual for Sales and Marketing” for further information on the Agent/Agency records.
        Enrollment—“User Manual for Enrollment” for further information on the enrolled group and member records. All the information about the existing group/members and their real time transaction details are required to invoice correctly.
        When bill run is in process there should be no other activities performed on the PX2 System. Bill generation process requires considerable overheads. Probable the best time to start batch billing process is at the end of the day when there would be no user accessing the system.
    
    


Application Functions
This application has the following functions:

    
    
        Suppress Batch Billing—Suppress Batch Billing is the process of suppressing periodic bill for a specific Group/Member or collective group and members
        Batch Billing—Batch billing is the process of generating running invoice for the existing groups/members. To run this process, scheduler must be started.
        Manual Billing—Manual billing is the process of creating the invoice manually for a specific group of members where in some special adjustments needs to be made.
        Billing Adjustments—Billing adjustment is the process of adjusting the bill amount either in full or in part against its value, for a specific group of members where in some special adjustments needs to be made.
        Dynamic Text—This process provides a feature to add dynamic content on the bills sent to the for a specific Group/Member or collective groups and members
    
    


Suppress Batch Billing
The sequential steps involved in Suppress Batch Billing are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Billing. Then select Suppress Batch Billing. (See FIG. D-1)
        Step—2: The screen navigates to Suppress Batch Billing screen. (See FIG. D-2)
        Step—3: Choose the group ids to suppress and click save button. This will disable save, filter and clear filter buttons and will have only new button enabled to proceed further.
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Bill Period
The text for bill period. Choose from the list the



invoice period for suppressing the bill.


Selected Group
The text displays the selected group count based on



the invoice period. Example 0 to 100. It is a read



only field


Group Id
The text for group Id. Accepts numeric values not



exceeding 7 digits.


Group Name
The text for group name. Accepts alphanumeric and



special characters.


Group Type
Choose a group type from the drop down list



available


ROE Cycle Date
The text for ROE Cycle Date From. Choose from the


From
calendar icon in the format MM/DD/YYYY.


ROE Cycle Date
The text for ROE cycle end date. Choose from the


To
calendar icon in the format MM/DD/YYYY


Effective Date
The text for effective start date. Choose from the


From
calendar icon in the format MM/DD/YYYY


Effective Date To
The text for effective end date. Choose from the



calendar icon in the format MM/DD/YYYY


Group Size From
The text for group size and specifies the starting



range. Accepts numeric values not exceeding 3



digits.


Group Size To
The text for group size and specifies the ending



range. Accepts numeric values not exceeding 3



digits.


Rate Type
Choose the rate type option from either Blended or



Non-Blended Rate


View
Choose view option from the available options like



All/Suppressed groups/Un-suppressed groups


View Selected
Check the View Selected Check Box to view only



selected groups.


Table
Table displays the Groups selected based on the



Search and filter conditions.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Bill Period
On Selecting the bill period, shows all the groups/



members available for the specific invoice period


Check All
(At Suppress Bill Header) Check All link Checks all



the groups from database.


Clear All
(At Suppress Bill Header). Clear All link uncheck all



the groups that are checked from database.


Filter
Click the Filter to display the Group based on the



search criteria / filter conditions provided.


Clear Filter
Clear the Content of the fields.


New
Click New to start new operation on this screen


Suppress
Click Suppress to Suppress billing for the groups



selected


Save
Click Save to save the content of suppress billing


Un-Suppress
Click Un-Suppress to Un-Suppress billing for the



groups selected.


Check All
The “Check All” Link will check all the records in



the table


Clear All
The “Clear All” Link will uncheck all the records in



the table that are checked.


Check All on this
The “Check All on this Page” Link will check all the


Page
records in the table on this Page


Invert Selection
The Invert Selection Link will invert the selection



criteria for the check boxes. I.e. All Check Groups



would be unchecked and vice versa.


<<, <, >, >>
These buttons are used for navigating to the next and



previous records for viewing.



<< - Show first record (s)



< - Show previous record (s)



> - Show next record (s)



>> - Show last record (s)









Batch Billing
The sequential steps involved in Batch Billing are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Billing. Then select Batch Billing. (See FIG. D-3)
        Step—2: The screen navigates to batch billing screen. (See FIG. D-4)
        Step—3: Select the bill period and click process button to create invoice for all the groups that are un-suppressed for that bill run period.
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.














Element
Description









Run Id
The text for sequential number of Run Id. It is a read




only field and is auto generated



Bill Period
Choose month and year for bill period from the drop




down list available, during which bills are to be




generated.



Run By
The text for name of the user who generated the bill.




It is a read only field.










Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Process
Click Process to start the bill run process for the all



the groups and member for the specified billing



period selected.


New
Click New to start new operation for the Bill Run.


View Status
Click view status to navigate to Auto Billing Status



Search









    
    
        Step—4: On clicking view status button the screen navigates to auto billing status search screen. {See FIG. D-5}
        Step—5: Enter the value of any one field or simply click search button to perform Search operation
        Step—6: This pops up a search result screen. (See FIG. D-6)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.














Element
Description









Run Id
The text for run id. It accepts numeric values not




exceeding 10 digits.



Run Date
The text for run date. Choose from the calendar icon




in the format MM/DD/YYYY



Run Status
Choose a run status from the drop down list




available. Run Status can be Completed, In Progress




or Error










Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Search
Click Search to search for the Billing Status based




on the search criteria entered.



Cancel
Clears the contents entered in the editable field.



Back
Navigates back to Auto Billing screen.










Manual Billing
The sequential steps involved in Manual Billing

    
    
        Step—1: After successful logon, click the menu Finance and select Billing. Then select Manual Billing. (See FIG. D-7)
        Step—2: The screen navigates to Manual Invoice screen. (See FIG. D-8)
        Step—3: Choose period and group id. If the bill for the group id is already generated for the selected month, will display the contents and create button will be disabled. Otherwise, create button will be enabled to generate a bill.
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description















Invoice Details








Bill #
Shows the Bill #. This is auto generated by the



system.


Bill Date
Shows the Bill Date. Show the date when this bill



was generated in the format MM/DD/YYYY


Period
The text for invoice period. Choose from the list the



invoice period for creating the bill.


Due Date
Shows the Due Date. Show the date when this bill is



due in the format MM/DD/YYYY


Status
Shows the status of the Bill.


Reconciled Date
Shows the Reconciled Date. Show the date when



this bill is reconciled in the format MM/DD/YYYY







Group Information








Group Id
Text for Group ID. Accepts numeric values not



exceeding 7 digits.


Group Type
Text for Group Type. It is a read only field.


Group Name
Text for Group Name. It is a read only field


Status
Text for Status. It is a read only field


Association Name
Text for Association Name. It is a read only field


Rate Type
Text for Rate Type. It is a read only field







Group Level Adjustment








Type
Choose a type of adjustment from the drop down list



available


Amount
The text for adjustment amount. Accepts value in the



format of currency (example 999999999.99)


Period
The text for the period of adjustment. Choose month



and year from the drop down list.


Billing Summary
Displays the bill summary.


Prior period billed
Text for Prior period billed amount. It is a read only


amount
field


Adjustments since
Text for Adjustments since prior period. It is a read


prior period
only field


Payments
Text for Payments Received. It is a read only field


Received



Past Due Amount
Text for Past Due Amount. It is a read only field


Current bill
Text for Current bill amount. It is a read only field


amount



Total Due
Text for Total Due. It is a read only field


Employee Level
Displays Employee Level Adjustments. This can be


Adjustments
due to Add On or Termed Employee/Members.


Current Premium
Displays current premium due for each employees


Due



Bill Summary
Displays the bill summary


Sub Total -
Text for Sub Total - Medical Premium. It is a read


Medical Premium
only field


Sub Total - Dental 
Text for Sub Total - Dental Premium. It is a read


Premium
only field


Sub Total - Vision 
Text for Sub Total - Vision Premium. It is a read


Premium
only field


Sub Total - CAM
Text for Sub Total - CAM Premium. It is a read only


Premium
field


Administration
Text for Administration member Fees. It is a read


member Fees
only field


Agent member
Text for Agent member Fees. It is a read only field


Fees



Administration flat
Text for Administration flat Fee. It is a read only


Fee
field


Agent flat Fee
Text for Agent flat Fee. It is a read only field


Total due current
Text for Total due current period. It is a read only


period
field


Add Past Due
Text for Add Past Due Amount. It is a read only


Amount
field


Total Due
Text for Total Due. It is a read only field









Button Functionality
The following table provides explanations for each button in the screen.














Element
Description









New
Click New to create a new manual bill.



Create
Click Create to Creates bill based on the information




provided



Add
Add the contents of adjustments into the table




below. It is only a temporary addition. Becomes




permanent only on saving the record.



Calculate
Click calculate button to calculate the adjustments




based on the adjustment period selected.



Update
Update the contents of adjustments. It is only a




temporary update. Becomes permanent only on




saving the record.



Delete
Delete button will delete the records in the table




checked for deletion. It is only a temporary deletion.




Becomes permanent only on saving the record.



Check All
The “Check All” Link will check all the records in




the table



Clear All
The “Clear All” Link will uncheck all the records in




the table that are checked.










Billing Adjustments
The sequential steps involved in Dynamic Text are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Billing. Then select Billing Adjustments. (See FIG. D-9)
        Step—2: The screen navigates to Adjustment Screen. (See FIG. D-10)
        Step—3: Enter adjustment date.
        Step—4: Choose a group id by clicking search icon. Corresponding fields are read only and selecting a group id populates the data.
        Step—5: Choose Type of group level adjustment and period. Only if the value of type is Late Fee, Calculate button is enabled to calculate and fetch the value in amount field otherwise calculate button is disabled.
        Step—6: Click Search button lead to have details of adjustment ids, generated. (See FIG. D-11)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description















Adjustment Details








Adjustment Id
This field is a read only and system generated id of



exactly 10 digits.


Adjustment Date
Text for Adjustment Date. Choose a date by



clicking calendar icon to have a date in the



MM/DD/YYYY format.


Status
Shows the status of the adjustment.







Group Information








Group ID
Choose a group ID by clicking search icon. Field is



mandatory.


Group Type
Field is read only. Populates data based on the



selected group ID


Group Name
Field is read only. Populates data based on the



selected group ID


Association Name
Field is read only. Populates data based on the



selected group ID


Status
Field is read only. Populates data based on the



selected group ID


Rate Type
Field is read only. Populates data based on the



selected group ID







Group Level Adjustments








Type
Choose a type of group level adjustment from the



drop down list available. Field is mandatory


Amount
Amount is calculated based on the inputs of type and



period. Value gets populated by clicking calculate



button


Period
Choose a period for which group level adjustment is



sought. Field is mandatory.









Button Functionality














Element
Description









Calculate
Click calculate button to calculate the adjustments




based on the adjustment period selected.



New
Click New to create a new group level adjustment



Save
Click Save to save the content of billing adjustment



Search
Click Search to search for the group level adjustment




status based on the search criteria entered.










Dynamic Text
The sequential steps involved in Dynamic Text are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Billing. Then select Dynamic Text. (See FIG. D-12)
        Step—2: The screen navigates to dynamic text screen. (See FIG. D-13)
        Step—3: Enter the text for dynamic text. This field is mandatory.
        Step—4: Enter the values in the fields as per the format briefed in fields' explanation table. Choose a group id.
        Step—5: On clicking Save button, the assigned dynamic text will be made available for the selected group and disable all the fields except New to continue the flow.
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Dynamic Text
The text for dynamic text. Accepts all characters.


Invoice Period
The text for invoice period. Choose from the list the



invoice period for embedding dynamic text on the



bill.


Selected Group
The text displays the selected group count based on



the invoice period. Example 0 to 100. It is a read



only field


Group Id
The text for group Id. Accepts numeric values not



exceeding 7 digits.


Group Name
The text for group name. Accepts alphanumeric and



special characters.


Group Type
Choose a group type from the drop down list



available


ROE Cycle Date
The text for ROE Cycle Date From. Choose from the


From
calendar icon in the format MM/DD/YYYY.


ROE Cycle Date
The text for ROE cycle end date. Choose from the


To
calendar icon in the format MM/DD/YYYY


Effective Date
The text for effective start date. Choose from the


From
calendar icon in the format MM/DD/YYYY


Effective Date To
The text for effective end date. Choose from the



calendar icon in the format MM/DD/YYYY


Group Size From
The text for group size and specifies the starting



range. Accepts numeric values not exceeding 3



digits.


Group Size To
The text for group size and specifies the ending



range. Accepts numeric values not exceeding 3



digits.


View Selected
Check the View Selected Check Box to view only



selected groups.


Table
Table displays the Groups selected based on the



Search and filter conditions.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Invoice Period
On Selecting the invoice period, shows all the



groups/members available for the specific invoice



period


Check All
(At Dynamic Text Header) Check All link Checks



all the groups displayed.


Clear All
(At Dynamic Text Header). Clear All link uncheck



all the groups that are checked


Filter
Click the Filter to display the Group based on the



search criteria/filter conditions provided.


Clear Filter
Clear the Content of the fields.


Check All
The “Check All” Link will check all the records in



the table


Clear All
The “Clear All” Link will uncheck all the records in



the table that are checked.


Check All on this
The “Check All on this Page” Link will check all the


Page
records in the table on this Page


Invert Selection 
The Invert Selection Link will invert the selection



criteria for the check boxes. I.e. All Check Groups



would be unchecked and vice versa.


<<, <, >, >>
These buttons are used for navigating to the next and



previous records for viewing.



<< - Show first record(s)



< - Show previous record(s)



> - Show next record(s)



>> - Show last record(s)


New
Click New to start new operation on this screen


Save
Click Save to save the Content of the dynamic text









3 Cash Receipts
Cash Receipt is the transaction module that encompasses the process of creating and maintaining Cash receipts for the group and member enrolled and invoiced in the PX2 System. Cash Receipt is the process of entering the cash received by BPI into the system. The cash receipt can be received in various modes as defined by the business process. Cash Receipt includes Lock Box receipts, Check, Credit Card, EFT and Transfer. Cash Receipts here identifies the Manual Cash batch and Credit Card over phone.
Access
The application can be accessed from the main menu as follows:

    
    
        Finance→Cash Receipts→Manual Batch
        
            →Credit Card over Phone
        
        
    
    


Pre-Requisites
All relevant transactional data pertaining to the group and member must be available for the Cash receipt process.

    
    
        Invoice should be generated and available for the Group/Member for cash receipts for existing groups and members.
        For new business enrollment the group information must be available in the system to enter the cash batch
        All billing information and the mode of payments must be available in the system.
        For credit card over phone process, Internet connection is a mandatory.
    
    


Application Functions
This application has the following functions:

    
    
        Manual Batch: Manual batch is the process of entering the payments and receipts into the system manually. The payments and receipts are identified based on the batch type that can be Manual Batch, NSF Batch, Returns Batch, Positive Transfer, Negative Transfer, Direct Deposit and Wire Transfer.
        Credit Card over Phone: Credit Card over phone is a interface built for processing credit card transactions over phone for the Group/Member who opts to pay be credit card.
    
    


Manual Batch
The sequential steps involved in Manual Batch are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Cash Receipts. Then select Manual Batch (See FIG. D-14)
        Step—2: The screen navigates to Manual Batch screen. (See FIG. D-15)
        Step—3: Choose Batch type and enter tape total.
        Step—4: Enter the values in the respective fields as per the format briefed in fields' explanation table.
        Step—5: On clicking add will do the temporary storage and clicking Save will have a permanent storage.
        Step—6: Clicking Search button navigates to search screen to have the details of Batch Ids generated. In the search screen, either value can be entered or simply click search button to perform the search operation.
        Step—7: Following is the search result screen. Click back, to go back to Manual Batch screen. (See FIG. D-16)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description















Batch Information








Batch Id
The text for Batch ID. This is auto generated by the



system


Batch Date
The text for batch date. Batch Date defaults to the



current date. Choose a date by clicking calendar



icon. Date accepts the format M/DD/YYYY.


Batch Total
The text for Batch Total. This is dynamically



calculated by the system based on the batch entries


Batch Type
Choose the batch type from the list provided. Batch



type can be Manual Batch, NSF Batch, Returns



Batch, Positive Transfer, Negative Transfer, Direct



Deposit and Wire Transfer.


Tape Total
The text for Tape Total. Accepts value in the format



of currency (example 9999999999.99). This field is



mandatory.


Tape Balance
The text for Tape Balance. This is dynamically



calculated by the system based on the batch entries.


Batch Status
The text for Batch Status. Displays the status of the



batch. Batch can be Open or Closed







Check Information








Post Mark Date
The text for Post Mark date. Choose a date by



clicking calendar icon. Date accepts the format



M/DD/YYYY. Post Mark Date cannot be greater



than Received date.


Received Date
The text for Received date. Choose a date by



clicking calendar icon. Date accepts the format



M/DD/YYYY. Received Date cannot be future date.



This field is mandatory.


Check #
The text for Check #. Accepts numeric values not



exceeding 10 digits. This field is mandatory.


Check Amount
The text for amount received. Accepts value in the



format of currency (example 9999999999.99). This



field is mandatory. Check amount should be equal



Group Amount Total.







Check Distribution








Group Id
Text for Group ID. Group ID accepts numeric value



of exactly 7 digits. This field is mandatory.


Group Name
Text for Group name. It is a read only field


Amount
The text for amount received. Accepts value in the



format of currency (example 9999999999.99)


Comments
Choose the comments from the list provided


Others
Text for others. If the Comments is Others specify



other comment


Table
Display the Check distribution added for the batch.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add
Click the Add Link to add additional row for the



Check Distribution


Add
Click add button to add the content of check



distribution to the table. The Check distribution



amount should be equal to the check amount to add.



This is only a temporary addition. Becomes



permanent only on saving the record.


New
Click New to Create a new Batch entry


Save
Click Save to save the batch entry data.


Delete 
Click Delete to delete the batch entry record checked



for deletion. Becomes permanent only on saving the



record.


Close
Click Close button to close the batch data and



process auto reconciliation. Closing the batch is



possible only if Tape Balance is equal to zero.


Search 
Click search for searching the existing status of



Batch Data.









Credit Card Over Phone
The sequential steps involved in Credit card over phone are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Cash Receipts. Then select Credit Card Over Phone. (See FIG. D-17)
        Step—2: The screen navigates to Credit Card over phone screen to have transaction, credit card information and amount distribution details. (See FIG. D-18)
        Step—3: Enter the values in the fields as per the format briefed in fields' explanation table.
        Step—4: Click Save to save the content. Initially Process button will be disabled. Once the contents are saved, Process button is enabled to process the contents.
        Step—5: Click Process button to process the transaction. Once Process is click, both Save and Process buttons are disabled.
        Step—6: Click Search button to have the list of all transactions ids This pops up a search screen. (See FIG. D-19)
        Step—7: Enter the value in any one of the field or simply click search to perform search operation.
        Step—8: This navigates to a screen with search results. (See FIG. D-20)
        Step—9: Click a transaction id for selection to view/modify the content or otherwise click back to credit card over phone screen.
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description















Transaction Information








Transaction Id
The text for Transaction ID. This is auto generated



by the system


Transaction Date
The text for Transaction date. Choose a date by



clicking calendar icon. Date accepts the format



M/DD/YYYY.


Transaction Status
The text for Transaction Status. This is a read only



field. The system shows the transaction status based



on credit card authorization







Credit Card Information








Card Holder's
The text for cardholder's name. Accepts alphabets


Name
and space between two words.


Credit Card
The text for credit card number. Accepts numeric


Number
values not exceeding 30 digits


Credit Card Type 
Choose the type of credit card from the drop down



list available.


Expiration Date
Choose a month and year of expiration from the drop



down list available


First Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 25 characters.


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 35 characters.


Street Address
The text for company address. Accepts alphanumeric



and special characters not exceeding 35 characters


City
The text for city. Accepts alphabets and space



between two words not exceeding 30 characters.


State
Choose the name of the state from the drop down list



of States available in United States of America


Zip
Text for ZIP Code. Accepts numeric value of exactly



5 digits.


Payment Amount
Text for Payment Amount. Displays the amount due.







Amount Distribution








Group Id
Text for Group ID. Group ID accepts numeric value



of exactly 7 digits.


Group Name
Text for Group name. It is a read only field


Amount Due
Text for Amount Due. It is a read only field


Payment Amount
The text for amount received. Accepts value in the



format of currency (example 9999999999.99)


Remarks
Text for Remarks. Accepts 50 characters









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add
Click the Add Link to add additional row for the



Check Distribution


New
Click new to Create a new Credit Card over phone



entry


Save
Click Save to save the Credit Card over phone entry.


Process
Click Process to process the credit card transaction


Search
Click search for searching the existing Credit Card



Information entered.


Back
Click Back Button to go back to the Credit card over



phone screen.









4 Cash Reconciliation
Cash Reconciliation is the transaction module that encompasses the process of reconciling the invoices, cash receipts and adjustments for a specific group and member enrolled and invoiced in the PX2 System. Reconciled Cash can be disbursed to the Carriers, Agents, PacAdvantage and Benefit Partners. Normally cash reconciliation is an automated process. But under special circumstances when the Cash Receipts, Invoices and Adjustments do not match the reconciliation can be done manually using the Cash reconciliation Process.
Also it encompasses the history of billing and payment details.
Access
The application can be accessed from the main menu as follows:

    
    
        Finance→Cash Reconciliation→Manual Reconciliation
        
            →Billing & Payment History
        
        
    
    


Pre-Requisites
Billing, Cash Receipts entries should have occurred for reconciliation.
Enrollment—Refer User Manual for Enrollment for further information on the enrollment process. Real time information and the transaction on the Group and member is required for Reconciliation.
Application Functions
This application has the following functions:

    
    
        Manual Reconciliation.
        Billing & Payment History
    
    


Manual Reconciliation
The sequential steps involved in Manual Reconciliation are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Cash Reconciliation. Then select Manual Reconciliation (See FIG. D-21)
        Step—2: The screen navigates to Group Search screen. (See FIG. D-22)
        Step—3: Enter value in any one of the field or simply click Search button to perform search operation.
        Step—4: This pops up a screen with search result (See FIG. D-23)
        Step—5: Click on any group id for selection
        Step—6: Screen navigates to Cash Reconciliation. (See FIG. D-24)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Group Id
Text to display the Group ID, This is a read only



field


Group Name
Text to display the Group Name, This is a read only



field


Association Name
Text for Association Name. It is a read only field


Rate Type
Text for Rate Type. It is a read only field


Group Type
Text for Group Type It is a read only field


Left to Balance
Text to display the Left to Balance, This is a read



only field. This field is dynamically populated based



on the Check box selected for the reconciliation.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Search
Click Search to search for a new group for



processing reconciliation


Clear
Click Clear to Cancel and restore to the state as was



on loading the page


Post
Click Post Reconciliation to Post Reconciliation. If


Reconciliation
the Amount Left To Balance is within (+/−2) any



user can post reconciliation. If the Amount is



between $3.00 to $50.00 User with Level II



authorization only can post reconciliation. Amount



Between $51.00 to $100.00 User with Level III



authorization only can post reconciliation. For



amount greater than $100.00 User with Level IV



authorization only can post reconciliation.









Billing & Payments History
The sequential steps involved in billing and payment history are listed below

    
    
        Step—1: After successful logon, click the menu Finance and select Cash Reconciliation. Then Billing & Payments History. (See FIG. D-25)
        Step—2: Screen navigates group search. (See FIG. D-26)
        Step—3: Enter value in any one of the field or simply click search button to perform search operation.
        Step—4: This pops up a search result screen. (See FIG. D-27)
        Step—5: Click a group id for selection.
        Step—6: Navigates to history screen. (See FIG. D-28)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description















Group Information








Group Id
Text for Group ID. It is a read only field.


Group Type
Text for Group Type. It is a read only field.


Group Name
Text for Group Name. It is a read only field


Status
Text for Status. It is a read only field


Association Name
Text for Association Name. It is a read only field


Rate Type
Text for Rate Type. It is a read only field









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Search 
Click Search to search for billing and payments




history










5 Cash Disbursement
Cash disbursement consists of utility operations like commission disbursement and commission adjustment.
Access
The application can be accessed from the main menu as follows:

    
    
        Finance→Cash Disbursement→Commission disbursement
        
            →Commission adjustments
        
        
        All relevant transactional data pertaining to the group and member must be available for the cash disbursement.
    
    


Application Functions
This application has the following functions:

    
    
        Commission disbursement
        Commission adjustments
    
    


Commission Disbursement
The sequential steps involved in Agent Commission run are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Finance Operations. Select Disbursement and then select Commission Disbursement. (See FIG. D-29)
        Step—2: The screen navigates to Commission Disbursement Screen. (See FIG. D-30)
        Step—3: Choose Bill period from the drop down list. Click Process
        Step—4: Click View Status to have the details of Run ids generated. Search screen pops up. Enter value in any of the fields, or simply click Search button to perform search operation. (See FIG. D-31)
        Step—5: This pops up a screen with search result. Click any Run Id for selection to view the status of a particular run id. (See FIG. D-32)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Run Id
The text for Export ID. This is auto generated by the



system


Bill Period
The text for Export date. This is a read only field.


Run By
The text for Export Status. This is a read only field.



The system shows the Export status based on



premium transmission data export









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Process 
Click Process to start the bill run process for the all



the groups and member for the specified billing



period selected.


New
Click New to start new operation for the Bill Run.


Search
Click Search to navigate to Commission Billing Run



Status Search









Commission Adjustments
The sequential steps involved in Commission Adjustments are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Cash disbursement. Then select Commission Adjustments
        Step—2: The screen navigates to commission adjustment. (See FIG. D-33)
        Step—3: Choose a type of adjustment. (See FIG. D-34)
        Step—4: Choose an agent/agency id by clicking search icon. Agent name gets populated based on the selected value.
        Step—5: Enter adjustment amount. Then click save.
        Step—6: Click on search button yields the details of the adjustment ids created. (See FIG. D-35)
    
    


6 Finance Operations
Finance Operation consists of the utility operations within the finance module for various processes like Premium Transmission Data Output, Mail House Billing Data Output, Lockbox and EFT Exports, Credit Card Import and export, and Import Risk Adjustment Factors.
Access
The application can be accessed from the main menu as follows:

    
    
        Finance→Finance Operations→Premium Transmission
        
            →Billing
            →Cash Receipts
            →Risk Adjustment
        
        
    
    


Pre-Requisites
All relevant transactional data pertaining to the group and member must be available for the Finance Operations. To run this process, scheduler must be started.
Application Functions
This application has the following functions:

    
    
        Premium Transmission
        Mail House Billing
        Lock Box
        EFT Data Export
        Credit Card Export
        Credit Card Import
        Mail house Commission Data Export
        Risk Adjustment Import
    
    


Premium Transmission
The sequential steps involved in Premium Transmission are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Finance Operations. Then select Premium Transmission (See FIG. D-36)
        Step—2: The screen navigates to Transmission screen. (See FIG. D-37)
        Step—3: Choose the dates for transmit and comments if any. Click Export. Immediately, the export status will display the status as “In Progress”.
        Step—4: Click Search to know the status of the export ids generated. (See FIG. D-38)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Export Id
The text for Export ID. This is auto generated by the



system


Export Status
The text for Export Status. This is a read only field.



The system shows the Export status based on



premium transmission data export


Exported By
The text for Exported By. This is a read only field.


Export Date
The text for Export date. This is a read only field.


Transmit for the
Choose “Transmit for the following Dates From” by


following Dates
clicking calendar icon. The date can be in the format


From:
MM/DD/YYYY


Transmit for the
Choose “Transmit for the following Dates To” by


following 
clicking calendar icon. The date can be in the format


Dates To
MM/DD/YYYY


Table
Display the Transmission ID for the Carrier and



Carrier Name


Comments
The text for Comments.









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









New
Click New button to Create new Premium Data




Transmission



Export 
Click Export button to Export the Premium Data




Transmission based on the selection criteria



Search 
Click Search Button to Search for the Premium Data




Transmission and view the Export Status










Mail House Billing Data Export
The sequential steps involved in Mail House Billing Export Data are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Finance Operations. Select Billing and then select Mail House Billing Data Export. (See FIG. D-39)
        Step—2: The screen navigates to Mail House Billing screen. (See FIG. D-40)
        Step—3: Choose Export date and a group id for export. Click Export.
        Step—4: Click view status to know the status of export ids generated. Search screen pops up. Enter value in any of the field, or simply click search button to perform search operation. (See FIG. D-41)
        Step—5: Click back to navigate back to Mail House Billing screen. (See FIG. D-42)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description















Mail House Billing Data








Export Id
The text for Export ID. This is auto generated by the



system


Status
The text for Export Status. This is a read only field.



The system shows the Export status based on data



exported


Exported By
The text for Exported By. This is a read only field.


Export Date
The text for Export date. This is a read only field.


Export Date as of
Choose “Export Date as of” from the list of billing



period


Selected Groups
The text displays the selected group count based on



the invoice period. Example 0 to 100. It is a read



only field


Comments
The text for Comments.







Filter








Group Id
The text for group Id. Accepts numeric values only.


Group Name
The text for group name. Accepts any characters.


Group Type
Choose a group type from the drop down list



available


ROE Cycle Date
The text for ROE Cycle Date From. Choose from the


From
calendar icon in the format MM/DD/YYYY.


ROE Cycle Date
The text for ROE cycle end date. Choose from the


To
calendar icon in the format MM/DD/YYYY


Effective Date
The text for effective start date. Choose from the


From
calendar icon in the format MM/DD/YYYY


Effective Date To
The text for effective end date. Choose from the



calendar icon in the format MM/DD/YYYY


Group Size From
The text for group size and specifies the starting



range. Accepts numeric values only.


Group Size To
The text for group size and specifies the ending



range. Accepts numeric values only.


View Selected
Check the View Selected Check Box to view only



selected groups.


Table
Table displays the Groups selected based on the



Search and filter conditions.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Check All
(At Text Header) Check All link Checks all the



groups displayed.


Clear All
(At Text Header). Clear All link uncheck all the



groups that are checked


Filter
Click the Filter to display the Group based on the



search criteria/filter conditions provided.


Clear Filter
Clear the Content of the fields.


Check All
The “Check All” Link will check all the records in



the table


Clear All
The “Clear All” Link will uncheck all the records in



the table that are checked.


Check All on 
The “Check All on this Page” Link will check all the


this Page
records in the table on this Page


Invert Selection 
The Invert Selection Link will invert the selection



criteria for the check boxes. I.e. All Check Groups



would be unchecked and vice versa.


View Selected
Check the View Selected Check Box to view only



selected groups.


<<, <, >, >>
These buttons are used for navigating to the next and



previous records for viewing.



<< - Show first record (s)



< - Show previous record (s)



> - Show next record (s)



>> - Show last record (s)


New
Click New to start new operation on this screen


Save
Click Save to save the Content of the Mail House



Billing


View status
Click view status button to search the Status of the



Mail House Billing Process









Process Lock Box
The sequential steps involved in Lock Box are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Finance Operations. Select Cash Receipts and then select Lock Box. (See FIG. D-43)
        Step—2: The screen navigates to Import Lock Box screen. (See FIG. D-44)
        Step—3: On clicking Search Button enables to have a list of Import Ids. This pops up a search screen. (See FIG. D-45)
        Step—4: Enter value in any of the field or simply click search button to perform search operation. This navigates to a screen with search result. (See FIG. D-46)
        Step—5: Choose an Import ID for selection to alter the content or simply click back button to navigate back to Lockbox screen.
        Step—6: Enter the values in the respective fields, as per the formats specified in the field explanation table and click Import.
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.














Element
Description









Import Id
Read only field to display import id value



Status
Read only field to display the status of import



Import Date
Read only field to display the import date



Imported By
Read only field to display the user who imported the




files



Import File
Enter the file path or select the path by clicking




browse button. The field is mandatory



Batch Date 
Enter the date for Batch date or select a date by




clicking calendar icon. The field is mandatory.



Tape Total 
Text for tape Total. Enter the tape total. Accepts




numeric values in the format 9999999.99



Comment
Text for comments.










Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







New
Click on new button enables to have a new import of



Lockbox File.


Import 
Click on import button will perform the action of



importing the file selected.


Search 
Click on the Search button to search for the Lockbox



file import status.


Browse 
Click on the Browse button will enable to choose a



file to import









EFT Data Export
The sequential steps involved in EFT Data Export are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Finance Operations. Select Cash Receipts and then select EFT Data Export. (See FIG. D-47)
        Step—2: The screen navigates to EFT Data Export screen. (See FIG. D-48)
        Step—3: On clicking Search button leads to EFT Data Search screen to have all the Export Ids. (See FIG. D-49)
        Step—4: Enter the value in any one of the field or simply click search button to perform search operation. This pops up a screen with search results. (See FIG. D-50)
        Step—5: Choose an Export ID for selection, otherwise click Back button to navigate back to EFT Data Export.
        Step—6: Enter the values in the respective fields as per the format briefed under Fields' Explanation and click Export.
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description















Export EFT Data








Export Id
The text for Export ID. This is auto generated by the



system


Status
The text for Export Status. This is a read only field.



The system shows the Export status based on data



exported


Exported By
The text for Exported By. This is a read only field.


Export Date
The text for Export date. This is a read only field.


Export Date as of
Choose “Export Date as of” from the list of billing



period


Selected Groups
The text displays the selected group count based on



the invoice period. Example 0 to 100. It is a read



only field


Total Bill 
Text to display the total bill amount. This is read


Amount
only field


Comments
The text for Comments.







Filter








Group Id
The text for group Id. Accepts numeric values only.


Group Name
The text for group name. Accepts any characters.


Group Type
Choose a group type from the drop down list



available


ROE Cycle Date
The text for ROE Cycle Date From. Choose from the


From
calendar icon in the format MM/DD/YYYY.


ROE Cycle Date
The text for ROE cycle end date. Choose from the


To
calendar icon in the format MM/DD/YYYY


Effective Date
The text for effective start date. Choose from the


From
calendar icon in the format MM/DD/YYYY


Effective Date To
The text for effective end date. Choose from the



calendar icon in the format MM/DD/YYYY


Group Size From
The text for group size and specifies the starting



range. Accepts numeric values only.


Group Size To
The text for group size and specifies the ending



range. Accepts numeric values only.


View Selected
Check the View Selected Check Box to view only



selected groups.


Table
Table displays the Groups selected based on the



Search and filter conditions.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Exported date As
On Selecting the Exported date As on, shows all the


on
groups/members available for the specific period


Check All
(At Text Header) Check All link Checks all the



groups displayed.


Clear All
(At Text Header). Clear All link uncheck all the



groups that are checked


Filter
Click the Filter to display the Group based on the



search criteria/filter conditions provided.


Clear Filter
Clear the Content of the fields.


Check All
The “Check All” Link will check all the records in



the table


Clear All
The “Clear All” Link will uncheck all the records in



the table that are checked.


Check All on this
The “Check All on this Page” Link will check all the


Page
records in the table on this Page


Invert Selection
The Invert Selection Link will invert the selection



criteria for the check boxes. I.e. All Check Groups



would be unchecked and vice versa.


<<, <, >, >>
These buttons are used for navigating to the next and



previous records for viewing.



<< - Show first record (s)



< - Show previous record (s)



> - Show next record (s)



>> - Show last record (s)


New
Click New to start new operation on this screen


Export
Click Save to save the Content of the EFT Export


Commit
Click Commit to effect the EFT Payment


Search
Click on Search navigates to have EFT search


Back
Click Back navigates back to EFT payment screen









Credit Card Export
The sequential steps involved in Credit Card Export are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Finance Operations. Select Cash Receipts and then select Credit Card Export. (See FIG. D-51)
        Step—2: The screen navigates to Credit Card Export Screen (See FIG. D-52)
        Step—3: Choose export date and a group id. Click Export. This pops up a screen for confirmation to download. Click Ok. (See FIG. D-53)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description















Credit Card Export








Export Id
The text for Export ID. This is auto generated by the



system


Status
The text for Export Status. This is a read only field.



The system shows the Export status based on data



exported


Exported By
The text for Exported By. This is a read only field.


Export Date
The text for Export date. This is a read only field.


Export Date as 
Choose “Export Date as of” from the list of billing


of
period


Selected Groups
The text displays the selected group count based on



the invoice period. Example 0 to 100. It is a read



only field


Comments
The text for Comments.







Filter








Group Id
The text for group Id. Accepts numeric values only.


Group Name
The text for group name. Accepts any characters.


Group Type
Choose a group type from the drop down list



available


ROE Cycle Date
The text for ROE Cycle Date From. Choose from the


From
calendar icon in the format MM/DD/YYYY.


ROE Cycle Date
The text for ROE cycle end date. Choose from the


To
calendar icon in the format MM/DD/YYYY


Effective Date
The text for effective start date. Choose from the


From
calendar icon in the format MM/DD/YYYY


Effective Date 
The text for effective end date. Choose from the


To
calendar icon in the format MM/DD/YYYY


Group Size From
The text for group size and specifies the starting



range. Accepts numeric values only.


Group Size To
The text for group size and specifies the ending



range. Accepts numeric values only.


View Selected
Check the View Selected Check Box to view only



selected groups.


Table
Table displays the Groups selected based on the



Search and filter conditions.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Exported date As
On Selecting the Exported date As on, shows all the


on
groups/members available for the specific period


Check All
(At Text Header) Check All link Checks all the



groups displayed.


Clear All
(At Text Header). Clear All link uncheck all the



groups that are checked


Filter
Click the Filter to display the Group based on the



search criteria/filter conditions provided.


Clear Filter
Clear the Content of the fields.


Check All
The “Check All” Link will check all the records in



the table


Clear All
The “Clear All” Link will uncheck all the records in



the table that are checked.


Check All on 
The “Check All on this Page” Link will check all the


this Page
records in the table on this Page


Invert Selection
The Invert Selection Link will invert the selection



criteria for the check boxes. I.e. All Check Groups



would be unchecked and vice versa.


<<, <, >, >>
These buttons are used for navigating to the next and



previous records for viewing.



<< - Show first record (s)



< - Show previous record (s)



> - Show next record (s)



>> - Show last record (s)


New
Click New to start new operation on this screen


Save
Click Save to save the Content of the Credit Card



Export









Credit Card Import
The sequential steps involved in Credit Card Import are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Finance Operations. Select Cash Receipts and then select Credit Card Import. (See FIG. D-54)
        Step—2: The screen navigates to Credit Card Import Screen. (See FIG. D-55)
        Step—3: Choose a file to import by clicking Browse button. The file should be in the format of .txt
        Step—4: Click Import button to import the selected file. If the file selected is imported successfully, status will show imported.
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.














Element
Description









Import Id
Read only field to display import id value



Status
Read only field to display the status of import



Import Date
Read only field to display the import date



Imported By
Read only field to display the user who 




imported the files



Import File
Enter the file path or select the path by clicking




browse button. The field is mandatory



Comments
Text for Comments










Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







New
Click on new button enables to have a new import of



Credit Card File.


Import 
Click on import button will perform the action of



importing the file selected.









Mail House Commission Data Export
The sequential steps involved in Agent Commission run are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Finance Operations. Select Cash Receipts and then select Mail house Commission data export. (See FIG. D-56)
        Step—2: The screen navigates to Mail House Commission Data Export Screen (See FIG. D-57)
        Step—3: Choose export date and group id to be exported. Click Export.
        Step—4: Click view status to have the status details of export ids generated. Search screen pops up. Enter value in any of the field or simply click search button to perform search operation. (See FIG. D-58)
        Step—5: This pops up a screen with search result. Click Back to navigate back to Mail house commission data export screen. (See FIG. D-59)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description















Cheque Billing








Export Id
The text for Export ID. This is auto generated by the



system


Status
The text for Status. This is a read only field. The



system shows the Export status based on premium



transmission data export


Exported By
The text for Exported By. This is a read only field.


Export Date
The text for Export date. This is a read only field.


Exported date As 
On Selecting the Exported date As on, shows all the


on
groups/members available for the specific period


Selected Groups
Displays the number of groups selected from the


Of
total number of available groups


Comments
The text for Comments.







Filter








Agent/Agency Id
Text for agent/agency id. Accepts numeric values of



not exceeding 10 digits


Agent/Agency
Choose either agent or agency to incorporate names


Agent First Name 
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 25 characters. Field is mandatory


Agent Last Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 35 characters. Field is mandatory


Agency Legal



Name



View Selected
Check the View Selected Check Box to view only



selected groups.


Effective Date
The text for effective start date. Choose from the


From
calendar icon in the format MM/DD/YYYY


Effective Date To
The text for effective end date. Choose from the



calendar icon in the format MM/DD/YYYY


Check All
The “Check All” Link will check all the records in



the table


Clear All
The “Clear All” Link will uncheck all the records in



the table that are checked.


Check All on this
The “Check All on this Page” Link will check all the


Page
records in the table on this Page


Invert Selection 
The Invert Selection Link will invert the selection



criteria for the check boxes. I.e. All Check Groups



would be unchecked and vice versa.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







New
Click New to start new operation on this screen


Export
Click Export button to Export the check billing data



based on the selection criteria


Search
Click Search Button to Search for the check billing



data and view the Export Status


Filter
Click the Filter to display the Group based on the



search criteria/filter conditions provided.


Clear Filter
Clear the Content of the fields.









Risk Adjustment
The sequential steps involved in Risk Adjustment Import are listed below.

    
    
        Step—1: After successful logon, click the menu Finance and select Finance Operations. Select Risk Adjustment and then select Risk Adjustment Import. (See FIG. D-60)
        Step—2: The screen navigates to Import Risk Adjustment Factor. (See FIG. D-61)
        Step—3: Choose a file to import by clicking Browse button. The file format should be of .txt Click Import to import the selected file.
        Step—4: Click search button to know the status of import ids generated. This pops up a search screen, where the enter any value in one of the field or simply click search to perform search operation.
        Step—5: This pops up a screen with search result. Click on any import id to view the contents or otherwise click Back button to navigate back to Import Risk Adjustment Factor screen. (See FIG. D-62)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Import Id
Read only field to display import id value


Import Status 
Read only field to display the status of import


Imported By
Read only field to display the user who imported the



files


Import Date
Read only field to display the import date


Import File
Enter the file path or select the path by clicking



browse button. The field is mandatory


Effective Date
Enter the date for Effective date or select a date by



clicking calendar icon. The field is mandatory.









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









New
Click on new button enables to have a new import 




of Risk Adjustment Factor File.



Import
Click on import button will perform the action of




importing the file selected.



Search
Click on the Search button to search for the Risk




Adjustment file import status.










PX2 User Manual
Others
1 Introduction
Others encompass the modules like Search Zip, Call Tracking, Manual Mail Merge, Report and Letter Regeneration.
The Applications
Search Zip—. Search Zip provides basically two types of searches. First it analyses the zip codes provided namely zip1 and zip2 and provides the distance between the two locations. Another one is search can be made either by entering zip code, county or city
Call Tracking—. Call Tracking is used to track the calls that are made or received with specific business intension. It can be inbound (calls received) or outbound (calls made). It also has a feature for identifying task on hand for the calls as “To do List”
Manual Mail Merge—. The Mail Merge module addresses the functionality of the system where it needs to generate business correspondences using predefined templates. The templates are basically RTF files with placeholders for dynamic data in them. The output is usually a RTF file, but at times this could be a PostScript or a PDF document
Letter Regeneration—. The Letter Regeneration is mainly to generate letters as per the templates provided. The templates can be selected based on the selected criteria, namely Group, Employee, Agent and Dependent.
Reports—. Report Module encompasses the process of displaying the business information to the viewers. The objective of the Reports is to provide information captured in the system to the user in a presentable manner. The reports can be single, two-dimensional and multi dimensional providing the information to the decision-maker
2 Search Zip
Search Zip provides basically two types of searches. First it analyses the zip codes provided namely zip1 and zip2 and provides the distance between the two locations. Entering zip code, county or city can make another one is search.
Access
The application can be accessed from the main menu as follows:

    
    
        Others→Search Zip
    
    


Pre-Requisites
Zip search provides the distance between the two zip codes and also search can be made by either on zip code, county or city.
Application Functions
The application consists of only one screen.

    
    
        Zip Search—to arrive the distance of two zip codes and also to have a search either on zip code, county or city.
    
    


Search Zip
Zip search provides the distance between the two zip codes and also either on zip code, county or city can make search.

    
    
        Step—1: After successful logon, click the menu Others and Search Zip. (See FIG. E-1)
        Step—2: Choose any one from the options [City, County, Zip] and enter corresponding value in the text field. Entry to this field is mandatory, before clicking Search button.
        Step—3: This pops up a screen with search results. (See FIG. E-2)
        Step—4: Enter zip code1 and zip code2, as per field explanation provided in Fields Explanation table. Also choose the search option from City/County/Zip. Click Search. (See FIG. E-3)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields











Element
Description







Zip1
Enter the value for zip1. Accepts numeric 



values of 5 digits.


Zip2
Enter the value for zip1. Accepts numeric 



values of 5 digits. Both zip1 and zip2



cannot have the same value.


Distance 
The text displays the distance between zip1 


between zip1
and zip2


and zip is



City
Choosing the value of the radio button for city 



for the text typed in the search box will display 



matched records. The text entered for this 



search should be alpha.


County
Choosing the value of the radio button for 



county for the text typed in the search box will 



display matched records. The text entered for 



this search should be alpha.


Zip
Choosing the value of the radio button for zip 



for the value typed in the search box will display 



matched records. The value entered for this 



search should be numeric with 5 digits.









Button Functionality
The following table provides explanation for each button in the screen














Element
Description









Search
Click on the search button will search based on the




selection of the radio button value for the text entered




in the search box. Search box should not be empty.



Cancel
Click on the cancel button to clear the data entered on




the screen and focus on the same screen to proceed.



Print
Click on Print will print the contents of the table




generated based on the search criteria.



Go button
Click on the go button to analyze the zip codes 




entered for their availability and displays the result 




for the valid zip codes.










3 Call Tracking
Call Tracking is used to track the calls that are made or received with specific business intension. It can be inbound (calls received) or outbound (calls made). It also has a feature for identifying task on hand for the calls as “To do List”.
Access
The application can be accessed from the main menu as follows:

    
    
        Others→Call Tracking
        
            →To Do List
        
        
    
    


Pre-Requisites
Group & Agent information must be available in the system. as a pre-requisite
Application Functions
This application has the following functions:

    
    
        Call Tracking—to keep track of information received from group/agent
        To Do List—gives a list of task to be performed
    
    


Call Tracking

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Call Tracking. Then select call tracking. (See FIG. E-4)
        Step—2: Screen navigates to Call Tracking screen. (See FIG. E-5)
        Step—3: Select a value for call type from the list available Choose. Group/Agent Id by clicking search icon. (See FIG. E-6)
        Step—4: On clicking search icon, a search screen pops up. Search operation can be performed either based on the inputs or even if the fields are empty. (See FIG. E-7)
        Step—5: Click on group id for selection
        Step—6: Enter the value of the fields, as per the format briefed in field's explanation section
        Step—7: Click save button.
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Call Type
Choose a type of call from the drop down list 



available


Referenced Entity
Choose an entity from either Group or Agent. 



Group is the default selected value


Group Id
The text for group id. Choose a group id by 



clicking search icon. It is valid only if the 



option of referenced entity is group. 



The field is mandatory


Agent Id
The text for agent id. Choose an agent id by 



clicking search icon. It is valid only if the 



option of referenced entity is agent. 



The field is mandatory


Caller Name
The text for caller name Accepts alphabets 



and special characters like hyphen and single 



quotes not exceeding 35 characters.



Field is mandatory


Nature of Call
Choose a nature of call from the drop down 



list available. Field is mandatory


Other
The text for others. It accepts alphanumeric 



values. The field is active only if the value of 



nature of call is other


Date & Time
The text for date and time. It is a system 



generated value and it is read only


Follow-up required
Click the check box, if the follow-up is 



required


Follow-up Date
The text for follow-up date. Choose a date in 



the format MM/DD/YYYY by clicking 



calendar icon. It is mandatory only if the



follow-up value is clicked.


Comment
The text for comments. Accepts alphanumeric 



and special characters except double quotes of 



maximum length 255 characters









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Save
Saves the entered information not only for the 




present screen.



Search
Clears the screen and perform search operation 




based on the input value for group/agent.



Cancel
Clears the contents entered in the fields or restore 




to the previous state as was before saving the 




changes.










To do List

    
    
        Step—1: After successful logon, click the menu Others and select Call Tracking. Then select To Do List. (See FIG. E-8)
        Step—2: Screen navigates to “To Do” List screen.
        Step—3: Choose call type. Enter date for either follow-up date or called date. Click Search. (See FIG. E-9)
        Step—4: This pops up a screen with search result. (See FIG. E-10)
        Step—5: On selecting an entity by clicking the check box, it means that the status is going to be changed.
        Step—6: On clicking save it will ask for confirming the change in status. Once it is confirmed the task is completed and get removed from the list.
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Call Type
Choose a type of call from the option of 



inbound and outbound. The default value 



selected is inbound


Follow-up Date
The text for follow-up date. Choose a date 



in the format MM/DD/YYYY by clicking 



calendar icon. provided the option of 



follow-up-date is selected


Called Date
The text for called date. Choose a date in 



the format MM/DD/YYYY by clicking 



calendar icon, provided called date is selected









Button Functionality
The following table provides explanation for each button in the screen.














Element 
Description









Save
Saves the entered information not only for the 




present screen.



Search
Clears the screen and perform search operation 




based on the input value for group/agent.



Cancel
Clears the contents entered in the fields or 




restore to the previous state as was before 




saving the changes.



Close
Close the window.










4 Manual Mail Merge
The Mail Merge module addresses the functionality of the system where it needs to generate business correspondences using predefined templates. The templates are basically RTF files with placeholders for dynamic data in them. The output is usually a RTF file, but at times this could be a PostScript or a PDF document
Access
The application can be accessed from the main menu as follows:

    
    
        Others→Manual Mail Merge
    
    


Pre-Requisites
All the pre-defined templates for generating business correspondence must be available for generating the same.
Application Functions
This application has the following functions:

    
    
        Mail Merge—to generate business correspondence as per the available templates.
    
    


Manual Mail Merge
The screen is to generate business correspondence.
The sequential steps involved in manual mail merge are listed below.

    
    
        Step—1: After successful logon, click the menu others select Manual Mail Merge. (See FIG. E-11)
        Step—2: Navigates to a screen wherein a category has to be selected. Based on the selected category, the templates pertaining to that category will be displayed for generating business correspondence. (See FIG. E-12)
        Step—3: Choose a template id for generating the business correspondence. (See FIG. E-13)
        Step—4: This navigates to a screen, which has mainly three headings stating about the details of Template information, the category selected and the output option. The header that contains the fields based on the selected category, are all dynamically generated. to have search operation. (See FIG. E-14)
        Step—5: The content of the fields based on the category selected, has to be selected by search icon. Enter any value or first letter in any one of the fields to perform search operation. Click search icon. (See FIG. E-15)
        Step—6: This pops up a screen with search result. (See FIG. E-16)
        Step—7: Click on any hyperlink for selection.
        Step—8: Choose the output option. If the option is View the user can a view of the business letter generated from the chosen template or otherwise if the option is Print to Mailroom will queue the business correspondence generated to printer. A pop up screen will appear stating the status of mail merge. (See FIG. E-17)
        Step—9: On clicking Ok button, screen navigates to word document as follows: (See FIG. E-18)
    
    


5 Letter Regeneration
Letter Regeneration is used to generate letters for a specific period with specific type of letter say Add On, Termination etc., with specific addressee say Employee, Group, Dependent etc.,
Access
The application can be accessed from the main menu as follows:

    
    
        Others→Letter Regeneration
    
    


Pre-Requisites
Relevant information must be available in the system as a pre-requisite
Application Functions
This application has the following functions:

    
    
        Letter Regeneration—to generate letters with specific request
    
    


Letter Regeneration

    
    
        Step—1: After successful logon, click the menu Others and then Letter Regeneration. (See FIG. E-19)
        Step—2: Screen navigates to Letter Regeneration screen.
        Step—3: Enter the values in the respective field as per the format explained in fields' explanation table.
        Step—4: Based on the selected value in Address Type, will allow to have search operation for address, by clicking the search icon. (See FIG. E-20)
        Step—5: By clicking the search icon for addressee, search screen displays, for the selected value in address type.
        Step—6: Select an employee id. The selected employee name gets reflected in Letter Regeneration screen. (See FIG. E-21)
        Step—7: According to the inputs, the templates will be displayed by clicking Search button to generate a letter. If no option is selected and simply clicking search button will display all the templates.
        Step—8: Click on any template for selection to generate a letter.
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.














Element
Description









Letter generated
The text for From date to generate a letter. 



between
Choose a date in the format MM/DD/YYYY by 




clicking calendar icon provided



And
The text for To date to generate a letter. Choose 




a date in the format MM/DD/YYYY by clicking 




calendar icon provided



Type of letter
Choose a type of letter from the drop down list




available namely, Add On, Termination, Missing 




Info, Others



Addressee type
Choose a type of addressee from the drop down 




list available namely, Group, Employee, 




Dependent, Agent. This field is mandatory.



Addressee
Based on the selected value of addressee type, 




will restrict to choose a addressee by clicking the 




search icon.



Addressee name
Text for addressee name. This is a read only field.




Data is populated by selecting an addressee by 




clicking search icon.










Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Search
Clears the screen and perform search operation 




based on the input value.



Clear
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes.










6 Reports
Reports Module encompasses the process of displaying the business information to the viewers. The objective of the Reports is to provide information captured in the system to the user in a presentable manner. The reports can be single, two-dimensional and multi dimensional providing the information to the decision-maker.
Reports are categorized based on the modules and the purpose of the reports.
Access
The application can be accessed from the main menu as follows:

    
    
        Others→Reports
    
    


Pre-Requisites
All the master and transactional data must be available in the system to display the real time reporting feature.
Application Functions
This application has the following functions:

    
    
        Generate—to generate reports
    
    


Report
The screen is to generate report
The sequential steps involved in generating a report are listed below.

    
    
        Step—1: After successful logon, click the menu Others select Report. (See FIG. E-22)
        Step—2: The screen navigates to report heading, which are identified as major headings to cover all the information. (See FIG. E-23)
        Step—3: Choose any heading. Click (+) to expand and (−) to collapse. Screen displays the sub-headings under each major heading. (See FIG. E-24)
        Step—4: Choose any sub-heading to have report.
        Step—5: Navigates to a screen for entering the query criteria. These fields are built dynamically based on the report sought. (See FIG. E-25)
        Step—6: Enter the search criteria as available on the screen and Click Generate Report. Click on the back button to navigated back to the Report Screen.
        Step—7: Opens up a new browser window and displays the report in the crystal viewer. (See FIG. E-26)
    
    


PX2 User Manual
Sales & Marketing
1 Introduction
Sales and Marketing is the master and transaction module that encompasses the process of creating and maintaining master and transaction information that is required for the PX2 System like Agent, Agency, Lead, Quotes, Work Group, Associates, Supplier request, Lead and Agent Tracking and Campaign.
The Applications
The above-mentioned processes are accomplished in several applications embedded into the Sales and Marketing Module. These applications steer the tasks of creating, and maintaining master and transaction information for the PX2 entities, thereby helping achieve the goals of the Sales and Marketing.
Supply Request—A Supply Request is the process of ordering the handbooks, rate books, forms and application, complementary, super directories that are sent to the employer groups and its members through the mailroom. Supplier Request basically consists of Internal Supplier request to cater to the internal needs of the BPI and External Supplier request to cater to the external needs of the BPI.
Work Groups—Workgroups is the process of categorization of a group of agents, internal working personnel of BPI, external working personnel associated with BPI into a subset of work groups.
Associates—The Associated is the process of identifying and managing the personnel who are employed by BPI and work with BPI.
Campaign—A campaign is the process of identifying a segment of potential employer groups targeted through the media like the radio, newspaper, mailers etc. Benefit Partners organizes for the marketing campaigns through third parties or by itself periodically.
Sales Master—Sales Master is the process of maintaining the entire master records relevant to the Sales. This includes operations like creation and maintenance of Agent, Agency, Lead Masters, Lead Tracking, and Agent Profiles.
Quotes—Quotes are the processes of providing Quotes for potential business entities as well as existing business entities. Quotes can be requested for small Employer Groups or Alternate Groups (Individual Association Member, Association Group, COBRA etc.) as well as for employees of those groups.
2 Supply Request
Supplier request is to setup basic information for ordering various Handbooks, stationeries and other materials needs by BPI for their day to day business in the PX2 system Supplier Request are of two types, Internal and External
Access
The application can be accessed from the main menu as follows:

    
    
        Sales & Marketing→Supply Request→Internal Supply Request
        Sales & Marketing→Supply Request→External Supply Request
        Sales & Marketing→Supply Request→Confirm Internal
        Sales & Marketing→Supply Request→Confirm External
    
    


Pre-Requisites

    
    
        Both internal and external supplier request contains header and the items (As Stock # in the header and Items below). The data for the Stock # and the Items are available in the tables TBL_BPICAS_CODE_CTRL and TBL_BPICAS_UTIL.
        Table TBL_BPICAS_CODE_CTRL has CODE_ID, CODE_VALUE and CODE_DESC
    
    


The table needs to be populated to have the Stock # on the screen
Example Data















CODE_ID
CODE_VALUE
CODE_DESC









EXTERNAL
PSP
Pre-Selected package



EXTERNAL
HB
Hand Book



INTERNAL
SOS
Standard Office Supply










    
    
        Table TBL_BPICAS_UTIL has REQUEST_TYPE, SUB_CLASS, UTIL_NAME and UTIL_DESC
    
    


The table needs to be populated to have the Items on the screen
Example Data













REQUEST_TYPE
SUB_CLASS 
UTIL_NAME
UTIL_DESC







EXTERNAL
HB
DNH
Dental Hand





Book


INTERNAL
SOS
BR
Binder Clips





Small









Application Functionality
The application consists of two screens.
Internal Supply Request—to have internal supply request
External Supply Request—to have external supply request
Internal Supply Request

    
    
        Step—1: After successful login, click Supply Request then select Internal Supply Request. (See FIG. F-1)
        Step—2: Navigates to Internal Supply Request screen. Entry in one quantity field is mandatory. Also confirmation can be accessed by clicking confirmation tab. (See FIG. F-2)
        Step—3: On clicking Save navigates Confirmation screen. (See FIG. F-3)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.














Element
Description









Qty
Enter the value for quantity. Accepts only numeric




values. At least one value for quantity is mandatory.



Special
Enter the text for special instructions. Accepts



Instructions
alphanumeric and special characters not exceeding 




255 characters. The field is optional.










Button Functionality
The following table provides explanations for each of the screen fields.














Element
Description









Save button
Click on save button to the save the content keyed 




in and navigates to confirmation screen displaying




the Confirmation ID.



Cancel button
Click on clear button clears the content and appears




again for fresh entries










External Supply Request

    
    
        Step—1: After successful login, click Supply Request then select External Supply Request. (See FIG. F-4)
        Step—2: Navigates to External Supply Request screen. Entry in one quantity field is mandatory. Also confirmation can be accessed by clicking confirmation tab. (See FIG. F-5)
        Step—3: On clicking Save navigates to Confirmation screen. (See FIG. F-6)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Qty
Enter the value for quantity. Accepts only numeric



values. At least one value for quantity is mandatory.


Customer Request
Enter a date or click calendar icon to select a date. 


Date
The field is mandatory.


Confirm fulfillment
Choose the option by ticking the checkbox to have 


by Email
a confirmation of request made by email.


Agent/Employer
Enter the value for agent/employer group id. The 


Group Id
field is mandatory. Or Choose the Agent or Group 



by clicking the Search Icon


Company Name
Enter the text for company name. The field is



mandatory


Address
The text for company address. Accepts 



alphanumeric and special characters not 



exceeding 35 characters


Suite
The text for company suite Accepts alphanumeric 



and special characters not exceeding 35 characters


City
The text for city. Accepts alphabets and space 



between two words not exceeding 30 characters. 



The field is mandatory


State
Choose a state from the drop down list. The field 



is mandatory


Referenced Entity
Choose the option either Group or Agent


Zip
The text for zip. Accepts numeric value of exactly 



5 digits.


Ship via
Choose the option of delivery from the available 



modes like Mailroom, Will Call,


Special Instructions
Enter the text for special instructions. Accepts



alphanumeric and special characters not exceeding 



255 characters.









Button Functionality
The following table provides explanations for each of the screen fields.











Element
Description







Save button
Click on save button to the save the content keyed in



and navigates to confirmation screen displaying the



Confirmation ID.


Cancel button
Click on clear button clears the content and appears



again for fresh entries









3 Work Groups
Work Group is to setup basic information like Category, Work Group and Child Work Group. Workgroups is the concept of categorization of a group of agents, internal working personnel of BPI, external-working personnel associated with BPI into a subset of work groups. Also this provides a feature of swapping the members within the work group.
Access
The application can be accessed from the main menu as follows:

    
    
        Sales & Marketing→Work Groups→Category
        Sales & Marketing→Work Groups→Main Workgroup
        Sales & Marketing→Work Groups→Child Workgroup
        Sales & Marketing→Work Groups→Mail Members
        Sales & Marketing→Work Groups→Swap Members
    
    


Pre-Requisites
There are no pre-requisites for using this application.
Application Functions
This application has the following functions:

    
    
        Category—To Create, Modify and view Category
        Main Workgroup—To Create, Modify and view Main Workgroup
        Child Workgroup—To Create, Modify and view Child Workgroup
        Mail Members—To Create, Modify and view Mail Members
        Swap Members—To Swap members between source and destination work groups
    
    


Category

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Work Groups. Then select Category. (See FIG. F-7)
        Step—2: Screen navigates to category screen. Enter the category name with its description as per the format briefed in field's explanation section. (See FIG. F-8)
        Step—3: Click Add button to have a temporary storage.
        Step—4: Select a category name by clicking Edit button to modify a category name. (See FIG. F-9)
        Step—5: Change any modifications and click Update
        Step—6: Click Save button to save the contents
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Name
The text for category name. Accepts alphabets and



numeric and “/ ” values not exceeding 30 characters.



Entry to this field is mandatory.


Description
The text for category description. Accepts alphabets



and numeric and special characters except double



quotes with values not exceeding 255 characters.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add
Add the contents of category. It is only a temporary



addition. Becomes permanent record only after saving


Edit
Edit button will allow for editing a specific record in



the table.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent record only after saving


Update
Update the contents of category. It is only a temporary



update. Becomes permanent record only after saving


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


Print
The Print will pops up a screen displaying the content



of the table created and enables the user to have print



out of the same.


Save
Saves the entered category in the database. The page



gets refreshed and the contents entered in the fields



are shown.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes.









Main Workgroup

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Work Groups. Then select Main Workgroup. (See FIG. F-10)
        Step—2: Screen navigates to main workgroup screen. Choose a category name. Enter the main workgroup name with its description and also select the option whether it is a child work group or main work group, as per the format briefed in field's explanation section. (See FIG. F-11)
        Step—3: Click Add button to have a temporary storage.
        Step—4: Select a main workgroup name by clicking Edit button to modify a main workgroup name. (See FIG. F-12)
        Step—5: Change any modifications and click Update
        Step—6: Click Save button to save the contents
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Category
Choose a category from the drop down list available


Name
The text for main workgroup name. Accepts alphabets



and numeric values not exceeding 30 characters.



Entry to this field is mandatory.


Description
The text for main workgroup description. Accepts



alphabets and numeric and all special characters



except double quotes with values not exceeding 255



characters. Field is optional


Is this a child
Choose this option, if the main work group is also a


workgroup
child work group









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add
Add the contents of main workgroup. It is only a



temporary addition. Becomes permanent record only



after saving


Edit
Edit button will allow for editing a specific record in



the table.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent record only after saving


Update
Update the contents of main workgroup. It is only a



temporary update. Becomes permanent record only



after saving


Check All
The “Check All” Link will check all the records in the



table


Clear All 
The “Clear All” Link will uncheck all the records in the



table that are checked.


Print
The Print will pops up a screen displaying the content



of the table created and enables the user to have print



out of the same.


Save
Saves the entered main workgroup in the database.



The page gets refreshed and the contents entered in



the fields are shown.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes.









Child Workgroup

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Work Groups. Then select Child Workgroup. (See FIG. F-13)
        Step—2: Screen navigates to child workgroup screen. Choose a main workgroup. Enter the child workgroup name with its description, as per the format briefed in field's explanation section. (See FIG. F-14)
        Step—3: Click Add button to have a temporary storage.
        Step—4: Select a child workgroup name by clicking Edit button to modify a child workgroup name. (See FIG. F-15)
        Step—5: Change any modifications and click Update
        Step—6: Click Save button to save the contents
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Main workgroup
Choose a main workgroup from the drop down 



list available


Name
The text for child workgroup name. Accepts 



alphabets and numeric values not exceeding 30 



characters.



Entry to this field is mandatory.


Description
The text for child workgroup description. Accepts



alphabets, numeric and special character except



double quotes not exceeding 255 characters. 



Field is optional









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add
Add the contents of child workgroup. It is only a



temporary addition. Becomes permanent record only



after saving


Edit
Edit button will allow for editing a specific record in



the table.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent record only after saving


Update
Update the contents of child workgroup. It is only a



temporary update. Becomes permanent record only



after saving


Check All
The “Check All” Link will check all the records in the



table


Clear All
The “Clear All” Link will uncheck all the records in the



table that are checked.


Print
The Print will pops up a screen displaying the content



of the table created and enables the user to have print



out of the same.


Save
Saves the entered Child Workgroup in the database.



The page gets refreshed and the contents entered in



the fields are shown.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes.









Mail Members

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Work Groups. Then select Mail Members. (See FIG. F-16)
        Step—2: Screen navigates to mail member's screen. Choose a child workgroup Enter the mail id, as per the format briefed in field's explanation section. (See FIG. F-17)
        Step—3: Click Add button to have a temporary storage.
        Step—4: Selecting a mail member and clicking Edit button to modify a mail member name. (See FIG. F-18)
        Step—5: Change any modifications and click Update
        Step—6: Click Save button to save the contents
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Child workgroup
Choose a child workgroup from the drop down 



list available


Mail Id
The text for mail id. Accepts alphabets, numeric 



and special characters in the standard email 



format of length not exceeding 100 characters 



Entry to this field are mandatory.









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Add
Add the contents of mail member. It is only a




temporary addition. Becomes permanent record only




after saving



Edit
Edit button will allow for editing a specific record in




the table.



Delete
Delete button will delete the records in the table




checked for deletion. It is only a temporary deletion.




Becomes permanent record only after saving



Update
Update the contents of mail member. It is only a




temporary update. Becomes permanent record only




after saving



Check All
The “Check All” Link will check all the records in 




the table



Clear All
The “Clear All” Link will uncheck all the records in 




the table that are checked.



Print
The Print will pops up a screen displaying the content




of the table created and enables the user to have print




out of the same.



Save
Saves the entered Mail Members in the database. The




page gets refreshed and the contents entered in the




fields are shown.



Cancel
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes.










Swap Members

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Work Groups. Then select Swap Members. (See FIG. F-19)
        Step—2: Screen navigates to swap members screen. Choose a category, source child group and destination child group to swap members. Also select from the options, whether swap is to be full, partial or duplicate. (See FIG. F-20)
        Step—3: Click Search to list the members for swapping from the Source work group to the destination work group.
        Step—4: Select the members for swapping and click Swap to swap the members from Source Work group to the destination Work Group.
        Step—5: Change any modifications and click Update
        Step—6: Click Save button to save the contents
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.














Element
Description









Choose Category
Choose the Category from the list. List all 




the Child Work Group for the specific 




Category selected.



Choose Source
Choose the Source Child Work group from 



Child Work group
the list 



Choose Destination 
Choose the Destination Child Work group 



Child Work group
from the list



Do you want to do 
Choose the Option Full, Partial or Duplicate 



a full swap or a
Default value of selection is Full



partial swap?










Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Search
Click the search button to list the Member belonging




to the Source Work Group for swapping. Based on 




the Option, Full, Partial or Duplicate the Check box 




is enabled or disabled. Say for Full the Check box is




disabled and the others the check box is enabled.



Swap
Click Swap to swap the member from Source to




Destination Child Work Group



Check All
The “Check All” Link will check all the records in 




the table



Clear All
The “Clear All” Link will uncheck all the records in 




the table that are checked.










4 Associates
An associate is to setup basic information of associates working with BPI in the PX2 System. Associates can be of two types, Internal and External.
Access
The application can be accessed from the main menu as follows:

    
    
        Sales & Marketing→Associates
    
    


Pre-Requisites
Work of Category Internal or External must be available in the system for Assigning associated work group.
Application Functions
This application has the following functions:

    
    
        Associate—To Create, Modify and Delete Associates
    
    


Associate

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Associates. (See FIG. F-21)
        Step—2: Screen navigates general information. Choose associate type as either internal or external. (See FIG. F-22)
        Step—3: Enter the values in the respective fields, as per the format briefed in field's explanation section.
        Step—4: Choose an available workgroup and assign it by clicking>>button. Then enter the value of license number if applicable.
        Step—5: Click Add button to have a temporary storage
        Step—6: Select an associate and click Edit button to modify an associate name. (See FIG. F-23)
        Step—7: Change any modifications and click Update
        Step—8: Click Save button to save the contents
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Associate Type
Choose a type from either Internal or External.



Default value selected is External


Salutation
Choose the salutation from the drop down list of



salutations available.


First Name
The text for associate first name. Accepts alphabets



and special characters like hyphen and single quotes



not exceeding 25 characters. This field is mandatory


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for associate last name. Accepts alphabets



and special characters like hyphen and single quotes



not exceeding 35 characters.


Suffix
Choose the suffix from the drop down list of 



suffixes available.


Title
The text for title. Accepts alphabets, numeric and



special characters except single quotes not 



exceeding 255 characters.


Address
The text for associate address. Accepts alphanumeric



and special characters not exceeding 35 characters


Suite
The text for associate suite Accepts alphanumeric 



and special characters except double quotes not 



exceeding 35 characters


City
The text for city. Accepts alphabets and space 



between two words not exceeding 30 characters.









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Add
Add the contents of associates. It is only a temporary




addition. Becomes permanent record only after saving



Edit
Edit button will allow for editing a specific record in




the table.



Delete
Delete button will delete the records in the table




checked for deletion. It is only a temporary deletion.




Becomes permanent record only after saving



Update
Update the contents of associate. It is only a temporary




update. Becomes permanent record only after saving



Check All
The “Check All” Link will check all the records in the




table



Clear All
The “Clear All” Link will uncheck all the records in 




the table that are checked.



Print
The Print will pops up a screen displaying the content




of the table created and enables the user to have print




out of the same.



Save
Saves the entered associate in the database. The page




gets refreshed and the contents entered in the fields




are shown.



Cancel
Clears the contents entered in the fields or restore to




the previous state as was before saving the changes.










5 Campaign
A marketing campaign is an initiative where an identifiable segment of potential employer groups are targeted and organizes for the marketing campaigns through third parties or by BPI PacAdvantage periodically.
The details of a campaign initiative are captured in the system through the campaign master the campaign master provides information on the campaign, duration and the personnel associated with the campaign. The media through which a campaign is done is captured in the system using the source type and source subtype.
Access
The application can be accessed from the main menu as follows:

    
    
        Sales & Marketing→Campaign→Source Type
        Sales & Marketing→Campaign→Source Sub Type
        Sales & Marketing→Campaign→Campaign
        Sales & Marketing→Campaign→Campaign Search
    
    


Pre-Requisites
There are no pre-requisites for using this application.
Application Functions
This application has the following functions:
Source Type
Source Sub Type
Campaign
Campaign Search
Source Type
The source type defines the media through which a campaign can be conducted. The screen provides functionality to save, edit or add new source type.
The sequential steps involved in the creation of a source type are listed below

    
    
        Step—1: After successful logon, click the menu Sales & Marketing. Select Campaign and then Source Type. (See FIG. F-24)
        Step—2: Enter the value of source type and select the option of input source as per the format briefed in field's explanation section. (See FIG. F-25)
        Step—3: Click Add button to have a temporary storage.
        Step—4: Selecting a source type and clicking Edit button to modify/a source type.
        Step—5: Change any modifications and click Update. (See FIG. F-26)
        Step—6: Click Save button to save the contents.
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Source Type
The text for source type name. Accepts alphabets 



and numeric values not exceeding 40 characters. 



Entry to this field is mandatory. Source Type 



Name does not accept duplicate values


Input Source
Choose the option of Yes or No. with a default 



value selected as Yes


Table
Table displays the Source type data added









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add
Add the contents of source type. It is only a temporary



addition. Becomes permanent record only after saving


Edit
Edit button will allow for editing a specific record in



the table.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent record only after saving


Update
Update the contents of source type. It is only a



temporary update. Becomes permanent record only



after saving


Check Box
Check box will be disabled which has any reference to



other fields. Otherwise the checkbox will be enabled to



have the utility of check all/clear all.


Check All
The “Check All” Link will check all the enabled records



in the table


Clear All
The “Clear All” Link will uncheck all the enabled



records in the table that are checked.


Print
The Print will pops up a screen displaying the content



of the table created and enables the user to have print



out of the same.


Save
Saves the entered source type in the database. The



page gets refreshed and the contents entered in the



fields are shown.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes.









Source Sub Type
Source sub type provides the information on the subcategory that may come under the source type. The screen provides functionality to save, edit or add new source sub type.
The sequential steps involved in the creation of a source sub type are listed below.

    
    
        Step—1: After successful logon, click the menu Sales & Marketing. Select Campaign and then Source Sub Type. (See FIG. F-27)
        Step—2: Select a source sub type. Enter the value of source sub type with its description as per the format briefed in field's explanation section. (See FIG. F-28)
        Step—3: Click Add button to have a temporary storage.
        Step—4: Selecting a source sub type and clicking Edit button to modify a source sub type.
        Step—5: Change any modifications and click Update
        Step—6: Click Save button to save the contents. (See FIG. F-29)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Source Type
Choose a source type from the available drop down list.



This field is mandatory.


Source sub 
The text for source sub type name. Accepts alphabets


Type
and numeric values of maximum length 40. Entry to



this field is mandatory. Source Sub Type Name does



not accept duplicate values


Description
The text for description of source sub type. Accepts



alphabets, numeric and special characters except



double quote with values not exceeding 255 characters.



Field is optional.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Add
Add the contents of source sub type. It is only a



temporary addition. Becomes permanent record only



after saving


Edit
Edit button will allow for editing a specific record in



the table.


Delete
Delete button will delete the records in the table



checked for deletion. It is only a temporary deletion.



Becomes permanent record only after saving


Update
Update the contents of source sub type. It is only a



temporary addition. Becomes permanent record only



after saving


Check Box
Check box will be disabled which has any reference to



other fields. Otherwise the checkbox will be enabled to



have the utility of check all/clear all.


Check All
The “Check All” Link will check all the enabled records



in the table


Clear All
The “Clear All” Link will uncheck all the enabled



records in the table that are checked.


Print
The Print will pops up a screen displaying the content



of the table created and enables the user to have print



out of the same.


Save
Saves the entered source sub type in the database. The



page gets refreshed and the contents entered in the



fields are shown.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes.









Campaign
The campaign master provides information on the campaign, duration and the personnel associated with the campaign. The media through which a campaign is done is captured in the system using the source type and source subtype.
The source type defines the media through which a campaign can be conducted and the source sub type provides the information on the subcategory that may come under the source type. The screen provides functionality to save, edit or add new source type The sequential steps involved in the creation of a Campaign are listed below.

    
    
        Step—1: After successful logon, click the menu Sales & Marketing. Select Campaign and then Campaign. (See FIG. F-30)
        Step—2: Enter the text for campaign name and its description. (See FIG. F-31)
        Step—3: Choose source type and source sub type from drop down list. Based on the selection of Source Type the page gets refreshed to list the corresponding Source Sub Type.
        Step—4: Choose an associated workgroup. Make it assigned workgroup by clicking>>button.
        Step—5: Choose from and to dates of duration by clicking calendar icon
        Step—6: Click Save button. Screen gets refreshed with auto generated Campaign Id. The save button is now in update mode. (See FIG. F-32)
        Step—7: Click Import button to import files. It pop up a new window. (See FIG. F-33)
        Step—8: Choose the file to be imported and click import button.
        Step—9: Confirms the status of imported files. Click Back to Import Screen to navigates back for further importing of files. (See FIG. F-34)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description















Campaign Master








Campaign Name
The text for campaign name. Accepts alphabets 



and numeric values not exceeding 40 characters. 



Field is mandatory.


Campaign ID
Text to Display Campaign ID. This is a read only 



field.


Description
The text for description of campaign name. Accepts



alphabets, numeric and special characters except



double quotes not exceeding 50 characters. Field is



optional.


Source Type
Choose a source type from drop down list. Field is



mandatory.


Source Sub Type
Choose a source sub type from the drop down list.



Source sub type depends on the selection of source



type. Field is mandatory.


Associated
Work groups are listed.


Workgroup



Assigned
Assign a work group. Field is mandatory


Workgroup



Duration From
Choose a valid date by clicking calendar icon. Date



accepts the format in MM/DD/YYYY. Field is



mandatory.


Duration To
Choose a valid date by clicking calendar icon. To 



date cannot be greater than from date. Date accepts 



the format in MM/DD/YYYY. Field is mandatory







Import Campaign Data








Campaign ID
Text to Display Campaign ID. This is a read only 



field.


File Path
Enter the file path or select the path by clicking



browse button. The field is mandatory


File Format
Choose a format from drop down list for File 



Format, which should match with selection of file. 



The field is mandatory


Comments
Text to enter comments. Accepts alphabets, numeric



and special characters except double quotes not



exceeding 250 characters. This field is optional









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description















Campaign Master








New
Creates a new campaign.


Save
Saves the entered campaign information. The 



page gets refreshed with auto generated 



campaign id. The save button is now shown



as Update Button and Import button is enabled


Import
Click import to display a pop up screen to 



import the campaign data.


Update
Updates the contents modified


Cancel
Clears the contents entered in the fields or restore 



to the previous state as was before saving the 



changes.







Import Campaign Data








New
Click new button to Import new Campaign 



data


View Previous
Navigates to a screen displaying imported files 


Import
for the particular campaign id.


Back to Campaign
Navigates back to import screen for further 


Import
import of files.


Import
Click import to import the campaign data in 



the database









Campaign Search
Campaign search is to search campaign based on either campaign id or campaign name. Campaign search is to have view, delete or modify the campaigns already created
The sequential steps involved in the campaign search are listed below.

    
    
        Step—1: After successful logon, click the menu Sales & Marketing. Select Campaign and then Campaign Search. (See FIG. F-35)
        Step—2: Search operation can be performed by clicking the search button either by entering the values in the fields or even with empty fields. Campaign id or a first letter of campaign name to have search operation. (See FIG. F-36)
        Step—3: Displays the results of search. (See FIG. F-37)
        Step—4: Select a campaign and choose the option of modify or view. If the option is modify the following screen appears for modification. (See FIG. F-38)
        Step—5: Change the contents and click Update.
        Step—6: If the option is view, the following screen appears only to have a view. Campaigns that are not referred elsewhere can also be deleted. (See FIG. F-39)
        Step—7: Click New Campaign button to go back to campaign create screen.
    
    


Fields Explanation
Refer field explanations provided for Create Campaign
Button Functionality
The following table provides explanation for each button in the screen.














Element 
Description









Search
Clears the screen and perform search operation 




based on the input value for group/agent.



Cancel
Clears the contents entered in the fields or restore




to the previous state as was before saving the




changes.










6 Sales Master
Sales Master is to setup basic information for Agent, Agency and Lead in the PX2 System. Sales Master also has functionality of Lead tracking, maintenance of Agent profile and Campaign to Lead conversion.
Access
The application can be accessed from the main menu as follows:

    
    
        Sales & Marketing→Sales Master→Create Agency
        Sales & Marketing→Sales Master→Search Agency
        Sales & Marketing→Sales Master→Create Agent
        Sales & Marketing→Sales Master→Search Agent
        Sales & Marketing→Sales Master→Create Lead
        Sales & Marketing→Sales Master→Search Lead
        Sales & Marketing→Sales Master→Campaign to Lead
        Sales & Marketing→Sales Master→Lead Tracking
        Sales & Marketing→Sales Master→Lead Tracking—To do list
        Sales & Marketing→Sales Master→Create Agent Profile
        Sales & Marketing→Sales Master→Search Agent Profile
    
    


Pre-Requisites
Pre-Requisites for using this application are as follows:
Work Group must be defined and available in the system Campaign data must be available to convert Campaign to lead
Associates data must be available for assigning BSS representatives.
Application Functions
This application has the following functions:

    
    
        Create Agency—to create/edit details of Agency
        Search Agency—to search the details of Agency for view modification or deletion
        Create Agent—to create/edit details of Agent
        Search Agent—to search the details of Agent for view modification or deletion
        Create Lead—to create/edit details of lead
        Search Lead—to search the details of lead for view modification or deletion
        Campaign to Lead—to convert campaign data to lead
        Lead Tracking—to track the information on lead
        Lead Tracking to do List—to track and follow up on lead
        Create Agent Profile—to create/edit details of Agent Profile
        Search Agent Profile—to search the details of Agent Profile for view modification or deletion
    
    


Create Agency

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Sales Master. Then select Create Agency. (See FIG. F-40)
        Step—2: Screen navigates to Agency Master screen. (See FIG. F-41)
        Step—3: Enter the values for the respective fields, as per the format briefed in field's explanation section. Click Next.
        Step—4: Navigates to second part of the agency master's screen for filling in further information. (See FIG. F-42)
        Step—5: Enter the values for the respective fields, as per the format briefed in field's explanation section. For agency work group, it should be selected by clicking search icon.
        Step—6: This pops up a screen for workgroup search. (See FIG. F-43)
        Step—7: Choose category, Main workgroup and child workgroup from the respective drop down list and Click Add.
        Step—8: This displays a screen with the selected workgroup. (See FIG. F-44)
        Step—9: After filling all the fields in agency master, click save to create agency master. Following is the sample confirmation screen for a successful creation of agency master. (See FIG. F-45)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Company Name
The text for company name. Accepts alphanumeric 



and special characters. Field is mandatory


DBA
The text for business nature. Accepts alphanumeric



and special characters. Field is optional


Street Address
The text for company address. Accepts alpha-



numeric and special characters not exceeding 35 



characters


Suite
The text for company suite. Accepts alphanumeric 



and special characters not exceeding 35 characters


City
The text for city. Accepts alphabets and space 



between two words not exceeding 30 characters.


State
Choose the name of the state from the drop down 



list of States available in United States of America


Zip
The text for zip. Accepts numeric value of exactly 



5 digits. Field is mandatory


Phone
The text for telephone number of the contact 



person. Accepts numeric values not exceeding 



10 digits. The format is (999) 999-9999.


Fax
The text for fax number of the contact person. 



Accepts numeric values not exceeding 10 digits. 



The format is (999) 999-9999.


Mode of
Choose a mode of communication from the drop 


Communication 
down list available. Based on the selected value, 



related fields are mandatory.


Salutation
Choose the salutation from the drop down list of



salutations available.


First Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 25 characters. Field is mandatory


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes 



not exceeding 35 characters. Field is mandatory


Street Address
The text for company address. Accepts 



alphanumeric and special characters not exceeding 



35 characters


Suite
The text for company suite Accepts alphanumeric 



and special characters not exceeding 35 characters


City
The text for city. Accepts alphabets and space 



between two words not exceeding 30 characters.


State
Choose the name of the state from the drop down 



list of States available in United States of America


Zip
The text for zip. Accepts numeric value of exactly 



5 digits. Field is mandatory


Phone
The text for telephone number of the contact person.



Accepts numeric values not exceeding 10 digits. 



The format is (999) 999-9999.


Extension
The text for extension of telephone number 



Accepts numeric values not exceeding 4 digits. 



The format is 9999.


Fax
The text for fax number of the contact person. 



Accepts numeric values not exceeding 10 digits. 



The format is (999) 999-9999.


E-mail
The text for email of the contact person. Accepts



alphabets, numeric and special characters in the



standard email format of length not exceeding 100



characters.


Broker Type
Choose an option for broker type from either



Statewide, Regional or unknown


Exclude from
Click this option to have exclusion of broadcast fax


Broadcast Fax



Exclude from
Click this option to have exclusion of


Employee/Member
employee/member term letter


Term Letter



Exclude from
Click this option to have exclusion of overdue 


overdue premium
premium notice


notice



Exclude from
Click this option to have exclusion of


Employee/Member
employee/member add on letter


Add on Letter



Agency Workgroup
Choose a agency work group by clicking search 



icon


Internal Workgroup
Choose an internal workgroup from the drop down 



list available. The field is mandatory.


BSS Rep
Choose a value for BSS Rep from the drop down 



list available


Tax ID/SSN
The text for Tax ID/SSN. Accepts numeric values 



of exactly 9 digits


License Number
The text for License number. Accepts numeric 



values not exceeding 15 digits


License Type
Choose a type for license from the drop down list



available


License Expiration
The text for License expiration date. Choose a 



date in the format MM/DD/YYYY by clicking



calendar icon.


E&O Number
The text for E&O number. Accepts numeric values 



not exceeding 15 digits


E&O Expiration
The text for E&O Expiration date. Choose a date 



in the format MM/DD/YYYY by clicking calendar 



icon.


Preferred Mode of
Choose an option for mode of payment either 


payment
Check or ACH


Bank Name
The text for bank name. Accepts alphabets, numeric



and special characters except double quotes with



values not exceeding 50 characters.


Account Number
The text for accounts number. Accepts numeric 



values not exceeding 9 digits


Account Type
Choose a type of account from the drop down list



available


Routing Number
The text for routing number. Accepts numeric 



values not exceeding 10 digits.


Name of the
The text for name of the account holder. Accepts


Account
alphabets and numeric values not exceeding 50



characters.


Payee Name
The text for payee name. Accepts alphabets not



exceeding 60 characters.


Requires special
Click this option for any special handling is 


handling
required









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Next
Click Next to move to the next screen for entering the



Agency information.


Save
Saves the entered information entered for the Agency



in the screen one and two.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes.


Close
Closes the window and go back to agency master



screen


Previous
Navigates to the previous screen. If any data is entered



on this screen it validate the data prior to moving to



the previous screen.









Search Agency

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Sales Master. Then select Search Agency. (See FIG. F-46)
        Step—2: Screen navigates to Search Agency Master screen. (See FIG. F-47)
        Step—3: Either enter the value in any one of the field or simply click Search.
        Step—4: This pops up a screen with the search result. (See FIG. F-48)
        Step—5: Choose an Agency Id for selection. The selected agency id can be modified or view and delete. If modify button is clicked details with the contents will be displayed for any modification or otherwise clicking view/delete button will enabled to view or deleted.
        Step—6: If the modify button is clicked following will be screen. Enter the text at the respective fields for modification, if any. The flow and procedure for modifying an agency master is similar to create agency master. (See FIG. F-49)
        Step—7: If the view/delete button is clicked, following is the screen, which allows to view and delete. (See FIG. F-50)
        Step—8: After viewing the contents, if the new agency is clicked will enable to add new agency master or if the delete button is clicked will delete the agency master that is currently in view. (See FIG. F-51)
        Step—9: On clicking delete, navigates to confirming the deletion of agency record. From here clicking new agency button can create also new agency. (See FIG. F-52)
    
    


Fields Explanation
Refer Field explanation provided for Create New Agency
Button Functionality
Refer Button Functionality provided for Create New Agency.
Create Agent

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Sales Master. Then select Create Agent. (See FIG. F-53)
        Step—2: Screen navigates to Agent Master screen. (See FIG. F-54)
        Step—3: Enter the values for the respective fields, as per the format briefed in field's explanation section. Click Next.
        Step—4: Navigates to second part of the agent master screen for entering further information. (See FIG. F-55)
        Step—5: Enter the values for the respective fields, as per the format briefed in field's explanation section. For agent work group, it should be selected by clicking search icon.
        Step—6: The selection procedure for Work group search is similar to that of workgroup search explained in Create Agency. For Associated agencies the procedure is same but the sample screen is as follows. (See FIG. F-56)
        Step—7: Enter the first letter of agency id or agency name to perform search operation
        Step—8: This displays a screen with the selected workgroup. (See FIG. F-57)
        Step—9: After filling all the fields in agent master, click save to create agent master. Following is the sample confirmation screen for a successful creation of agent master. (See FIG. F-58)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







First Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes 



not exceeding 25 characters. Field is mandatory


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 35 characters. Field is mandatory


Company Name
The text for company name. Accepts alphanumeric 



and special characters. Field is mandatory


DBA
The text for business nature. Accepts alphanumeric



and special characters. Field is optional


Street Address
The text for company address. Accepts alphanumeric



and special characters not exceeding 35 characters


Suite
The text for company suite Accepts alphanumeric 



and special characters not exceeding 35 characters


City
The text for city. Accepts alphabets and space 



between two words not exceeding 30 characters.


State
Choose the name of the state from the drop down 



list of States available in United States of America


Zip
The text for zip. Accepts numeric value of exactly 5



digits. Field is mandatory


Phone
The text for telephone number of the contact person.



Accepts numeric values not exceeding 10 digits. 



The format is (999) 999-9999.


Fax
The text for fax number of the contact person. 



Accepts numeric values not exceeding 10 digits. 



The format is (999) 999-9999.


Mode of
Choose a mode of communication from the drop 


Communication
down list available. Based on the selected value, 



related fields are mandatory.


E-mail
The text for email of the contact person. Accepts



alphabets, numeric and special characters in the



standard email format of length not exceeding 100



characters.


Gender
Choose a gender from the drop down list available.


Date of Birth
The text for date of birth. Choose a date by clicking



calendar icon. Date accepts the format 



MM/DD/YYYY. 



Birth date cannot be later than the current date.


Salutation
Choose the salutation from the drop down list of



salutations available.


First Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 25 characters. Field is mandatory


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 35 characters. Field is mandatory


Street Address
The text for address. Accepts alphanumeric and 



special characters not exceeding 35 characters


Suite
The text for suite Accepts alphanumeric and special



characters not exceeding 35 characters


City
The text for city. Accepts alphabets and space 



between two words not exceeding 30 characters.


State
Choose the name of the state from the drop down 



list of States available in United States of America


Zip
The text for zip. Accepts numeric value of exactly 5



digits. Field is mandatory


Phone
The text for telephone number of the contact person.



Accepts numeric values not exceeding 10 digits. 



The format is (999) 999-9999.


Extension
The text for extension number of the employee.



Accepts numeric values not exceeding 4 digits


Fax
The text for fax number of the contact person. 



Accepts numeric values not exceeding 10 digits. 



The format is (999) 999-9999.


E-mail
The text for email of the contact person. Accepts



alphabets, numeric and special characters in the



standard email format of length not exceeding 100



characters.


Broker Type
Choose an option for broker type from either



Statewide, Regional or unknown


Exclude from
Click this option to have exclusion of broadcast fax


Broadcast Fax



Exclude from
Click this option to have exclusion of


Employee/Member



Term Letter
employee/member term letter


Exclude from
Click this option to have exclusion of overdue 


overdue premium
premium notice


notice



Exclude from
Click this option to have exclusion of


Employee/Member
employee/member add on letter


Add on Letter



Agent Workgroup
Choose a agent work group by clicking search 



icon


Internal Workgroup
Choose an internal workgroup from the drop down 



list available. The field is mandatory.


BSS Rep
Choose a value for BSS Rep from the drop down 



list available


Associated Agency
Choose a Associated Agency by clicking search 



icon


Tax ID/SSN 
The text for Tax ID/SSN. Accepts numeric values



of exactly 9 digits


License Number
The text for License number. Accepts numeric 



values not exceeding 15 digits


License Type
Choose a type for license from the drop down list



available


License Expiration
The text for License expiration date. Choose a date 



in the format MMJDD/YYYY by clicking 



calendar icon.


E&O Number
The text for E&O number. Accepts numeric values 



not exceeding 15 digits


E&O Expiration
The text for E&O Expiration date. Choose a date in 



the format MM/DDIYYYY by clicking calendar 



icon.


Preferred Mode of 
Choose an option for mode of payment either Check


payment
or ACH


Bank Name
The text for bank name. Accepts alphabets, numeric



and special characters except double quotes with



values not exceeding 50 characters.


Account Number
The text for accounts number. Accepts numeric 



values not exceeding 9 digits


Account Type
Choose a type of account from the drop down list



available


Routing Number
The text for routing number. Accepts numeric 



values not exceeding 10 digits.


Name of the
The text for name of the account holder. Accepts


Account
alphabets and numeric values not exceeding 50 



characters.


Payee Name 
The text for payee name. Accepts alphabets not



exceeding 60 characters


Requires special
Click this option for any special handling is 


handling
required









Button Functionality
The following table provides explanation for each button in the screen.











Element 
Description







Next
Click Next to move to the next screen for entering the



Agency information.


Save
Saves the entered information entered for the Agency



in the screen one and two.


Cancel
Clears the contents entered in the fields or restore to



the previous state as was before saving the changes.


Close
Closes the window and go back to agency master



screen


Previous
Navigates to the previous screen. If any data is entered



on this screen it validate the data prior to moving to



the previous screen.









Search Agent

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Sales Master. Then select Search Agent. (See FIG. F-59)
        Step—2: Screen navigates to Search Agent Master screen. (See FIG. F-60)
        Step—3: Either enter the value in any one of the field or simply click Search.
        Step—4: This pops up a screen with the search result. (See FIG. F-61)
        Step—5: Choose an Agent Id for selection. The selected agent id can be modified or view and delete. If modify button is clicked details with the contents will be displayed for any modification or otherwise clicking view/delete button will enabled to view or deleted.
        Step—6: If the modify button is clicked following will be screen. (See FIG. F-62)
        Step—7: Enter the text at the respective fields for modification, if any. The flow and procedure for modifying an agency master is similar to create agency master.
        Step—8: If the view/delete button is clicked, following is the screen that can have view or delete. (See FIG. F-63)
        Step—9: After viewing the contents, if the new agency is clicked will enable to add new agency master or if the delete button is clicked it will delete the agent master which is currently in view.
        Step—10: On clicking delete, navigates to confirming the deletion of agency record. From here clicking new agency button can create new agency. (See FIG. F-64)
    
    


Fields Explanation
Refer field explanation provided for Create Agent.
Button Functionality
Refer button functionality provided in Create Agent
Create Lead

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Sales Master. Then select Create Lead. (See FIG. F-65)
        Step—2: Screen navigates to Lead Master screen. (See FIG. F-66)
        Step—3: Enter the values for the respective fields, as per the format briefed in field's explanation section. Click Next.
        Step—4: Navigates to second part of the lead master screen for entering further information. (See FIG. F-67)
        Step—5: Enter the values for the respective fields, as per the format briefed in field's explanation section. Based on the selection of name as either agent/agency the corresponding value for agency/agent is selected by clicking search icon.
        Step—6: After filling all the fields in lead master, click save to create lead master. Following is the sample confirmation screen for a successful creation of lead master. (See FIG. F-68)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Group Type
Choose the Group Type from the list.


Association Id
Choose the association id from the list. If the Group



type is Guaranteed, Endorsed, PEO or Chamber



corresponding association name will be listed.


Member Type
Choose the member type as Individual Member or



Association Group. This option will be available if 



the Association selected is Guaranteed.


Source Sub Type
Choose sub source type from the list.


Company Name
The text for company name. Accepts alphanumeric 



and special characters. Field is mandatory


DBA
The text for business nature. Accepts alphanumeric



and special characters. Field is optional


Street Address
The text for company address. Accepts alphanumeric



and special characters not exceeding 35 characters


Suite
The text for company suite Accepts alphanumeric 



and special characters not exceeding 35 characters


City
The text for city. Accepts alphabets and space 



between two words not exceeding 30 characters.


State
Choose the name of the state from the drop down list



of States available in United States of America


Zip
The text for zip. Accepts numeric value of exactly 5



digits. Field is mandatory


Phone
The text for telephone number of the contact person.



Accepts numeric values not exceeding 10 digits. The



format is (999) 999-9999.


Fax
The text for fax number of the contact person. 



Accepts numeric values not exceeding 10 digits. 



The format is (999) 999-9999.


Salutation
Choose the salutation from the drop down list of



salutations available.


First Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 25 characters. Field is mandatory


Middle Initial
The text for middle initial. Accepts alphabets not



exceeding 1 character.


Last Name
The text for contact name. Accepts alphabets and



special characters like hyphen and single quotes not



exceeding 35 characters. Field is mandatory


Street Address
The text for address. Accepts alphanumeric and 



special characters not exceeding 35 characters


Suite
The text for suite Accepts alphanumeric and special



characters not exceeding 35 characters


City
The text for city. Accepts alphabets and space 



between two words not exceeding 30 characters.


State
Choose the name of the state from the drop down list



of States available in United States of America


Zip
The text for zip. Accepts numeric value of exactly 5



digits. Field is mandatory


Phone
The text for telephone number of the contact person.



Accepts numeric values not exceeding 10 digits. The



format is (999) 999-9999.


Extension
The text for extension of telephone number Accepts



numeric values not exceeding 4 digits. The format is



9999.


Fax
The text for fax number of the contact person. 



Accepts numeric values not exceeding 10 digits. 



The format is (999) 999-9999.


E-mail
The text for email of the contact person. Accepts



alphabets, numeric and special characters in the



standard email format of length not exceeding 100



characters.


None
Choose the option as none if applicable.


Agent
Choose an agent by clicking search icon. The option 



is enabled only if the value is selected as agent for 



name.


Agency
Choose an agency by clicking search icon. The 



option is enabled only if the value is selected as 



agency for name.


Internal 
Choose an internal workgroup from the drop down 


Workgroup
list available. The field is mandatory.


BSS Rep
Choose a value for BSS Rep from the drop down list



available


No. Of employees
The text for number of employees. Accepts numeric



values not exceeding 4 digits.


Plan Type
Choose a plan type from the drop down list 



available


Current Carrier
Choose a current carrier from the drop down list



available


Deductible
The text for deductible. Accepts numeric values not



exceeding 12 digits.


Co Pay
The text for co pay. Accepts numeric values not



exceeding 12 digits.


Benefit level in
The text for benefit level in network


Network



Benefit level out 
The text for benefit level out of network


of Network



Employer
The text for employer contribution.


Contribution in %



Approximate
The text for approximate monthly premium.


monthly premium



Renewal Date
The text for renewal date. Accepts date in the 



format MM/DD/YYYY by clicking calendar icon.


Best time to call
The text for best to call.


Comments
The text for comments.


Mode of
Select a mode of communication from the drop 


communications
down list available









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Save
Saves the entered information not only for the 




present screen.



Search
Clears the screen and perform search operation 




based on the input value for group/agent.



Cancel
Clears the contents entered in the fields or 




restore to the previous state as was before saving 




the changes.



Close
Closes the window and go back to agency master




screen



Previous
Navigates to the screen earlier to this.










Search Lead

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Sales Master. Then select Search Lead. (See FIG. F-69)
        Step—2: Screen navigates to Search Lead screen. (See FIG. F-70)
        Step—3: Either enter value in any of the field or simply click Search.
        Step—4: This pops up a screen with the search result. (See FIG. F-71)
        Step—5: Choose an Lead Id for selection. The selected lead id can be modified or view and delete. If modify button is clicked details with the contents will be displayed for any modification or otherwise clicking view/delete button will enabled to view or deleted.
        Step—6: If the modify button is clicked following will be screen. (See FIG. F-72)
        Step—7: Enter the text at the respective fields for modification, if any. The flow and procedure for modifying a lead master is similar to create lead master.
        Step—8: If the view/delete button is clicked, following is the screen that can have view or delete. (See FIG. F-73)
        Step—9: After viewing the contents, if the new lead is clicked, will enable to add new lead master or if the delete button is clicked it will delete the lead master, which is currently in view.
        Step—10: On clicking delete, navigates to confirming the deletion of lead record. From here clicking new lead button can create new lead. (See FIG. F-74)
    
    


Fields Explanation
Refer field explanation provided for Create Lead
Button Functionality
Refer button functionality provided for Create Lead
Campaign to Lead

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Sales Master. Then select Campaign to Lead. (See FIG. F-75)
        Step—2: Screen navigates to Campaign to Lead screen. (See FIG. F-76)
        Step—3: Enter the value of a campaign id or choose a campaign id by clicking search icon
        Step—4: Either enter value in any of the field or simply click Search. (See FIG. F-77)
        Step—5: Click on any campaign id for selection (See FIG. F-78)
        Step—6: By clicking Search Campaign Data the following screen gets displayed. (See FIG. F-79)
        Step—7: Choose Campaign id. Click Convert to lead This converts campaign to lead and the selected campaign gets
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Campaign Id
Text for Campaign ID. Enter the Campaign 



ID or click the search icon.


Campaign Name
Text for Campaign ID


From Date
The text for From Date. Choose a date by 



clicking calendar icon. Date accepts the 



format MM/DD/YYYY.


To Date
The text for To Date. Choose a date by 



clicking calendar icon. Date accepts the 



format MM/DD/YYYY.









Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Search
Click search to display the Campaign ID 



based on the search criteria.


Close
Closes the window and go back to campaign 



to lead screen


Search Campaign
Displays the content of selected campaign id


Data



Convert to Lead
Converts campaign to lead and the item gets 



removed from the campaign id list table.


Check All
The “Check All” Link will check all the 



records in the table


Clear All
The “Clear All” Link will uncheck all the 



records in the table that are checked.


Cancel
Clears the contents entered in the field.









Lead Tracking

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Sales Master. Then select Lead Tracking. (See FIG. F-80)
        Step—2: Screen navigates to Lead Tracking screen. (See FIG. F-81)
        Step—3: Enter the value of a lead id and Click Get Status to display the current status of the lead or choose a lead id by clicking search icon. (See FIG. F-82)
        Step—4: Either enter value in any one of the field or simply click Search.
        Step—5: This pops up a screen with search result. (See FIG. F-83)
        Step—6: Click on any lead id for selection. The status of the lead is displayed.
        Step—7: Choose the respective values and click save. (See FIG. F-84)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.














Element
Description









Lead Id
Text for Lead ID. Enter lead id of choose 




Lead ID by clicking the Search Icon.



Company Name
Read only field to display Company Name



Phone
Read only field to display Company Phone



First Name
Read only field to display First Name



Last Name
Read only field to display Last Name



Call Status
Choose from the Call Status provided.



Contact Result
Choose from the Contact Result provided. 




Only if the “Call Status” option is “Made 




Contact” this will be enabled.



Qualified Lead
Choose from the Qualified Lead Result 



Result
provided. Only if the “Contact Result” option 




is “Qualified Lead” this will be enabled.



Non-Qualified 
Choose from the Non-Qualified Lead Reasons



Lead Reasons
provided. Only if the “Contact Result” option 




is “Non-Qualified Lead” this will be enabled.



Not Interested
Choose from the Not Interested Reasons 



Reasons
provided. Only if the “Qualified Lead Result” 




option is “Not Interested” this will be enabled.



Post Quote Result
Choose from the Post Quote Result provided. 




Only if the “Qualified Lead Result” option is 




“Produced Quotes” this will be enabled.



Status
Displays the status dynamically based on the




combination of the options selected.



Notes
Text area to enter brief notes on the lead 




tracking



Follow up Date
The text for Follow up Date. Choose a date 




by clicking calendar icon. Date accepts the 




format MM/DD/YYYY.










Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Save
Saves the entered information not only for the 




present screen.



Get Status
Show the status of the Lead being Tracked.



Cancel
Clears the contents entered in the fields or 




restore to the previous state as was before saving 




the changes.










Lead Tracking—To Do List

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Sales Master. Then select Lead Tracking—To Do List.
        Step—2: Screen pops up a new window Lead Tracking To Do List screen. The screen can have only view option. The contents of this screen are the inputs of lead tracking screen. This screen displays the follow up on the Lead tracking. (See FIG. F-85)
        Step—3: Click close.
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.














Element
Description









User Id
Read only field for User id.



Lead Id
Read only field for Lead Id.



Lead Name
Read only field Lead Name.



Phone
Read only field for Phone.



Follow up Date
Read only field for follow up date.










Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Close
Closes the pop up window.










Create Agent Profile

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Create Agent Profile (See FIG. F-86)
        Step—2: Screen navigates to Agent Profile (See FIG. F-87)
        Step—3: Click Save. Confirms the creation of agent profile. (See FIG. F-88)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description















Agent Details








Workgroup Name
Choose a work group name from the available list.



List all child workgroup for the selected workgroup


Agent ID
Choose a agent id from the available list


Agent Name
Text for agent name. Field is read only


Company Name
Text for agent name. Field is read only


Present Rating
Text for present rating accepts numeric values







Profile Information








Do you currently
Choose the option from Yes or No


sell Health



Insurance



Do you currently
Choose the option from Yes/No/Unknown


sell PacAdvantage



Types of Insurance 
Select the check box of insurance from the available


sold by Agent
check box list.


Percentage of time 
Text for percentage of time focussed on health


focused on Health
insurance. Accepts numeric values.


Insurance



Average Group
Text for average group size [within Pac Advantage].


Size (within
Accepts numeric values.


PacAdvantage)



Average Group
Text for average group size [outside Pac Advantage].


Size (outside
Accepts numeric values.


PacAdvantage)



Percentage of staff
Text for percentage of staff concentrating on Health


concentrating on
Insurance. Accepts numeric values.


Health Insurance



Years in Business
Text for years in business. Accepts numeric values.







Subjective Ratings








Broker knowledge
Choose a rating from 0 to 4


of PacAdvantage



Broker Potential
Choose a rating from 0 to 4


Broker loyalty and
Choose a rating from 0 to 4


confidence with



PacAdvantage



Subjective Rating
Choose a rating from 0 to 4







Other Information








Marketing Plans
Choose a marketing plan from the available drop list.


No. 1 Selling Plan
Choose a plan for selling plan [plan-1] from the



available drop down list


No. 2 Selling Plan
Choose a plan for selling plan [plan-2] from the



available drop down list









Button Functionality
The following table provides explanations for each of the screen fields.











Element
Description







Save button
Click on save button to the save the content keyed in



and navigates to confirmation screen displaying the



Confirmation ID.


Cancel button
Click on clear button clears the content and appears



again for fresh entries









Search Agent Profile

    
    
        Step—1: After successful logon, click the menu Sales & Marketing and select Sales Master. Then select Search Agent Profile. (See FIG. F-89)
        Step—2: Screen navigates to Search Agent Profile screen (See FIG. F-90)
        Step—3: Either enter value in any of the field or simply click Search.
        Step—4: This pops up a screen with the search result. (See FIG. F-91)
        Step—5: Choose an Agent Id for selection. The selected agent id can be modified or viewed. If modify button is clicked details with the contents will be displayed for any modification or otherwise clicking view button will enabled to view the contents and prevents any modification
        Step—6: If the modify button is clicked following will be screen. (See FIG. F-92)
        Step—7: Enter the text at the respective fields for modification, if any. The flow and procedure for modifying an agency profile is similar to create agency profile. On any change, and clicking Update will pop up a screen. (See FIG. F-93)
        Step—8: If the view button is clicked, following is the screen, which can have only to view the contents, and no modification is allowed. (See FIG. F-94)
        Step—9: After viewing the contents, if the new agency is clicked will enable to add new agency profile.
    
    


Fields Explanation
Refer field explanation referred in Create Agent Profile
Button Functionality
The following table provides explanations for each of the screen fields.











Element
Description







Save
Click on save button to the save the content keyed in



and navigates to confirmation screen displaying the



Confirmation ID.


Cancel
Click on clear button clears the content and appears



again for fresh entries


Modify
Modify enables to edit and modifications is possible


View
View enables to edit the content and modification is



not possible


Update
Update the contents of source sub type. It is only a



temporary addition. Becomes permanent record only



after saving


New Agent Profile
Creates a new agent profile









7 Quotes
Quotes are provided for potential business entities as well as existing business entities. Quotes can be requested for small Employer Groups or Alternate Groups (Individual Association Member, Association Group, COBRA etc.) as well as for employees of those groups.
Access
The application can be accessed from the main menu as follows:

    
    
        Sales & Marketing→Quotes
    
    


Pre-Requisites
All master data must be available in the system for generation of Quotes. Pre-requisites for using this application are as follows:

    
    
        Carrier Maintenance—Refer “User Manual for Carrier Maintenance” for further information on the master records.
        Agent/Agency—Refer “User Manual for Sales and Marketing” for further information on the Agent/Agency records.
        Work Group—Refer “User Manual for Sales and Marketing” for further information on the Work Group records.
        Internal Associates—Refer “User Manual for Sales and Marketing” for further information on the Internal Associates records.
        Enrollment—Refer “User Manual for Enrollment” for further information on the Group and Member records.
    
    


Application Functions
This application has the following functions:

    
    
        Create Quotes
        Modify Quote/Create Quote Revision
        Generate Quote
        Generate Interim Quote
        View Missing Information
    
    


Create Quotes
This function enables the user to input necessary input information/parameters for quotes and save the information for retrieval at a later point in time.
A quote is unique for each Group and Lead; any changes to the quote will result in a new revision. To modify an existing quote or create a new quote revision, please refer to next section “Modify Quote/Create Quote Revision”.

    
    
        Step—1: After successful logon, click menu Sales & Marketing and select the option Quotes. (See FIG. F-95)
        Step—2: Browser navigates to Group/Lead Info screen. Choose whether the quote is for a Lead or an Existing Group. Select the Lead/Group by clicking Lookup icon, found next to the lead/group Id field. Alternately, if the lead/group id is known, it can be entered directly into the field. (See FIG. F-96)
        Step—3: On clicking the Lookup icon, based on whether the quote is for a lead or group, the browser navigates to either lead search or to group search screen. (See FIG. F-97)
        A lead can be searched using first few characters of lead name, contact first/last name or contact phone number.
        A group can be searched using first few characters of its legal name, contact first/last name or tax id/SSN or group's effective date or phone number. (See FIG. F-98)
        Step—4: Click on the group/lead, for which the quote is being created, to return to the main screen.
        Step—5: On selecting a lead/group, either using the lookup option or entering directly into the field, lead/group details and agent details get populated on the screen.
        If quoting for a group, an additional option, “Populate Current Enrollment” is enabled. Clicking the option populates additional group information like coverage and contribution option, agent fee, current employee information with their plans.
        Step—6: Choose the coverage and contribution options selected by the lead/group.
        Alternately, the “Default Coverage and Contribution” option can be used. Default coverage and contribution is Medical coverage alone selected with an employer contribution of 50% of lowest cost HMO plan towards employee premium and none towards dependent premium.
        Note: This section is enabled only if the lead/group is an employer group.
        Step—7: Click on the “Employee Info” tab on the top or the link at the bottom to navigate to employee information screen. If “Populate Current Enrollment” option was selected earlier, the screen comes populated with current employee information.
        Use “Set Size” option to set the number of employees on the quote; the screen inserts specified number of blank employee rows. Enter employee name, employee age/date of birth, coverage option, number of persons covered under the employee (including the employee), and the employee's zip code of residence. (See FIG. F-99)
        Note: If zip code is not specified for an employee, the lead's/group's zip code is used for rates calculation.
        Alternately, employee information can be uploaded from a flat file. (See FIG. F-100)
        Specify the file format, whether CSV ASCII or Fixed Position ASCII, browse and locate the file to be uploaded. Click Upload to upload employee information from the file.
        Step—8: Click on the “Quote Output” tab on the top or the link at the bottom to navigate to quote output screen. (See FIG. F-101)
        Choose whether Standard quote or Interim quote is required. (Interim quote is explained in a subsequent section).
        Use “Exclude Plans” option to exclude any plans that should not appear on the quote. Select the plan(s) that need to be excluded (Hold ‘Control’ key to select multiple plans) and click Add button.
        Enter other information required for quotes like quote for, mode of output and addressee information.
        Step—9: Click Save button to save quote input information.
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.
Common











Element
Description







Quote #
The id with which the quote is uniquely identified



along with the revision. The field is read only. Quote id



is auto generated.


Quote Date
Date on the quote. The field is read only and reflects



the value entered in the quote date field on the



“Group/Lead Info” tab.


Lead/Group Id
Unique id of lead/group being quoted. The field is read-



only and reflects the value entered in the lead/group id



field on the “Group/Lead Info” tab.


Lead/Group Name
Name of the lead/group being quoted. This field is read



only.


Type
Lead/Group's type; whether Small Employer Group,



Individual Association Member, Cal-COBRA etc.









Group/Lead Info Tab











Element
Description















Lead/Group Information








Quote for
Choose the option to quote for either lead or group.


Lead/Group Id
Unique id of lead/group being quoted. Lead/Group



id can be selected by clicking Lookup icon.


Other revisions
List all revisions for the quote and allows user to 



select a specific revision.







General Information








Quote Date
Date on the quote. Entry in this field is mandatory.


Mode of Request
Choose a type of mode of request from the drop 



down list available


Post Mark Date
Date on which request for quote was post-marked.



Choose a date by clicking calendar icon. Entry in 



this field is mandatory.


Receive Date
Date on which request for quote was received. 



Choose a date by clicking calendar icon. Entry in 



this field is mandatory.


Rate Type
Choose a rate type to be used for quoting.


Agent Commission
Agent commission percentage to be used for 



blended rate calculation. Entry in this field is man-



datory. The field is enabled only for the quotes on 



blended rate structure.


Effective Date
Effective date for the quote. Choose a date by click-



ing calendar icon. Entry in this field is mandatory.







Coverage &Contribution Information








Use default
Check to generate quote using default coverage and


coverage and
contribution options. Default coverage and con-


contribution
tribution is Medical coverage alone selected with 



an employer contribution of 50% of lowest cost 



HMO plan towards employee premium and none 



towards dependent premium


Contribution Type
For the line of coverage, choose contribution type 



opted by the lead/group. Leave as blank, when not 



quoting the line of coverage.


Specify Plan
When employer contribution is percentage of 



specified plan, choose specified plan.


Value for EE
Specify employer contribution towards employee's



premium.


Value for Dep
Specify employer contribution towards dependent's



premium.









Employee Info Tab.











Element
Description















Employee Information








Quote Spec EE
Check to indicate employees to be quoted, when using



“Employee Rate Illustration”, “Cal-COBRA” or “Fed-



COBRA” options.


Employee Name
Name of employee. Entry in this field is mandatory.


Age/DOB
Age or date of birth of employee. Date of birth has to



specify in MM/dd/yyyy format. Entry in this field is



mandatory.


Tier
Coverage choice opted by the employee. Entry in this



field is mandatory.


#
Count of members covered under the employee's



coverage including the employee. System defaults



value in this field based on the coverage type selected



but is editable by the user.


Zip
Zip code of employee's residence. If no value is



provided, employer's zip code is used for rate



calculation.


County
County of employee's residence. This is normally a



read-only field except in cases where employee's zip



code spans multiple counties. In such cases, when the



user tries to generate a quote, the system prompts the



user to select the county.


Medical Plan
Medical plan to be used when quoting using “Quote for



specified plans only” option.


Dental Plan
Dental plan to be used when quoting using “Quote for



specified plans only” option.


Vision Plan
Vision plan to be used when quoting using “Quote for



specified plans only” option.


CAM Plan
CAM plan to be used when quoting using “Quote for



specified plans only” option.


Total Employees
Total number of employees on the quote. This field is



read only.


Total Waiving
Total number of employees waiving medical coverage.


Total Declining
Total number of employees declining coverage through



PacAdvantage plans.


Total COBRAs
Total number of COBRAs covered under the employer.







Rate Differential Factor








Calculated by
Specify whether differential factor has to be calculated


System/Entered
by the system or is entered by the user. Option for


by user
entry by user is allowed only when quoting for a lead



or doing a group renewal quote.


Differential
Rate differential factor applicable for the lead/group.


Factor









Interim Quote Tab











Element
Description















Medical








Quote Medical
Check to include quote for medical coverage.


Contribution
Check to include employer contribution summary in


Summary?
quote output.


Employer
Check to include employer rate summary in quotes


Summary
output for each of the contribution options, namely, %



of lowest cost HMO plan, % of lowest cost plan, % of



specified plan and flat $ amount.


Employee Quotes
Check to include individual employee quote sheets in



quotes output for each of the contribution option.


Value for 
Specify contribution percentage or dollar amount of


Employee
employer (in case of flat dollar contribution) towards



employee's premium for each of the contribution



option.


Value for
Specify contribution percentage or dollar amount of


Dependent
employer (in case of flat dollar contribution) towards



dependent's premium for each of the contribution



option.







Dental








Quote Dental
Check to include quote for dental coverage.


Contribution
Check to include employer contribution summary in


Summary?
quote output.


Employer 
Check to include employer rate summary in quotes


Summary
output for each of the contribution options, namely, %



of lowest cost plan, % of specified plan and flat $



amount.


Employee Quotes
Check to include individual employee quote sheets in



quotes output for each of the contribution option.


Value for 
Specify contribution percentage or dollar amount of


Employee
employer (in case of flat dollar contribution) towards



employee's premium for each of the contribution



option.


Value for
Specify contribution percentage or dollar amount of


Dependent
employer (in case of flat dollar contribution) towards



dependent's premium for each of the contribution



option.







Vision








Quote Vision
Check to include quote for vision coverage.


Contribution
Check to include employer contribution summary in


Summary?
quote output.


Employer 
Check to include employer rate summary in quotes


Summary
output for each of the contribution options, namely, %



of lowest cost plan, % of specified plan and flat $



amount.


Employee Quotes
Check to include individual employee quote sheets in



quotes output for each of the contribution option.


Value for 
Specify contribution percentage or dollar amount of


Employee
employer (in case of flat dollar contribution) towards



employee's premium for each of the contribution



option.


Value for
Specify contribution percentage or dollar amount of


Dependent
employer (in case of flat dollar contribution) towards



dependent's premium for each of the contribution



option.







CAM








Quote CAM
Check to include quote for CAM coverage.


Contribution
Check to include employer contribution summary in


Summary?
quote output.


Employer 
Check to include employer rate summary in quotes


Summary
output for each of the contribution options, namely, %



of lowest cost plan, % of specified plan and flat $



amount.


Employee Quotes
Check to include individual employee quote sheets in



quotes output for each of the contribution option.


Value for 
Specify contribution percentage or dollar amount of


Employee
employer (in case of flat dollar contribution) towards



employee's premium for each of the contribution



option.


Value for
Specify contribution percentage or dollar amount of


Dependent
employer (in case of flat dollar contribution) towards



dependent's premium for each of the contribution



option.









Quote Output











Element
Description







Generate
Specify whether to generate a standard quote or an



interim quote. It is not sufficient to enter input



parameters for interim quotes; this field has to be set



to “Interim Quote” to generate an interim quote.


Quote for spec-
Specify whether to quote only for plans specified


ified plans only
against each employee.


Exclude spec-
Exclude plans from appearing in the quote output.


ified plan



Quote for
Specify whether quote is for a group or selected set of



employees within the group.


When quoting
When quoting for groups, specify whether the quote


groups, include
output should have employer rate summary alone or



employer rate summary and employee quote pages.


Mode of Output
Specify mode of quote output.


Send to whose
Specify whether the quote has to be sending to agent's


attention
attention or group's attention or other. If “other” is



selected name and address or email or fax of addressee



has to be specified.


Include program
Specify whether to include program brochure as part of


brochure
the quote output or not.









Button Functionality
The following table provides explanation for each button in the screen.
Common














Element
Description









New
Clears the screen to allow creation of a quote.



Save
Saves quote input information to the database. The




saved quote can be retrieved at a later point in time.



Search
Allows searching for a saved quote.










Group/Lead Info Tab











Element
Description







Populate Current
Populates quotes screen with additional group


Enrollment
information like coverage and contribution option,



agent fee, current employee information with their



plans.









Employee Info Tab











Element
Description







Set Size
Sets the size of the employee information entry



table based on the number entered in the field 



preceding the button.


Upload Employee
Allows uploading employee information from 


Information
text files of specific format.


Delete
Deletes selected (checked) employee rows from 



the entry table.









Quote Output Tab











Element
Description







Generate quote
Generates quotes output based on the quotes output



options specified.









Modify Quote/Create Quote Revision
This function enables the user to modify input information for an existing quote and save it as modification to current revision or as a new revision.

    
    
        Step—1: After successful logon, click menu Sales & Marketing and select the option Quotes.
        Step—2: Click Search button to search for an existing quote. The browser navigates to quotes search screen.
        A quote can be searched using quote number, quote date, first few characters of lead/group name. (See FIG. F-102)
        Click on quote to be modified to return to the main screen. (See FIG. F-103)
        Step—3: Existing revision available for the quote gets listed in next to lead/group id field in the “Lead/Group Information” section. Select the revision number to modify. The screen refreshes to load the selected revision.
        Step—4: Make necessary modifications to the quotes input information and click save button. The system prompts with a question “Do you want to save changes as a new revision? . . . ”. Click OK to save the modifications as a new revision; click Cancel to save the modifications to the same revision.
    
    


Generate Quote
This function enables the user to generate a quote and view, print, email or fax the quote output.

    
    
        Step—1: After successful logon, click menu Sales & Marketing and select the option Quotes. (See FIG. F-104)
        Step—2: Click Search button to search for an existing quote. The browser navigates to quotes search screen.
        A quote can be searched using quote number, quote date, first few characters of lead/group name.
        Click on the quote to be modified to return to the main screen.
        Step—3: Click on the “Quote Output” tab on the top or the link at the bottom to navigate to quotes output screen. Ensure that the mode of output and “attention to” information are as desired. Click Generate Quote button to generate the quote.
        If “View” option was selected, a popup window appears and the quote output opens up as a word document in the window.
        If “Email” or “Fax” option was selected, the quotes output is send via email or fax directly to “Group”, “Agent” or “Other” as specified in “attention to” information.
        If “Print in Mailroom” option was selected, the quote output is send to the mailroom queue.
    
    


Generate Interim Quote
This function enables the user to generate an interim quote and view, print, email or fax the quote output.
An interim quote is different from a standard quote, in that, parameters can be specified for all the 4 contribution options.

    
    
        Step—1: After successful logon, click menu Sales & Marketing and select the option Quotes.
        Step—2: Click Search button to search for an existing quote. The browser navigates to quotes search screen.
        A quote can be searched using quote number, quote date, first few characters of lead/group name.
        Click on the quote to be modified to return to the main screen.
        Step—3: Click on the “Interim Quote” tab on the top or the link at the bottom to navigate to employee information screen. Specify the line of coverage to be quoted and the contribution parameters for each line of coverage. (See FIG. F-105)
        Step—4: Click on the “Quote Output” tab on the top or the link at the bottom to navigate to quotes output screen. Choose Interim quote option. Ensure that other information required for quotes like quote for, mode of output and addressee information is entered as desired. Click Generate Quote button to generate the quote.
    
    


View Missing Information
This function enables the user to view any missing input information required for quote generation. The option would also list out any business rule that is not satisfied.
Step 1: After successful logon, click menu Sales & Marketing and select the option Quotes.

    
    
        Step—2: Please refer to previous sections on how to create a new quote or modify a saved quote. Before clicking on save button to the save the quote-input information to the database, click on the “Missing Info” tab on the top or the link at the bottom to navigate to missing information screen.
        Step—3: If the quote has any mission information or any business rule not satisfied, the screen would list out all such items. (See FIG. F-106)
        The missing information is grouped on how the input fields are grouped in the input screens. Click on the hyperlink at the top corner of each section to navigate to the specific area in the input screen where the missing information is located.
    
    


Related Applications
No related applications
PX2 User Manual
User Administration
1 Introduction
User Administration is the administrative module that encompasses the processes of creating and maintaining the PX2 entities like Module, Application, Resource, Group, User, User Role, Group Access rights, User Role Group Mapping and Password Configuration.
The Applications
The above-mentioned processes are accomplished in several applications embedded into the User Administration system. These applications steer the tasks of creating, and administering the PX2 entities, thereby helping achieve the goals of the User Administration system.
Module Master—Modules are the encapsulation from a wider perspective, of the broad functionalities of the PX2 system. For e.g. Carrier Maintenance, Sales and Marketing, Enrollment, Finance etc. This module master application is used to manage modules within the PX2 system.
Application Master—An application represents a business use case or a set of related use cases. The organization of related resources or pages in sequence constitute an application. A module consists of many applications. For e.g. Carrier Maintenance module consists of following applications viz. Zip Master, Carrier Master, and M Plan etc. This application master application is used to manage applications within the PX2 system.
Resource Master—These are entities or pages that are organized in logical sequence to achieve the functionality of an application. An application can have one or more resources, access to which is administered by the User Administration module. This resource master application is used to manage resources within the PX2 system.
Group Master—A group is a functional or logical collection of users. The grouping is based on the nature of operations performed by the users. A user can belong to multiple groups. This group master application is used to manage groups within the PX2 system.
User Master—A user is an entity representing a person working in any of the departments in Benefit Partners Inc. The identity of the user is to be authenticated by the User Administration System in consideration of his/her group and role. A user can belong to multiple groups and can play multiple roles. This user master application is used to manage users within the PX2 system.
User Role Master—User role represents a job a particular person performs in the system. A user can play multiple roles in the system. For e.g., a manager can play the role of a data entry personnel as well as that of an authorizing body. When logged in as data entry personnel, he/she may not have the privileges what was available as a manager. This user role master application is used to manage user roles within the PX2 system.
Mapping—This crucial process involves the creation of modular combinations of the entities. This process of mapping the entities is three-fold as detailed below.
User Role Group Mapping—This bi-fold process assigns a selected role to a user and then assigns the user to a selected group.
Group Access Rights—This process assigns access rights to a group for an application. Subsequently the resources in the selected application could be allotted individual Read, Write or No Access rights to the group.
User Access Rights—This process assigns access rights to the user for an application's resources. This assignment over-rides the rights available to the group to which the user belongs.
Password Configuration—This process configures the various password-related parameters. These parameters include maximum & minimum password length, maximum & minimum expiry days, password repeat count etc.
2 Module
Modules are the encapsulation from a wider perspective, of the functionalities associated with the PX2 system. For e.g. Carrier Maintenance, Sales and Marketing, Enrollment, Finance etc.

    
    
        The module comprises of a group of applications. The following modules form an integral part of the core administrative system viz. Carrier Maintenance, Enrollment, Sales and Marketing and Finance.
    
    


Access
The application can be accessed from the main menu as follows:

    
    
        Security→Module→Create/Modify
        
            →Delete Module
        
        
    
    


Pre-Requisites
There are no pre-requisites for using this application.
Application Functions
This application has the following functions:

    
    
        Create Module
        Modify Module
        Delete Module
    
    


Create Module
This function enables the creation of a new module. This creates a module with a unique id, under which several applications could be organized.
The sequential steps involved in the creation of a new module are listed below.


    
    
        Step—1: After successful logon, click the menu Module and select the option Create/Modify. (See FIG. G-G-1)
        Step—2: Enter the values in the respective field as per the format briefed in the Fields Explanation section, and click the Save button. (See FIG. G-2)
    
    


Fields Explanation
The following table provides explanations for each of the screen fields.











Element
Description







Module Id
The id with which the module is uniquely identified.



Accepts alphabets and numeric values. Entry in this



field is mandatory.


Module Name
The text for module name. Accepts alphabets and



numeric values. Entry in this field is mandatory.


Comments
The comments pertinent to the module being



created. Accepts alphabets and numeric values.



Entry in this field is optional.









Button Functionality
The following table provides explanation for each button in the screen.














Element
Description









Save
Saves the entered module information in the




database. The page gets refreshed and the contents




entered in the fields are cleared.



Cancel
Clears the contents entered in the fields.










Modify Module
This function enables the modification of an existing module. After modification, the organization of applications under the module remains intact.
The sequential steps involved in the modification of an existing module are listed below.

    
    
        Step—1: After successful logon, click the menu Module and select the option Create/Modify (See FIG. G-3)
        Step—2: Module id has to be selected by clicking the lookup icon. (See FIG. G-4)
        This pops a window enlisting the existing module ids. (See FIG. G-5)
        Step—3: Choose a module id by double clicking on any of the listed module ids. The selected module id gets inserted in the module id field automatically. (See FIG. G-6)
        Step—4: Change the contents to be modified and click Update.
    
    


Fields Explanation
The following table provides explanation for each of the screen fields.











Element
Description







Module Id
The id with which the module is uniquely identified.



Accepts alphabets and numeric values. Entry in this



field is mandatory.


Module Name
The text for module name. Accepts alphabets and



numeric values. Entry in this field is mandatory.


Comments
The comments pertinent to the module being



modified. Accepts alphabets and numeric values.



Entry in this field is optional.









Button Functionality
The following table provides explanation for each button in the screen











Element
Description







Module Id
The id with which the module is uniquely identified.



Accepts alphabets and numeric values. Entry in this



field is mandatory.


Module Name
The text for module name. Accepts alphabets and



numeric values. Entry in this field is mandatory.


Comments
The comments pertinent to the module being



modified. Accepts alphabets and numeric values.



Entry in this field is optional.









Delete Module
This function enables the deletion of an existing module. Only the modules that are not associated with any other application are available for deletion.
The sequential steps involved in the deletion of an existing module are listed below.

    
    
        Step—1: After successful logon, click the menu Module and select the Delete option. (See FIG. G-7)
        Step—2: Check the ids of the modules to be deleted. Only modules that do not have any applications organized under them can be deleted.
        Step—3: Click the Delete button to perform delete operation on the selected modules. (See FIG. G-8)
    
    


Button Functionality
The following table provides explanation for each button in the screen.











Element
Description







Check Box
Check the modules to be deleted. Check box will be



in disabled state for applications that have been used



in any of the higher-level entities of the User



Administration system.


Delete
Deletes the selected applications.









Related Applications
Related applications are:

    
    
        Application Master
        Resource Master
    
    


3 Application
An application represents a business use case or a set of related use cases. The organization of related resources or pages in sequence constitute an application. A module consists of many applications. For e.g. Carrier Maintenance module consists of following applications viz. Zip Master, Carrier Master, and M Plan etc. Each application is constituted of several pages.
Access
The application can be accessed from the main menu as follows:

    
    
        Security→Application→Create/Modify
        
            →Delete Application
        
        
    
    


Pre-Requisites
The Module, under which the application is to be organized, must have been created and available.
Application Functions
This application has the following functions:

    
    
        Create application
        Modify application
        Delete application
    
    


Create Application
This function enables the creation of a new application. This creates an application with a unique id under which several resources could be organized.
The sequential steps involved in the creation of a new application are listed below.

    
    
        Step—1: After successful logon, click the menu Application and select the option Create/Modify. (See FIG. G-9)
        Step—2: Enter the values in the respective fields, as per the format briefed in Fields Explanation section. (See FIG. G-10)
        Step—3: To select an application, click the lookup icon. This pops a window enlisting the existing application ids. Choose an application id by double clicking on any application id for selection. Corresponding application name of the selected application id will be inserted automatically. (See FIG. G-11)
        Step—4: Enter the application name directly.
        Step—5: Enter the comments directly.
        Step—6: To select a module, click the lookup icon. This pops a window enlisting the existing module ids. Choose a module id by double clicking on any module id for selection. The module name of the selected module id will be inserted automatically (See FIG. G-12)
        Step—7: Click Save button to save the contents.
    
    


Fields Explanation











Element
Description







Application Id
The id with which the application is uniquely



identified. Accepts alphabets and numeric values.



Entry in this field is mandatory. Selection could also



be made, by clicking the lookup icon.


Application Name
The text for application name. Accepts alphabets and



numeric values. Entry in this field is mandatory.


Comments
The comments pertinent to the Application being



created. Accepts alphabets and numeric values.



Entry in this field is optional.


Select the module
Clicking on the Lookup icon enlists the existing



modules, selecting which automatically makes an



entry in the field. Entry in this field is mandatory.



On this selection, modules selected will get



associated with the application being created.









Button Functionality











Element
Description







Application Id
The id with which the application is uniquely



identified. Accepts alphabets and numeric values.



Entry in this field is mandatory. Selection could also



be made, by clicking the lookup icon.


Application Name
The text for application name. Accepts alphabets and



numeric values. Entry in this field is mandatory.


Comments
The comments pertinent to the Application being



created. Accepts alphabets and numeric values.



Entry in this field is optional.


Select the module
Clicking on the Lookup icon enlists the existing



modules, selecting which automatically makes an



entry in the field. Entry in this field is mandatory.



On this selection, modules selected will get



associated with the application being created.









Modify Application
This function enables the modification of an existing application. After modification, the organization of resources under the application remains intact.
The sequential steps involved in the modification of an existing application are listed below.

    
    
        Step—1: After successful logon, click the menu Application and select the option Create/Modify. (See FIG. G-13)
        Step—2: Application id could be directly entered or selected by clicking the lookup icon. (See FIG. G-14)
        This pops a window enlisting the existing application ids. (See FIG. G-15)
        Step—3: Choose an application id by double clicking on any application id. The selected application id gets automatically inserted in the application id field with its corresponding application name.
        Step—4: Module has to be selected by clicking the lookup icon. [See step—3 of create application] (See FIG. G-16)
        Step—5: Change the contents to be modified and click Update.
    
    


Fields Explanation











Element
Description







Application Id
The id with which the application is uniquely



identified. Accepts alphabets and numeric values.



Entry in this field is mandatory.


Application Name
The text for Application name. Accepts alphabets



and numeric values. Entry in this field is mandatory.


Comments
The comments pertinent to the application being



modified. Accepts alphabets and numeric values.



Entry in this field is optional.


Selected the
Clicking on the lookup icon enlists the existing


module
Modules, selecting which automatically makes an



entry in the field. Entry in this field is mandatory.



Upon this selection, the selected modules will get



associated with the application being modified.









Button Functionality














Element
Description









Update
Saves the entered Application information in the




database. The page gets refreshed and the contents




entered in the fields are cleared.



Cancel
Clears the contents entered in the fields.










Delete Application
This function enables the deletion of an existing application. Only the applications that are not associated with any other resource or module are available for deletion.
The sequential steps involved in the deletion of an existing application are listed below.

    
    
        Step—1: After successful logon, click the menu Application and select the Delete option. (See FIG. G-17)
        Step—2: Check the application ids to be deleted. Only applications that don't have any resources under them can be deleted.
        Step—3: Click Delete button to perform delete operation on the selected application ids. (See FIG. G-18)
    
    


Button Functionality











Element
Description







Check Box
Check the applications to be deleted. Check box will



be in disabled state for applications that have been



used in any other User Administration levels of



higher than it.


Delete
Deletes the selected applications.









Related Applications
Related applications are:

    
    
        Module Master
        Resource Master
    
    


4 Resources
These are entities or pages that are organized in logical sequence to achieve the functionality of an application. An application can have one or more resources, access to which is administered by the User Administration module.
The resources accessible from the system can be protected using a single access control (ACL). The ACL specifies the nature of access rights available for a page. For e.g. Read or Write or None.
Access
The application can be accessed from the main menu as follows:

    
    
        Security→Resource→Create/Modify
        
            →Delete Resource
        
        
    
    


Pre-Requisites
An application is constituted of resources. The application, to which the resources are to be attached, must be available in the system.
Application Functions
This application has the following functions:

    
    
        Create resource
        Modify resource
        Delete resource
    
    


Create Resource
This function enables the creation of a new resource. This creates a resource with a unique id.
The sequential steps involved in the creation of a new resource are listed below.

    
    
        Step—1: After successful logon, click menu Resource and select the option of Create/Modify. (See FIG. G-19)
        Step—2: Enter the values in the respective fields, as per the format briefed in Fields Explanation section. (See FIG. G-20)
        Step—3: For selecting an application, click the lookup icon. This pops a window enlisting the existing application ids. Choose an application id by double clicking on any application id for selection. The name of the selected application id will be inserted automatically. (See FIG. G-21)
        Step—4: Enter the resource name directly.
        Step—5: Enter screen URL directly.
        Step—6: Enter comments directly.
        Step—7: Click the Save button to save the contents.
    
    


Fields Explanation











Element
Description







Resource Id
The id with which the resource is uniquely



identified. Accepts alphabets and numeric values.



Entry in this field is mandatory.


Resource Name
The text for resource name. Accepts alphabets and



numeric values. Entry in this field is mandatory.


Screen URL
The path URL for accessing the resource. Accepts



alphabets and numeric values. Entry in this field is



mandatory.


Comments
The comments pertinent to the resource being



created. Accepts alphabets and numeric values.



Entry in this field is optional.


Select the
Clicking on the lookup icon enlists the existing


Application
applications, selecting which automatically makes an



entry in the field. Entry in this field is mandatory.



Upon this selection, the application selected will get



associated with the resource being created.









Button Functionality














Element
Description









Save
Saves the entered resource information in the




database. The page gets refreshed and the contents




entered in the fields are cleared.



Cancel 
Clears the contents entered in the fields.










Modify Resource
This function enables the modification of an existing resource.
The sequential steps involved in the modification of an existing module are listed below.

    
    
        Step—1: After successful logon, click Resource menu and select the option Create/Modify. (See FIG. G-22)
        Step—2: Resource id has to be selected by clicking the lookup icon. (See FIG. G-23)
        This pops a window enlisting the existing application ids. (See FIG. G-24)
        Step—3: Choose a resource id by double clicking on any resourced id. The selected resource id gets automatically inserted in the resource id field with its corresponding resource name.
        Step—4: Application has to be selected by clicking the lookup icon. [See step—3 of create resource] (See FIG. G-25)
        Step—5: Change the contents to be modified and click Update.
    
    


Fields Explanation











Element
Description







Resource Id
The id with which the resource is uniquely



identified. Entry in to this field is mandatory.


Resource Name
The text for resource name. Accepts alphabets and



numeric values. Entry in this field is mandatory.


Screen URL
The URL of the resource. Accepts alphabets and



numeric values. Entry in this field is mandatory.


Comments
The comments pertinent to the resource being



modified. Accepts alphabets and numeric values



Entry in this field is optional.


Selected the 
Clicking on the lookup icon enlists the existing


Application
applications selecting which automatically makes an



entry in the field. Entry in this field is mandatory.



On this selection, applications selected will get



associated with the resource being modified.









Button Functionality














Element
Description









Update 
Saves the entered resource information in the




database. The page gets refreshed and the contents




entered in the fields are cleared.



Cancel
Clears the contents entered in the fields.










Delete Resource
This function enables the deletion of an existing resource. Only the resources that are not associated with any application are available for deletion.
The sequential steps involved in the deletion of an existing resource are listed below.

    
    
        Step—1: After successful logon, click Resource menu and select the Delete option. (See FIG. G-26)
        Step—2: Select the values of resource ids to be deleted. The resources that are not associated with any application only are available for deletion.
        Step—3: Click Delete button to perform delete operation on the selected resources. (See FIG. G-27)
    
    


Button Functionality














Element
Description









Check Box
Check the resources to be deleted. Check box will be




in disabled state for resources that have been used in




any other User Administration levels of higher than




this.



Delete
Deletes the selected resources.










Related Applications
Related applications are:

    
    
        Module Master
        Application Master
    
    


5 Group
A group is a functional or logical collection of users. The grouping is based on the nature of operations performed by the users. A user can belong to multiple groups. Groups provide an efficient way to manage large numbers of users because an administrator can specify permissions for an entire group at one time. The resources can be allocated to a group instead of assigning to an individual user. The user being a part of the group acquires access rights to those resources attached to the group.
Access
The application can be accessed from the main menu as follows:

    
    
        Security→Group→Create/Modify
        
            →Delete Group
        
        
    
    


Pre-Requisites
There are no pre-requisites for using this application.
Application Functions
This application has the following functions:

    
    
        Create group
        Modify group
        Delete group
    
    


Create Group
This function enables the creation of a new group. This creates a group with a unique id under which several users could be organized.
The sequential steps involved in the creation of a new group are listed below.

    
    
        Step—1: After successful logon, click the menu Group and select the option Create/Modify. (See FIG. G-28)
        Step—2: Enter the values in the respective fields as per the format briefed in the field's explanation section, and click the Save button. (See FIG. G-29)
    
    


Fields Explanation














Element
Description









Group Id
The id with which the group is uniquely identified.




Accepts alphabets and numeric values. Entry in this




field is mandatory.



Group Name
The text for group name. Accepts alphabets and




numeric values. Entry in this field is mandatory.



Comments
The comments pertinent to the group being created.




Accepts alphabets and numeric values. Entry in this




field is optional.










Button Functionality














Element
Description









Save
Saves the entered group information in the database.




The page gets refreshed and the contents entered in




the fields get cleared.



Clear
Clears the contents entered in the fields.










Modify Group
This function enables the modification of an existing group. After modification, the organization of users under the group remains intact.
The sequential steps involved in the modification of an existing group are listed below.

    
    
        Step—1: After successful logon, click the menu Group and select the option Create/Modify. (See FIG. G-30)
        Step—2: Group id has to be selected by clicking the lookup icon. This pops a window enlisting the existing application ids. (See FIG. G-31)
        Step—3: Choose a group id by double clicking on any group id for selection. The selected group id gets automatically inserted in the group id field with its corresponding group name. (See FIG. G-32)
        Step—4: Change the contents to be modified and click the Update button. (See FIG. G-33)
    
    


Fields Explanation














Element
Description









Group Id
The id with which the group is uniquely identified.




Accepts alphabets and numeric values. Entry in this




field is mandatory.



Group Name
The text for group name. Accepts alphabets and




numeric values. Entry in this field is mandatory.



Comments
The comments pertinent to the group being




modified. Accepts alphabets and numeric values




Entry in this field is optional.










Button Functionality














Element
Description









Update
Saves the entered group information in the database.




The page gets refreshed and the contents entered in




the fields are cleared.



Cancel
Clears the contents entered in the fields.










Delete Group
This function enables the deletion of an existing group. Only the groups that are not associated with any other application are available for deletion.
The sequential steps involved in the deletion of an existing group are listed below.

    
    
        Step—1: After successful logon, click the menu Group and select the Delete option. (See FIG. G-34)
        Step—2: Check the ids of the groups to be deleted. The disabled checkboxes represent the groups that are previously mapped to any users.
        Step—3: Click the Delete button to perform delete operation on the selected groups. (See FIG. G-35)
    
    


Button Functionality














Element
Description









Check Box
Check the groups to be deleted. Check box will be in




disabled state for groups that have been previously




associated with users.



Delete
Deletes the selected groups.










Related Applications
Related application is:

    
    
        Users
    
    


6 User
A user is an entity representing a person working in any of the departments in Benefit Partners Inc. The identity of the user is to be authenticated by the User Administration system in consideration of his/her group and role. A user can belong to multiple groups and can play multiple roles.
Access
The application can be accessed from the main menu as follows:

    
    
        Security→User→Create/Modify
        
            →Delete User
        
        
    
    


Pre-Requisites
Groups must have been created and available to attach users to those groups. This attachment can be of any form like one user to one group or one user to many groups.
Application Functions
This application has the following functions:

    
    
        Create user
        Modify user
        Delete user
    
    


Create User
This function enables the creation of a new user.
The sequential steps involved in the creation of a new user are listed below.

    
    
        Step—1: After successful logon, click the menu User and select the option Create/Modify. (See FIG. G-36)
        Step—2: Enter the values in the respective fields as per the format briefed in Fields Explanation section, and click the Save button. (See FIG. G-37)
    
    


Fields Explanation











Element
Description







First Name
The first name of the user. Accepts alphabets of



length not exceeding 25 characters. Entry in this



field is mandatory.


Middle Initial
The middle initial of the user. Accepts only 1



alphabet character. Entry in this field is optional.


Last Name
The last name of the user. Accepts alphabets of



length not exceeding 35 characters. Entry in this



field is mandatory.


User Id
The id with which the user is uniquely identified.



Accepts alphabets and numeric values. Entry in this



field is mandatory.


Password
The password to logon. Accepts alphabets, numeric



values and special characters. Entry in this field is



mandatory.


Display name
The display name is the name by which a user



wishes to display his/her name. Accepts alphabets



and numeric values. Entry in this field is mandatory.


Phone
The telephone number of a user. Accepts only 10



digits of numeric and should be in the format 999



999 9999. Entry in this field is mandatory.


Extension
The extension number to access a user. Accepts only



4 digits of numeric and should be in the format



9999. Entry in this field is optional.


Fax
The fax number of a user. Accepts only 10 digits of



numeric and should be in the format 999 999 9999.



Entry in this field is optional.


E-mail
The email id of a user. Accepts alphabets, numeric



values and special characters of length not exceeding



100 with a valid email format. Entry in this field is



mandatory.


Lock
Lock the user access to the PX2 system. On



checking the lock check box, the user is denied



access to the entire PX2 system.









Button Functionality














Element
Description









Save
Saves the entered user information in the database.




The page gets refreshed and the contents entered in




the fields are cleared.



Cancel
Clears the contents entered in the fields.










Modify User
This function enables the modification of an existing user.
The sequential steps involved in the modification of an existing user are listed below.

    
    
        Step—1: After successful logon, click the menu User and select the option Create/Modify. (See FIG. G-38)
        Step—2: User id has to be selected by clicking the lookup icon. (See FIG. G-39)
        Step—3: This pops up a screen. Enter the user id. To run a search on existing user ids type a few letter(s) and click on the Search button. (See FIG. G-40)
        Step—4: Double click on any user-id for selection. Corresponding display name will get inserted in the field automatically. (See FIG. G-41)
        Step—5: Change the contents to be modified and click Update.
    
    


Field Explanation











Element
Description







First Name
The first name of the user. Accepts alphabets of



length not exceeding 25 characters. Entry in this



field is mandatory.


Middle Initial
The middle initial of the user. Accepts only 1



alphabet character. Entry in this field is optional.


Last Name
The last name of the user. Accepts alphabets of



length not exceeding 35 characters. Entry in this



field is mandatory.


User Id
The id with which the user is uniquely identified.



Accepts alphabets and numeric values. Entry in this



field is mandatory.


Password
The password to logon. Accepts alphabets, numeric



values and special characters. Entry in this field is



mandatory.


Display name
The display name is the name by which a user



wishes to display his/her name. Accepts alphabets



and numeric values. Entry in this field is mandatory.


Phone
The telephone number of a user. Accepts only 10



digits of numeric and should be in the format 999



999 9999. Entry in this field is mandatory.


Extension
The extension number to access a user. Accepts only



4 digits of numeric and should be in the format



9999. Entry in this field is optional.


Fax
The fax number of a user. Accepts only 10 digits of



numeric and should be in the format 999 999 9999.



Entry in this field is optional. Entry in this field is



mandatory.


E-mail
The email id of a user. Accepts alphabets, numeric



values and special characters of length not exceeding



100 with a valid email format. Entry in this field is



mandatory.


Lock
Lock the user access to the PX2 system. On



checking the lock check box the user is denied access



to the entire PX2 system.









Button Functionality














Element
Description









Update
Saves the entered user information in the database.




The page gets refreshed and the contents entered in




the fields are cleared.



Cancel
Clears the contents entered in the fields.










Delete User
This function enables the deletion of an existing user. Only the users that are not associated with any other groups are available for deletion.
The sequential steps involved in the deletion of an existing user are listed below.

    
    
        Step—1: After successful logon, click the menu User and select the Delete option. (See FIG. G-42)
        Step—2: Check the user ids to be deleted. Only the users that are not associated with any other groups are available for deletion.
        Step—3: Click Delete button to perform delete operation on the selected user ids. (See FIG. G-43)
    
    


Button Explanation











Element
Description







Check Box
Check the users to be deleted. Check box will be in



disabled state for users that have been used in any



other User Administration levels of higher than it.


Delete
Deletes the selected users.









Related Applications
Related application is:

    
    
        Group Master
    
    


7 User Role
User role represents a job a particular person performs in the system. A user can play multiple roles in the system. For e.g. a manager can play the role of data entry personnel as well as that of an authorizing body. When logged in as data entry personnel, he/she may not have the privileges what was available as a manager.
Access
The application can be accessed from the main menu as follows:

    
    
        Security→Application→Create/Modify
        
            →Delete User Role
        
        
    
    


Pre-Requisites
There are no pre-requisites as such for using this application.
Application Functions
This application has the following functions:

    
    
        Create user role
        Modify user role
        Delete user role
    
    


Create User Role
This function enables the creation of a new user role. This creates a user role with a unique id to which several users could be mapped.
The sequential steps involved in the creation of a new user role are listed below.

    
    
        Step—1: After successful login, click the menu User Role and select the option Create/Modify. (See FIG. G-44)
        Step—2: Enter the values in the respective fields as per the format briefed in fields explanation section, and click the Save button. (See FIG. G-45)
    
    


Field Explanation











Element
Description







User Role Id
The id with which the user role is uniquely



identified. Accepts alphabets and numeric values of



length not exceeding 35 characters. Entry in this



field is mandatory.


User Role Name
The text for user role name. Accepts alphabets and



numeric values. Entry in this field is mandatory.


Comments
The comments pertinent to the user role being



created. Accepts alphabets and numeric values.



Entry in this field is optional.









Button Functionality














Element
Description









Save
Saves the entered user role information in the




database. The page gets refreshed and the contents




entered in the fields get cleared.



Cancel
Clears the contents entered in the fields.










Modify User Role
This function enables the modification of an existing user role. Many user roles can be assigned to a user but only one role can be exercised at a time.
The sequential steps involved in the modification of an existing user role are listed below.

    
    
        Step—1: After successful logon, click the menu User Role and select the option Create/Modify. (See FIG. G-46)
        Step—2: Enter the User role or select the user role id by clicking the lookup icon. (See FIG. G-47)
        This pops a window enlisting the existing application ids. (See FIG. G-48)
        Step—3: Double click on any user role id for selection. Corresponding display name will get inserted in the field automatically. (See FIG. G-49)
        Step—4: Change the contents to be modified and click the Update button.
    
    


Field Explanation











Element
Description







User Role Id
The id with which the user role is uniquely



identified. Accepts alphabets and numeric values of



length not exceeding 35 characters. Entry in this



field is mandatory.


User Role Name
The text for user role name. Accepts alphabets and



numeric values. Entry in this field is mandatory.


Comments
The comments pertinent to the user role being



created. Accepts alphabets and numeric values.



Entry in this field is optional.









Button Functionality














Element
Description









Update
Saves the entered user role information in the




database. The page gets refreshed and the contents




entered in the fields are cleared.



Cancel
Clears the contents entered in the fields.










Delete User Role
This function enables the deletion of an existing user role. Only he user roles that are not mapped to any users are only available for deletion.
The sequential steps involved in the deletion of an existing user role are listed below.

    
    
        Step—1: After successful logon, click the menu User Role and select the Delete option. (See FIG. G-50)
        Step—2: Check the user role ids to be deleted. The user roles that are not associated with any other higher-level hierarchy of users only are available for deletion.
        Step—3: Click Delete button to perform delete operation on the selected user role ids. (See FIG. G-51)
    
    


Button Explanation














Element
Description









Check Box
Check the user role to be deleted. Check box will be




in disabled state for user roles that have been used in




any other User Administration levels of higher than




it.



Delete
Deletes the selected User roles.










Related Applications
Related applications are:

    
    
        User
        Mapping
    
    


8 Mapping
The Mapping master is the application used to create mapping between Groups, User and User Roles. This crucial process involves the creation of modular combinations of these entities.
Access
The application can be accessed from the main menu as follows:

    
    
        Security→User Role→Group Access Rights
        
            →User Role Group
            →User Access Rights
        
        
    
    


Pre-Requisites
Users, Groups, User Roles, Resources must be available in the system to establish mapping amongst them.
Application Functions
This application is to establish a relationship between Groups, User and User Roles.

    
    
        Create/Remove Group Access Rights
        Create/Remove User Role Group
        Create/Remove User Access Rights
    
    


User Role Group
This bi-fold process assigns a selected role to a user and then assigns the user to a selected group.
The sequential steps involved in the creating user role group are listed below.

    
    
        Step—1: After successful logon, click the menu Mapping and select the User Role Group option. (See FIG. G-52)
        Step—2: User id has to be selected by clicking the lookup icon. (See FIG. G-53)
        This pops up a screen. Enter the user id. (See FIG. G-54)
        To run a search on existing user ids type a few letter(s) and click on the Search button.
        Step—3: Double click on any user-id for selection. User id and its corresponding display name will get inserted in the respective fields automatically.
        Step—4: To assign a role to the user, select an existing role by clicking the lookup icon. This pops a window enlisting the existing roles. Choose a role by double clicking on any role. The selected role name gets inserted in the role field automatically. (See FIG. G-55)
        Step—5: Click Select button to complete the mapping of user to role. The window gets refreshed displaying the list of available groups. (See FIG. G-56)
        Step—6: Now to associate the user with the assigned role to a group, check the group ids to be associated with.
        Step—7: Click on Save button to complete the process of mapping of the user to role to group.
    
    


Field Explanation














Element
Description









User Id
The id with which the user is uniquely identified.



Display Name
The display name is the name by which a user




wishes to display his/her name.



Select the Role
The selection of a role is to assign a role to the




selected user id.










Button Functionality














Element
Description









Select
Select will map the selected user to the selected role




and enlist the existing groups.



Save
Saves the entered user, role, and group information




in the database. The page gets refreshed and the




contents entered in the fields are cleared.



Clear/Cancel
The mapping process carried out up to that point




gets cancelled. Clears the contents entered in the




fields.










Group Access Rights
This process assigns access rights to a group for an application. Subsequently the resources in the selected application could be allotted individual read, write or no access rights to the group.
The sequential steps involved in the creating group access rights are listed below.

    
    
        Step—1: After successful login, click the menu Mapping and select the Group Access Rights option. (See FIG. G-57)
        Step—2: Group id has to be selected by clicking the lookup icon. This pops a window enlisting the existing groups ids. Choose a group id by double clicking on any group id for selection. The selected group id gets inserted in the group id field automatically. (See FIG. G-58)
        Step—3: Now to assign applications to the selected group, select the application id by clicking the lookup icon. This pops a window enlisting the existing applications. Choose an application by double clicking on any application id for selection. The selected application id gets inserted in the application field automatically. (See FIG. G-59)
        Step—4: Click the Select button to complete the mapping of group to application. The window gets refreshed displaying the resources available under the application. (See FIG. G-60)
        Step—5: Now to assign resource-wise access rights to the assigned group and application, check the resource names to be associated with and set the desired access right from the adjoining access right list as read or write or no access.
        Step—6: Click on Save button to complete the process of creating group access rights.
    
    


Field Explanation











Element
Description







Select the Group
The id with which the group is uniquely identified.


Select the
The id with which the application is uniquely


Application
identified.


ACL [Access
Level indicates the level of accessing methods say


control level]
read, write and no access for the each of the



resources.









Button Explanation














Element
Description









Select
Select will map the selected group to the selected




Application and enlist the resources under the




selected application.



Save
Saves the entered information in the database. The




page gets refreshed and the contents entered in the




fields are cleared.



Clear/Cancel
The group access rights carried out up to that point




gets cancelled. Clears the contents entered in the




fields.










User Access Rights
User access rights represent the privileges required for accessing resources. An administrator protects resources by establishing access control lists to grant permissions to users and groups. Individual user permissions take precedence over group permissions. Individual user permission overrides the more restrictive group permission.
This process assigns access rights to the user for an application's resources. This assignment over-rides the rights available to the group to which the user belongs.
The sequential steps involved in the creating user access rights are listed below.

    
    
        Step—1: After successful logon, click the menu Mapping and select the User Access Rights (See FIG. G-61)
        Step—2: User id has to be selected by clicking the lookup icon. (See FIG. G-62)
        Enter the user id. To run a search on existing user ids type a few letter(s) and click on the Search button. The screen illustrated below pops up.
        Step—3: Double click on any user-id for selection. Corresponding display name will get inserted in the field automatically.
        Step—4: Application id has to be selected by clicking the lookup icon. This pops a window enlisting the existing application ids. Choose an application id by double clicking on any application id for selection. The selected application id gets inserted in the application id field automatically. (See FIG. G-63)
        Step—5: To assign a role to the user with assigned application, now select an existing role by clicking the lookup icon. This pops a window enlisting the existing roles. Choose a role by double clicking on any role for selection. The selected role name gets inserted in the role field automatically. (See FIG. G-64)
        Step—6: Click Select button to complete the process of user access rights. The window gets refreshed displaying the resources available under the selected application. (See FIG. G-65)
        Step—7: Now to assign resource-wise access rights to the assigned user, application and role, check the resource names to be associated with and set the desired access right from the adjoining access right list as read or write or no access.
        Step—8: Click on Save button to complete the process of creating user access rights.
    
    


Field Explanation











Element
Description







User Id
The id with which the user is uniquely identified.


Display Name
The display name is the name by which a user



wishes to display his/her name.


Select the
The id with which the application is uniquely


Application
identified.


Select the Role
The selection of a role is to assign a role to the



selected user id, application.


ACL [Access
Level indicates the level of accessing methods say


control level]
read, write and no access for the each of the



resources.









Button Functionality














Element
Description









Select
Select will map the selected User, Role to the




selected Application and enlist the resources under




the selected Application.



Save
Saves the entered information in the database. The




page gets refreshed and the contents entered in the




fields are cleared.



Clear/Cancel
The user access rights carried out up to that point




gets cancelled. Clears the contents entered in the




fields.










Related Applications
Related applications are:

    
    
        Users
        Groups
        User Roles
        Resources
    
    


9 Password Configuration
This process configures the various password-related parameters. These parameters include maximum & minimum password length, maximum & minimum expiry days, password repeat count etc.
Access
The application can be accessed from the main menu as follows:

    
    
        Security→Configure→Password Configuration
    
    


Pre-Requisites
There are no pre-requisites as such for using this application.
Application Functions
This application is to administer the parameters related to password.
Configure Password
Password configuration is mainly to monitor and control the usage of password.
Following is the screen snapshot for password configuration. (See FIG. G-66)
Fields Explanation











Element
Description







Maximum
Maximum allowed length in characters of the


Password length
password. Entry in this field is mandatory.


Minimum
Minimum allowed length in characters of the


password length
password. Entry in this field is mandatory.


Maximum Expiry
Maximum allowed date for password expiration in


Days
days. Entry in this field is mandatory.


Minimum Expiry
Minimum allowed date for password expiration in


Days
days. Entry in this field is mandatory.


Prompt Expiry
Prompt expiry date is to highlight as a reminder for


Period
password expiration in days. Entry in this field is



mandatory.


Password Repeat
This specifies the number of times the password has


Count
to have a new entry with no repetition of previous



passwords. Entry in this field is mandatory.


Invalid Password
Invalid password count will have the count of


Count
attempting with invalid passwords before the user is



locked. Entry in this field is mandatory.


Lock time for
Lock time for password in HH:MM:SS format to


password
have session-out. Entry in this field is mandatory.









Button Functionality














Element
Description









Save
Saves the entered password information in the




database. The page gets refreshed and the content




entered in the fields appear on the screen.










Related Applications
None
Benefit Partners Inc
Process Specification
BPI_CAS_FSD_CM—01
1. Introduction
1.1. Purpose

    
    
        This purpose of this document is to identify the process associated with the business use case Create Carrier Master.
    
    


1.2. Business Use Case Specification Reference
Business Use Specification














Business Use Specification ID
Business Use Case Name









BPI_SCOPE_CM_001
Create Carrier Master










1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
2.1. Background
Create Carrier Master is user for creation of master record for the carrier which includes the general information about the carrier, Department Contact Information, Mode of Communications Line of Coverage, plan type and the benefit level offered by the carrier and the benefit description.
2.2. Process Description & Flow

    
    
        This process describes the Use Case “Create Carrier Master”. This document is the amendment of BPI_CAS_FSD_CM—01 (Version 1.1).
    
    


2.2.1. Create Carrier Master

    
    
        The flow of the process is as described below.
        a. Input the general information about the carrier.
        b. Input the Department Contact Information
        c. Validate if the department contact information has the right data type.
        d. If yes add the information to a temporary storage.
        e. If not re enter the information correctly and add again.
        f. Continue adding further department contact information.
        g. If yes follow steps from b) to e)
        h. Edit or delete the Department Contact Information.
        i. On edit remove the data from temporary storage and populate the department contact information data to the fields and change the data. Continue from c) to e).
        j. On delete remove the data from the temporary storage.
        k. Can continue from step b) onwards or go to step 1)
        l. If not then check if the data entered for the general carrier information is correct or erroneous.
        m. If erroneous re enter the correct data.
        n. If Correct then save the data to the repository.
        o. System auto generates a unique identification number for the carrier.
        p. Choose the Line of coverage
        q. For the line of coverage choose the system show the Plan type.
        r. Choose the Plan Type
        s. For the plan type choose the system show the benefit level
        t. Choose the benefit level and enter the benefit level name for the specific carrier and add.
        u. The Line of coverage, plan type, Benefit Level and the name is populated in and shown.
        v. Check if the data entered is correct or erroneous.
        w. If erroneous then edit or delete the benefit level name.
        x. Else continue adding the next line of coverage
        y. If the process is completed save the data.
        z. The data is saved into the repository and unique identification number is generated for the all the benefit level offered by the specific carrier a
        
            CarrierName_PlanType_BenefitLevel_UniqueID
        
        
    
    


2.2.2. Process Flow Diagrams

    
    
        (See FIG. H-1)
    
    


3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's














Corresponding HTML File


Screen ID (SID)
Screen Name
Name







carrier.general
Carrier General
/bpi/cas/carrier/master/CarrierInfo.jsp



Info



carrier.search
Carrier Search
/bpi/cas/carrier/master/Carrier




Search.jsp


carrier.view
Carrier General
/bpi/cas/carrier/master/Carrier



Info View
GeneralInfo.jsp


carrier.product
Carrier Product
/bpi/cas/carrier/master/Carrier



Info
Product.jsp


carrier.prodsearch
Search Product
/bpi/cas/carrier/master/Product




Search.jsp


carrier.prodinfo
Carrier Product 
/bpi/cas/carrier/master/Product



Info
View.jsp









3.1.2. User Interface ID: Create Carrier Master
3.1.2.1. Screen Name: Create Carrier Master
(BPI_CAS_SCR_CM—001—001)
(See FIG. H-2)
3.1.2.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the 


Create

Create 
screen being navigated


Carrier

Carrier



Master

Master



Sub Header
Text
Sub Header
Provide Content Area Text


Carrier

Carrier



General

General



Information

Information



Sub Header
Text
Sub Header
Text for the Company Address


Address

Address



Company
Text
Company
Text for the entry field


Name

Name



Company
Entry Field
Company
Entry Field for Company name


Name (Entry

Name (Entry



Field)

Field)



Address
Text
Address
Text for the Address


Address
Entry Field
Address
Entry Field for Address


(Entry Field)

(Entry Field)



Suite/Apt #
Text
Suite/Apt #
Text for Suite/Apt #


Suite/Apt #
Entry Field
Suite/Apt #
Entry Field for Suite/Apt #


(Entry Field)

(Entry Field)



City
Text
City
Text for City


City (Entry
Entry Field
City (Entry
Entry Field for City


Field)

Field)



State
Text
State
Text for state


State (Entry
Entry Field
State (Entry
Entry Field for State


Field)

Field)



ZIP
Text
ZIP
Text for ZIP


ZIP (Entry 
Entry Field
ZIP (Entry
Entry Field for ZIP


Field)

Field)



Sub Header
Text
Sub Header
Text for the sub heading


Contact

Contact



Department

Department



Department
Drop Down
Department
List all the departments for



List

the carrier for contact 





information


Contact
Text
Contact 
Text for Contact name


Name

Name



Salutation
Text
Salutation
Text for Salutation


First Name
Text
First Name
Text for First name


Middle name
Text
Middle name
Text for middle name


Last name
Text
Last name
Text for last name


Suffix
Text
Suffix
Text for Suffix


Title
Text
Title
Text for title


Salutation
Entry Field
Salutation
Entry Field for Salutation


First Name
Entry Field
First Name
Entry field for first name


Middle name
Entry Field
Middle name
Entry field for middle name


Last name
Entry Field
Last name
Entry field for last name


Suffix
Entry Field
Suffix
Entry Field for Suffix


Title
Entry Field
Title
Entry Field for title


Address
Text
Address
Text for the Address


Address
Entry Field
Address
Entry Field for Address


(Entry Field)

(Entry Field)



Suite/Apt #
Text
Suite/Apt #
Text for Suite/Apt #


Suite/Apt #
Entry Field
Suite/Apt #
Entry Field for Suite/Apt #


(Entry Field)

(Entry Field)



City
Text
City
Text for City


City (Entry
Entry Field
City (Entry
Entry Field for City


Field)

Field)



State
Text
State
Text for state


State (Entry 
Entry Field
State (Entry 
Entry Field for State


Field)

Field)



ZIP
Text
ZIP
Text for ZIP


ZIP (Entry
Entry Field
ZIP (Entry 
Entry Field for ZIP


Field)

Field)



Mode of
Drop Down
Mode of
List various modes of contact


Communi-
List
Communi-
preferred


cation

cation 



Phone
Text
Phone
Text for phone


FAX
Text
FAX
Text for FAX


Email
Text
Email
Text for email


Phone
Entry Field
Phone
Entry Field for Phone number


FAX
Entry Field
FAX
Entry field for FAX


Email
Entry Field
Email
Entry field for email


ADD
Button
ADD
To add the above details on to



(HTML

the html table after validation



Submit

check.



button)




Table
HTML 
Table
Table for adding up the contact



Table

information


Delete
Button
Delete
To delete the contact 



(HTML

information checked for



Button)

deletion


Check All
Text Link
Check All
To check all the check boxes 





in the table


Clear All
Text Link
Clear All
To un check all the check boxes





checked in the table


Delete
Check box
Delete
To check the items for deletion


Edit
Button
Edit
To edit the contact information 



(HTML

against the row selected for 



Button)

edition


Department 
Text 
Department
Shows the name of the depart-


Name

Name
ment. added For example 





finance, marketing etc.


Last Name
Text
Last Name
Name of the contact person


Phone
Text
Phone
Phone of the contact person


FAX
Text
FAX
FAX of the contact person


Email
Text
Email
Email address of the contact 





person


SAVE
Button
SAVE
Save all the above information



(HTML

to the repository



Submit





button)




CANCEL
Button
CANCEL
To reset the entries made in all



(HTML

the fields



reset





button)









3.1.2.3. Front End Validations
Validation Details

    
    
        This section provides the front-end screen validations along with the associated message—Success/Error Message text
    
    















#
Element Name
Action/Validation Details
Message


















1.
Company Name
Refer Document
Refer Document



(Entry Field)
No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


2.
Address (Entry
Refer Document
Refer Document



Field)
No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


3.
Suite/Apt #
Refer Document
Refer Document




No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


4.
Suite/Apt #
Refer Document
Refer Document



(Entry Field)
No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


5.
City
Refer Document
Refer Document




No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


6.
City (Entry
Refer Document
Refer Document



Field)
No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


7.
State
Refer Document
Refer Document




No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


8.
State (Entry
Refer Document
Refer Document



Field)
No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


9.
ZIP (Entry Field)
Refer Document
Refer Document




No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


10.
Department
Should list various departments like
If none of the option is




Finance, Sales, Administration,
selected. Then should




Technical, Miscellaneous etc from the
show an Error Dialog




repository.
Box With message.




The First option should be
“Department Name -




-- Choose One --. Subsequent options
Is required”




should be listed alphabetically.



11.
Salutation
Refer Document
Refer Document




No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


12.
First Name
Refer Document
Refer Document




No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


13.
Middle name
Refer Document
Refer Document




No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


14.
Last name
Refer Document
Refer Document




No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


15.
Suffix
Refer Document
Refer Document




No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


16.
Title
Refer Document
Refer Document




No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


17.
Address (Entry
Refer Document
Refer Document



Field)
No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


18.
Suite/Apt #
Refer Document
Refer Document



(Entry Field)
No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


19.
City (Entry
Refer Document
Refer Document



Field)
No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


20.
State (Entry
Refer Document
Refer Document



Field)
No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


21.
ZIP (Entry Field)
Refer Document
Refer Document




No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


22.
Mode of
Should list various types of Mode of
If none of the option is



Communication
Communications like Phone, FAX,
selected. Then should




email, USPS etc. from the repository.
show an Error Dialog




The First option should be
Box With message.




-- Choose One --. Subsequent options





should be listed alphabetically.



23.
Phone
Refer Document
Refer Document




No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


24.
Email
Refer Document
Refer Document




No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


25.
FAX
Refer Document
Refer Document




No. BPI_CAS_FSD_COMMON
No. BPI_CAS_FSD_COMMON


26.
ADD
Should function with Enter Key
Error Dialog Box




Cursor Positioned on the“ADD”
Text:




button or Mouse Click.
“Department Name -




Check if the Contact Department is
Is required”




selected. If --choose one - default





option is only selected throw a Java





script error message.





Check if the Mode of Communication





is selected. If --choose one - default





option is only selected throw a Java





script error message.





Check if the value entered for the





fields for the Department contact





information are correct. If not throw





error message.





Success: Populates the HTML Table





with the data on each column as





relevant with the data entered in the





entry field.



27.
Table
Should have column header and each





subsequent row should be identified





by alternate color combinations. i.e.





First row should have color ‘x’ and





the next row should have color ‘y’.





The next row should have color ‘x’





again and so on. The size of any text





inside any cell should be wrapped if





the text becomes too long.



28.
Delete
Should function with Enter Key
Error Message:




Cursor Positioned on the “Delete”
“Please choose the




button or on Mouse Click.
row or rows to be




Delete Button should work on
deleted.”




multiple deletes based on the check





box or boxes selected. If the user





clicks on the delete button without





checking any of the delete check box





should throw error message.





Success: Deletes the row or rows from





the HTML Table(temporary storage)



29.
Check All
On clicking the “Check All” link
On clicking the




should check all the check boxes in
“Check All” link




the HTML table.
should check all the





check boxes in the





HTML table.


30.
Clear All
On clicking the “Clear All”l ink
On clicking the “Clear




should uncheck all the checked check
All” link should




boxes in the HTML table.
uncheck all the





checked check boxes





in the HTML table.


31.
Delete
Check box option with default
Check box option with




“unchecked”
default “unchecked”


32.
Edit
Should function with Enter Key
Should function with




Cursor Positioned on the “Edit”
Enter Key Cursor




button or on Mouse Click.
Positioned on the




On clicking the edit button the row
“Edit” button or on




edited should be removed from the
Mouse Click.




HTML table and the data should be
On clicking the edit




populated back on the editable entry
button the row edited




fields.
should be removed





from the HTML table





and the data should be





populated back on the





editable entry fields.


33.
Department
Display the data in a text




Name




34.
Name
Display the data in a text



35.
Phone
Display the data in a text



36.
Email
Display the data in a text



37.
FAX
Display the data in a text



38.
SAVE
Should function with Enter Key
Error Dialog Box




Cursor Positioned on the “SAVE”
Text:




button or on Mouse Click.
“The value entered for




On saving the data the data gets saved 
‘field name’ is




to the database.
incorrect. Please enter




Validation Check: For the entire field
the correct value.”




on the carrier general information.
Note: The field name




Check if the data entered for the
should be picked up




Carrier General Information is correct.
dynamically for the




If not throw error message.
each field that is




Check if there is data populated on the
erroneous.




Department Contact information field.
For general script




If yes show a dialog box with message
validations for




“Would you like to Add the
common functionality




department contact information before
refer




saving” Yes/No.
BPI_CAS_FSD_COMMON




If yes allow the user to add the data.
System Error:




If no save the data without adding the
Common Text shall be




Department contact information to the
followed for the




HTML Table.
System Error.




On Successful saving the flow should
Dialog Box Text:




automatically be navigated to the next





screen.(BPI_CAS_SCR_CM_001_002)



39.
Cancel
Cancel Button should clear all the





content filled on the entry fields.









3.1.3. User Interface ID: Create Product
3.1.3.1. Screen Name: Create Product (BPI_CAS_SCR_CM—001—002)

    
    
        (See FIG. H-3)
    
    


3.1.3.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main Header 
Text
Main Header
To give the heading for the 


Carrier

Carrier
screen being navigated


Offered Plan

Offered Plan



Trans Id
Text
Trans Id
Text for Trans Id


Trans Id
Entry Field
Trans Id
To Enter Trans Id


Plan Name
Text
Plan Name
Text for Plan Name


Plan Name
Entry Field
Plan Name
To Enter Plan Name


Carrier Name
Text
Carrier Name
Text for Carrier Name


Carrier Name
Drop Down
Carrier Name
Lists various Carrier Names.



List




Line of
Text
Line of
Text for Line of Coverage


Coverage

Coverage



Line of
Drop Down
Line of
Lists various line of coverage


Coverage
List
Coverage
offered. Example Medical, 





Dental, Vision, CAM etc.


Plan Type
Text
Plan Type
Text for plan type


Plan Type
Drop Down
Plan Type
List the Plan Type available for



List

the line of coverage selected.





Example HMO, PPO, PSO etc.


Add
Button
Add
To add the Benefit Level Name



(HTML

to the HTML table.



Button)




Table
HTML 
Table
For adding and displaying all 



table

the names of the benefit level 





offered by the carrier


Delete
Button
Delete
To delete single or multiple 



(HTML

rows of the benefit level 



Button)

checked


Check All
Text Link
Check All
To check all the check boxes 





in the table


Clear All
Text Link
Clear All
To un check all the check 





boxes checked in the table


Enrolment
Button
Enrolment
To Navigate to Enrolment 





Transmission Screen


Premium
Button
Premium
To Navigate to Premium 





Transmission Screen


Delete
Check box
Delete
To check the items for deletion


Edit
Button
Edit
To edit the benefit level against 



(HTML

the row selected for edition



Button)




SAVE
Button
SAVE
Save all the above information 



(HTML

to the repository



Submit





button)




Cancel
Button
Cancel
To reset the entries made in all



(HTML 

the fields



reset





button)









3.1.3.3. Front End Validations
Validation Details

    
    
        This section provides the front-end screen validations along with the associated message—Success/Error Message text
    
    
















Element 




#
Name
Action/Validation Details
Message


















1.
Trans Id
This name should be brought from the 
Plan Id is required




previous screen
PlanId accepts




BPI_CAS_SCR_CM_001_001.
alphanumeric values





only


2.
Line of 
Should list various types of Line of
Note: The Screen



Cov-
Coverage from the database.
should not be



erage
Default Line of Coverage should be
refreshed when




-- Choose One --
choosing different




Subsequent line of coverage should be
Line of Coverage.




listed alphabetically.
Line of Coverage is




On choosing the line of coverage
required




corresponding Plan Type should be





listed.





On choosing different Line of





Coverage the Plan Type List should





be refreshed and new set of plan type





should be listed for the new line of





coverage selected.



3.
Plan 
Should list various types of Plan Type
Note: The Screen



Type
from the database.
should not be




Plan Type should be Listed
refreshed when




alphabetically
choosing different




On choosing the Plan Type
Plan Type.




Corresponding Benefit Level Should
Plan Type is required




be listed.





On choosing different Plan Type the





Benefit Level List should be refreshed





and new set of Benefit Level should





be listed of the new Plan Type





selected.



4.
Carrier 
Should be entered
Carrier Name is



Name

required


5.
Plan 
Should be entered
Plan Name is required



Name




6.
Add
Should function with Enter Key
Error Dialog Box




Cursor Positioned on the “ADD”
Text:




button or Mouse Click.
“The name entered for




Check if alternate Benefit Level name
alternate Benefit Level




is valid.
Name is incorrect.




If not throw error message.
Please enter the




Check if there is no duplicate entry for
correct name.”




the Combination of Line of Coverage,
“The is no name




Plan Type and Benefit level selected.
entered for Benefit




If Duplicate Show Error Message
Level Name. Please




Check if there is blank field if so
enter the name.”




throw error message
Error Dialog Box




Success: The items selected with the
Text:




benefit level name are added to the
“The Benefit Level




HTML table below (temporary)
Name for the





combination of Line





of Coverage, Plan type





and Benefit Level is





already entered. Please





select other





combination.”


7.
Table
Should have column header and each





subsequent row should be identified





by alternate color combinations. i.e.





First row should have color ‘x’ and





the next row should have color





‘y’.The next row should have color ‘x’





again and so on. The size of any text





inside any cell should be wrapped if





the text becomes too long.



8.
Delete
Should function with Enter Key
Error Message:




Cursor Positioned on the “Delete”
“Please choose the




button or on Mouse Click.
row or rows to be




Delete Button should work on
deleted.”




multiple deletes based on the check





box or boxes selected. If the user





clicks on the delete button without





checking any of the delete check box





should throw error message.





Success: Deletes the row or rows from





the HTML table(temporary storage)



9.
Check 
On clicking the “Check All” Link all
On clicking the



All
the rows with the check box option are
“Check All”Link all




checked.
the rows with the





check box option are





checked.


10.
Clear 
On clicking the “Clear All” Link all
On clicking the “Clear



All
the rows with the check box option
All” Link all the rows




checked are unchecked.
with the check box





option checked are





unchecked.


11.
Delete
Check box option with default





“unchecked”



12.
Edit
Should function with Enter Key
Note: All edits that are




Cursor Positioned on the “Edit”
done on the data from




button or on Mouse Click.
the repository or




On clicking the edit button the row
database, history of




edited should be removed from the
the changes made




table and the data should be populated
must be available.




back on the editable entry field.



13.
SAVE
Should function with Enter Key
System Error:




Cursor Positioned on the “SAVE”
Common Text shall be




button or on Mouse Click.
followed for the




Validation Check:
System Error.




Check if there is any data entered in
Dialog box :




the alternate Benefit Level Name
“Would you like to




field.
Add the Alternate




If yes show a dialog box with message
Benefit Level name




“Would you like to Add the Alternate
before saving” Yes/




Benefit Level name before saving”
No.




Yes/No.





If yes allow the user to add the data.





If no save the data without adding the





Alternate Benefit Level Name to the





HTML Table.





On saving the data the data gets saved





to the database.





Success:





On Successful saving the flow should





be automatically be navigated back to





the previous screen.





(BPI_CAS_SCR_CM_001_001)



14.
Cancel
Cancel Button should clear all the





content filled on the entry fields.









3.1.4. User Interface ID: Search Carrier Master
3.1.4.1. Screen Name: Search Carrier Master
(BPI_CAS_SCR_CM—001—003)
(See FIG. H-4)
3.1.4.2. Element Name, Element Type, Label & Purpose
3.1.4.3. Front End Validations
Validation Details

    
    
        This section provides the front-end screen validations along with the associated message—Success/Error Message text
    
    
















Element 




#
Name
Action/Validation Details
Message







1.
Carrier 
Default option on the list is




name
-- Choose One --





Lists all the active carrier in





alphabetical order



2.
View
Should function with Enter Key
Error Dialog Box




Cursor Positioned on the “View”
Text: “Please choose




button or on Mouse Click.
a carrier to view




On clicking the View Button if no
information”




Carrier name is selected then throw an





error message.





Else Success should navigate to the





view page





BPI_CAS_SCR_CM_001_006 with





the data pertaining to the carrier





selected.



3.
Edit
Should function with Enter Key
Error Dialog Box




Cursor Positioned on the “Edit”
Text:




button or on Mouse Click.
“Please choose a




On clicking the Edit Button if no
carrier to Edit




Carrier name is choose then throw an
information”




error message.





Else Success should navigate to the





Edit pages





BPI_CAS_SCR_CM_001_004 with





the data pertaining to the carrier





selected.









3.1.5. User Interface ID: Modify Carrier Master
3.1.5.1. Screen Name: Modify Carrier Master
(BPI_CAS_SCR_CM—001—004)
(See FIG. H-5)
3.1.5.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the screen being


Edit Carrier

Edit Carrier
navigated


Master

Master



Sub Header
Text
Sub Header
Provide Content Area Text


Carrier

Carrier



General

General



Information

Information



Sub Header
Text
Sub Header
Text for the Company Address


Address

Address



Company
Text
Company
Text for the entry field


Name

Name



Company
Entry Field
Company
Entry Field for Company name with data


Name (Entry

Name (Entry
filled and editable


Field)

Field)



Address
Text
Address
Text for the Address


Address
Entry Field
Address
Entry Field for Address with data filled


(Entry Field)

(Entry Field)
and editable


Suite/Apt #
Text
Suite/Apt #
Text for Suite #


Suite/Apt #
Entry Field
Suite/Apt #
Entry Field for Suite/Apt # with data


(Entry Field)

(Entry Field)
filled and editable


City
Text
City
Text for City


City (Entry
Entry Field
City (Entry
Entry Field for City with data filled and


Field)

Field)
editable


State
Text
State
Text for state


State (Entry
Entry Field
State (Entry
Entry Field for State with data filled and


Field)

Field)
editable


ZIP
Text
ZIP
Text for ZIP


ZIP (Entry
Entry Field
ZIP (Entry
Entry Field for ZIP with data filled and


Field)

Field)
editable


Sub Header
Text
Sub Header
Text for the sub heading


Contact

Contact



Department

Department



Department 
Drop Down
Department
List all the departments for the carrier for



List

contact information


Contact
Text
Contact Name
Text for Contact name


Name





Salutation
Text
Salutation
Text for salutation


First Name
Text
First Name
Text for First name


Middle name
Text
Middle name
Text for middle name


Last name
Text
Last name
Text for last name


Suffix
Text
Suffix
Text for suffix


Title
Text
Title
Text for title


Salutation
Entry Field
Salutation
Entry Field for salutation


First Name
Entry Field
First Name
Entry field for first name


Middle name
Entry Field
Middle name
Entry field for middle name


Last name
Entry Field
Last name
Entry field for last name


Suffix
Entry Field
Suffix
Entry Field for suffix


Title
Entry Field
Title
Entry Field for title


Address
Text
Address
Text for the Address


Address
Entry Field
Address
Entry Field for Address


(Entry Field)

(Entry Field)



Suite/Apt #
Text
Suite/Apt #
Text for Suite #


Suite/Apt #
Entry Field
Suite/Apt #
Entry Field for Suite/Apt #


(Entry Field)

(Entry Field)



City
Text
City
Text for City


City (Entry
Entry Field
City (Entry
Entry Field for City


Field)

Field)



State
Text
State
Text for state


State (Entry
Entry Field
State (Entry
Entry Field for State


Field)

Field)



ZIP
Text
ZIP
Text for ZIP


ZIP (Entry
Entry Field
ZIP (Entry 
Entry Field for ZIP


Field)

Field)



Mode of
Drop Down
Mode of
List various modes of contact preferred


Communication
List
Communication



Phone
Text
Phone
Text for phone


FAX
Text
FAX
Text for FAX


Email
Text
Email
Text for email


Phone
Entry Field
Phone
Entry Field for Phone number


Email
Entry Field
Email
Entry field for email address


FAX
Entry Field
FAX
Entry field for FAX


ADD
Button
ADD
To add the above details on to the HTML



(HTML

table below



Submit





button)




Table
HTML Table
Table
Table for adding up the contact





information. The table also contains all the





contact information already available in a





multiple rows.


Delete
Button
Delete
To delete the contact information.



(HTML





Button)




Check All
Text Link
Check All
To check all the check boxes in the table


Clear All
Text Link
Clear All
To un check all the check boxes checked





in the table


Delete
Check box
Delete
To check the items for deletion


Edit
Button
Edit
To edit the contact information against the



(HTML

row selected for edition



Button)




Department
Text
Department
Shows the name of the department added.


Name

Name
For example finance, marketing etc.


Last Name
Text
Last Name
Last Name of the contact person


Phone
Text
Phone
Phone of the contact person


Email
Text
Email
Email address of the contact person


FAX
Text
FAX
Fax of the contact person


SAVE
Button
SAVE
Save all the above information to the



(HTML

repository



Submit





button)




CANCEL
Button
CANCEL
Cancels the current operations and sets to



(HTML Reset

the value as before saving



button)




EDIT
Button
EDIT
Navigates to the next screen without


CARRIER
(HTML
CARRIER
saving the data.The purpose is if the


OFFERED
Submit
OFFERED
editing needs to be done for the next


PLAN
button)
PLAN
screen (BPI_SCREEN_005)


New
Button (HTML
New
To create a new page as first time.



button)









3.1.6. User Interface ID: Modify Carrier Product
3.1.6.1. Screen Name: Modify Carrier Product
(BPI_CAS_SCR_CM—001—005)
(See FIG. H-6)
3.1.6.2. Element Name, Element Type, Label & Purpose
3.1.6.3. Front End Validations
Validation Details

    
    
        This section provides the front-end screen validations along with the associated message—Success/Error Message text
    
    















#
Element Name
Action/Validation Details
Message


















1.
Carrier name
This name should be brought from the





previous screen





BPI_CAS_SCR_CM_001_004.



2.
Line of Coverage
Should list various types of Line of
Note: The Screen




Coverage from the database.
should not be




Default Line of Coverage should be
refreshed when




— Choose One —
choosing different line




Subsequent line of coverage should be
of coverage.




listed alphabetically.





On choosing the line of coverage





corresponding Plan Type should be





listed.





On choosing different Line of





Coverage the Plan Type List should





be refreshed and new set of plan type





should be listed for the new line of





coverage selected.



3.
Plan Type
Should list various types of Plan Type
Note: The Screen




from the database.
should not be 




Plan Type should be Listed
refreshed when




alphabetically
choosing different




On choosing the Plan Type
Plan Type.




Corresponding Benefit Level Should





be listed.





On choosing different Plan Type the





Benefit Level List should be refreshed





and new set of Benefit Level should





be listed of the new Plan Type





selected.



4.
Benefit Level
Should list various types of Benefit





Level from the database.





Benefit Level should be listed





alphabetically.



5.
Benefit Level
The field is used for filling Benefit




Name
Level Name



6.
Alternate name
The field is used for entering
Error Dialog Box Text:




Alternate Benefit Level Name
“The value entered for





Alternate Benefit





Level Name is





incorrect. Please enter





the correct value.”


7.
Add
Should function with Enter Key
Error Dialog Box Text:




Cursor Positioned on the “ADD”
“The value entered for




button or Mouse Click.
Benefit Level Name is




Check if Alternate Benefit Level name
incorrect. Please enter




is valid.
the correct value.”




If not throw error message.
Embedded Error




Check if there is no duplicate entry for
Message:




the Combination of Line of Coverage,
Show this message on




Plan Type and Benefit level selected.
space above the




If Duplicate Show Error Message
HTML table with




Success: The items selected with the
RED color.




benefit level name are added to the
“The Benefit Level




HTML table below (temporary)
Name for the





combination of Line





of Coverage, Plan type





and Benefit Level is





already available.





Please select other





benefit level.”


8.
Table
Should have column header and each





subsequent row should be identified





by alternate color combinations. i.e.





First row should have color ‘x’ and





the next row should have color





‘y’. The next row should have color ‘x’





again and so on. The size of any text





inside any cell should be wrapped if





the text becomes too long.



9.
Delete
Check box option with default





“unchecked”



10.
Delete
Should function with Enter Key
Error Message:




Cursor Positioned on the “Delete”
“Please choose the row or




button or on Mouse Click.
rows to be deleted.”




Delete Button should work on





multiple deletes based on the check





box or boxes selected. If the user





clicks on the delete button without





checking any of the delete check box





should throw error message.





Note: the delete action should only





delete the single or multiple rows





selected from the view inside the





table.





However the data must not be deleted





from the database on saving. It should





only inactivate the benefit level name/





names selected for deletion.



11.
Edit
Should function with Enter Key
Repository Data




Cursor Positioned on the “Edit”
should be green in




button or on Mouse Click.
color and the




On clicking the edit button the row
Temporary data




edited should be removed from the
should be red in color.




table and the data should be populated





back on the editable entry field.



12.
SAVE
Should function with Enter Key
System Error:




Cursor Positioned on the “SAVE”
Common Text shall be




button or on Mouse Click.
followed for the




Validation Check:
System Error.




Check if there is any data entered in
Dialog box:




the Alternate Name field.
“Would you like to




If yes show a dialog box with message
Add the Alternate




“Would you like to Add Alternate
Benefit Level name




Benefit Level name before saving”
before saving”




Yes/No.
Yes/No.




If yes allow the user to add the data. 
Note: For all the




If no save the data without adding the
changes made history




Benefit Level Name to the HTML
of changes should be




Table.
available for viewing




On saving the data the data gets saved
via reports for the




to the database.
specific modules.




Success:





On Successful saving the flow should





be automatically be navigated back to





the Search Screen.





(BPI_CAS_SCR_CM_001_003)





Note: Data must not be deleted from





the database on saving. It should only





inactivate the benefit level name/





names selected for deletion.



13.
Cancel
To cancel the previous operation.









3.1.7. User Interface ID: View Carrier Master
3.1.7.1. Screen Name: View Carrier Master (BPI_CAS_SCR_CM—001—006)
(See FIG. H-7)
3.1.7.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the 


View Carrier

View Carrier
screen being navigated


Master

Master



Sub Header
Text
Sub Header
Name for the sub header


carrier

carrier



general

general



Information

Information



Carrier name
Dynamic Text
Carrier name 
Name of the carrier being 





viewed


Sub Header
Text
Sub Header
Name of the sub header


Address

Address



Company
Text
Company
Text for the entry field


Name

Name



Company
Text
Company
Text for Company name 


Name

Name
with data filled


Address
Text
Address
Text for the Address


Address
Entry Field
Address
Text for Address with data 





filled


Suite/Apt #
Text
Suite/Apt #
Text for Suite #


Suite/Apt #
Text
Suite/Apt #
Text for Suite/Apt # with 





data filled


City
Text
City
Text for City


City
Text
City
Text for City with data filled


State
Text
State
Text for state


State
Text
State
Text for State with data filled


ZIP
Text
ZIP
Text for ZIP


ZIP
Text
ZIP
Text for ZIP with data filled


Table
HTML Table
Table
Table for populating the 





contact details


Department
Text
Department
Shows the name of the 


Name

Name
department added.





For example finance,





marketing etc.


Name
Text
Name
Name of the contact person


Phone
Text
Phone
Phone of the contact person


Email
Text
Email
Email address of the contact 





person


FAX
Text
FAX
Fax of the contact person


Back
HTML
Back
Submit Button to navigate 



Button

back to the start screen


Delete
HTML
Delete
Button to delete the partic-



Button

ular record currently viewed.









3.1.7.3. Front End Validations

    
    
        None.
    
    


3.1.8. User Interface ID: Search Product
3.1.8.1. Screen Name: Search Product (BPI_CAS_SCR_CM—001—007)

    
    
        (See FIG. H-8)
    
    


3.1.8.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Search
Text
Search
To give the heading for the 


Product

Product
screen being navigated


Plan name
Text
Plan name
Title for carrier name


Plan name
Drop Down
Plan name
List all the active carrier names 



List

available in the system


View
HTML
View
Button to view the carrier name 



Button

selected


Edit
HTML
Edit
Button to edit the carrier name 



Button

selected









3.1.8.3. Front End Validations
Validation Details
This section provides the front-end screen validations along with the associated message—Success/Error Message text














Element 




#
Name
Action/Validation Details
Message







1.
Carrier
Default option on the list is




name
— Choose One —





Lists all the active carrier in





alphabetical order



2.
View
Should function with Enter Key
Error Dialog




Cursor Positioned on the “View”
Box Text: 




button or on Mouse Click.
“Please




On clicking the View Button if 
choose a 




no Carrier name is selected then 
carrier to view 




throw an error message.
information”




Else Success should navigate to 





the view page





BPI_CAS_SCR_CM_001_006





with the data pertaining to the 





carrier selected.



3.
Edit
Should function with Enter Key
Error Dialog 




Cursor Positioned on the “Edit”
Box Text:




button or on Mouse Click.
“Please 




On clicking the Edit Button if no
choose a 




Carrier name is choose then 
carrier to Edit




throw an error message.
information”




Else Success should navigate to 





the Edit pages





BPI_CAS_SCR_CM_001_004 





with the data pertaining to the 





carrier selected.









3.1.9. User Interface ID: View Product Info
3.1.9.1. Screen Name: View Product Info (BPI_CAS_SCR_CM—001—008)

    
    
        (See FIG. H-9)
    
    


3.1.9.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the


Carrier

Carrier
screen being navigated


Product Info

Product Info



Sub Header
Text
Sub Header
Name for the sub header


Plan Info

Plan Info



Plan Id
Text
Plan Id
Provide Text


Plan Id
Dynamic Text
Plan Id
Name of the Plan Id being 





viewed


Plan Name
Text
Plan Name
Provide Text


Plan Name
Dynamic Text
Plan Name
Name of the Plan Name 





being viewed


Carrier Name
Text
Carrier Name
Provide Text


Carrier Name
Dynamic Text
Carrier Name
Name of the Carrier Name 





being viewed


Line Of
Text
Line Of
Provide Text


Coverage

Coverage



Line Of
Dynamic Text
Line Of
Name of the Line Of Cov-


Coverage

Coverage
erage Name being viewed


Plan Type
Text
Plan Type
Provide Text


Plan Type
Dynamic Text
Plan Type
Name of the Plan Type 





being viewed


Carrier name
Dynamic Text
Carrier name
Name of the carrier being 





viewed


Sub Header
Text
Sub Header
Name of the sub header


Address

Address



Table
HTML Table
Table
Table for populating the





plan offered


Benefit level
Text
Benefit level
For showing the benefit 


name

name
level name


Product
Text
Product 
For showing the Product 


Name

Name
name


Delete
HTML
Delete
Button to delete the 



Button

particular record currently 





viewed.


Back
HTML
Back
To Navigate to Search 



Button

Screen









3.1.9.3. Front End Validations

    
    
        None.
    
    


3.1.10. Screen Flow

    
    
        (See FIG. H-10)
    
    


Benefit Partners Inc
Process Specification
BPI_CAS_FSD_CM—02
1. Introduction
1.1. Purpose
This purpose of this document is to identify the process associated with the business use case Create Plan. This document is the amendment of BPI_CAS_FSD_CM—02 (Version 1.0).
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









BPI_SCOPE_CM_002
Create M Plan










1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
2.1. Background
This process identifies the functionality for creation of Line of Coverage, Plan Type and Benefit Level.
This process is used to create various Line of Coverage, Plan type and benefit level offered by PacAdvantage. Line of coverage includes the coverage offered by PacAdvantage e.g. Medical, Dental, Vision, Chiropractic, Voluntary Medical etc. These classify broad range of all the line of coverage offered.
Plan type includes plan type for specific line of coverage e.g. PPO, HMO, PSO etc.

    
    
        Benefit Level specifies the specific benefit level offered for the line of coverage and plan type e.g. Standard, Preferred, preferred plus etc.
    
    


2.2. Process Description & Flow
2.2.1. Create Line of Coverage
1. Input Line of Coverage name
2. Validate Line of Coverage name
3. If yes add the information to a temporary storage.
4. If not re enter the information correctly and add again.
5. Edit or delete Line of Coverage name
6. If erroneous re enter the correct data.
7. If Correct then save the data to the repository
8. System auto generates a unique identification number for Line of Coverage
Refer Process Flow Diagram
2.2.2. Create Plan Type
1. Input Plan Type name
2. Validate Plan Type name
3. If yes add the information to a temporary storage.
4. If not re enter the information correctly and add again.
5. Edit or delete Plan Type name
6. If erroneous re enter the correct data.
7. If Correct then save the data to the repository
8. System auto generates a unique identification number for Plan Type
Refer Process Flow Diagram
2.2.3. Create Benefit Level
1. Input Benefit Level name
2. Validate Benefit Level name
3. If yes add the information to a temporary storage.
4. If not re enter the information correctly and add again.
5. Edit or delete Benefit Level name
6. If erroneous re enter the correct data.
7. If Correct then save the data to the repository
8. System auto generates a unique identification number for Benefit Level
Refer Process Flow Diagram
2.2.4. Process Flow Diagrams
(See FIG. H-11)
3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's












Screen
Screen



ID (SID)
Name
Corresponding HTML File Name







plan.loc
Line of
/bpi/cas/carrier/mplan/LineOfCoverage.jsp



Coverage



plan.plan
Plan Type
/bpi/cas/carrier/mplan/PlanType.jsp


plan.ben
Benefit Level
/bpi/cas/carrier/mplan/BenefitLevel.jsp









3.1.2. User Interface ID: Create Line of Coverage
3.1.2.1. Screen Name: Create Line of Coverage (BPI_CAS_SCR_CM—002—001) (See FIG. H-12)
3.1.2.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main
Text
Main Header
To give the heading for the


Header Line

Line of
screen being navigated


of coverage

coverage



Line of
Text
Line of
Provide text


Coverage

Coverage



Loc Name
Entry Field
Loc Name
Entering line of coverage


Add
HTML
Add
Button for adding the Line of 



Button

coverage to the table below


Table
HTML table
Table
For adding and displaying all 





the names of the Line of 





Coverage


Delete
Button
Delete
To delete the line of Coverage 



(HTML

checked



Button)




Check All
Text Link
Check All
To check all the check boxes 





in the table


Clear All
Text Link
Clear All
To un check all the check boxes 





checked in the table


Delete
Check box
Delete
To check the items for deletion


Edit
Button
Edit
To edit the Line of coverage 



(HTML

against the row selected for 



Button)

edition


Save
Button
Save
Save all the above information 



(HTML

to the repository



Submit





button)




Cancel
Button
Cancel
To reset the entries made in 



(HTML reset

all the fields



button)









3.1.2.3. Front End Validations
Validation Details
This section provides the front-end screen validations along with the associated message—













#
Element Name
Action/Validation Details
Message


















1.
Line of
This field is used for entering the
“Line of Coverage - Is required.”



coverage Entry
line of coverage. The Line of
“Line of Coverage -




coverage should be alphanumeric
Accepts alphanumeric values only”




only. The special character





permitted is only space bar





between the two words. And can





have max length 20. Blank line of





coverage not allowed



2.
Add
On Clicking add button or pressing
On click of Add button




enter key field with the cursor
checks for the above




position on the Add button, The
mentioned validations +




data gets added to the table.
“Line of Coverage - Already exists.”




Validation checks are done to not
(Occurs on duplicate record entry)




allow null value on the entry field





and the entry field should have





only alphanumeric values.





Duplicate name for the line of





coverage should not be allowed.



3.
Table
Should have column header and





each subsequent row should be





identified by alternate color





combinations. i.e. First row should





have color ‘x’ and the next row





should have color ‘y’. The next row





should have color ‘x’ again and so





on. The size of any text inside any





cell should be wrapped if the text





becomes too long.



4.
Delete
Should function with Enter Key
“! Select record(s) for deletion”




Cursor Positioned on the “Delete”
(If the operation is in




button or on Mouse Click.
Edit Mode & delete




Delete Button should work on
operation is invoked)




multiple deletes based on the





check box or boxes selected. If the





user clicks on the delete button





without checking any of the delete





check box should throw error





message.





Success: Deletes the row or rows





from the table (temporary storage)



5.
Check All
On clicking the “Check All” link





should check all the check boxes





in the HTML table.



6.
Clear All
On clicking the “Clear All” link





should uncheck all the checked





check boxes in the HTML table.



7.
Delete
Check box option with default
Delete Check box is




“unchecked”
disabled and grayed





out if the data in the





corresponding row/





rows has child parent





relationship. (I.e. it has





reference somewhere





else in the database.)


8.
Edit
Should function with Enter Key
“! Complete the update process”




Cursor Positioned on the “Edit”
(If the operation is already




button or on Mouse Click.
in Edit Mode & another Edit




On clicking the edit button the row
operation is invoked)




edited should be disabled and the





data should be populated back on





the editable entry field.





Note: All data that are from the





repository should be in green





color. The data that is added and





not saved should be in red. The





data selected for editing should be





displayed in gray. The “Add”





button will be changed to “Update”





button.



9.
Save
Should function with Enter Key
For general script




Cursor Positioned on the “SAVE”
validations for common




button or on Mouse Click.
functionality refer




On saving the data the data gets
BPI_CAS_FSD_COMMON




saved to the database.
System Error:




Check if there is data populated for
Common Text shall be




editing. If yes show a dialog box
followed for the




with message “Complete update
System Error.




Process.”
“! Do any operation to save.”





(Displayed when invoked





immediately after the





screen is loaded).





“! Complete the update process”





(Displayed when Save





is invoked in Edit





Mode).


10.
Cancel
Should reset all the entries to





previous status before saving. i.e.





the fields should be blank. If any of





the data has been selected for





editing, the same data should





appear when cancel button is





clicked.









3.1.3. User Interface ID: Create Plan Type
3.1.3.1. Screen Name: Create Plan Type (BPI_CAS_SCR_CM—002—002) (See FIG. H-13)
3.1.3.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main
Text
Main 
To give the heading for the 


Header

Header
screen being navigated


Plan Type

Plan Type



Plan Type
Text
Plan Type
Provide text


Plan type
Entry Field
Plan type
Entering Plan type


Entry

Entry



Add
HTML
Add
Button for adding the Plan Type 



Button

to the table below


Table
HTML table
Table
For adding and displaying all the 





names of the Plan Type


Delete
Button
Delete
To delete the Plan Type checked



(HTML





Button)




Check All
Text Link
Check All
To check all the check boxes in





the table


Clear All
Text Link
Clear All
To un check all the check boxes





checked in the table


Delete
Check box
Delete
To check the items for deletion


Edit
Button
Edit
To edit the Plan Type against the 



(HTML

row selected for edition



Button)




SAVE
Button
SAVE
Save all the above information 



(HTML

to the repository



Submit





button)




CANCEL
Button
CANCEL
To reset the entries made in 



(HTML reset

all the fields



button)









3.1.3.3. Front End Validations
Validation Details
This section provides the front-end screen validations along with the associated message—Success/Error Message text













#
Element Name
Action/Validation Details
Message


















1.
Plan type Entry
This field is used for entering the Plan
Error Dialog Box:




Type. The Plan Type should be
“Plan Name - Is




alphanumeric only. The special character
required”




permitted is only space bar between the
“Plan Name - Accepts




two words. And can have max length 255.
alphanumeric values only”




Blank line of coverage not allowed



2.
Add
On Clicking add button or pressing
Error Dialog Box:




enter key field with the cursor
On click of Add button




position on the button, The data
checks for the above




gets added to the table. Validation
mentioned validations +




checks are done to not allow null
“Plan Name - already




value on the entry field and the
exists.”




entry field should have only
(Occurs on duplicate




alphanumeric values.
record entry)


3.
Table
Should have column header and





each subsequent row should be





identified by alternate color





combinations. i.e. First row should





have color ‘x’ and the next row





should have color ‘y’. The next row





should have color ‘x’ again and so





on. The size of any text inside any





cell should be wrapped if the text





becomes too long.



4.
Delete
Should function with Enter Key
Error Dialog Box:




Cursor Positioned on the “Delete”
“! Select record(s) for




button or on Mouse Click.
deletion”




Delete Button should work on
“! Complete the update




multiple deletes based on the
process”




check box or boxes selected. If the
(If the operation is in




user clicks on the delete button
Edit Mode & delete




without checking any of the delete
operation is invoked)




check box should throw error





message.





Success: Deletes the row or rows





from the table temporarily.



5.
Check All
On clicking the “Check All” link





should check all the check boxes





in the HTML table.



6.
Clear All
On clicking the “Clear All” link





should uncheck all the checked





check boxes in the HTML table.



7.
Delete
Check box option with default
Delete Check box is




“unchecked”
disabled and grayed out if





the data in the





corresponding row/rows





has child parent





relationship. (I.e. it has





reference somewhere else





in the database.)


8.
Edit
Should function with Enter Key
“! Complete the update




Cursor Positioned on the “Edit”
process”




button or on Mouse Click.
(If the operation is already




On clicking the edit button the row
in Edit Mode & another Edit




edited should be disabled in the
operation is invoked)




table and the data should be





populated back on the editable





entry field.





Note: All the data inside the table





that are available from the





repository should be green in color





text. The temporary data should be





red in color text. The data selected





for editing should be displayed in





gray. The “Add” button will be





changed to “Update” button.



9.
Save
Should function with Enter Key
For general script




Cursor Positioned on the “SAVE”
validations for common




button or on Mouse Click.
functionality refer




On saving the data the data gets
BPI_CAS_FSD_COMMON




saved to the database.
System Error:




Check if there is data populated for
Common Text shall be




editing. If yes show a dialog box
followed for the




with message “Complete update
System Error.




Process.”
“! Do any operation to





save.”





(Displayed when invoked





immediately after the





screen is loaded).





“! Complete the update





process.”





(Displayed when Save is





invoked in Edit Mode).


10.
Cancel
Should reset to the previous status





on clicking the cancel button. i.e.





make all the entry field blank. If





any of the data has been selected





for editing, the same data should





appear when cancel button is





clicked.









3.1.4. User Interface ID: Create Benefit Level
3.1.4.1. Screen Name: Create Benefit Level (BPI_CAS_SCR_CM—002—003) (See FIG. H-14)
3.1.4.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main
Text
Main
To give the heading for the


Header

Header
screen being navigated


Benefit

Benefit



Level

Level



Benefit
Text
Benefit
Provide text


Level Name

Level Name



Benefit
Entry Field
Benefit
Entering the benefit level 


Level Name

Level Name
name


Entry

Entry



Add
HTML
Add
Button for adding the Benefit 



Button

Level to the table below


Table
HTML table
Table
For adding and displaying all 





the names of the Benefit Level


Delete
Button
Delete
To delete the Benefit Level 



(HTML

checked



Button)




Check All
Text Link
Check All
To check all the check boxes 





in the table


Clear All
Text Link
Clear All
To un check all the check 





boxes checked in the table


Delete
Check box
Delete
To check the items for deletion


Edit
Button
Edit
To edit the Benefit Level 



(HTML

against the row selected 



Button)

for edition


Save
Button
Save
Save all the above information 



(HTML

to the repository



Submit





button)




Cancel
Button
Cancel
To reset the entries made in 



(HTML reset

all the fields



button)









3.1.4.3. Front End Validations
Validation Details
This section provides the front-end screen validations along with the associated message—Success/Error Message text













#
Element Name
Action/Validation Details
Message


















1.
Benefit Level
This field is used for entering the
Error Dialog Box:




Benefit Level. The Benefit Level
“Benefit Level - Is required”




should be alphanumeric only. The
“Benefit Level -




special character permitted is only
Accepts alphanumeric values only”




space bar between the two words.





And can have max length 255.





Blank line of coverage not allowed



2.
Add
On Clicking add button or pressing
Error Dialog Box:




enter key field with the cursor
On click of Add button




position on the button, The data
checks for the above




gets added to the table. Validation
mentioned validations +




checks are done to not allow null
“Benefit Level - already exists.”




value on the entry field and the
(Occurs on duplicate




entry field should have only alpha
record entry)




values.





Should check for duplicate entries



3.
Table
Should have column header and





each subsequent row should be





identified by alternate color





combinations. i.e. First row should





have color ‘x’ and the next row





should have color ‘y’. The next row





should have color ‘x’ again and so





on. The size of any text inside any





cell should be wrapped if the text





becomes too long.



4.
Delete
Should function with Enter Key 
Error Dialog Box:




Cursor Positioned on the “Delete”
“! Select the record(s) for deletion”




button or on Mouse Click.
“! Complete the update process”




Delete Button should work on
(If the operation is in




multiple deletes based on the
Edit Mode & delete




check box or boxes selected. If the
operation is invoked)




user clicks on the delete button





without checking any of the delete





check box should throw error 





message.



5.
Check All
On clicking the “Check All” link





should check all the check boxes





in the HTML table.



6.
Clear All
On clicking the “Clear All” link





should uncheck all the checked





check boxes in the HTML table.



7.
Delete
Check box option with default
Delete Check box is




“unchecked”
disabled and grayed





out if the data in the





corresponding row/





rows has child parent





relationship. (I.e. it has





reference somewhere





else in the database.)


8.
Edit
Should function with Enter Key
“! Complete the update process”




Cursor Positioned on the “Edit”
(If the operation is already




button or on Mouse Click.
in Edit Mode & another




On clicking the edit button the row
Edit operation is invoked)




edited should be removed from the





table and the data should be





populated back on the editable





entry field.





If the data is from the repository





show it in green color text. If it is





temporary data just added show it





in red color text. The data selected





for editing should be displayed in





gray. The “Add” button will be





changed to “Update” button.



9.
Save
Should function with Enter Key
For general script




Cursor Positioned on the “Save”
validations for common




button or on Mouse Click. On
functionality refer




saving the data the data gets
BPI_CAS_FSD_COMMON




saved to the database.
SystemError:




Check if there is data populated for
Common Text shall be




editing. If yes show a dialog box
followed for the




with message “Complete update
System Error.




Process.”
“! Do any operation to save.”





(Displayed when invoked





immediately after the





screen is loaded).





“! Complete the update process.”





(Displayed when Save





is invoked in Edit





Mode).


10.
Cancel
Should reset to the previous status





on clicking the cancel button. If





any of the data has been selected





for editing, the same data should





appear when cancel button is





clicked.









3.1.5. Screen Flow
The flow of the process is as described below. (See FIG. H-15)
Benefit Partners Inc
Process Specification
BPI_CAS_FSD_CM—03
1. Introduction
1.1. Purpose
This purpose of this document is to identify the process associated with the business use case Create Rate Master. This document is the amendment of BPI_CAS_FSD_CM—03 (Version 1.1).
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









BPI_SCOPE_CM_003
Create Rate Master










1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
2.1. Background
This process describes the Use Case “Rate Master”.
Rate Master is used to upload all the rates for the products (Benefits) provided by individual health insurance provider (Carrier). The individual rate files are provided by PacAdvantage with the rate for all the products offered by all the carriers in a specific file format. This Process for loading the rates would be covered in the Document Reference No: BPI_CAS_FSD_EC
The rates are normally classified as blended rates and raw rates.
Raw rates would include only the premium rates for the products offered.
Blended rate would include the sum total of the entire raw rate, admin fees, agent commission additional fees and Differential Fees. The rate classification would define the formula for calculating the blended rate for the product under offering. Using the administrative screens the classification of rates for arriving to these calculations is provided.
Admin Fees Further Admin fees can be of two types % of the premium or a fixed flat $ amount.
Agent Commission Agent commission can be a % of premium or a flat $ amount per member or a flat $ amount per group size.
Additional Fees Additional Fees can be a % premium or flat $ amount for the carrier.
Differential Fees The amount type for Differential Rate should include Flat $ amount as Flat $ amount per member and also Flat $ amount per Group. When the Flat $ amount is per group it should be able to specify group size.
The state is divided into several service areas based on the number of counties and their population. In the state of California there are presently 6 service areas. The Rate is based on the service area where the employees are residing. Also there are cases when the ZIP code has two or more Service Areas. Under these conditions the ZIP code should be attached to those services areas from where the rates are to be picked.
2.2. Process Description & Flow
2.2.1. Admin Fee
The flow of the process is as described below.
1. Input the rate type information.
2. Validate if the rate type information has the right data type.
3. If Correct then save the data to the repository.
4. Search admin fee records.
5. Select a record in modify mode
6. Edit the rate type information.
7. Validate if the rate type information has the right data type.
8. If Correct then save the data to the repository.
9. Search admin fee records.
10. Select a record in view/delete mode
11. View the selected admin fee
12. Delete the selected admin fee from the repository.
Refer Process Flow Diagram FIG. 1.
2.2.2. Agent Fee

    
    
        The flow of the process is as described below.
    
    


1. Input the rate type information.
2. Validate if the rate type information has the right data type.
3. If Correct then save the data to the repository.
4. Search agent fee records.
5. Select a record in modify mode
6. Edit the rate type information.
7. Validate if the rate type information has the right data type.
8. If Correct then save the data to the repository.
9. Search agent fee records.
10. Select a record in view/delete mode
11. View the selected agent fee.
12. Delete the selected agent fee from the repository.
Refer Process Flow Diagram FIG. 2.
2.2.3. Additional Fee

    
    
        The flow of the process is as described below.
    
    


1. Input the rate type information.
2. Validate if the rate type information has the right data type.
3. If Correct then save the data to the repository.
4. Search additional fee records.
5. Select a record in modify mode
6. Edit the rate type information.
7. Validate if the rate type information has the right data type.
8. If Correct then save the data to the repository.
9. Search additional fee records.
10. Select a record in view/delete mode
11. View the selected additional fee.
12. Delete the selected additional fee from the repository.
Refer Process Flow Diagram FIG. 3.
2.2.4. Rate Differential

    
    
        The flow of the process is as described below.
    
    


1. Input the rate type information.
2. Validate if the rate type information has the right data type.
3. If Correct then save the data to the repository.
4. Search rate differential records.
5. Select a record in modify mode
6. Edit the rate type information.
7. Validate if the rate type information has the right data type.
8. If Correct then save the data to the repository.
9. Search rate differential records.
10. Select a record in view/delete mode
11. View the selected rate differential.
12. Delete the selected rate differential from the repository.
Refer Process Flow Diagram FIG. 4.
2.2.5. Process Flow Diagrams
(See FIG. H-16)
(See FIG. H-17)
(See FIG. H-18)
(See FIG. H-19)
3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's














Corresponding HTML File


Screen ID (SID)
Screen Name
Name







rate.admin
Admin Fees
/bpi/cas/carrier/rates/




AdminFee.jsp


rate.admin.search
Search Admin 
/bpi/cas/carrier/rates/



Fees
AdminFeeSearch.jsp


rate.admin.view
View Admin 
/bpi/cas/carrier/rates/



Fees
AdminFeeView.jsp


rate.admin.confirm
Confirm Admin 
/bpi/cas/carrier/rates/



Fees
AdminFeeConfirm.jsp


rate.agent
Agent Commission
/bpi/cas/carrier/rates/




AgentFee.jsp


rate.agent.search
Search Agent 
/bpi/cas/carrier/rates/



Commission
AgentFeeSearch.jsp


rate.agent.view
View Agent 
/bpi/cas/carrier/rates/



Commission
AgentFeeView.jsp


rate.agent.confirm
Confirm Agent 
/bpi/cas/carrier/rates/



Commission 
AgentFeeConfirm.jsp


rate.add
Additional Fees
/bpi/cas/canier/rates/




AdditionalFee.jsp


rate.add.search
Search Additional 
/bpi/cas/carrier/rates/



Fees
AdditionalFeeSearch.jsp


rate.add.view
View Additional 
/bpi/cas/carrier/rates/



Fees
AdditionalFeeView.jsp


rate.add.confirm
Confirm Additional 
/bpi/cas/carrier/rates/



Fees
AdditionalFeeConfirm.jsp


rate.ratediff
Differential Fees
/bpi/en/carrier/rates/




DifferentialRate.jsp


rate.ratediff.search
Search Differential 
/bpi/cas/carrier/rates/



Fees
DifferentialRateSearch.jsp


rate.ratediff.view
View Differential 
/bpi/cas/carrier/rates/



Fees
DifferentialRateView.jsp


rate.ratediff.confirm
Confirm Differential 
/bpi/cas/carrier/rates/



Fees
DifferentialRateConfirm.jsp









3.1.2. User Interface ID: Rate Classification—Admin Fees
3.1.2.1. Screen Name: Rate Classification—Admin Fees
(BPI_CAS_SCR_CM—003—001) (See FIG. H-20)
3.1.2.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main
Text
Main Header
To give heading for the 


Header rate

rate Classifi-
screen being navigated


Classification

cation for 



for Admin

Admin



Fees

Fees



Rate Type
Radio
Rate Type
To Select a rate type 





(Whether Blended or





Non Blended)


Rate Type
Radio
Rate Type
To Select a rate type 





(Whether Enroll or





Renew)


Group Type
Drop Down
Group Type
List all the Group 



List

Type Available in 





the system


Association
Drop Down
Association
List all the Association 


ID
List
ID
Type Available in the





system


Member
Radio
Member
To Select a Member 


Type

Type
type (Whether





Individual or





Association)


Percentage
Entry Field
Percentage
Entry field for entering 


Premium

Premium
% premium


Effective
Entry Field
Effective
To choose the date 


Date

Date
required, by calendar 





or entering it


Amount
Entry Field
Amount
Entry field for entering 





Amount in $


Medical
Entry Field
Medical
Entry field for entering 





the Medical Fee in $


Dental
Entry Field
Dental
Entry field for entering 





the Dental Fee in $


Vision
Entry Field
Vision
Entry field for entering 





the Vision Fee in %


CAM
Entry Field
CAM
Entry field for entering 





the CAM Fee in %


Save
Button
Save
Save all the above 



(HTML

information to the 



Submit

repository



button)




Cancel
Button
Cancel
To reset the entries made 



(HTML reset

in all the fields



Button)









3.1.2.3. Front End Validations
Validation Details
This section provides the front-end screen validations along with the associated message—Success/Error Message text













#
Element Name
Action/Validation Details
Message


















1.
Rate Type
Rate Type should be selected for
“Rate Type - Is required”




Adding Admin Fees(Either one of





Blended Rate or Non Blended





Rate) and (Either one of Enroll or





Renew).



2.
Group Type
Should list all the Group Type
“Group Type - Is required”




within the system





The first option should be





- Choose One -. Subsequent





Group Types should be listed in





alphabetical order



3.
Association Id
Should list all the Association Id
“Association Id - Is required”




within the system .The first option





should be





- Choose One -. Subsequent





Group Types should be listed in





alphabetical



4.
Member Type
Member Type should be selected
“Member Type - Is required. 




for Adding Admin Fees if Group
Select either Individual Member




Type is Guaranteed Association.
or Association Group”


5.
Percentage Premium
Percentage Premium should be
“Percentage Premium - Is




entered if the rate type is Blended
Required”





“Percentage Premium - Accepts 





numeric value only (0 to 100)”


6.
Effective Date
Effective Date should be selected
“Effective Date - Is required ”




from Calendar or entered
“Effective Date - Accepts the




For valid Date Format
format in MM/DD/YYYY”




Refer BPI CAS FSD Common



7.
Amount
Amount should be entered if the
“Amount - Is required”




rate type is Non Blended
“Amount - Accepts currency





format only (# # #. # #)


8.
Medical
Medical should be entered if the
“Medical - Is required”




rate type is Non Blended
“Medical - Accepts currency





format only (# # #. # #)


9.
Dental
Medical should be entered if the
“Dental - Is required”




rate type is Non Blended
“Dental - Accepts currency 





format only (# # #. # #)


10.
Vision
Medical should be entered if the
“Vision - Is required”




rate type is Non Blended
“Vision - Accepts numeric value





only (0 to 100)”


11.
CAM
Medical should be entered if the
“CAM - Is required”




rate type is Non Blended
“CAM - Accepts numeric value 





only (0 to 100)”


12.
Save
Should function with Enter Key
For general script validations for




Cursor Positioned on the “SAVE”
common functionality refer




button or on Mouse Click.
BPI_CAS_FSD_COMMON




On saving the data the data gets
System Error:




saved to the database.
Common Text shall be followed




Should there be any validation
for the System Error.




error on any of the fields. Should





show the script error and place the





cursor on the specific entry field.





Check if the entries are not





duplicate.





On Successful saving the flow
“! Do any operation to save.”




should reside in the same screen.
(Displayed when invoked




Exception: If the data selected for
immediately after the screen is




edition is from the repository retain
loaded).




its previous state. I.e. the data





should be visible in the table after





saving.





Also show different text color for
“! Complete the update process.”




the data added (temporary) and
(Displayed when Save is invoked




the data picked from the
in Edit Mode).




repository.



13.
Cancel
Should reset to the previous state





on clicking the cancel button









3.1.3. User Interface ID: Rate Classification—Search Admin Fees
3.1.3.1. Screen Name: Rate Classification—Search Admin Fees
(BPI_CAS_SCR_CM—003—002) (See FIG. H-21)
3.1.3.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main
Text
Main Header 
To give heading for 


Header rate

rate
the screen being


Classification

Classification
navigated


for Admin

for Admin



Fees

Fees



Rate Type
Radio
Rate Type
To Select a rate type 





(Whether Blended or 





Non Blended)


Rate Type
Radio
Rate Type
To Select a rate type 





(Whether Enroll or





Renew)


Group Type
Drop Down
Group Type
List all the Group 



List

Type Available in 





the system


Association
Drop Down
Association 
List all the Associ-


ID
List
ID
ation Type Available





in the system


Percentage
Entry Field
Percentage
Entry field for 


Premium

Premium
entering % premium


Effective 
Entry Field
Effective
To choose the date 


Date

Date
required, by calendar





or entering it


Search
HTML
Search
Button to search the



Button

data based on inputs





and displays the 





results in HTML





table below


Table
HTML table
Table
Shows the all the 





data in the column 





format


View/
Button
View/
Button to view 


Delete
(HTML
Delete
the selected record 



Button)

data


Check
Radio 
Check Index
To check the items 


Index
Button

for modify, view





and deletion


Edit
Button 
Edit
To edit the data 



(HTML

against the row



Button)

selected for edition


Cancel
Button
Cancel
To reset the entries 



(HTML

made in all the



Button)

fields









3.1.3.3. Front End Validations
Validation Details
This section provides the front-end screen validations along with the associated message—Success/Error Message text













#
Element Name
Action/Validation Details
Message







1
Effective Date
Effective Date should be selected
“Effective Date -




from Calendar or entered
Accepts the 




For valid Date Format
format in




Refer BPI_CAS_FSD_Common
MM/DD/YYYY


2
Search
Should function with Enter Key 
On click of Search




Cursor Positioned on the “Search”
button checks for




button or Mouse Click.
the above 




All the entries are valid. It fetches 
mentioned




the records from repository based
validations




on inputs and displays the records





in the table below. Else throws





error dialog box.



3
Table
Should have column header and





each subsequent row should be





identified by alternate color





combinations. I.e. first row should





have color ‘x’ and the next row





should have color ‘y’. The next row





should have color ‘x’ again and so





on. The size of the text inside any





cell should be wrapped if the text





becomes too long.



4
View/Delete
Should function with Enter Key
“! Select any 




Cursor Positioned on the “View/
one of




Delete” button or on Mouse Click. 
the record”




If the user clicks on the view





button without checking any of the





view radio button should throw





error message.





Success: View the current row





from the table.



5
Modify
Should function with Enter Key





Cursor Positioned on the “Modify”





button or on Mouse Click.





On clicking the modify button the





row is edited and the data should





be populated.



5
Cancel
Should reset to the previous state





on clicking the cancel button









3.1.4. User Interface ID: Rate Classification—View Admin Fees
3.1.4.1. Screen Name: Rate Classification—View Admin Fees
(BPI_CAS_SCR_CM—003—003) (See FIG. H-22)
3.1.4.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main
Text
Main Header 
To give heading for the


Header rate

rate
screen being navigated


Classification

Classification



for Admin

for Admin



Fees

Fees



Rate Type
Text Field
Rate Type
Displays Blended or 





Non Blended rates


Enroll
Text Field
Enroll
Displays Enroll or 


Renew

Renew
Renew


Group Type
Text Field
Group Type
Displays Group Type


Association 
Text Field
Association
Displays Association 


ID

ID
Type


Member
Text Field
Member
Displays Individual or 


Type

Type
Association


Percentage
Text Field
Percentage
Displays % premium


Premium

Premium



Effective
Text Field
Effective
Displays Effective date


Date

Date



Amount
Text Field
Amount
Displays Amount in $


Medical
Text Field 
Medical
Displays Medical Fee in $


Dental
Text Field
Dental
Displays Dental Fee in $


Vision
Text Field
Vision
Displays Vision Fee in %


CAM
Text Field
CAM
Displays CAM Fee in %


Delete
Button
Delete
To delete the data



(HTML





Button)




New Admin
Button
New Admin
Go to New Admin fee screen


fees
(HTML
fees




Button)









3.1.4.3. Front End Validations
Validation Details
This section provides the front-end screen validations along with the associated message—Success/Error Message text













#
Element Name
Action/Validation Details
Message







1
Delete
Should function with Enter Key
“Do you want to




Cursor Positioned on the “Delete”
delete the selected




button or on Mouse Click.
record?”




If the user clicks on the delete





button throw message box.





Success: Deletes the row from the





data base



2
New Admin
Should go to the admin fees




Fees
screen clicking the New Admin





Fees button









3.1.5. User Interface ID: Rate Classification—Agent Commission
3.1.5.1. Screen Name: Rate Classification—Agent Commission
(BPI_CAS_SCR_CM—003—004) (See FIG. H-23)
3.1.5.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main
Text
Main Header
To give heading for the 


Header rate

rate
screen being navigated


Classification

Classification



for Agent

for Agent



Fees

Fees



Rate Type
Radio
Rate Type
To Select a rate type 





(Whether Blended or





Non Blended)


Rate Type
Radio
Rate Type
To Select a rate type





(Whether Enroll or





Renew)


Enrolled
Check Box
Enrolled
To be checked if enrolled 


before 1997

before 1997
before 1997.


Group Type
Drop Down
Group Type
List all the Group Type 



List

Available in the system


Association
Drop Down
Association 
List all the Association 


ID
List
ID
Type Available in the 





system


Member
Radio
Member
To Select a Member type


Type

Type
(Whether Individual or





Association)


Percentage
Entry Field
Percentage
Entry field for entering 


Premium

Premium
% premium


Effective
Entry Field
Effective
To choose the date required 


Date

Date
by calendar or entering


Group Size
Entry Field
Group Size
Entry field for entering 


Lower Limit

Lower Limit
Group size Lower limit.


Group Size
Entry Field
Group Size
Entry field for entering 


Upper Limit

Upper Limit
Group size Upper limit.


Amount
Entry Field
Amount
Entry field for entering 





Amount in $


Medical
Entry Field
Medical
Entry field for entering 





the Medical Fee in $


Dental
Entry Field
Dental
Entry field for entering 





the Dental Fee in $


Vision
Entry
Field Vision
Entry field for entering 





the Vision Fee in %


CAM
Entry Field
CAM
Entry field for entering 





the CAM Fee in %


Save
Button
Save
Save all the above 



(HTML

information to the 



Button)

repository


Cancel
Button
Cancel
To reset the entries made 



(HTML

in all the fields



Button)









3.1.5.3. Front End Validations
Validation Details
This section provides the front-end screen validations along with the associated message—Success/Error Message text













•
Element Name
Action/Validation Details
Message


















1.
Rate Type
Rate Type should be selected for
“Rate Type - Is Required”




Adding Agent Fees (Either one of





Blended or Non Blended Rate and





Either one of Enroll or Renew)



2.
Enrolled before 1997
Should be selected if enrolled





before 1997.



3.
Group Type
Should list all the Group Type
“Group Type - Is required”




within the system





The first option should be





- Choose One -.Subsequent





Group Types should be listed in





alphabetical order



4.
Association Id
Should list all the Association Id 
“Association Id - Is required”




within the system. The first option





should be





- Choose One -. Subsequent





Group Types should be listed in





alphabetical



5.
Member Type
Member Type should be selected
“Member Type - Is required. Select




for Adding Agent Fees if Group
Individual Member or Association




Type is Guaranteed Association.
Group.”


6.
Percentage Premium
Percentage Premium should be
“Percentage Premium” - Is required




entered if the rate type is Blended
“Percentage Premium in - Accepts





numeric values only (0 to 100)”


7.
Effective Date
Effective Date should be selected
“Effective Date - Is required”




from Calendar or entered
“Effective Date - Accepts the




For valid Date Format
format in MM/DD/YYYY ”




Refer BPI_CAS_FSD_Common



8.
Group Size Lower Limit
Group Size Lower Limit should be
“Group Size Lower Limit - Is required”




entered if the rate type is Non
“Group Size Lower limit - Accepts




Blended
numeric values only (1-999)”


9.
Group Size Upper Limit
Group Size Upper Limit should be
“Group Size Upper Limit - Is required”




entered if the rate type is Non
“Group Size Upper Limit - Accepts




Blended
numeric values only (1-999)”





“Kindly enter Group Size Upper limit





greater than Lower Limit”


10. 
Amount
Amount should be entered if the
“Amount - Is required”




rate type is Non Blended
“Amount - Accepts currency format only





(# # #. # #)


11. 
Medical
Medical should be entered if the
Medical - Is required”




rate type is Non Blended
“Medical - Accepts currency format only





(# # #. # #)


12. 
Dental
Medical should be entered if the
“Dental - Is required”




rate type is Non Blended
“Dental - Accepts currency format only





(# # #. # #)


13. 
Vision
Medical should be entered if the
“Vision - Is required”




rate type is Non Blended
“Vision - Accepts numeric value only





(0 to 100)”


14. 
CAM
Medical should be entered if the
“CAM - Is required”




rate type is Non Blended
“CAM - Accepts numeric value only





(0 to 100)”


15. 
Save
Should function with Enter Key 
For general script validations for 




Cursor Positioned on the “SAVE”
common functionality refer




button or on Mouse Click.
BPI_CAS_FSD_COMMON




On saving the data the data gets
System Error: Common Text shall be




saved to the database.
followed for the System Error.




Should there be any validation
“! Do any operation to save.”




error on any of the fields. Should
(Displayed when invoked immediately




show the script error and place the
after the screen is loaded).




cursor on the specific entry field.





Check if the entries are not





duplicate.





On Successful saving the flow





should reside in the same screen.





Exception: If the data selected for





edition is from the repository retain





its previous state. I.e. the data





should be visible in the table after





saving.



16. 
Cancel
Should reset to the previous state





on clicking the cancel button









3.1.6. User Interface ID: Rate Classification—Search Agent Commission
3.1.6.1. Screen Name: Rate Classification—Search Agent Commission
(BPI_CAS_SCR_CM—003—005) (See FIG. H-24)













Element
Element




Name
Type
Label
Purpose







Main
Text
Main Header
To give heading for the


Header rate

rate
screen being navigated


Classification

Classification 



for Agent

for Agent



Fees

Fees



Rate Type
Radio
Rate Type
To Select a rate type 





(Whether Blended or





Non Blended)


Enroll/
Radio
Enroll/
To Select a rate type 


Renew

Renew
(Whether Enroll or





Renew)


Group Type
Drop Down
Group Type
List all the Group 



List

Type Available in the





system


Association
Drop Down
Association 
List all the Association 


ID
List
ID
Type Available in the





system


Effective
Entry Field
Effective
To choose the date 


Date

Date
required by calendar





or entering


Group Size
Entry Field
Group Size
Entry field for entering 


Lower Limit

Lower Limit
Group size Lower limit.


Group Size
Entry Field
Group Size
Entry field for entering 


Upper Limit

Upper Limit
Group size Upper limit.


Search
HTML Button
Search
Button to search the 





data based on inputs





and displays the results





in HTML table below


Table
HTML table
Table
Shows the all the data 





in the column format


View/
Button (HTML
View/
Button to view the 


Delete
Button)
Delete
selected record data


Check
Radio Button
Check Index
To check the items for 


Index


modify, view and 





deletion


Modify
Button (HTML
Modify
To edit the data against 



Button)

the row selected for





edition


Cancel
Button (HTML
Cancel
To reset the entries made 



Button)

in all the fields









3.1.6.3. Front End Validations
Validation Details
This section provides the front-end screen validations along with the associated message—Success/Error Message text













•
Element Name
Action/Validation Details
Message







1
Effective Date
Effective Date should be selected
“Effective Date -




from Calendar or entered
Accepts the 




For valid Date Format
format in




Refer BPI_CAS_FSD_Common
MM/DD/





YYYY ”


2
Group Size
Group Size Lower Limit should be
“Group Size 



Lower Limit
entered if the rate type is Non
Lower limit -




Blended
Accepts





numeric 





values only





(1-999)”


3
Group Size
Group Size Upper Limit should be
“Group Size 



Upper Limit
entered if the rate type is Non
Upper Limit -



Blended

Accepts





numeric values





only (1-999)”





“Kindly enter 





Group Size





Upper limit





greater than





Lower Limit”


4
Search
Should function with Enter Key
On click of 




Cursor Positioned on the “Search”
Search button




button or Mouse Click.
checks for the




All the entries are valid. It fetches
above mentioned




the records from repository based
validations




on inputs and displays the records





in the table below. Else throws





error dialog box.



5
Table
Should have column header and





each subsequent row should be





identified by alternate color





combinations. I.e. first row should





have color ‘x’ and the next row





should have color ‘y’. The next row





should have color ‘x’ again and so





on. The size of the text inside any





cell should be wrapped if the text





becomes too long.



6
View/Delete
Should function with Enter Key
“! Select any 




Cursor Positioned on the “View/
one of




Delete” button or on Mouse Click.
the record”




If the user clicks on the view





button without checking any of the





view radio button should throw





error message.





Success: View the current row





from the table.



7
Modify
Should function with Enter Key
“! Select any 




Cursor Positioned on the “Modify”
one of




button or on Mouse Click.
the record”




On clicking the modify button the





row is edited and the data should





be populated.



8
Cancel
Should reset to the previous state





on clicking the cancel button









3.1.7. User Interface ID: Rate Classification—View Agent Commission
3.1.7.1. Screen Name: Rate Classification—View Agent Commission
(BPI_CAS_SCR_CM—003—006) (See FIG. H-25)
3.1.7.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main
Text
Main Header
To give heading for the screen 


Header rate

rate
being navigated


Classification

Classification



for Agent

for Agent



Fees

Fees



Rate Type
Text Field
Rate Type
To Display rate type (Whether





Blended or Non Blended)


Enroll Type
Text Field
Enroll Type
To Display enroll type (Whether 





Enroll or Renew)


Enrolled
Text Field
Enrolled
To Display enrolled before 1997 


before 1997

before 1997
or not.


Group Type
Text Field
Group Type
To Display Group Type


Association
Text Field
Association
To Display Association Type


ID

ID



Member
Text Field
Member
To Display member type 


Type

Type
(Individual or Association)


Percentage
Text Field
Percentage
To Display % premium


Premium

Premium



Effective
Text Field
Effective
To Display Effective date


Date

Date



Group Size
Text Field
Group Size
To Display Group size Lower 


Lower Limit

Lower Limit
limit.


Group Size
Text Field
Group Size
To Display Group size Upper 


Upper Limit

Upper Limit
limit.


Amount
Text Field
Amount
To Display Amount in $


Medical
Text Field
Medical
To Display Medical Fee in $


Dental
Text Field
Dental
To Display Dental Fee in $


Vision
Text Field
Vision
To Display Vision Fee in %


CAM
Text Field
CAM
To Display CAM Fee in %


Delete
Button
Delete
To delete the data



(HTML





Button)




New Agent
Button
New Agent
To go to New Agent fees screen


Fees
(HTML
Fees




Button)









3.1.7.3. Front End Validations
Validation Details
This section provides the front-end screen validations along with the associated message—Success/Error Message text













•
Element Name
Action/Validation Details
Message







1
Delete
Should function with Enter Key
“Do you want to




Cursor Positioned on the “Delete”
delete the selected




button or on Mouse Click.
record?”




If the user clicks on the delete





button throw message box.





Success: Deletes the row from the





data base



2
New Agent
Should go to the agent fees screen




Fees
clicking the New Agent Fees





button









3.1.8. User Interface ID: Rate Classification—Additional Fees
3.1.8.1. Screen Name: Rate Classification—Additional Fees
(BPI_CAS_SCR_CM—003—007) (See FIG. H-26)
3.1.8.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main
Text
Main Header
To give heading for the screen 


Header rate

rate
being navigated


Classification

Classification



for

for



Additional

Additional



Fees

Fees



Cobra Type
Radio
Cobra Type
To Select a Cobra Type (Whether 





Cal Cobra or Federal Cobra)


Additional
Entry Field
Additional
Entry field for entering % 


Fee

Fee
Additional Fees


Percentage

Percentage



Effective
Entry Field
Effective
To choose the date required by


Date

Date
calendar or entering


Save
Button
Save
Save all the above information 



(HTML

to the repository



Button)




Cancel
Button
Cancel
To reset the entries made in 



(HTML

all the fields



Button)









3.1.8.3. Front End Validations
Validation Details
This section provides the front-end screen validations along with the associated message—Success/Error Message text













•
Element Name
Action/Validation Details
Message







1.
Cobra Type
Cobra Type should be selected for
“Kindly choose 




Adding Additional Fees
Cobra”


2.
Additional Fee
Additional Fee Percentage should
“% Of Additional 



Percentage
be entered.
Fees—Is required”





“% of Additional 





Fees—Accepts





numeric value





only (0 to 100)


3.
Effective Date
Effective Date should be selected
“Effective Date—Is




from Calendar or entered
required”




For valid Date Format
“Effective Date -—




Refer BPI_CAS_FSD_Common
Accepts the format 





in MM/DD/YYYY”


4.
Save
Should function with Enter Key
For general script




Cursor Positioned on the “SAVE”
validations for




button or on Mouse Click.
common




On saving the data the data gets
functionality refer




saved to the database.
BPI_CAS_FSD_




Should there be any validation
COMMON




error on any of the fields. Should
System Error:




show the script error and place 
Common Text shall




the cursor on the specific entry 
be followed for the




field.
System Error.




Check if the entries are not
“! Do any operation 




duplicate.
to save.”




On Successful saving the flow
(Displayed when




should reside in the same screen.
invoked immediately




Exception: If the data selected for
after




edition is from the repository 
the screen is




retain its previous state. 
loaded).




I.e. the data should be visible 





in the table after saving.



5.
Cancel
Should reset to the previous state





on clicking the cancel button









3.1.9. User Interface ID: Rate Classification—Search Additional Fees
3.1.9.1. Screen Name: Rate Classification—Search Additional Fees
(BPI_CAS_SCR_CM—003—008) (See FIG. H-27)
3.1.9.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main
Text
Main Header
To give heading for the 


Header rate

rate
screen being navigated


Classification

Classification



for

for



Additional

Additional



Fees

Fees



Cobra Type
Radio
Cobra Type
To Select a Cobra Type 





(Whether Cal Cobra or 





Federal Cobra)


Additional
Entry Field
Additional
Entry field for entering % 


Fee

Fee
Additional Fees


Percentage

Percentage



Effective
Entry Field
Effective
To choose the date required by


Date

Date
calendar or entering


Search
HTML
Search
Button to search the data based 



Button

on inputs and displays the 





results in HTML table below


Table
HTML table
Table
Shows the all the data in the 





column format


View/
Button
View/
Button to view the selected 


Delete
(HTML
Delete
record data



Button)




Check
Radio 
Check Index
To check the items for modify, 


Index
Button

view and deletion


Modify
Button 
Modify
To edit the data against the row



(HTML 

selected for edition



Button)




Cancel
Button
Cancel
To reset the entries made in 



(HTML

all the fields



Button)









3.1.9.3. Front End Validations
Validation Details
This section provides the front-end screen validations along with the associated message—Success/Error Message text













•
Element Name
Action/Validation Details
Message







1
Additional Fee
Additional Fee Percentage should
“% of Additional 



Percentage
be entered.
Fees—Accepts 





numeric value 





only (0 to 100)


2
Effective Date
Effective Date should be selected
“Effective Date -—




from Calendar or entered
Accepts the format 




For valid Date Format
in MM/DD/YYYY”




Refer BPI_CAS_FSD_Common



3
Search
Should function with Enter Key
On click of Search




Cursor Positioned on the “Search”
button checks for 




button or Mouse Click.
the above 




All the entries are valid. It 
mentioned




fetches the records from
validations




repository based on inputs





and displays the records





in the table below. Else 





throws error dialog box.



4
Table
Should have column header and





each subsequent row should be





identified by alternate color





combinations. I.e. first row should





have color ‘x’ and the next row





should have color ‘y’. The next row





should have color ‘x’ again and so





on. The size of the text inside any





cell should be wrapped if the text





becomes too long.



5
View/Delete
Should function with Enter Key
“! Select any one 




Cursor Positioned on the “View/
of the record”




Delete” button or on Mouse Click.





If the user clicks on the view





button without checking any of the





view radio button should throw





error message.





Success: View the current row





from the table.



6
Modify
Should function with Enter Key
“! Select any one 




Cursor Positioned on the “Modify”
of the record”




button or on Mouse Click.





On clicking the modify button the





row is edited and the data should





be populated.



7
Cancel
Should reset to the previous state





on clicking the cancel button










3.1.10. User Interface ID: Rate Classification—View Additional Fees
3.1.10.1. Screen Name: Rate Classification—View Additional Fees
(BPI_CAS_SCR_CM—003—009) (See FIG. H-28)
3.1.10.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main
Text
Main Header
To give heading for the screen 


Header rate

rate
being navigated


Classification

Classification



for

for



Additional

Additional



Fees

Fees



Cobra Type
Text Field
Cobra Type
To Display Cobra Type 





(Whether Cal Cobra





or Federal Cobra)


Additional
Text Field
Additional
To Display % Additional 


Fee

Fee
Fees


Percentage

Percentage



Effective
Text Field
Effective
To Display Effective date


Date

Date



New
HTML
New
Button to go to new Additional 


Additional
Button
Additional
fees


Fees

Fees



Delete
Button
Delete
To delete the current additional 



(HTML

fees data



Button)









3.1.10.3. Front End Validations













•
Element Name
Action/Validation Details
Message







1
Delete
Should function with Enter Key
“Do you want to




Cursor Positioned on the “Delete”
delete the selected




button or on Mouse Click.
record?”




If the user clicks on the delete





button throw message box.





Success: Deletes the row from the





data base



2
New Additional
Should go to the additional fees




Fees
screen clicking the New additional





Fees button









3.1.11. User Interface ID: Rate Classification—Differential Fees
3.1.11.1. Screen Name: Rate Classification—Differential Fees
(BPI_CAS_SCR_CM—003—010) (See FIG. H-29)
3.1.11.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main
Text
Main Header
To give heading for the screen 


Header rate

rate
being navigated


Classification

Classification



for

for



Differential

Differential



Factor

Factor



Group Size
Entry Field
Group Size
Entry field for entering Group 


Lower Limit

Lower Limit
size Lower limit.


Group Size
Entry Field
Group Size
Entry field for entering Group 


Upper Limit

Upper Limit
size Upper limit.


Differential
Entry Field
Differential
Entry field for entering 


Factor

Factor
Differential Factor


Effective
Entry Field
Effective
To choose the date required by


Date

Date
calendar or entering


Applicable
Radio
Applicable
To Select a Applicable For 


For

For
(Whether New Business Only 





or New Business or Renewal)


Group Size
Radio
Group Size
To Select a Group Size Criteria


Criteria

Criteria
(Whether Eligible Employee or





Enrolled Employee)


Save
Button
Save
Save all the above information 



(HTML

to the repository



Submit





button)




Cancel
Button
Cancel
To reset the entries made in 



(HTML reset

all the fields



Button)









3.1.11.3. Front End Validations
Validation Details
This section provides the front-end screen validations along with the associated message—Success/Error Message text













•
Element Name
Action/Validation Details
Message







1.
Group Size
Group Size Lower Limit 
“Group Size Lower



Lower Limit
should be entered.
Limit—Is required”





“Group Size Lower





limit—Accepts 





numeric values





only (1-999)”


2.
Group Size
Group Size Upper Limit 
“Group Size Upper



Upper Limit
should be entered.
Limit—Is required”





“Group Size Upper





Limit—Accepts





numeric values only





(1-999)”





“Kindly enter Group 





Size Upper limit





greater than Lower





Limit”


3.
Differential
Differential Factor should be
“Differential 



Factor
entered.
Factor—Is





required”





“Differential 





Factor—





Accepts numeric 





values only.”





“Differential 





Factor—





Cannot be Zero”


4.
Effective Date
Effective Date should be 
“Effective Date—Is




selected from Calendar or 
required”




entered
“Effective Date-—




For valid Date Format
Accepts the format in




Refer BPI_CAS_FSD_
MM/DD/YYYY”




Common



5.
Save
Should function with Enter 
For general script




Key Cursor Positioned on 
validations for




the “SAVE” button or on 
common




Mouse Click.
functionality refer




On saving the data the 
BPI_CAS_FSD_




data gets saved to the 
COMMON




database.
System Error:




Should there be any 
Common Text shall




validation error on any of 
be followed for the




the fields. Should show 
System Error.




the script error and place
“! Do any operation 




the cursor on the specific 
to save.”




entry field.
(Displayed when




Check if the entries are 
invoked immediately




not duplicate.
after the screen is




On Successful saving 
loaded).




the flow should reside 





in the same screen.










3.1.12. User Interface ID: Rate Classification—Search Differential Fees
3.1.12.1. Screen Name: Rate Classification—Search Differential Fees
(BPI_CAS_SCR_CM—003—011) (See FIG. H-30)
3.1.12.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main
Text
Main Header
To give heading for the 


Header rate

rate
screen being navigated


Classification

Classification



for

for



Differential

Differential



Factor

Factor



Group Size
Entry Field
Group Size
Entry field for entering 


Lower Limit

Lower Limit
Group size Lower limit.


Group Size
Entry Field
Group Size
Entry field for entering 


Upper Limit

Upper Limit
Group size Upper limit.


Differential
Entry Field
Differential
Entry field for entering 


Factor

Factor
Differential Factor


Effective
Entry Field
Effective
To choose the date required 


Date

Date
by calendar or entering


Applicable
Radio
Applicable
To Select a Applicable For 


For

For
(Whether New Business 





Only or New Business or 





Renewal)


Group Size
Radio
Group Size
To Select a Group Size 


Criteria

Criteria
Criteria (Whether Eligible 





Employee or Enrolled 





Employee)


Search
HTML
Search
Button to search the data 



Button

based on inputs and 





displays the results in 





HTML table below


Table
HTML table
Table
Shows the all the data in 





the column format


View/
Button
View/
Button to view the selected 


Delete
(HTML
Delete
record data



Button)




Check
Radio Button
Check Index
To check the items for 


Index


modify, view and deletion


Modify
Button (HTML
Modify
To edit the data against the 



Button)

row selected for edition


Cancel
Button
Cancel
To reset the entries made in 



(HTML

all the fields



Button)









3.1.12.3. Front End Validations
Validation Details
This section provides the front-end screen validations along with the associated message—Success/Error Message text














Element




•
Name
Action/Validation Details
Message







1
Group Size
Group Size Lower Limit should
“Group Size 



Lower 
accept numeric.
Lower limit— 



Limit

Accepts





numeric values 





only (1-999)”


2
Group Size
Group Size Upper Limit should
“Group Size 



Upper 
accept numeric.
Upper Limit—



Limit

Accepts





numeric values 





only (1 -999)”





“Kindly enter 





Group Size





Upper limit 





greater than 





Lower Limit”


3
Differential
Differential Factor should accept
“Differential 



Factor
numeric..
Factor—Accepts 





numeric values 





only.”


4
Effective 
Effective Date should be 
“Effective 



Date
selected from Calendar or 
Date -—Accepts 




entered For valid Date Format
the format in




Refer BPI_CAS_FSD_Common
MM/DD/YYYY”


5
Search
Should function with Enter Key
On click of 




Cursor Positioned on the 
Search button 




“Search” button or Mouse Click.
checks for the 




All the entries are valid. It 
above mentioned




fetches the records from 
validations




repository based on inputs 





and displays the records





in the table below. Else throws





error dialog box.



6
Table
Should have column header and





each subsequent row should be





identified by alternate color





combinations. I.e. first row 





should have color ‘x’ and 





the next row should have 





color ‘y’. The next row should





have color ‘x’ again and so on.





The size of the text 





inside any cell should be 





wrapped if the text becomes too 





long.



7
View/
Should function with Enter Key
“! Select any one 



Delete
Cursor Positioned on the “View/
of the record”




Delete” button or on Mouse 





Click. If the user clicks on 





the view button without 





checking any of the view 





radio button should throw 





error message.





Success: View the current row





from the table.



8
Modify
Should function with Enter Key
“! Select any one 




Cursor Positioned on the 
of the record”




“Modify” button or on





Mouse Click.





On clicking the modify button 





the row is edited and the 





data should be populated.



9
Cancel
Should reset to the previous 





state on clicking the cancel 





button









3.1.13. User Interface ID: Rate Classification—View Differential Fees
3.1.13.1. Screen Name: Rate Classification—View Differential Fees
(BPI_CAS_SCR_CM—003—012) (See FIG. H-31)
3.1.13.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main
Text
Main Header
To give heading for the screen 


Header rate

rate
being navigated


Classification

Classification



for

for



Differential

Differential



Factor

Factor



Group Size
Text Field
Group Size
To Display Group size Lower 


Lower Limit

Lower Limit
limit.


Group Size
Text Field
Group Size
To Display Group size Upper 


Upper Limit

Upper Limit
limit.


Differential
Text Field
Differential
To Display Differential Factor


Factor

Factor



Effective
Text Field
Effective
To Display Effective date


Date

Date



Applicable
Text Field
Applicable
To Display Applicable For 


For

For
(Whether New Business Only 





or New Business or Renewal)


Group Size
Text Field
Group Size
To Display Group Size Criteria


Criteria

Criteria
(Whether Eligible Employee or





Enrolled Employee)


New
Button
New
To go to Differential rate screen.


Differential 
(HTML
Differential



Rate
Button)
Rate



Delete
Button
Delete
To delete the current Differential 



(HTML

fee



Button)









3.1.13.3. Front End Validations
Validation Details
This section provides the front-end screen validations along with the associated message—Success/Error Message text













•
Element Name
Action/Validation Details
Message







1
Delete
Should function with Enter Key
“Do you want to




Cursor Positioned on the “Delete”
delete the selected




button or on Mouse Click.
record?”




If the user clicks on the delete





button throw message box.





Success: Deletes the row from the





data base



2
New
Should go to the agent fees screen




Differential
clicking the New Differential Fees




Fees
button









3.1.14. Screen Flow
(See FIG. H-32)
Benefit Partners Inc
Process Specification
BPI_CAS_FSD_CM—04
1. Introduction
1.1. Purpose
This purpose of this document is to identify the process associated with the business use case Create ZIP. This document is the amendment of BPI_CAS_FSD_CM—04 (Version 1.0).
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









BPI_SCOPE_CM_004
Create ZIP










1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
2.1. Background
This process describes the Use Case “Create ZIP”. Standard ZIP is loaded into the system. Refer the document reference no. BPI_CAS_FSC_EC for process of loading ZIP Code. Also for the specific ZIP Codes the corresponding service areas are loaded. The state is divided into several service areas based on the number of counties and their population. In the state of California there are presently 6 service areas. The Rate is based on the service area where the employees are residing.
2.2. Process Description & Flow
2.2.1. Zip Code Search
The Screen described below has two features provided:
Zip code search feature is by which the user can search for zip based on any of the selection criteria. Search for zip is based on City name, County name or a Valid Zip code. When user enters the search value, search results are displayed on a table format.
There is also provision for canceling the search value. Numbers of records fetched are also displayed on the screen.
There is also a feature to print the records fetched. A separate page is invoked on clicking the printer icon. The print page has the fetched records with print button. Clicking on which will invoke the printer dialog.
User can view records in Normal as well as Expanded mode. Expanded mode can be invoked by clicking the gif in the table header.
2.2.2. Zip Distance
Zip Distance feature is by which user can get the distance of the zip codes entered. Zip distance is calculated based on the geographical distribution of the area by its latitudinal & longitudinal position. The result is displayed in miles.
The user interface for Zip is provided below. The two screenshots is the same screen shown to describe these two features.
2.2.3. Process Flow Diagrams
(See FIG. H-33)
3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's














Corresponding 


Screen ID (SID)
Screen Name
HTML File Name







zip.zipsearch
Zip Search
/bpi/cas/carrier/zip/ZipSearch.jsp









3.1.2. User Interface ID: Zip Search
3.1.2.1. Screen Name: Zip Search (BPI_CAS_SCR_CM—004—001) (See FIG. H-34)
Zip Distance: BPI_CAS_SCR_CM—004—002 (See FIG. H-35)
3.1.2.2. Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Main
Text
Main Header
To give heading for the 


Header

Searching
screen being navigated


Searching

ZIPS



ZIPS





City
Text
City
Provide Text


City
Radio
City
To choose a city for search


County
Text
County
Provide Text


County
Radio
County
To choose a county for search


ZIP
Text
ZIP
Provide Text


ZIP
Radio
ZIP
To choose a zip for search


Search
Entry Field
Search
Entering the Zip search value


Value

Value



Search
HTML
Search
Button to be invoked for 



Button

displaying the search results 





based on the Entered 





text in Search Value.


Cancel
HTML
Cancel
To clear the entered field.



Button




ZIP 1
Text
ZIP 1
Provide Text


ZIP 1
Entry Field
ZIP 1
Entering the Zip1 value


ZIP 2
Text
ZIP 2
Provide Text


ZIP 2
Entry Field
ZIP 2
Entering the Zip2 value


Go
HTML
Go
Button to be invoked for 



Button

displaying the distance 





between the two zip codes 





entered in miles.


Cancel
HTML
Cancel
To clear the entered field.



Button









3.1.2.3. Front End Validations
Validation Details
This section provides the front-end screen validations along with the













#
Element Name
Action/Validation Details
Message







1.
City
Max length of the search 





field is set.



2.
County
Max length of the search





field is set.



3.
Zip
Max length of the search 





field is set.



4.
Search
On click of the button, 
“Search Value - Is




records are fetched from 
required.”




repository based on
“City - Accepts




selection criteria.
alphabetic characters





only.”





“County - Accepts





alphabetic characters





only.”





“ZIP - Accepts exactly





5 digit numbers only.”


5.
Cancel
On click of this button, 





entry field is cleared.



6.
Go
On click of the button, 
“Zip1 - Is required.”




distance between the two 
“Zip2 - Is required.”




zip codes is displayed.
“ZIP - Accepts exactly





5 digit numbers only.”


7.
Cancel
On click of this button, 





entry field is cleared.









3.2. Screen Flow
This section describes the screen flow for the group enrollment process. (See FIG. H-36)
Benefit Partners Inc
Process Specification
Cobra Enrollment
1 Introduction
1.1 Purpose
The purpose of this document is to describe the process of COBRA Enrollment. This document identifies how the user interacts with the system, the data to be captured, the business logic to be implemented, and the output of the process.
1.2 Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









BPI_SCOPE_EN
Enrollment



BPI_SCOPE_EN_002
COBRA Enrollment



BPI_SCOPE_EN_001
Group Enrollment










1.3 Document Reference











Document ID
Document Name







BPI_CAS_FSD_EN
Functional Specification Document - Enrollment


BPI_CAS_FSD_EN_001
Process Flow - New Business Enrollment


BPI_CAS_FSD_EN_002
Process Flow - Enrollment Changes/Add-On


BPI_CAS_FSD_EN_003
Process Flow - COBRA Enrollment/Changes


BPI_CAS_FSD_EN_005
Process Flow - Termination/Reinstatement









1.4 Definitions, Acronyms & Abbreviations
















Term
Explanation










2 Process Identification
2.1 Background
California State laws and federal laws govern COBRA Rules based on whether it is Cal COBRA or Federal COBRA.
The decision whether the Group is a CAL COBRA or FEDERAL COBRA would be based on the Group size or the number of employee in the group. If the number of the employee were greater than or equal to 20 then it would be FEDERAL COBRA. If the group size were less than 20 employees then it would be Cal COBRA. This needs to be entered at the time of group enrollment. Based on applications received for group.
2.2 Process Description
The objective of the COBRA Enrollment is to:

    
    
        New Business COBRA Enrollment
        Existing member converting to COBRA because of the qualifying rules.
        Add on for COBRA members
        Changes to COBRA members
        Requalification and Open enrollment and Open enrollment for the COBRA members.
    
    


2.3 Process Flow
Process for COBRA is based on the type of COBRA enrollment

    
    
        New Business COBRA Enrollment
        Existing members converting into COBRA after termination
    
    


Process Flow for New Business COBRA Enrollment
1) Search for the group and select the SEG Group or Alternate Group with whom the COBRA members are to be added.
2) Specify if the Member is enrolling as COBRA member as an individual or with dependent
3) If the member is enrolling with dependent then specify the number of dependent
4) Enter member general information, which includes the personal information and address information.
5) Add the dependant/dependents if the option selected is with dependent and enter the dependent/dependents information.
6) Enter COBRA information for the member and dependents as applicable.
7) Select the Line of coverage options for the member and dependent as applicable.
8) List COBRA member summary and select the Benefit Level (Carrier Selection) based on the ZIP code and Service area provided.
9) Show missing information for the COBRA enrollment.
10) Enroll/Decline the COBRA enrollment (based on ACL).
Process Flow for New Business COBRA (See FIG. I-1)
Process Flow for Existing Member COBRA Enrollment
1) Search for the group and employee who need to be converted into the COBRA members.
2) Check the term status and reasons for the Employee/dependent.
3) Process COBRA Eligibility checks. This checks the eligibility of the Employee if termed and the reasons for the term, which form the basic for the qualifying event. Of if the employee is not termed and the dependent/dependents are termed their reasons for terms and qualifying event. If none qualify then COBRA enrollment is declined based on ACL. If either qualifies then the COBRA enrollment information is shown with option to select line of coverage for the termed members.
4) Identify the primary member based on the criteria.
Employee is also termed and opts for COBRA then the employee becomes the primary member.
If spouse is termed with children and spouse opts for COBRA coverage then spouse becomes the primary member
If Children/child is termed and opts for COBRA coverage the oldest child becomes the primary member.
5) Check if the Plan is available in the Primary members ZIP/Service area.

    If so then the member should select the same plan as was before. If not, pend and send quote for plans available and then allow the member to select the plan that is available in the new ZIP service area.


6) Dependents should have the same plan as well. However they can waive any plan. (Refer the business rules for COBRA)
7) Show Summary and missing information.
8) Enroll/Decline member/members as COBRA group.
Process Flow for Existing COBRA Conversion (See FIG. I-2)
3 User Interface
3.1 User Interface Screens
3.1.1 Screen ID's













Screen 
Corresponding 


Screen ID (SID)
Name
HTML File Name







bpi.enrollment.cobra.
Group 
/bpi/cas/enrollment/cobra/new/


new.search
Search
groupsearch/GroupSearch.jsp


bpi.enrollment.cobra.
Group
/bpi/cas/enrollment/cobra/new/


new.general
Information
generalinfo/GeneralInfo.jsp


bpi.enrollment.cobra.
Billing Info
/bpi/cas/enrollment/cobra/new/


new.billing

billinginfo/BillingInfo.jsp


bpi.enrollment.cobra.
Coverage 
/bpi/cas/enrollment/cobra/new/


new.coverage
Info
coverageinfo/CoverageInfo.jsp


bpi.enrollment.cobra.
Dependent 
/bpi/cas/enrollment/cobra/new/


new.dependent
Information
dependentinfo/




DependentInfo.jsp


bpi.enrollment.cobra.
Cobra 
/bpi/cas/enrollment/cobra/new/


new.searchcobra
Search
cobrasearch/CobraSearch.jsp


bpi.enrollment.cobra.
Missing 
/bpi/cas/enrollment/cobra/new/


new.missing
Information
missinginfo/MissingInfo.jsp


bpi.enrollment.cobra.
Group 
/bpi/cas/enrollment/cobra/new/


new.inactivate
Inactivate
groupinactivate/




GroupInactivate.jsp


bpi.enrollment.cobra.
Confirmation
/bpi/cas/enrollment/cobra/new/


new.confirmation

confirmation/Confirmation.jsp


bpi.enrollment.cobra.
Employee 
/bpi/cas/enrollment/cobra/existing/


existing.
Search
employeesearch/


employeesearch

EmployeeSearch.jsp


bpi.enrollment.cobra.
Member 
/bpi/cas/enrollment/cobra/existing/


existing.
Process
memberprocess/


memberprocess

MemberProcess.jsp


bpi.enrollment.cobra.
Existing 
/bpi/cas/enrollment/cobra/existing/


existing.general
General
generalinfo/GeneralInfo.jsp



Information



bpi.enrollment.cobra.
Existing 
/bpi/cas/enrollment/cobra/existing/


existing.billing
Billing Info
billinginfo/BillingInfo.jsp


bpi.enrollment.cobra.
Existing 
/bpi/cas/enrollment/cobra/existing/


existing.coverage
Coverage 
coverageinfo/CoverageInfo.jsp



Info



bpi.enrollment.cobra.
Existing 
/bpi/cas/enrollment/cobra/existing/


existing.dependent
Dependent
dependentinfo/DependentInfo.jsp



Info



bpi.enrollment.cobra.
Existing 
/bpi/cas/enrollment/cobra/existing/


existing.searchcobra
Cobra 
cobrasearch/CobraSearch.jsp



Search



bpi.enrollment.cobra.
Existing 
/bpi/cas/enrollment/cobra/existing/


existing.missing
Missing Info
missinginfo/MissingInfo.jsp


bpi.enrollment.cobra.
Existing 
/bpi/cas/enrollment/cobra/existing/


existing.confirmation
confirmation
confirmation/Confirmation.jsp


bpi.enrollment.cobra.
Existing 
/bpi/cas/enrollment/cobra/existing/


existing.inactivate
Inactivate
groupinactivate/




GroupInactivate.jsp









3.1.2 User Interface Id: BPI_SCR_EN—002—001—Group Search
3.1.2.1 Screen Name: Group Search (See FIG. I-3)
3.1.2.2 Element Name, Element Type, Label & Purpose













Element





Name
Element Type
Label
Purpose







Group Id
Text
Group Id
To provide text


Group Id
Entry Field
Group Id
Enter the group Id 





for Search


Group
Text
Group Name
To provide text


Name





Group
Entry Field
Group Name
To enter group name for


Name


search


Group
Text
Group Phone
To provide text


Phone





Group
Entry field
Group phone
Enter group phone 


phone


number for search


Search
HTML button
Search
Button for searching the





Group


Table
HTML Table
Table
Table to display group





information


Select
Radio Button
Select Group
Button to select the group 


Group


for Attaching the 





COBRA members


Single
Radio Button
Single Member
To choose if the COBRA


Member


Member is enrolling as a





single member


Member
Radio Button
Member With 
To choose if the COBRA


With

dependent
Member is enrolling as a


dependent


member with dependent


Dependent
Entry Field
Dependent 
Field to enter the 


Member

Member 
number of dependent 


Count

Count
members being added to 





the member as COBRA









3.1.2.3 Screen Validations












Element Name
Action/Validation Details
Message







Group ID
Enter valid group ID only
Error Dialog Box:




“Please enter valid 




group ID”


Group Name
Enter the group name
None


Group Phone
Enter valid phone 
Error Dialog Box:



number for the group
“Please enter valid 




phone number”


Search
On click of the search 
None



button should list the




groups or a single group 




based on the search




criteria.



Select Group
If the groups are multiple 
Error Dialog Box:



then the radio button 
“Please select a group 



option to select the specific 
with whom you



group should be provided.
would like to add 



If the Group available is 
COBRA member”



only one then it should be 




selected by default.



Select member
There should be option 
None


Only or Member
either to select single 



with dependent
member or member 




with dependent.



Dependent
If the option selected is 
Error Dialog Box:


Member Count
member with 
“Please enter the 



dependent specify the
number of dependent



number of dependents.
as the option selected is 




member with dependent.









3.1.2.4 Help Menu
New Business enrollment can bring in the members as COBRA. This screen is used for adding the COBRA members to the new business groups based on the selection of the group.












Element Name
Purpose
Valid Values







Search
To search for
Should list single or multiple 



the Group
groups based on the search criteria.


Single Member 
This is to specify
None


or member with
if the member is



dependent
availing COBRA




benefits




individually or




with dependents



Dependent
Specify the
None


Member Count
count of the




dependent




members to be




enrolled with the




primary member




as COBRA.









3.1.3 User Interface Id: BPI_SCR_EN—002—002—Group Information
3.1.3.1 Screen Name: Group Information (See FIG. I-4)
3.1.3.2













Element
Element




Name
Type
Label
Purpose







Employer
Text
Employer 
To provide text


Information

Information



Date PM
Text
Date PM
To provide text


Date PM
Entry field
Date PM
Provide entry for Date





Postmarked


Date
Text
Date Recd
To provide text


Recd





Date
Entry field
Date Recd
Provide entry for Date


Recd


Received


Salutation
Text
Salutation
To provide text


Salutation
Drop 
Salutation
List the Salutation MR.,



Down List

MRS., MS.


First
Text
First name
To provide text


name





First
Entry field
First name
Provide entry field for the


name


First name


Last
Text
Last name
To provide text


name





Last
Entry Field
Last Name
Provide entry field for the


Name


Last name


MI
Text
MI
To provide text


MI
Entry Field
MI
Enter the middle initial


Suffix
Text
Suffix
To provide text


Suffix
List
Suffix
List the suffix for selection


Social
Text
Social 
To provide text


Security

Security



Number

Number



SSN
Entry field
SSN
Enter the SSN number


Unique
Text
Unique ID
To provide text


ID





Unique
Entry 
Unique ID
Show the unique ID


ID
field (Un

generated



editable).




Auto
HTML 
Auto 
Button to generate Unique 


Generate
button
Generate
Id if SSN is not provided


Date of
Text
Date of 
To provide text


Birth

Birth



Date of
Calendar
Date of 
Calendar to select the birth


Birth

Birth
date, Should also allow to





enter date of birth as MM/





DD/YYYY


Gender
Text
Gender
To provide text


Gender
List
Gender
List whether Male or Female


Physical
Text
Physical 
To provide text


Main

Main 



Address

Address



Street
Entry field
Street 
Enter the street address


Address

Address



Suite/
Text
Suite/Apts.
To provide text


Apts.





Suite/
Entry Field
Suite/Apts.
Enter the suite/apts. number


Apts.





City
Text
City
To provide text


City
Entry Field
City
Enter the city name


State
Text
State
To provide text


State
Drop 
State
List all the state in US



Down List




ZIP
Text
ZIP
To provide text


ZIP
Entry Field
ZIP
Enter zip code


Service
Text
Service 
To provide text


Area

Area



Service
Entry 
Service 
Shows the Service Area


Area
Field (un
Area
based on the ZIP code typed



editable) 

Show list if the ZIP has



or list

multiple service area


County
Text
County
To provide text


County
Entry 
County
Display the county name



Field (un

based on the zip and service



editable)

area selected


Preferred 
Text
Preferred 
To provide 


mode of

mode of
text


correspon-

correspon-



dence

dence



Mode of
Drop 
Mode of 
List the mode of


correspon-
Down List
correspon-
communication, USPS, 


dence

dence
FAX, or email/web. 





Phone is not





allowed.


Phone
Text
Phone 
To provide text


number

number



Phone
Entry Field
Phone
To enter phone number


Home
Text
Home 
To provide text


FAX No.

FAX No.



FAX
Entry Field
FAX
To enter FAX number


Extension
Entry Field
Extension
To enter extension number


E-Mail
Text
E-Mail 
To provide text


Address

Address



E-mail
Entry field
E-mail 
Enter email address


Address

Address



Mailing
Text
Mailing 
To provide text


Address

Address



Street
Text
Street 
To provide text


Address

Address



Street
Entry field
Street 
Enter the street address


Address

Address



Suite/
Text
Suite/Apts./
To provide text


Apts./PO

PO Box #



Box #





Suite/
Entry Field
Suite/Apts./ 
Enter the suite/apts. 


Apts./PO

PO Box #
number


Box #





City
Text
City
To provide text


City
Entry Field
City
Enter the city name


State
Text
State
To provide text


State
Drop 
State
List all the state in US



Down List




ZIP
Text
ZIP
To provide text


ZIP
Entry Field
ZIP
Enter zip code


Cancel
HTML 
Cancel
To cancel the operation and



Reset 

reset for new selection



Button




Continue
HTML
Continue
To save the data gathered in



Submit

this screen and continue to



Button

the next screen





BPI_CAS_SCR_EN_002_003









3.1.3.3 Screen Validations












Element 




Name
Action/Validation Details
Message







Salutation
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


First 
Refer Document No. 
Refer Document No.


name
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Last 
Refer Document No. 
Refer Document No. 


name
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


MI
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Suffix
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Birth 
Refer Document No. 
Refer Document No. 


date
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


SSN
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Unique 
Unique 9 digit ID should be
None


Id
generated if the SSN number is




not provided. This unique ID




should not be repeated for any




employee. Also unique Id 




should be generated on 




change mode.




Number should start with




999 999 000 and start




descending e.g.




999 998 999




999 998 998 and so on



Street 
Refer Document No. 
Refer Document No. 


Address
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Suite/
Refer Document No.
Refer Document No.


Apts.
BPI_CAS_FSD_COMMON
BPI_CAS_FSD COMMON


City
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


State
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


ZIP
Refer Document No. 
Refer Document No.



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Service 
Should pick up the service area
None


Area
based on the Zip code number




typed in the above ZIP entry 




field from the database




If there are multiple service 




area then it should list the 




service area for picking up 




the service area.



County
Show the county name based on
none



the ZIP code and Service area




combination



Mode of
List mode of communications 
Error Dialog Box:


Com-
like USPS, FAX, Email/
“Please choose the mode of


munica-
Web and others. If the 
communication”


tion
option selected is Email 




then the Email address 




field cannot be blank.




Default Option should be




- choose one -




If none is selected should 




throw error message.



Phone
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Extension
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


FAX
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Extension
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


E-mail 
Refer Document No. 
Refer Document No.


Address
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Gender
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Street 
Refer Document No. 
Refer Document No. 


Address
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Suite/
Refer Document No. 
Refer Document No. 


Apts.
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


City
Refer Document No.
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


State
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


ZIP
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Cancel
Reset Button
To reset the value in the 




Entry Field to its previous 




state as was on loading 




the page


Continue
Should function with Enter Key
Error Dialog Box:



Cursor Positioned on the
“The value entered for the 



“Continue” button or on Mouse
Field Name is erroneous. 



Click.
Please enter valid values. 



Check for all the validation 
“Please choose the mode 



on the fields
of communication”



If any data type error throw 




error message.




Allows blank entry




On Success Leads to the next




page for filling further 




information on the employee.




Screen




BPI_CAS_SCR_EN_002_003









3.1.3.4 Help Menu
This screen is used for filling up the primary COBRA member information. The information contained here is the personal information and the address information. The ZIP and the service are provided here governs the rate calculation for the COBRA member.















Element Name
Purpose
Valid Values









Continue
On clicking the 
None




button leads to





the next page





for filling up the





dependent





information if





applicable of





member





coverage





information.










3.1.4 User Interface Id: BPI_SCR_EN—002—003—Dependent Information
3.1.4.1 Screen Name: Dependent Information (See FIG. I-5)
3.1.4.2 Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Salutation
Text
Salutation
To provide text


Salutation
List
Salutation
List type of salutation


Dependent
Text
Dependent 
To provide text


First

First name



name





First
Entry Field
First Name
Enter the first name


Name





Dependent
Text
Dependent 
To provide text


Last

Last name



name





Last
Entry field
Last name
Enter the last name


name





MI
Text
MI
To provide text


MI
Entry Field
MI
Enter the middle initial


Suffix
Text
Suffix
To provide text


Suffix
Entry Field
Suffix
Enter the suffix


Dependent
Text
Dependent 
To provide text


Social

Social 



Security

Security



Number

Number



SSN
Text
SSN
To provide text


SSN
Entry field
SSN
Enter the SSN number


Unique
Text
Unique ID
To provide text


ID





Unique
Entry 
Unique ID
Show the unique ID


ID
field (Un

generated



editable).




Gender
Text
Gender
To provide text


Gender
List
Gender
List the gender


Relationship
Text
Relationship
To provide text


Relationship
List
Relationship
List all types of relationship





like spouse, domestic





partner, child, step child





others


Birth
Text
Birth Date
To provide text


Date





Birth
Calendar
Birth Date
Calendar to choose the birth


Date


date


Add
HTML 
Add 
To add the above dependent


Dependent
Submit
Dependent
Information to the html table



Button

below


Table
HTML 
Table
Table for adding up the



Table

dependent information


Delete
Button 
Delete
To delete the items checked



(HTML

for deletion



Button)




Check
Text Link
Check All
To check all the check boxes


All


in the table


Clear All
Text Link
Clear All
To un check all the check





boxes checked in the table


Delete
Check box
Delete
To check the items for





deletion


Edit
Button 
Edit
To edit the items against the



(HTML

row selected for edition



Button)




Disabled
Text
Disabled
To provide text


Disabled
Radio 
Disabled 
Temporary or permanent


Radio
Button
Radio Button
disability (Can be only one or


Button


the other) Default NONE.


Domestic
Text
Domestic 
To provide text


Partner

Partner



Domestic
Check box
Domestic 
Is Form available if so check.


Partner

Partner



Legal
Text
Legal 
To provide text


Guardian

Guardian



Legal
Check box
Legal 
Is Form available if so check.


Guardian

Guardian



Signature
Text
Signature
To provide text


Signature
Check box
Signature
Is signature available if check


Continue
HTML 
Continue
On clicking the continue



Button

button save the information


Cancel
HTML 
Cancel
To reset to the state as was



reset Button

before loading the page









3.1.4.3 Screen Validations












Element 




Name
Action/Validation Details
Message







First Name
Refer 
Refer 



BPI_CAS_FSD_Common
BPI_CAS_FSD_Common


Last name
Refer 
Refer 



BPI_CAS_FSD_Common
BPI_CAS_FSD_Common


MI
Refer 
Refer 



BPI_CAS_FSD_Common
BPI_CAS_FSD_Common


Suffix
Refer 
Refer 



BPI_CAS_FSD_Common
BPI_CAS_FSD_Common


SSN Number
Refer 
Refer 



BPI_CAS_FSD_Common
BPI_CAS_FSD_Common


Unique Id
Unique 9 digit ID should be
None



generated if the SSN number is




not provided. This unique ID




should not be repeated for any




employee. Also unique Id should




be generated on change mode.




Number should start with




999 999 000 and start




descending e.g.




999 998 999




999 998 998 and so on



Birth Date
Refer BPI_CAS_FSD_Common
Refer 




BPI_CAS_FSD_Common


Gender
Refer BPI_CAS_FSD_Common
Refer 




BPI_CAS_FSD_Common


Relationship
Default option should be
Error Dialog Box:



- Choose one -. If none is
“Please select the 



selected throw error message
relationship of the 




dependent with the 




employee”


Add 
On clicking the Add Dependent
Error Dialog Box:


Dependent
the dependent information gets
“The value entered in the 



filled in the HTML Table. All
field name is incorrect. 



validation checks are performed
Please enter valid entries”



on the entry field before adding




the dependent.



Table
Should have column header and
None



each subsequent row should be




identified by alternate color




combinations. i.e. First row




should have color ‘x’ and the next




row should have color ‘y’. The




next row should have color ‘x’




again and so on. The size of any




text inside any cell should be




wrapped if the text becomes too




long.




Note: The values inside the table




on create mode would be blank.




If this screen is reached on edit/




change mode then the values




inside the table would be green in




color if retrieved from the




database, if temporarily added




then it would be red in color.



Delete
Should function with Enter Key
Error Dialog Box:



Cursor Positioned on the “Delete”
“Please choose the 



button or on Mouse Click.
row or rows to be deleted.”



Delete Button should work on




multiple deletes based on the




check box or boxes selected. If




the user clicks on the delete




button without checking any of




the delete check box should




throw error message.




Success: Deletes the row or




rows from the HTML Table




(temporary storage)



Check All
On clicking the “Check All” link
On clicking the “Check 



should check all the check boxes
All” link should check 



in the HTML table.
all the check boxes in 




the HTML table.


Clear All
On clicking the “Clear All” link
On clicking the “Clear All” 



should uncheck all the checked
link should uncheck all the 



check boxes in the HTML table.
checked check boxes in 




the HTML table.


Delete
Check box option with default
Check box option with 



“unchecked”
default “unchecked”


Edit
Should function with Enter Key
On clicking the edit button 



Cursor Positioned on the “Edit”
the row edited should be 



button or on Mouse Click.
removed from the HTML 



On clicking the edit button the
table and the data 



row edited should be removed
should be populated back 



from the HTML table and the data
on the editable entry



should be populated back on the
fields.



editable entry fields.




On clicking the edit for the data




that is Green in color (permanent




data) the edit becomes disabled




and the Add button becomes




Update.




On clicking edit for the red color




data (temporary data) the row




with the data disappears from the




table



Domestic 
Default is un checked. Allow to
None


Partner
check if applicable



Legal 
Default is un checked. Allow to
None


Guardian
check if applicable



Signature
Default is un checked. Allow to
None



check if applicable



Continue
Should function with Enter Key
Dialog Box:



Cursor Positioned on the
“Do you want to add the 



“Continue” button or on Mouse
coverage information 



Click.
before continuing” 



On success should save the data
Yes/No



lead to the next page.



Cancel
Should reset to the state as was
None



before loading the page.









3.1.4.4 Help Menu
This screen is used for filling up the dependent COBRA member information. The information contained here is the personal information. If there are multiple dependent then you can add the dependent COBRA members here.















Element Name
Purpose
Valid Values









Continue
On clicking the
none




button leads to





the next page





for filling up the





member





coverage





information.










3.1.5 User Interface Id: BPI_SCR_EN—002—004—Coverage Information
3.1.5.1 Screen Name: Coverage Information (See FIG. I-6)
3.1.5.2 Element Name, Element Type, Label & Purpose













Element
Element 




Name
Type
Label
Purpose







COBRA
Page sub 
COBRA 
To provide text


qualifying
Header
qualifying 



Event

Event



Initial
Text
Initial COBRA 
To provide text


COBRA

effective date



effective





date





Date
Entry field
Date
Enter the initial 





effective date


COBRA
Text
COBRA 
To provide text


End

End Date



Date





Period
Entry field
Period
Enter the COBRA 





effective period


Reasons
Text
Reasons for 
To provide text


for

electing 



electing

COBRA



COBRA





Reasons
Drop 
Reasons for 
List the reasons 


for
Down List
electing 
for COBRA election


electing

COBRA



COBRA





Where
Text
Where would 
To provide text


would

you like the



you like

bills to be sent



the bills





to be





sent





Where
Check Box
Where would 
Check if the bill 


would

you like the
is to be sent


you like

bills to be sent
to the group 


the bills


or the member


to be





sent





Is
Text
Is member 
To provide text


member

signature 



signature

verified



verified





Is
Check box
Is member 
Check if signature 


member

signature 
is verified


signature

verified



verified





Line of
HTML 
Line of 
Table to display 


Coverage
Table
Coverage
the Member names 


Selection

Selection
and the Line of 


Table

Table
coverage check boxes 





for picking the line of 





coverage for each 





COBRA members


Coverage
Check Box
Coverage 
Check box to select 


Selection

Selection
the line of coverage


Show
HTML 
Show 
Button to show the 


Coverage
button
Coverage 
coverage choice for 


Choice

Choice
each line of coverage 





based on the check 





box/boxes checked.


Continue
HTML 
Continue
Button to save the 



Button

data and lead to the 





next screen for 





showing the 





summary and 





selection of Benefit 





level offered by 





carriers (Screen 





BPI_CAS_SCR_EN_002_004)









3.1.5.3 Screen Validations












Element Name
Action/Validation Details
Message







Date
Defaults to system date. User
Error Dialog Box:



can either enter the date of pick
“Date cannot be 



the date form the calendar
future date” Please




enter past date”


COBRA 
Defaults to 18 months. Can be
None


effective
changed by the user.



period




Reasons for
List the qualifying reasons for
None


electing 
COBRA.



COBRA




Where would 
Option to bill either the group of
None


you like the 
the COBRA member based on



bills to be sent
the flag checked



Is member
Check if the member signature is
None


signature
verified



verified




Line of 
Table to show the Line of
None


Coverage
coverage against each member



Selection Table
for picking the option. The Line of




coverage displayed is based on




the line of coverage selected by




the primary group.




Note: The table would display the




Member name in the following




priority.




Employee as primary member




Spouse as the next member




Other members would be listed




based on the age.



Coverage
Check Box to pick any
None


Selection
combination of coverage's for all




the member for this specific




COBRA group



Show Coverage
On click of the Coverage choice
None


Choice
system should identify the




coverage choice based on the




options checked. Whether




member only, member and




spouse etc.



Continue
On clicking the continue button
Dialog Box:



saves the data and leads to the
“Are you sure 



page
to continue”



BPI_CAS_SCR_EN_002_005









3.1.5.4 Help Menu
This screen is used for filling up the COBRA qualifying events and the COBRA tenure for the members. Also there is an option to select the line of coverage opted for the various members.















Element Name
Purpose
Valid Values









Continue
On clicking the
None




button leads to





the next page





for selecting the





benefit level





(Carrier)










3.1.6 User Interface Id: BPI_SCR_EN—002—006—Summary/Missing Information
3.1.6.1 Screen Name: Missing Info (See FIG. I-7)
3.1.6.2 Element Name, Element Type & Purpose













Element





Name
Element Type
Label
Purpose







Member
Text
Member 
To provide text


Missing

Missing



Information

Information



Employee
Expandable 
Employee 
Should be able to expand the


Tab
Tree
Tab
Employee Tab to list the





Details for the Employee





Missing and information and





Also show an expandable tab





for the Dependent Missing





Information


Enrollment
Drop 
Enrollment 
List the status of enrollment.


Status
Down List
Status
Can be Enroll or Decline


Remarks
Entry Field
Remarks
Remark for the status of





enrollment


Reasons
Drop 
Reasons for 
List the reasons for decline


for
Down List
Decline



Decline





Other
Entry Field
Other 
Any other reasons for decline


Reasons

Reasons
or others


Cancel
HTML 
Cancel
To reset the operation



Button




Process
HTML 
Process 
Process the enrollment and


Enrollment
Button
Enrollment
leads to the enrollment





confirmation page.





BPI_CAS_SCR_EN_001_011









3.1.6.3 Screen Validations












Element Name
Action/Validation Details
Message







Enrollment 
List the status of enrollment.
The Error 


Status
default option should be 
Dialog Box:



- choose one -
“Please choose 



If the option selected is Decline.
enrollment status



Should list the list box containing
before continuing.”



reasons for the decline.




If none is selected throw error




message.



Remarks
Can accept any character.



Reasons for
List the reasons for the decline.
Error Dialog Box:


Decline
The default option should be 
“Please choose 



- choose one -
reasons for declining



If none is selected throw error
before continuing.”



message.



Other Reasons
Can accept any character.
None


Cancel
Resets to the status as was on
None



loading this page.



Process
Should function with Enter Key
Error Dialog Box:


Enrollment
Cursor Positioned on the
“Please choose 



“Process Enrollment” button or on
enrollment status



Mouse Click.
before continuing.”



On success leads to the
“Please choose



confirmation page.
reasons for declining



BPI_CAS_SCR_EN_001_011
before continuing.”



It checks the eligibility rule for the




COBRA member once again.




Process the post enrollment




activity like sending emails,




welcome letter. First month




invoices and email alert to GMS,




Sales and finance.









3.1.7 User Interface Id: BPI_SCR_EN—002—007—Existing COBRA Employee Search
3.1.7.1 Screen Name: Employee Search (See FIG. I-8)
3.1.7.2 Element Name, Element Type & Purpose













Element





Name
Element Type
Label
Purpose







Group
Text
Group ID
To provide text


ID





Group Id
Entry field
Group Id
Enter the group id for





searching the employee


Employee
Text
Employee ID
To provide text


ID





Employee
Entry field
Employee ID
Enter the Employee ID for


ID


searching the employee


Employee
Text
Employee 
To provide text


SSN

SSN



Employee
Entry field
Employee 
Enter the Employee SNN for


SSN

SSN
searching the employee


Phone
Text
Phone 
To provide text


number

number



Phone
Entry field
Phone 
Enter the Employee Phone


number

number
number for searching the





employee


List
HTML Tree
List 
Tree to List the Employee


Employee

Employee
and their dependent


Employee
HTML Table
Employee 
Table to list employee


Table

Table
information and status


Dependent
HTML table
Dependent 
Table to list dependent


Table

Table
information and status


Process 
HTML button
Process 
Button to check the COBRA


COBRA

COBRA
eligibility and take to the next





page





BPI_CAS_SCR_EN_002_008





if eligible. If not the show





the same page.









3.1.7.3 Screen Validations












Element 




Name
Action/Validation Details
Message







Group Id
Enter the Group ID or pick the
Group ID can be entered 



group ID based on the Group
along with any other valid 



search
fields for the employee 




provided below.


Employee 
Enter the employee Id or pick the
Note: At least on of the 


ID
employee based on the
field with the search 



employee search window.
criteria for the employee 




must be entered


Employee 
Enter the employee SSN or pick
Note: At least on of the 


SSN
the employee based on the
field with the search 



employee search window.
criteria for the employee 




must be entered


Phone 
Enter the employee Phone or
Note: At least on of the 


number
pick the employee based on the
field with the search 



employee search window.
criteria for the employee 




must be entered


List 
Tree to open up if dependent
None


Employee
exist for the employee



Employee 
List the employee with status and
None


Table
effective date



Dependent 
List the dependent with status
None


Table
and effective date



Process 
Check the status and term
Embedded error if non-of 


COBRA
reasons and process the
the member is termed 



eligibility check for the existing
or not qualifies for 



member to COBRA
COBRA.



Note: It should check the




following status. Term Status,




Term reasons




Only the member termed all




eligible for the COBRA. The




reasons for term can either




decline COBRA enrollment or




define the COBRA period.









3.1.8 User Interface Id: BPI_SCR_EN—002—008—Existing COBRA Enrollment
3.1.8.1 Screen Name: COBRA Enrollment (See FIG. I-9)
3.1.8.2 Element Name, Element Type & Purpose













Element
Element




Name
Type
Label
Purpose







COBRA
Page sub 
COBRA 
To provide text


qualifying
Header
qualifying



Event

Event



Initial
Text
Initial COBRA 
To provide text


COBRA

effective date



effective





date





Date
Entry 
Date
Enter the initial 



field

effective date


COBRA
Text
COBRA 
To provide text


End

End Date



Date





Period
Entry 
Period
Enter the COBRA effective



field

period Default to the period





based on the qualifying





event.


Reasons
Text
Reasons for Term
To provide text


for Term





Reasons
Dynamic 
Reasons for Term
Reasons for Term based on


for Term
Text

the term reasons provided


Term
Text
Term Date
To provide text


Date





Term
Dynamic 
Term Date
Display the term date of the


Date
text

member


Where
Text
Where would 
To provide text


would

you like the 



you like

bills to be sent



the bills





to be





sent





Where
Check 
Where would 
Check if the bill is to be sent


would
Box
you like the bills 
to the group or the member


you like

to be sent



the bills





to be





sent





Is
Text
Is member 
To provide text


member

signature 



signature

verified



verified





Is
Check 
Is member 
Check if signature is verified


member
box
signature



signature

verified



verified





Line of
HTML 
Line of Coverage 
Table to display the Member


Coverage
Table
Selection Table
names and the Line of





coverage check boxes for


Selection


picking the line of coverage


Table


for each COBRA members


Check if
Check 
Check if member 
Check if the member is not


member
box
is not enrolling 
enrolling for COBRA


is not

for COBRA



enrolling





for





COBRA





Coverage
Check 
Coverage 
Check box to select the line


Selection
Box
Selection
of coverage


Show
HTML 
Show Coverage 
Button to show the coverage


Coverage
button
Choice
choice for each line of


Choice


coverage based on the check





box/boxes checked.


Continue
HTML 
Continue
Button to save the data and



Button

lead to the next screen for





showing the summary and





selection of Benefit level





offered by carriers (Screen





BPI_CAS_SCR_EN_002_009)









3.1.8.3 Screen Validations












Element Name
Action/Validation Details
Message







Date
Default to the date next to the
Error Dialog 



term date. Allow for making
Box:



changes based on authorization
“Date cannot be 




prior to the term 




date. Please enter 




the valid date”


Period
Default to the period based on
none



the Qualifying events. Allow to




change based on authorization



Where would you
Check the option for billing,
none


like the bills to be
Whether to the group or the



sent
member



Is member
Check if signature is verified
none


signature verified




Line of Coverage
Table to show the Line of
None


Selection Table
coverage against each member




for picking the option. The Line of




coverage displayed is based on




the line of coverage selected by




the primary group.




Note: The table would display the




Member name in the following




priority.




Employee as primary member




Spouse as the next member




Other members would be listed




based on the age.



Check if member
This is check if the member is not
None


is not enrolling for
opting for the COBRA



COBRA




Coverage
Check Box to pick any
None


Selection
combination of coverage's for all




the member for this specific




COBRA group



Show Coverage
On click of the Coverage choice
None


Choice
system should identify the




coverage choice based on the




options checked. Whether




member only, member and




spouse etc.



Continue
On clicking the continue button
Dialog Box:



saves the data and leads to the
“Are you sure



page
to continue”



BPI_CAS_SCR_EN_002_009









3.1.9 User Interface Id: BPI_SCR_EN—002—009—Primary Member Information
3.1.9.1 Screen Name: Primary Member Information (See FIG. I-10)
Note: This screen is pre filled with the employee information available in the employee master for all the members and the dependents belonging to this employee. Changes can be made to the information as applicable.
3.1.9.2













Element
Element




Name
Type
Label
Purpose







Main
Text
Main Address
To provide text


Address





Street
Entry field
Street Address
Enter the street address


Address





Suite/
Text
Suite/Apts.
To provide text


Apts.





Suite/
Entry Field
Suite/Apts.
Enter the suite/apts. 


Apts.


number


City
Text
City
To provide text


City
Entry Field
City
Enter the city name


State
Text
State
To provide text


State
Drop 
State
List all the state in US



Down List




ZIP
Text
ZIP
To provide text


ZIP
Entry Field
ZIP
Enter zip code


Service
Text
Service Area
To provide text


Area





Service
Entry 
Service Area
Shows the Service Area


Area
Field(un

based on the ZIP code typed



editable)

Show list if the ZIP has



or list

multiple service area


County
Text
County
To provide text


County
Entry 
County
Display the county name



Field(un

based on the zip and service



editable)

area selected


Preferred
Text
Preferred 
To provide text


mode

mode of



of

correspondence



correspon-





dence





Mode of
Drop 
Mode of 
List the mode of


correspon-
Down List
correspondence
communication, USPS, 


dence


FAX, email


Home
Text
Home Phone 
To provide text


Phone

number



number





Phone
Entry Field
Phone
To enter phone number


Extension
Entry Field
Extension
To enter extension number


Home
Text
Home 
To provide text


FAX No.

FAX No.



FAX
Entry Field
FAX
To enter FAX number


Extension
Entry Field
Extension
To enter extension number


E-Mail
Text
E-Mail 
To provide text


Address

Address



E-mail
Entry field
E-mail 
Enter email address


Address

Address



Alternate
Text
Alternate 
To provide text


Address

Address



Street
Text
Street Address
To provide text


Address





Street
Entry field
Street Address
Enter the street address


Address





Suite/
Text
Suite/Apts./
To provide text


Apts./PO

PO Box #



Box #





Suite/
Entry Field
Suite/Apts./ 
Enter the suite/apts. 


Apts./

PO Box #
number


PO Box





#





City
Text
City
To provide text


City
Entry 
City
Enter the city name



Field




State
Text
State
To provide text


State
Drop 
State
List all the state in US



Down List




ZIP
Text
ZIP
To provide text


ZIP
Entry Field
ZIP
Enter zip code


Cancel
HTML 
Cancel
To cancel the operation and



Reset Button

reset for new selection


Continue
HTML 
Continue
To save the data gathered in



Submit

this screen and continue to



Button

the next screen





BPI_CAS_SCR_EN_002_010









3.1.9.3 Screen Validations












Element




Name
Action/Validation Details
Message







Street 
Refer Document No. 
Refer Document No. 


Address
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Suite/Apts.
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


City
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


State
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


ZIP
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Service 
Should pick up the service 
None


Area
area based on the Zip 




code number typed in the 




above ZIP entry field 




from the database




If there are multiple service 




area then it should list the 




service area for picking up 




the service area.



County
Show the county name based 
none



on the ZIP code and 




Service area combination



Mode of
List mode of communications 
Error Dialog Box:


Com-
like USPS, FAX, Email 
“Please choose the mode of


munication
and others. If the option 
communication”



selected is Email then the 




Email address field cannot 




be blank.




Default Option should be 




- choose one -




If none is selected should 




throw error message.



Phone
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Extension
Refer Document No. 
Refer Document No.



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


FAX
Refer Document No. 
Refer Document No.



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Extension
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


E-mail 
Refer Document No. 
Refer Document No.


Address
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Street 
Refer Document No. 
Refer Document No. 


Address
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Suite/
Refer Document No. 
Refer Document No. 


Apts.
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


City
Refer Document No. 
Refer Document No.



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


State
Refer Document No. 
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


ZIP
Refer Document No.
Refer Document No. 



BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


Cancel
Reset Button
To reset the value in the 




Entry Field to its 




previous state as was on 




loading the page


Continue
Should function with Enter 
Error Dialog Box:



Key Cursor Positioned on the
“The value entered for the 



“Continue” button or on 
Field Name is erroneous.



Mouse Click.
Please enter valid values.



Check for all the validation 
“Please choose the mode of



on the fields
communication”



If any data type error throw 




error message.




Allows blank entry




On Success Leads to the next




page for filling further 




information on the employee.




Screen




BPI_CAS_SCR_EN_002_010









3.1.10 User Interface Id: BPI_SCR_EN—002—010—Existing Coverage Information
3.1.10.1 Screen Name: Coverage Information (See FIG. I-11)
3.1.10.2 Element Name, Element Type, Label & Purpose













Element
Element




Name
Type
Label
Purpose







Benefit
HTML 
Benefit Level 
Table to display all the


Level
Table
(carrier 
Members in the row and The


(carrier

Selection)
Benefit level selection option


Selection)


in the Columns.


Member
Link
Member 
Provide feature to edit the


name

name
member information by





clicking this link


Coverage
HTML 
Coverage 
The row get pre populated


Choice
ROW
Choice
based on the choice made in





the screen





BPI_CAS_SCR_EN_002_009


Benefit
Link
Benefit Level 
Link to the carrier selection


Level

Name
for the specific line of


Name


coverage if not available in





the ZIP and service area of





the Primary member.


PCP info 
Link
PCP info 
Link to edit the PCP info of


(Available)

(Available)
the individual members as





applicable.


COBRA
HTML 
COBRA 
Button to click for saving the


Summary
Button
Summary
date and navigating to the





next page for displaying





COBRA summary/missing





information


Cancel
HTML 
Cancel
Button to reset to the state as



rest button

was on loading the page.









3.1.10.3 Screen Validations












Element Name
Action/Validation Details
Message







Benefit Level
Should have column header and
None


(carrier 
each subsequent row should be



Selection)
identified by alternate color




combinations. I.e. First row




should have color ‘x’ and the next




row should have color ‘y’. The




next row should have color ‘x’




again and so on. The size of any




text inside any cell should be




wrapped if the text becomes too




long.




The Header and the Left Column




should be distinguishable.



Member
This is a link to edit the member
None


name
information when on change or




edit mode. This



PCP Info
This is a link to edit the PCP
None



information for the specific




member. If PCP information is




not available then on clicking the




link it allows to fill in the PCP




information for the specific line of




coverage.



Coverage 
Displays the dynamic text based
None


Choice
on the choices checked in the




previous screen




BPI_CAS_SCR_EN_002_004



Benefit 
Default benefit level would that
None


Level
the employee selected when the



Selection
status was enrolled.




On clicking the Link show a




minimized window with option to




select the benefit level for the




specific line of coverage. Note




the line of coverage is displayed




based on the Group options. (i.e




only if the group has selected the




line of coverage.




Also the benefit level (carrier)




displayed is based on the ZIP




code/Service area of the




primary COBRA member.




Only if the prior Benefit level is




not available in the current ZIP/




service are of the primary




member this is allowed to be




changed.



COBRA
On clicking the COBRA Summary
Dialog Box:


Summary
button save the content of this
“Are you sure 



page into the repository and
you would like 



leads to the COBRA summary
to continue”



page to display the COBRA




missing information. Screen




BPI_CAS_SCR_EN_002_006




This also does all the COBRA




eligibility checks prior to the




display of summary page.



Cancel
Resets to the state as was on
none



loading the page.









Note: the rest of the flow is common for both new Business COBRA and the Existing member conversion to COBRA.
Screen BPI_CAS_SCR_EN—006 followed by COBRA enrollment.
3.2 Screen Flow:
Screen Flow Diagram for COBRA Enrollment (See FIG. I-12)
4 Business Rule Mapping













Activity
Rules





New Business
Need to know initial COBRA effective date


COBRA 
Need to have system calculate COBRA end date


(NB brings
(18 mo, 36 mo, or other) based on Term Reason


in COBRA)
(Qualifying events). 



For system to do this we need to have the



following data captured during the New Business



COBRA Enrollment



a) Initial Effective date



b) Qualifying events


COBRA coverage
COBRA coverage has no lapse of time from the



date of term & COBRA enrollment



Exception: Death



Main subscribers coverage is terminated date of 



death and not the end of the month: qualified 



beneficiaries (i.e. spouse/child) effective date of



COBRA is the day after the members death



Note: Since the COBRA coverage has no lapse of



time it should be basically effective from the day 



following the term date what ever be the reasons.



Normal terms are always done on the end of the



Month. 



Death is done on the day of the death.


COBRA Election
60 days to elect COBRA coverage from the time



of COBRA notification letter.



60 days is based off the:



Date that we are notified of the termination



(Postmark date for termination)



OR



The termination date



WHICHEVER IS LATER. The decision is to be



made based on manual review by GMS personnel.


COBRA Election
If a FED COBRA group, we need to include an 


for Federal
additional 14 days from termination notification


COBRA
date because FED Employers have 14 days to no-



tify their employees of their rights after which



they notify the plan administrator/Pac Advan-



tage). The decision is to be made based on man-



ual review by GMS personnel.


COBRA Premium
COBRA members initial premium (all premiums


Dues
from effective date to current) must be made/



mailed/postmarked within 45 days from the



COBRA election date (the date the application is



postmarked) 



If payment is not MADE within this time frame,



the COBRA coverage is termed flat (effective



date). Any partial premium payments made will



be reimbursed.



Provide over ride for 45th day rule (ACL)



(This override needs to be available upon creating



the COBRA)


COBRA Employee
If main Employer group goes into possible term 


governed by
status or is termed, the COBRA will need to be 


Employer (Groups)
notified and put in same status. Employee will



have the same coverage type, carrier & co-pay as



when termed (continue with exact coverage as 



before)



Cannot add dependents that were not previously



covered (until o/e or qualifying event)


Benefit Levels
Benefit level cannot change. Optional benefits and 



medical offered by the group is not mandatory



[Line of Coverage]


Possible
Social Security disability - coverage extended to a


extension of
total of 29 month (11 mo. Extension) (all other


COBRA coverage
term reasons apply)



The main subscriber does not have to elect to



extend the coverage for himself, just his



dependents can elect to take the extension



Age 60 prior to loss of employment & worked for



Employer for 5 consecutive years - coverage



extended until the Employee turns age 65 (all other



term reasons apply)



The main subscriber does not have to elect to



extend the coverage for himself, just his



dependents can elect to take the extension



Also there should be a facility to grant COBRA



extension if applicable based on authority.













Qualifying
Continua-


Qualifying Events
Beneficiaries
tion period





TERMINATION_OF_EMPLOY-
Employee, Spouse
18


MENT
and Children



REDUCTION_OF_WORK_HOURS
Employee, Spouse
18



and Children



CAN_ NO LONGER_AF-
Employee, Spouse
18


FORD_COVERAGE
and Children



OBTAINED_COVERAGE_ELSE-
Employee, Spouse
18


WHERE
and Children



DEATH
Spouse and Children
36


ENTITLED_TO_MEDICARE
Employee, Spouse
36



and Children



FRAUD_OR_MISREPRESEN-
Employee, Spouse
36


TATION
and Children



DPND OBTAINED_COVER-
Employee, Spouse
18


AGE_ELSEWHERE
and Children



DIVORCE_OR_LEGAL_SEP-
Employee, Spouse
36


ARATION
and Children



EMPLOYEE_CANNOT_AF-
Spouse
36


FORD_SPOUSE_COVERAGE




DPND_DEATH
None
18


DPND_ENTITLED_TO_MED-
Dependent Spouse
36


ICARE
and Children



DPND_FRAUD_OR_MISREP-
None
36


RESENTATION




OVER_AGE_23
Dependent Child
18


NO_LONGER_AN_ELIGI-
Dependent Spouse
18


BLE_DEPENDENT
and Children



NO_LONGER_A_DISA-
Dependent Child
18


BLED_CHILD




EMPLOYEE_CAN_NO_LONG-
Child
18


ER_AFFORD_CHILD_COVER-




AGE




OTHERS
Employee, Spouse
36



and Children





There are other qualifying events, which are also considered while COBRA enrollment based on their Reason For Term.






5 User Role
The respective level of user role can over rule the following missing information.
User Role Level II, Level III, Level IV
S. No., Missing Information Condition
1 SSN already exists. Employee SSN already exists
2 SSN already exists. Dependent SSN already exists
Benefit Partners INC
Process Specification
Functional Design Process Specification
1. Introduction
1.1. Purpose
This document identifies how the user interacts with the system, the data to be captured, the business logic to be implemented, and the output of the process.
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









BPI_SCOPE_EN
Enrollment



BPI_SCOPE_EN_002
Enrollment Add On










Other Document Reference











Document ID
Document name







BPI_CAS_FSD_EN
Functional Specification Document - Enrollment


BPI_CAS_FSD_EN_001
Process Flow - New Business Enrollment


BPI_CAS_FSD_EN_003
Process Flow - COBRA Enrollment/Changes


BPI_CAS_FSD_EN_005
Process Flow - Termination/Reinstatement


BPI_CAS_RULEBOX
RULE BOX for Add on and change









1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
Process Flow and Description
This process is used to make changes to the Existing groups/members or dependents or add a new member/dependent to the Group or employee based on the business rules associated with changes and “Add ON's”.
2.1. Background
2.2. Process Description
The objective of the process
2.3. Process Flow
This process is used to make changes to the Existing groups/members or dependents or add a new member/dependent to the Group or employee based on the business rules associated with changes and “Add ON's”.
2.4. User Interface Screens
2.4.1. Screen ID's













Screen



Screen ID (SID)
Name
Corresponding HTML File Name







Enrollment.addon.newemp.groupsearch
Group Search
bpi/cas/enrollment/addon/newemp/groupsearch


Enrollment.addon.newemp.changerequest
ChangeRequest
bpi/cas/enrollment/addon/newemp/changerequest


Enrollment.addon.newemp.groupgeneral
EmployeeGeneralInfo
bpi/cas/enrollment/addon/newemp/addemployee


Enrollment.addon.newemp.employeecoverage
EmployeeCoverageInfo
bpi/cas/enrollment/addon/newemp/employeecoverage


Enrollment.addon.newemp.dependent
DependentGeneralInfo
bpi/cas/enrollment/addon/newemp/adddependent


Enrollment.addon.newemp.missing
PreEnrollment
bpi/cas/enrollment/addon/newemp/preenrollment


Enrollment.addon.newemp.summary
EnrollmentSummary
bpi/cas/enrollment/addon/newemp/enrollmentsummary


Enrollment.addon.newemp.confirmation
Confirmation
bpi/cas/enrollment/addon/newemp/confirmation


Enrollment.addon.newemp.employeesearch
Employee
bpi/cas/enrollment/addon/newemp/employeesearch



Search



enrollment.addon.newemp.dependentsearch
Dependent
bpi/cas/enrollment/addon/newemp/dependentsearch



Search



enrollment.addon.employeesearch
Employee
bpi/cas/enrollment/addon/adddependent/employeesearch



Search



enrollment.addon.changerequest
Change
bpi/cas/enrollment/addon/adddependent/changerequest



Request



enrollment.addon.dependent
Dependent
bpi/cas/enrollment/addon/adddependent/dependent



General Info



enrollment.addon.adddependentsearch
Modify
bpi/cas/enrollment/addon/adddependent/dependentsearch



dependent



enrollment.addon.missingforadddependent
PreEmrollment
bpi/cas/enrollment/addon/adddependent/preenrollment


enrollment.addon.addconfirmation
Confirmation
bpi/cas/enrollment/addon/adddependent/confirmation


bpi.enrollment.change.group.groupsearch
Group Search
bpi/cas/enrollment/change/group/groupsearch


bpi.enrollment.change.group.changerequest
Change
bpi/cas/enrollment/change/group/changerequest



Request



bpi.enrollment.change.group.identifychanges
Identify
bpi/cas/enrollment/change/group/identifychanges



Changes



bpi.enrollment.change.group.general
Group
bpi/cas/enrollment/change/group/generalinfo



GeneralInfo



bpi.enrollment.change.group.billing
Group Billing
bpi/cas/enrollment/change/group/billinginfo



Info



bpi.enrollment.change.group.agent
Agent Info
bpi/cas/enrollment/change/group/agentinfo


bpi.enrollment.change.group.coverage
Coverage Info
bpi/cas/enrollment/change/group/coverageinfo


bpi.enrollment.change.group.missinginfo
Missing Info
bpi/cas/enrollment/change/group/missinginfo


bpi.enrollment.change.group.confirmation
Confirmation
bpi/cas/enrollment/change/group/confirmation


bpi.enrollment.change.group.groupmodifysearch
Modify Search
bpi/cas/enrollment/change/group/groupmodifysearch


bpi.enrollment.change.employee.employeesearch
Employee
bpi/cas/enrollment/change/employee/employeesearch



Search



bpi.enrollment.change.employee.changerequest
Change
bpi/cas/enrollment/change/employee/changerequest



Request



bpi.enrollment.change.employee.identifychanges
Identify
bpi/cas/enrollment/change/employee/identifychanges



Changes



bpi.enrollment.change.employee.individualemployee
Individual
bpi/cas/enrollment/change/employee/indivemployee



Employee



bpi.enrollment.change.employee.individualbilling
Individual
bpi/cas/enrollment/change/employee/indivbilling



Billing



bpi.enrollment.change.employee.individualcoverage
Individual
bpi/cas/enrollment/change/employee/indivcoverage



Coverage



bpi.enrollment.change.employee.individualmissing
Individual
bpi/cas/enrollment/change/employee/indivmissing



Employee




Missing



bpi.enrollment.change.employee.employeemodifysearch
Modify Search
bpi/cas/enrollment/change/employee/employeemodifysearch


bpi.enrollment.change.employee.employeeconfirm
Employee
bpi/cas/enrollment/change/employee/employeeconfirm



Confirm



bpi.enrollment.change.employee.employeegeneral
Employee
bpi/cas/enrollment/change/employee/employeegeneral



General Info



bpi.enrollment.change.employee.employeecoverage
Employee
bpi/cas/enrollment/change/employee/employeecoverage



Coverage



bpi.enrollment.change.employee.employeemissing
Missing Info
bpi/cas/enrollment/change/employee/employeemissing


bpi.enrollment.change.dependent.dependentsearch
Dependent
bpi/cas/enrollment/change/dependent/dependentsearch



Search



bpi.enrollment.change.dependent.changerequest
Change
bpi/cas/enrollment/change/dependent/changerequest



Request



bpi.enrollment.change.dependent.identifychanges
Identify
bpi/cas/enrollment/change/dependent/identifychanges



Changes



bpi.enrollment.change.dependent.dependentgeneral
Dependent
bpi/cas/enrollment/change/dependent/dependentgeneral



General



bpi.enrollment.change.dependent.missinginfo
Missing Info
bpi/cas/enrollment/change/dependent/missinginfo


bpi.enrollment.change.dependent.dependentconfirm
Confirmation
bpi/cas/enrollment/change/dependent/dependentconfirm


bpi.enrollment.change.dependent.dependentmodify
Modify Search
bpi/cas/enrollment/change/dependent/dependentmodify









2.4.1.1. SID, Element Name, Element Type & Purpose
2.4.1.1.1 SID: enrollment.addon.newemp.groupsearch
2.4.1.1.1.1 Screen Snap Shot
Refer BPI_CAS_FSD_EN—01—user Interface ID: BPI_CAS_SCR_EN—001—012
2.4.1.1.1.2 Element Name, Element Type & Purpose
Refer 3.1.13.2 of BPI_CAS_FSD_EN—01 for the details.
2.4.1.1.2 SID: enrollment.addon.newemp.changerequest
2.4.1.1.2.1 Screen Snap Shot
2.4.1.1.2.2 Element Name, Element Type & Purpose
2.4.1.1.3 SID: enrollment.addon.newemp.groupgeneral
2.4.1.1.3.1 Screen Snap Shot
Refer User Interface ID: BPI_CAS_SCR_EN—001—002—Group General of BPI_CAS_FSD_EN—01
2.4.1.1.3.2 Element Name, Element Type & Purpose
Refer 3.1.3.2 of BPI_CAS_FSD_EN—01 for the details.
2.4.1.1.4 SID: enrollment.addon.newemp.employeecoverage
2.4.1.1.4.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—007—Employee Coverage of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.4.2 Element Name, Element Type & Purpose
Refer 3.1.8.2 of BPI_CAS_FSD_EN—01 for the details.
2.4.1.1.5 SID: enrollment.addon.newemp.dependent
2.4.1.1.5.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—008—Dependent of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.5.2 Element Name, Element Type & Purpose
Refer 3.1.9.2 of BPI_CAS_FSD_EN—01 for the details
2.4.1.1.6 SID: enrollment.addon.newemp.missing
2.4.1.1.6.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—010—Missing Information of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.6.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.11.2 of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.7 SID: enrollment.addon.newemp.summary
2.4.1.1.7.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—009—Enrollment Summary of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.7.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.10.1 of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.8 SID: enrollment.addon.newemp.confirmation
2.4.1.1.8.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—011—Enrollment Confirmation of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.8.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.12.2 of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.9 SID: enrollment.addon.newemp.employeesearch
2.4.1.1.9.1 Screen Snap ShotElement Name, Element Type & Purpose

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—013—Employee Search of BPI_CAS_FSD—01
    
    


2.4.1.1.9.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.14.2 of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.10 SID: enrollment.addon.newemp.dependentsearch
2.4.1.1.10.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—014—Dependent Search of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.10.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.15.2 of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.11 SID: enrollment.addon.employeesearch
2.4.1.1.11.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—013—Employee Search of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.11.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.14.2 of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.12 SID: enrollment.addon.changerequest
2.4.1.1.12.1 Screen Snap Shot
2.4.1.1.12.2 Element Name, Element Type & Purpose
2.4.1.1.13 SID: enrollment.addon.dependent
2.4.1.1.13.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—008—Dependent of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.13.2 Element Name, Element Type & Purpose
2.4.1.1.14 SID: enrollment.addon.adddependentsearch
2.4.1.1.14.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—014—Dependent Search of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.14.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.15.2 of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.15 SID: enrollment.addon.missingforadddependent
2.4.1.1.15.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—010—Missing Information of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.15.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.11.2 of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.16 SID: enrollment.addon.addconfirmation
2.4.1.1.16.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—011—Enrollment Confirmation of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.16.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.12.2 of BPI_CAS_FSD_EN—01
    
    


2.4.1.1.17 Change Screen SID
2.4.1.1.17.1 Screen Snap Shot

    
    
        Refer to User Interface ID BPI_CAS_FSD_EN—01
        
            BPI_CAS_RULKEBOX
        
        
    
    


2.4.1.1.17.2 Element Name, Element Type & Purpose

    
    
        Refer to User Interface ID BPI_CAS_FSD_EN—01
        
            BPI_CAS_RULKEBOX
        
        
    
    


2.4.2. Screen Flow
(See FIG. I-13)
(See FIG. I-14)
(See FIG. I-15)
(See FIG. I-16)
(See FIG. I-17)
Change: —Group Change New Request
(See FIG. I-18)
Change: —Group Modify Pending Changes
(See FIG. I-19)
Change: —Employee Change New Request
(See FIG. I-20)
Change: —Employee Modify Pending Changes
(See FIG. I-21)
Change: —Dependent Change New Request
(See FIG. I-22)
Change: —Dependent Modify Pending Changes
(See FIG. I-23)
3. Business Rule Mapping











Activity
Rules







Employer Add On
The rate for the employer is guaranteed for one



year (One year from the date of enrollment) Hence



the entire rates that is effective for the employer/



group needs to be effective for the new employees



as well. However the eligibility of the Employee is



base on the normal eligibility rules that is applicable



for the Employee at the time of enrollment. Counts



for the add-on employee can go more than 70 and



up to 100 if Small Employer Group (override based



on ACL). If Guaranteed association then there is no



limit on the employee count at any time.


Process Add on
Shows the missing information of the Add On



employee and emails the missing information to the



GMS rep.


Process Add on
On successful Add On the welcome mail is sent to



the Employer/Employee and cc to Agent. Billing



adjustment is made which would be handled in the



Finance Module.


Process Add On
Adding employee needs to check on the Waiting


(waiting Period)
Period. If the employee does not satisfy the waiting



period then it should send email to the GMS rep.



Also the employee effective date should default to



the date when the employee is actually eligible.



If the Employee satisfied the waiting period and is



60 days past the waiting period then it should flag



this as missing information as this becomes a late



application, which needs clarification from the



employer before enrolling the employee. This



employee can be enrolled only with authorization.



The employee application form is not deemed as



“Late” if it is postmarked within 60 days from the



eligibility date. If it is postmarked more than 60



days from the eligibility date, the application is



declined as it is “Late”.



Late application can be enrolled only on the next



ROE.









Employee Add On (Adding Dependent)











Activity
Rules







Employee Add On
The rate for the employer is guaranteed for one



year (One year form the date of enrollment) Hence



the entire rate that is effective for the employer/



group needs to be effective for the new dependent



as well. However the eligibility of the Dependent is



base on the normal eligibility rules that is applicable



for the Dependent at the time of enrollment.



Coverage Choice to be manipulated by System



automatically.


Process Add on
Shows the missing information of the Add On



Dependent and emails the missing information to



the GMS rep.


Process Add on
On successful Add On the welcome mail is sent to



the Employer/Employee/Dependent and cc to



Agent. Billing adjustment is made which would be



handled in the Finance Module.


General Rules
If the employee has selected the Employee only



option as coverage choice then it needs to be



changed for adding a dependent. System would not



allow adding dependent with Employee only status.









Employer Change











Activity
Rules







Demographic 
Demographic change can include change in


changes
Company Name, Contact name, Address, Phone,



Fax, Email, Tax ID. All these change can be made



and does not affect the business rules except for



transmission of letter, email contacts


Billing Changes
All Billing changes are flag and email is sent to



GMS rep and Finance for Information. Billing



changes would effect the billing frequency or the



mode of payment (EFT, Credit Card or Check)


Waiting Period 
Change in the waiting period would affect the


Change
Employee Eligibility criteria for all add on



employees, going forward, as the change may be.



Change in the Employee type for the waiting period



consideration would also affect the Employee



Eligibility for the New Employees ‘Add-On’, going



forward.



Waiting Period would be based on the Employer



Effective date.



Effective date for changing the Waiting period



should default to the 1st of the following month.



Waiting period can be changed only once from the



date of enrollment (effective date) to one-year cycle



for the employer.



If the waiting period changes are more than once in



the calendar year for the employer. This is to be



notified to the GMS rep and only the authorized



person can override this and allow for waiting



period change beyond 1 in employer anniversary



date (one year cycle).


Employer 
Contribution would be based on the Employer


Contribution
Effective date.



Effective date for changing the Contribution should



default to the 1st of the following month.



Contribution can be changed only twice from the



date of enrollment (effective date) to one-year cycle



for the employer.



If the Contribution changes are more than once in



the calendar year for the employer. This is to be



notified to the GMS rep and only the authorized



person can override this and allow for contribution



change beyond 1 in employer calendar year.



Note: Effective dates for Contribution changes



should be 1st following month if the billing cycle



has not completed.



If the billing cycle is complete then it should be



effective the next billing cycle. I.e. 1st of the



month following the next month.









Optional benefits 
a)
Medical: No change allowed.


Changes
b)
Dental Can be added only during ROE cycle.




Can be dropped any time. Note if dental is




dropped then it can be added in the ROE




following 12 month from the date of dropping




the dental plan.



c)
Vision and CAM: Can be added and dropped




any time. Note if an optional benefit is dropped




then it can be added in the ROE following 12




month from the date of dropping the optional




benefit.



d)
This is to be notified to the GMS rep and only




the authorized person can override this.








Employee Counts 
Can be changed only at next ROE cycle.


(Number of 



employee)



COBRA
Can Change any time but will effective from 1st of



the month only



If this changes then any existing COBRA with this



group will change accordingly and automatically, 1st



of the month.



Should trigger automatic transmission


TEFRA
Can be change any time but will be effective from



1st of the month only.



Transmit record to the carrier only if the employee



is 65+


Part time coverage/
Can be change only during open enrollment or Re


Domestic partner
qualification and open enrollment. But should allow



for overriding this feature based on authority.



Note: Any over riding function should trigger auto



email to the concerned GMS rep for making the



changes based on their authority.


Agent Change
This triggers a new process flow. (Refer process



flow diagram FIG. 4.)









Note: For all changes effective date will be defaulted based on POST MARK DATE, If POST MARK date is lesser than 15th Day of month then Effective date will be 1st day of next month else it will be 1st day of next of the next month
4. User Role
The respective level of user role can over rule the following missing information.














User Role
Level II, Level III, Level IV



S. No., Missing Information
Condition









1 SSN already exists.
Employee



2 SSN already exists.
Dependent










Employee, Group and Dependent Changes (w.r.t. Current Date)











User Role
Condition







Level I
Reinstatement date is with in 30 days prior or later


Level II
Reinstatement date is with in 30 days prior or later


Level III
Reinstatement date is with in 60 days prior or later









Benefit Partners Inc
Process Specification
ROE/OE Process
1. Introduction
1.1. Purpose
The purpose of this document is to describe the process of ROE/OE Process. This document identifies how the user interacts with the system, the data to be captured, the business logic to be implemented, and the output of the process.
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









BPI_SCOPE_EN
Enrollment



BPI_SCOPE_EN_004
Enrollment - ROE










1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










1.4. Document Reference











Document ID
Document Name







BPI_CAS_FSD_EN
Functional Specification Document - Enrollment


BPI_CAS_FSD_EN_001
Process Flow - New Business Enrollment


BPI_CAS_FSD_EN_002
Process Flow - Enrollment Changes/Add-On


BPI_CAS_FSD_EN_003
Process Flow - COBRA Enrollment/Changes


BPI_CAS_FSD_EN_005
Process Flow - Termination/Reinstatement









2. Process Identification
2.1. Background
Once a year, on the anniversary date of a group's enrollment in PacAdvantage (or for some, it's July 1st, not their anniversary date), the group's participation, contribution and qualification is reviewed. This review is to ensure that the group meets the qualification requirement. The main objective of this process is to review these criteria and re qualify as needed, notify them of rate changes and provide an opportunity for employees of the group to make changes to their enrollment.
This process is identified as Re-qualification and open enrollment. Also there is another process associated with this called as open enrollment where in the group has the privilege to make the changes to the plan, waiting period etc.
The difference between the two processes is that for re-qualification the Group has to under go the eligibility check to qualify for their next term.
For open enrollment the group need not re qualify and under go the eligibility checks.
The group should already have been enrolled with the PacAdvantage and have no termination date for the ROE to be done.
2.2. Process Description
The objective of the ROE/OE Process is to:

    
    
        Annual Re qualification or open enrollment form filled by the Employer
        Open Enrollment Change form completed by employee, if applicable
        Employee Enrollment form(s) completed by employee, if applicable
        Dependent Enrollment form(s) completed by employee, if applicable
    
    


The following are the other requirements that will be supported and constraints on the proposed system:

    
    
        1) The system has to initiate ROE/OE process 3 months prior to the actual anniversary date for the specific group. This process needs to be initiated by GMS personnel.
        2) System has to pick up the Groups for ROE based on the rules defined below:
        Group Size: less than or equal to 4—All the groups needs to be re-qualified.
        Group Size: 5 to 9—10% of the Group needs to be re-qualified
        Group Size: greater than or equal to 10—1% of the group needs to be re-qualified.
        3) System has to randomly pick up the groups based on the above rules for ROE based on random generator algorithm.
        4) All other Group that is a part of ROE and OE needs to have their open enrollment processed.
        5) Also their needs to be a facility to have manual OE process wherein the Employee or Employees are manually picked for ROE or OE process. Manual OE is usually performed based on searching the Employee based on line of coverage and plan.
        6) There needs to be a feature to Finalize the ROE or OE for all the groups that have the same ROE/OE cycle.
    
    


2.3. Process Flow
Process for ROE/OE
The process starts after manual initiation

    
    
        1) Identify the group that has their anniversary date 3 months hence.
        2) Based on the group size identify if the group needs to be re-qualified.
        3) Randomly pick up the group for re-qualification
        4) If the group is not picked for re-qualification then the group only needs to have open enrollment.
        5) Send ROE/OE packets to mail house. The packet includes the Agent Packet and the group packet.
        6) Also sent the packets to the COBRA members of the existing group.
        7) Send reminder for the ROE/OE every month.
        8) Receive the ROE/OE packets completed by the Group and enter into the system.
        9) Follow up for missing information
        10) Convey the Group/Agent about the ROE status on completion of the process.
    
    


Note the screens for entry of data for the ROE/OE processes are similar to the Group/Employee/Dependent Changes screen. However for the ROW/OE process the status would be identified as ROE process.
Process Flow Diagram—ROE Process (See FIG. I-24)
3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's












Screen ID (SID)
Screen Name
Corresponding HTML File Name







enrollment.roe.groupsearch
Group Search
/bpi/cas/enrollment/roe/groupsearch


enrollment.roe.request
Group Request
/bpi/cas/enrollment/roe/request


enrollment.roe.identifygroupchange
Identify Group Change
/bpi/cas/enrollment/roe/identifygroupchange



Request



enrollment.roe.groupgeneral
Group General Info
/bpi/cas/enrollment/roe/groupgeneral


enrollment.roe.groupbilling
Group Billing Info
/bpi/cas/enrollment/roe/groupbilling


enrollment.roe.groupagent
Group Agent Info
/bpi/cas/enrollment/roe/groupagent


enrollment.roe.agentsearch
Agent Search
/bpi/cas/enrollment/roe/agentsearch


enrollment.roe.groupcoverage
Group Coverage Info
/bpi/cas/enrollment/roe/groupcoverage


enrollment.roe.employeesearch
Employee Search
/bpi/cas/enrollment/roe/employeesearch


enrollment.roe.identifyemployeechange
Identify Employee Change
/bpi/cas/enrollment/roe/identifyemployeechange



Request



enrollment.roe.employeegeneral
Employee General Info
/bpi/cas/enrollment/roe/addemployee


enrollment.roe.employeecoverage
Employee Coverage Info
/bpi/cas/enrollment/roe/employeecoverage


enrollment.roe.dependentsearch
Dependent Search
/bpi/cas/enrollment/roe/dependentsearch


enrollment.roe.identifydependentchange
Identify Dependent Change
/bpi/cas/enrollment/roe/identifydependentchange



Request



enrollment.roe.dependentgeneral
Dependent General
/bpi/cas/enrollment/roe/adddependent


enrollment.roe.groupsummary
Group Summary
/bpi/cas/enrollment/roe/enrollmentsummary


enrollment.roe.groupmissing
Group Missing Info
/bpi/cas/enrollment/roe/preenrollment/


enrollment.roe.groupconfirm
Group Confirm
/bpi/cas/enrollment/roe/groupconfirm


enrollment.roe.individualemployeesearch
Indiv Employee Search/
/bpi/cas/enrollment/roe/indivemployeesearch



Indiv Group Search



enrollment.roe.indivemployeerequest
Indiv Employee Request
/bpi/cas/enrollment/roe/indivemployeerequest


enrollment.roe.identifyindivemployeechange
Identify Indiv Employee
/bpi/cas/enrollment/roe/identifyindivemployeechange



Change Request



enrollment.roe.individualemployeegeneral
Indiv Employee General
/bpi/cas/enrollment/roe/indivemployee



Info



enrollment.roe.individualbilling
Indiv Billing Info
/bpi/cas/enrollment/roe/indivbilling


enrollment.roe.individualagent
Indiv Agent Info
/bpi/cas/enrollment/roe/indivagent


enrollment.roe.individualagentsearch
Indiv Agent Search
/bpi/cas/enrollment/roe/indivagent


enrollment.roe.individualemployeecoverage
Indiv Coverage Info
/bpi/cas/enrollment/roe/indivcoverage


enrollment.roe.individualdependentsearch
Indiv Dependent Search
/bpi/cas/enrollment/roe/indivdependentsearch


enrollment.roe.identifyindivdependentchange
Identify Indiv Dependent
/bpi/cas/enrollment/roe/identifyindivdependentchange



Change Request



enrollment.roe.individualdependentgeneral
Indiv Dependent General
/bpi/cas/enrollment/roe/indivdependent/



Info



enrollment.roe.individualsummary
Indiv Enrollment Summary
/bpi/cas/enrollment/roe/indivenrollmentsummary


enrollment.roe.individualmissing
Indiv Pre Enrollment
/bpi/cas/enrollment/roe/indivpreenrollment


bpi.enrollment.cobraroe.new.searchcobra
COBRA Search
/bpi/cas/enrollment/cobraroe/new/cobraroesearch


bpi.enrollment.cobraroe.new.request
COBRA ROE/OE
/bpi/cas/enrollment/cobraroe/new/request



Process Request



bpi.enrollment.cobraroe.new.identifychanges
Identify COBRA ROE/
/bpi/cas/enrollment/cobraroe/new/identifychanges



OE Change Request Info



bpi.enrollment.cobraroe.new.general
COBRA General Info
/bpi/cas/enrollment/cobraroe/new/generalinfo


bpi.enrollment.cobraroe.new.billing
COBRA Billing Info
/bpi/cas/enrollment/cobraroe/new/billinginfo


bpi.enrollment.cobraroe.new.coverage
COBRA Coverage Info
/bpi/cas/enrollment/cobraroe/new/coverageinfo


bpi.enrollment.cobraroe.new.dependent
COBRA Dependent Info
/bpi/cas/enrollment/cobraroe/new/dependentinfo


bpi.enrollment.cobraroe.new.missing
COBRA Missing Info
/bpi/cas/enrollment/cobraroe/new/missinginfo


bpi.enrollment.cobraroe.new.confirmation
COBRA Confirmation
/bpi/cas/enrollment/cobraroe/new/confirmation


Enrollment.roe.manualroe
ROE/OE Process
/bpi/cas/enrollment/roe/manualroe


Enrollment.roe.roetransfer
ROE/OE Transfer
/bpi/cas/enrollment/roe/roetransfer









3.1.2. SID, Element Name, Element Type & Purpose
3.1.2.1. SID: enrollment.roe.groupsearch
3.1.2.1.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—012—Group Search of BPI_CAS_FSD_EN—01
    
    


3.1.2.1.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.13.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.2. SID: enrollment.roe.request
3.1.2.2.1 Screen Snap Shot (See FIG. I-25)
3.1.2.3. SID: enrollment.roe.identifygroupchange
3.1.2.3.1 Screen Snap Shot (See FIG. I-26)
3.1.2.4. SID: enrollment.roe.groupgeneral
3.1.2.4.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—002—Group General of BPI_CAS_FSD_EN—01
    
    


3.1.2.4.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.3.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.5. SID: enrollment.roe.groupbilling
3.1.2.5.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—003—Billing of BPI_CAS_FSD_EN—01
    
    


3.1.2.5.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.4.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.6. SID: enrollment.roe.groupagent
3.1.2.6.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—005—Agent of BPI_CAS_FSD_EN—01
    
    


3.1.2.6.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.6.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.7. SID: enrollment.roe.agentsearch
3.1.2.7.1 Screen Snap Shot
3.1.2.7.2 Element Name, Element Type & Purpose
3.1.2.8. SID: enrollment.roe.groupcoverage
3.1.2.8.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—004—Group Coverage of BPI_CAS_FSD_EN—01
    
    


3.1.2.8.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.5.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.9. SID: enrollment.roe.employeesearch
3.1.2.9.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—013—Employee Search of BPI_CAS_FSD_EN—01
    
    


3.1.2.9.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.14.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.10. SID: enrollment.roe.identifyemployeechange
3.1.2.10.1 Screen Snap Shot (See FIG. I-27)
3.1.2.11. SID: enrollment.roe.employeegeneral
3.1.2.11.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—006—Employee Information of BPI_CAS_FSD_EN—01
    
    


3.1.2.11.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.7.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.12. SID: enrollment.roe.employeecoverage
3.1.2.12.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—007—Employee Coverage of BPI_CAS_FSD_EN—01
    
    


3.1.2.12.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.8.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.13. SID: enrollment.roe.dependentsearch
3.1.2.13.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—014—Dependent Search of BPI_CAS_FSD_EN—01
    
    


3.1.2.13.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.15.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.14. SID: enrollment.roe.identifydependentchange
3.1.2.14.1 Screen Snap Shot (See FIG. I-28)
3.1.2.15. SID: enrollment.roe.dependentgeneral
3.1.2.15.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—008—Dependent of BPI_CAS_FSD_EN—01
    
    


3.1.2.15.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.9.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.16. SID: enrollment.roe.groupsummary
3.1.2.16.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—009—Enrollment Summary of BPI_CAS_FSD_EN—01
    
    


3.1.2.16.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.10.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.17. SID: enrollment.roe.groupmissing
3.1.2.17.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—010—Missing Information of BPI_CAS_FSD_EN—01
    
    


3.1.2.17.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.11.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.18. SID: enrollment.roe.groupconfirm
3.1.2.18.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—011—Enrollment Confirmation of BPI_CAS_FSD_EN—01
    
    


3.1.2.18.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.12.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.19. SID: enrollment.roe.individualemployeesearch
3.1.2.19.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—013—Employee Search of BPI_CAS_FSD_EN—01
    
    


3.1.2.19.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.14.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.20. SID: enrollment.roe.indivemployeerequest
3.1.2.20.1 Screen Snap Shot
3.1.2.20.2 Element Name, Element Type & Purpose
3.1.2.21. SID: enrollment.roe.identifyindivemployeechange
3.1.2.21.1 Screen Snap Shot
3.1.2.21.2 Element Name, Element Type & Purpose
3.1.2.22. SID: enrollment.roe.individualemployeegeneral
3.1.2.22.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—006—Employee Information of BPI_CAS_FSD_EN—01
    
    


3.1.2.22.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.7.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.23. SID: enrollment.roe.individualbilling
3.1.2.23.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—003—Billing of BPI_CAS_FSD_EN—01
    
    


3.1.2.23.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.4.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.24. SID: enrollment.roe.individualagent
3.1.2.24.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—005—Agent of BPI_CAS_FSD_EN—01
    
    


3.1.2.24.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.6.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.25. SID: enrollment.roe.individualagentsearch
3.1.2.25.1 Screen Snap Shot
3.1.2.25.2 Element Name, Element Type & Purpose
3.1.2.26. SID: enrollment.roe.individualemployeecoverage
3.1.2.26.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—007—Employee Coverage of BPI_CAS_FSD_EN—01
    
    


3.1.2.26.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.8.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.27. SID: enrollment.roe.individualdependentsearch
3.1.2.27.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—014—Dependent Search of BPI_CAS_FSD_EN—01
    
    


3.1.2.27.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.15.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.28. SID: enrollment.roe.identifyindivdependentchange
3.1.2.28.1 Screen Snap Shot
3.1.2.28.2 Element Name, Element Type & Purpose
3.1.2.29. SID: enrollment.roe.individualdependentgeneral
3.1.2.29.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—008—Dependent of BPI_CAS_FSD_EN—01
    
    


3.1.2.29.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.9.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.30. SID: enrollment.roe.individualsummary
3.1.2.30.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—009—Enrollment Summary of BPI_CAS_FSD_EN—01
    
    


3.1.2.30.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.10.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.31. SID: enrollment.roe.individualmissing
3.1.2.31.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—010—Missing Information of BPI_CAS_FSD_EN—01
    
    


3.1.2.31.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.11.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.32. SID: bpi.enrollment.cobraroe.new.searchcobra
3.1.2.32.1 Screen Snap Shot
Refer to 3.1.1 Screen Shot: BPI_SCR_EN—002—001 of BPI_CAS_FSD_EN—02
3.1.2.32.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.2 of BPI_CAS_FSD_EN—02
    
    


3.1.2.33. SID: bpi.enrollment.cobraroe.new.request
3.1.2.33.1 Screen Snap Shot (See FIG. I-29)
3.1.2.34. SID: bpi.enrollment.cobraroe.new.identifychanges
3.1.2.34.1 Screen Snap Shot (See FIG. I-30)
3.1.2.35. SID: bpi.enrollment.cobraroe.new.general
3.1.2.35.1 Screen Snap Shot
Refer to 3.8.1 Screen Shot: BPI_SCR_EN—002—009 of BPI_CAS_FSD_EN—02
3.1.2.35.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.8.2 of BPI_CAS_FSD_EN—02
    
    


3.1.2.36. SID: bpi.enrollment.cobraroe.new.billing
3.1.2.36.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—003—Billing of BPI_CAS_FSD_EN—01
    
    


3.1.2.36.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.4.2 of BPI_CAS_FSD_EN—01
    
    


3.1.2.37. SID: bpi.enrollment.cobraroe.new.coverage
3.1.2.37.1 Screen Snap Shot
Refer to 3.9.1 Screen Shot: BPI_SCR_EN—002—010 of BPI_CAS_FSD_EN—02
3.1.2.37.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.9.2 of BPI_CAS_FSD_EN—02
    
    


3.1.2.38. SID: bpi.enrollment.cobraroe.new.dependent
3.1.2.38.1 Screen Snap Shot
Refer to 3.3.1 Screen Shot: BPI_SCR_EN—002—003 of BPI_CAS_FSD_EN—02
3.1.2.38.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.3.2 of BPI_CAS_FSD_EN—02
    
    


3.1.2.39. SID: bpi.enrollment.cobraroe.new.missing
3.1.2.39.1 Screen Snap Shot
Refer to 3.5.1 Screen Shot: BPI_SCR_EN—002—006 of BPI_CAS_FSD_EN—02
3.1.2.39.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.5.2 of BPI_CAS_FSD_EN—02
    
    


3.1.2.40. SID: bpi.enrollment.cobraroe.new.confirmation
3.1.2.40.1 Screen Snap Shot

    
    
        Refer to User Interface ID: BPI_CAS_SCR_EN—001—011—Enrollment Confirmation of BPI_CAS_FSD_EN—01
    
    


3.1.2.40.2 Element Name, Element Type & Purpose

    
    
        Refer to 3.1.12.2 of BPI_CAS_FSD_EN—01
    
    


3.1.3. Screen Flow
(See FIG. I-31)
(See FIG. I-32)
(See FIG. I-33)
4. Business Rule Mapping











Activity
Rules







ROE Process
Identify the group randomly based on the Group



size for ROE.


ROE validation
All the eligibility rules that are applicable as new bus-



iness enrollment are applicable for the ROE as well.


Open Enrollment
Open enrollment allows for making the changes that 



are normally not possible during the normal changes.


Billing
Bill in a normal way if the ROE/OE has a completed



status. Make the bill for the new effective date.



If the ROE/OE has a status as pend then pend the bill



for the new effective date.









5. User Role
The respective level of user role can over rule the following missing information.










ROE OE SEG/Alternate/Indiv Group










User Role
Level II, Level III, Level IV



S. No., Missing Information
Condition







1 SSN already exists.
Employee SSN already exists



2 SSN already exists.
Dependent SSN already exists



3 Employer Tax Id already exists.
Employer Tax Id already exists




















ROE OE COBRA Group










User Role
Level II, Level III, Level IV



S. No., Missing Information
Condition







1 SSN already exists.
Employee SSN already exists



2 SSN already exists.
Dependent SSN already exists










Benefit Partners Inc
Process Specification
Termination Reinstatemenet
1. Introduction
1.1. Purpose
The purpose of this document is to identify the process associated with the business use case Termination and Reinstatement
1.2. Business Use Case Specification Reference











Business Use Specification ID
Business Use Case Name







BPI_SCOPE_EN
Enrollment


BPI_SCOPE_EN_005
Termination and Reinstatement









1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
2.1. Background
<Brief Description of the Process>
2.2. Process Description
Process Flow for Group Term
This process is used to terminate or reinstate the Group, Employee and or Dependent.
The FIG. 1 shows the process flow for the group termination. The group can be termed broadly based on two reasons; Non-payment of Premium or by group request for termination. Non-payment of premium is an automated process and starts and completes the term process automatically. The employer request is a manual term process and the Group is termed manually.
Automated Term process initiates the Term Process. Letter is sent to the Group with 15 days notice for reinstatement. The system holds the status as “Term Pending” although the group believes they are completely termed. The reason for this is to prevent the sending of termination then reinstatement transmissions to the carriers; which causes confusion. The finance department then processes the term to completion if the payment is not received. Finance also has ability to override the term pend status based on authority.
Manual Term process is based on the request received from the group. All manual term process is notified to finance for necessary action. If the Group has a shortfall then the system notifies the finance department and finance processes the term. Term letter is send to the Group for paying through the balance premium. If the balance premium is paid then the finance department completes the term. If the balance is not paid then finance terms the group retrospectively.
If the Group has a refund due them then the system notifies the finance department and finance processes the refund and completes the term process.
Process Flow for Employee Term
Employee term is based on the Employer request to terminate the employee based on certain reasons. Based on these reasons the employee is termed and all employees who are termed needs to be sent the COBRA packets for COBRA enrollment. Billing adjustments are made for the employee term in the next invoice generated.
Process Flow for Dependent Term
Dependent term is based on the Employer/Employee request to terminate the Dependent based on certain reasons. Based on these reasons the Dependent is termed and the termed Dependent are sent the COBRA packets for COBRA enrollment. Billing adjustments are made for the Dependent term in the next invoice generated for the Group.
2.3. Process Flow
Process Flow Description (See FIG. I-34)
3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's












Screen ID
Screen 
Corresponding HTML File


(SID)
Name
Name







enrollment.
Search Group 
/bpi/cas/enrollment/termination/


termination.group-
for Termination
group/GroupSearch.jsp


search




enrollment.
Group 
/bpi/cas/enrollment/termination/


termination.group-
Termination 
group/GroupTermination-


terminationrequest
Request
Request.jsp


enrollment.
Group 
/bpi/cas/enrollment/termination/


termination.group-
Termination
group/GroupProcessTermination.


process-
Process
jsp


termination




enrollment.
Group 
/bpi/cas/enrollment/termination/


termination.group-
Termination
group/GroupTermination-


termination-
Confirmation
Confirm.jsp


confirm




enrollment.
Multiple Group 
/bpi/cas/enrollment/termination/


termination.multiple 
Termination
group/MultipleGroup-


groupsearch
Request
TerminationRequest.jsp


enrollment.ter-
Multiple Group 
/bpi/cas/enrollment/termination/


mination.multiple
Termination
group/MultipleGroup-


grouptermination- 
Confirmation
TerminationConfirm.jsp


confirm




enrollment.termination.
Search 
/bpi/cas/enrollment/termination/


employee-
Employee for
employee/EmployeeSearch.


search
Termination
jsp


enrollment.ter-
Employee 
/bpi/cas/enrollment/termination/


mination.employee-
Termination
employee/EmployeeTermina-


termination-
Request
tionRequest.jsp


request




enrollment.termination.
Employee 
/bpi/cas/enrollment/termination/


employee-
Process 
employee/EmployeeProcess


process-
Termination
Termination.jsp


termination




enrollment.termination.
Employee 
/bpi/cas/enrollment/termination/


employee-
Termination
employee/EmployeeTermina-


termination-
Confirmation
tionConfirm.jsp


confirm




enrollment.term-
Search 
/bpi/cas/enrollment/termination/


ination.dependent-
Dependent for
dependent/DependentSearch.


search
Termination
jsp


enrollment.
Dependent 
/bpi/cas/enrollment/termination/


termination.dependent-
Termination
dependent/DependentTermi-


termination-
Request
nationRequest.jsp


request




enrollment.
Dependent 
/bpi/cas/enrollment/termination/


termination.
Process 
dependent/DependentProcess-


dependentprocess-
Termination
Termination.jsp


termination




enrollment.
Dependent 
/bpi/cas/enrollment/termination/


termination.
Termination
dependent/Dependent-


dependent-
Confirmation
TerminationConfirm.jsp


terminationconfirm




enrollment.re- 
Search 
/bpi/cas/enrollment/reinstate-


instatement.group- 
Group for
ment/group/GroupSearch.jsp


search
Reinstatement



enrollment.re- 
Group 
/bpi/cas/enrollment/reinstate-


instatement.group-
Reinstatement
ment/group/GroupReinstatement


reinstatement-
Request
Request.jsp


request




enrollment.re-
Group Process 
/bpi/cas/enrollment/reinstate-


instatement.group-
Reinstatement
ment/group/GroupProcessRein-


processreinstate-

statement.jsp


ment




enrollment.re-
Group 
/bpi/cas/enrollment/reinstate-


instatement.group-
Reinstatement
ment/group/GroupReinstatement


reinstatement-
Confirmation
Confirm.jsp


confirm




enrollment.re-
Search for 
/bpi/cas/enrollment/reinstate-


instatement.
Employee
ment/employee/Employee-


employeesearch
Reinstatement
Search.jsp


enrollment.re- 
Employee 
/bpi/cas/enrollment/reinstate-


instatement.employee-
Reinstatement
ment/employee/Employee-


reinstatement-
Request
ReinstatementRequest.jsp


request




enrollment.re-
Employee 
/bpi/cas/enrollment/reinstate-


instatement.employee-
Process
ment/employee/Employee-


process-
Reinstatement
ProcessReinstatement.jsp


reinstatement




enrollment.re-
Employee 
/bpi/cas/enrollment/reinstate-


instatement.employee-
Reinstatement
ment/employee/EmployeeRein-


reinstatement-
Confirmation
statementConfirm.jsp


confirm




enrollment.re-
Search 
/bpi/cas/enrollment/reinstate-


instatement.depen-
Dependent for
ment/dependent/Dependent-


dentsearch
Reinstatement
Search.jsp


enrollment.re-
Dependent 
/bpi/cas/enrollment/reinstate-


instatement.depen-
Reinstatement
ment/dependent/Dependent-


dentreinstate-
Request
ReinstatementRequest.jsp


mentrequest




enrollment.re-
Dependent 
/bpi/cas/enrollment/reinstate-


instatement.depen-
Process
ment/dependent/Dependent-


dentprocess-
Reinstatement
ProcessReinstatement.jsp


reinstatement




enrollment.re- 
Dependent 
/bpi/cas/enrollment/reinstate-


instatement.depen-
Reinstatement
ment/dependent/Dependent-


dentreinstate-
Confirmation
ReinstatementConfirm.jsp


mentconfirm









3.1.1.1. SID, Element Name, Element Type & Purpose
SID: enrollment.termination.groupsearch
Screen Snap Shot (See FIG. I-35)















Element
Element 




Name
Type
Purpose









Group Id
Entry Field
Enter Group Id



Group Name
Entry Field
Enter Group Name



Phone Number
Entry Field
Enter Phone Number










SID: enrollment.termination.groupterminationrequest
Screen Snap Shot (See FIG. I-36)












Element Name
Element Type
Purpose







Mode of Request
Selection Box
Entry Field for the Group Id.


Postmark Date
Entry Field
Entry Field for the Group Name


Date Received
Entry Field
Entry Field for the Date Received


Authorized Contact
Selection Box
Entry Field for the Authorized 




Contact


Requested Term
Entry Field
Entry Field for the Request 


Date

Term Date


Reason for Term
Selection Box
Select the Reason for Term


Other Reason
Entry Field
Entry Field for the Other Reason









SID: enrollment.termination.groupprocesstermination
Screen Snap Shot (See FIG. I-37)












Element Name
Element Type
Purpose







Effective Term Date
Entry Field
Entry Field for the Group Id.


Change Term Status 
Select Box
Select Change Term Status









SID: enrollment.termination.groupterminationconfirm
Screen Snap Shot (See FIG. I-38)
SID enrollment.termination.multiplegroupsearch
Screen Snap Shot (See FIG. I-39)












Element Name
Element Type
Purpose







Postmark Date
Entry Field
Entry Field for the Group Name


Date Received
Entry Field
Entry Field for the Date Received


Requested Term 
Entry Field
Entry Field for the Request Term 


Date

Date


Reason for Term
Selection Box
Select the Reason for Term


Other Reason
Entry Field
Entry Field for the Other Reason









SID: enrollment.termination.multiplegroupterminationconfirm
Screen Snap Shot (See FIG. I-40)
SID: enrollment.termination.employeesearch
Screen Snap Shot (See FIG. I-41)












Element Name
Element Type
Purpose







Group Name
Entry Field
Entry Field for the Group Name.


Group Id
Entry Field
Entry Field for the Group ID


Employee First
Entry Field
Entry Field for the 


Name

Employee First Name


Employee Last 
Entry Field
Entry Field for the Employee 


Name

Last Name


Employee Phone
Entry Field
Entry Field for the Employee 


Number

Phone Number


Employee SSN
Entry Field
Entry Field for the Employee SSN


Employee ID
Entry Field
Entry Field for the Employee ID









SID: enrollment.termination.employeeterminationrequest
Screen Snap Shot (See FIG. I-42)












Element Name
Element Type
Purpose







Mode of Request
Selection Box
Entry Field for the Group Id.


Postmark Date
Entry Field
Entry Field for the Group Name


Date Received
Entry Field
Entry Field for the Date Received


Authorized Contact
Selection Box
Entry Field for the Authorized 




Contact


Requested Term
Entry Field
Entry Field for the Request 


Date

Term Date


Reason for Term
Selection Box
Select the Reason for Term


Other Reason
Entry Field
Entry Field for the Other Reason









SID: enrollment.termination.employeeprocesstermination
Screen Snap Shot (See FIG. I-43)












Element Name
Element Type
Purpose







Effective Term Date
Entry Field
Entry Field for the Group Id.


Change Term Status 
Select Box
Select Change Term Status









SID: enrollment.termination.employeeterminationconfirm
Screen Snap Shot (See FIG. I-44)
SID: enrollment.termination.dependentsearch
Screen Snap Shot (See FIG. I-45)












Element Name
Element Type
Purpose







Employee First
Entry Field
Entry Field for the 


Name

Employee First Name.


Employee Last 
Entry Field
Entry Field for the 


Name

Employee Last Name


Employee SSN
Entry Field
Entry Field for the Employee SSN


Employee Id
Entry Field
Entry Field for the Employee Id


Dependent First
Entry Field
Entry Field for the 


Name

Dependent First Name


Dependent Last 
Entry Field
Entry Field for the 


Name

Dependent Last Name


Dependent SSN
Entry Field
Entry Field for the Dependent SSN


Dependent Id
Entry Field
Entry Field for the Dependent Id









SID: enrollment.termination.dependentterminationrequest
Screen Snap Shot (See FIG. I-46)












Element Name
Element Type
Purpose







Mode of Request
Selection Box
Entry Field for the Group Id.


Postmark Date
Entry Field
Entry Field for the Group Name


Date Received
Entry Field
Entry Field for the Date Received


Authorized Contact
Selection Box
Entry Field for the 




Authorized Contact


Requested Term
Entry Field
Entry Field for the Request 


Date

Term Date


Reason for Term
Selection Box
Select the Reason for Term


Other Reason
Entry Field
Entry Field for the Other Reason









SID: enrollment.termination.dependentprocesstermination
Screen Snap Shot (See FIG. I-47)















Element Name
Element Type
Purpose









Effective Term Date
Entry Field
Entry Field for 





the Term Date.



Change Term Status 
Select Box
Select Change 





Term Status










SID: enrollment.termination.dependentterminationconfirm
Screen Snap Shot (See FIG. I-48)
SID: enrollment.reinstatement.groupsearch
Screen Snap Shot (See FIG. I-49)















Element





Name
Element Type
Purpose









Group Id
Entry Field
Enter Group Id



Group Name
Entry Field
Enter Group Name



Phone Number
Entry Field
Enter Phone Number










SID: enrollment.reinstatement.groupreinstatementrequest
Screen Snap Shot (See FIG. I-50)












Element Name
Element Type
Purpose







Mode of Request
Selection Box
Entry Field for the Group Id.


Postmark Date
Entry Field
Entry Field for the Group Name


Date Received
Entry Field
Entry Field for the Date Received


Authorized Contact
Selection Box
Entry Field for the Authorized Contact


Reinstatement Date
Entry Field
Entry Field for the Request Rein Date


Requested




Reason for
Selection Box
Select the Reason for Reinstatement


Reinstatement




Other Reason
Entry Field
Entry Field for the Other Reason









SID: enrollment.reinstatement.groupprocessreinstatement
Screen Snap Shot (See FIG. I-51)












Element Name
Element Type
Purpose







Effective Date
Entry Field
Entry Field for the Date.


Change Status
Select Box
Select Change Status









SID: enrollment.reinstatement.groupreinstatementconfirm
Screen Snap Shot (See FIG. I-52)
SID: enrollment.reinstatement.employeesearch
Screen Snap Shot (See FIG. I-53)












Element Name
Element Type
Purpose







Group Name
Entry Field
Entry Field for the Group Name.


Group Id
Entry Field
Entry Field for the Group ID


Employee First
Entry Field
Entry Field for the Employee First Name


Name




Employee Last
Entry Field
Entry Field for the Employee Last Name


Name




Employee Phone
Entry Field
Entry Field for the Employee Phone 


Number

Number


Employee SSN
Entry Field
Entry Field for the Employee SSN


Employee ID
Entry Field
Entry Field for the Employee ID









SID: enrollment.reinstatement.employeereinstatementrequest
Screen Snap Shot (See FIG. I-54)












Element Name
Element Type
Purpose







Mode of Request
Selection Box
Entry Field for the Group Id.


Postmark Date
Entry Field
Entry Field for the Group Name


Date Received
Entry Field
Entry Field for the Date Received


Authorized Contact
Selection Box
Entry Field for the Authorized Contact


Reinstatement Date
Entry Field
Entry Field for the Request Rein Date


Requested




Reason for
Selection Box
Select the Reason for Reinstatement


Reinstatement




Other Reason
Entry Field
Entry Field for the Other Reason









SID: enrollment.reinstatement.employeeprocessreinstatement
Screen Snap Shot (See FIG. I-55)












Element Name
Element Type
Purpose







Effective Date
Entry Field
Entry Field for the Date.


Change Status
Select Box
Select Change Status









SID: enrollment.reinstatement.employeereinstatementconfirm
Screen Snap Shot
SID: enrollment.reinstatement.dependentsearch
Screen Snap Shot (See FIG. I-56)












Element Name
Element Type
Purpose







Employee First
Entry Field
Entry Field for the Employee First Name.


Name




Employee Last
Entry Field
Entry Field for the Employee Last Name


Name




Employee SSN
Entry Field
Entry Field for the Employee SSN


Employee Id
Entry Field
Entry Field for the Employee Id


Dependent First
Entry Field
Entry Field for the Dependent First Name


Name




Dependent Last
Entry Field
Entry Field for the Dependent Last Name


Name




Dependent SSN
Entry Field
Entry Field for the Dependent SSN


Dependent Id
Entry Field
Entry Field for the Dependent Id









SID: enrollment.reinstatement.dependentreinstatementrequest
Screen Snap Shot (See FIG. I-57)












Element Name
Element Type
Purpose







Mode of Request
Selection Box
Entry Field for the Group Id.


Postmark Date
Entry Field
Entry Field for the Group Name


Date Received
Entry Field
Entry Field for the Date Received


Authorized Contact
Selection Box
Entry Field for the Authorized Contact


Reinstatement Date
Entry Field
Entry Field for the Request Rein Date


Requested




Reason for
Selection Box
Select the Reason for Reinstatement


Reinstatement




Other Reason
Entry Field
Entry Field for the Other Reason









SID: enrollment.reinstatement.dependentprocessreinstatement
Screen Snap Shot (See FIG. I-58)












Element Name
Element Type
Purpose







Effective Date
Entry Field
Entry Field for the Date.


Change Status
Select Box
Select Change Status









SID: enrollment.reinstatement.dependentreinstatementconfirm
Screen Snap Shot (See FIG. I-59)
3.1.2. Screen Flow (See FIG. I-60)
4. Business Rule Mapping











Activity
Rules







Term Process 
The person who requested the term should be the


(request 
designated contact person or agent assigned to


received from)
that group. Other persons are not authorized to



initiate the term request.


Term Process 
On employer request the term process is initiated.


(Manual)
The term process should check the billing



status and the balance due or refund. If the



group has paid through and there is no



shortage or surplus then this process should



auto initiate the term process. Send letters the



Group, Employee and dependent. Notify via



mail to the GMS rep if the group size is less



than 15 and if above 15 notify the Sales rep.



If there is a shortage then send a mail to the



finance and put the term status as term



pending. Finance should initiate follow up for



collecting the balance due and sent the term



letter and payment letter. On receipt of



payment term the Group. If the Payment is not



received then retro terms the group.



If there is refund due to the group the finance



should process the refund and initiate the term



there after.



Note: GMS can process Term up to 30 days.



(LEVEL I)



Term beyond 30 days-60 days can be



processed only by lead (LEVEL II)



Term extended beyond 60 days is based on



ultimate authority to a specified user ((LEVEL III



and IV)


Term Process 
Automated term process is initiated if the group


(Automated)
does not pay the premium or there is shortage of



premium. Term letter is sent to the group on 32 day



of non-receipt of payment and the Group is given



15-day notice to repay. If the Group does not pay



within 32 + 15 days the finance should finalize term



based on authority.


General Term 
If the group is termed then all the employees and


rules
dependents for the group are termed. The COBRA



Members associated with the group should also be



termed. The term letter should be sent to the entire



member for the Group including the COBRA group.



EFT and auto credit card deductions should stop



on term.


Term Process
Dependent can be terminated based on various



reason provide for the employee termination



All term should be effective end of the current



month or if the term is requested for the month after



the current month.



Dependent cannot be termed with past date



beyond 30 days.



Exception:



Death of the dependent. The dependent is termed



the on the day of the death.


Term Rules
Auto initiate Dependent terms if the age of the



dependent is 23 and the dependent other than



spouse or domestic partner are no longer eligible.



Also send the COBRA packet to the dependent if



termed.


Billing Adjustment
Make adjustment to the billing for the termed



dependent in the next billing cycle.


Term Process 
The person who requested the term should be the


(request 
designated contact person. Other persons are not


received from)
authorized to initiate the term request.


Term Process 
On employer request the term process is initiated.


(Manual)
The term process should check the billing



status and the balance due or refund. If the



group has paid through and there is no



shortage or surplus then this process should



auto initiate the term process. Send letters the



Group, Employee and dependent. Notify via



mail to the GMS rep if the group size is less



than 15 and if above 15 notify the Sales rep.



If there is a shortage then send a mail to the



finance and put the term status as term



pending. Finance should initiate follow up for



collecting the balance due and sent the term



letter and payment letter. On receipt of



payment term the Group. If the Payment is not



received then retro terms the group.



If there is refund due to the group the finance



should process the refund and initiate the term



there after.



Note: GMS can process Term up to 30 days.



(LEVEL I)



Term beyond 30 days-60 days can be



processed only by lead (LEVEL II)



Term extended beyond 60 days is based on



ultimate authority to a specified user (LEVEL III



and IV)


Term Process 
Automated term process is initiated if the group


(Automated)
does not pay the premium or there is shortage of



premium. Term letter is sent to the group on 32 day



of non-receipt of payment and the Group is given



15-day notice to repay. If the Group does not pay



within 32 + 15 days the finance should finalize term



based on authority.


General Term 
If the group is termed then all the employees and


rules
dependents for the group are termed. The COBRA



Members associated with the group should also be



termed. The term letter should be sent to the entire



member for the Group including the COBRA group.



EFT and auto credit card deductions should stop



on term.


Term Process
This is to complete the term process where the



term status was term pend. All auto initiated term



process has the term status as term pend. It



requires user intervention to complete the term



process based on authority.


Term Process
Employee can be terminated based on various



reason provide for the employee termination



All term should be effective end of the current



month or if the term is requested for the month after



the current month.



Employee cannot be termed with past date beyond



30 days.



Exception:



Death of the employee. The employee is termed



the on the day of the death.


Process 
All employee terms should send term letter to the


Associated
employee and group. The employee can opt for


with term
COBRA and hence the COBRE enrollment packet



should be sent to the employee


Billing 
There should be billing adjustment in the


Adjustment
subsequent bill for the termed employee.


Term Process
Dependent can be terminated based on various



reason provide for the employee termination



All term should be effective end of the current



month or if the term is requested for the month after



the current month.



Dependent cannot be termed with past date



beyond 30 days.



Exception:



Death of the dependent. The dependent is termed



the on the day of the death.


Term Rules
Auto initiate Dependent terms if the age of the



dependent is 23 and the dependent other than



spouse or domestic partner are no longer eligible.



Also send the COBRA packet to the dependent if



termed.


Billing 
Make adjustment to the billing for the termed


Adjustment
dependent in the next billing cycle.


Reinstatement 
The person who requested the reinstatement


Process
should be the designated contact person. Other



persons are not authorized to initiate the



reinstatement request.



If reinstatement cannot happen then send the



denial letter.



If reinstated notify finance



System should calculate the reinstatement fees.



Finance will reinstate on receipt of payment.



Note When the group is reinstated all the members



associated with the group are also reinstated.



Including COBRA group.



GMS can reinstate within 30 days. Any period



above this needs authorization.


Reinstatement 
The person who requested the reinstatement


Process
should be the designated contact person. Other



persons are not authorized to initiate the



reinstatement request.



If reinstatement cannot happen then send the



denial letter.



Note When the Employee is reinstated all the



dependents of the Employee are also reinstated.


Reinstatement 
The person who requested the reinstatement


Process
should be the designated contact person. Other



persons are not authorized to initiate the



reinstatement request.



If reinstatement cannot happen then send the



denial letter.



If reinstated notify finance for reinstatement fees



calculation if applicable.









5. User Role
The respective level user can terminate or reinstate the dependent, employee or group based on the criteria mention in the following table. The following validations are done with respect to the current date.











S.No., User Role
Condition















Dependent Termination








1 Level I
Termination date is with in 30 days prior or later


2 Level II
Termination date is with in 60 days prior or later


3 Level III, Level IV
Termination date is with in 90 days prior or later







Employee Termination








1 Level I
Termination date is with in 30 days prior or later


2 Level II
Termination date is with in 60 days prior or later


3 Level III, Level IV
Termination date is with in 90 days prior or later







Group Termination








1 Level I
Termination date is with in 30 days prior or later


2 Level II
Termination date is with in 60 days prior or later


3 Level III, Level IV
Termination date is with in 90 days prior or later







Dependent Reinstatement








1 Level I
Reinstatement date is with in 30 days prior or later


2 Level II
Reinstatement date is with in 60 days prior or later


3 Level III, Level IV
Reinstatement date is with in 90 days prior or later







Employee Reinstatement








1 Level I
Reinstatement date is with in 30 days prior or later


2 Level II
Reinstatement date is with in 60 days prior or later


3 Level III, Level IV
Reinstatement date is with in 90 days prior or later







Group Reinstatement








1 Level I
Reinstatement date is with in 30 days prior or later


2 Level II
Reinstatement date is with in 60 days prior or later


3 Level III, Level IV
Reinstatement date is with in 90 days prior or later









Benefit Partners Inc
Process Specification
Appeals and Grievances
1. Introduction
1.1. Purpose
The purpose of this document is to describe the process of Appeals and Grievances. This document identifies how the user interacts with the system, the data to be captured, the business logic to be implemented, and the output of the process.
1.2. Business Use Case Specification Reference











Business Use Specification ID
Business Use Case Name







BPI_SCOPE_EN
Enrollment


SCOPE_ADD
Addendum to the Scope Document









1.3. Definitions, Acronyms & Abbreviations














Term
Explanation









BPI_CAS_FSD_EN
Functional Specification 




Document—Enrollment



BPI_CAS_FSD_EN_001
Process Specification—New Business 




Enrollment



BPI_CAS_FSD_EN_002
Process Specification—Enrollment 




Changes/Add-On



BPI_CAS_FSD_EN_003
Process Specification—COBRA 




Enrollment/Changes



BPI_CAS_FSD_EN_004
Process Specification—ROE/OE



BPI_CAS_FSD_EN_005
Process Specification—Termination/




Reinstatement










2. Process Identification
2.1. Background
Any process or transaction that is performed by PacAdvantage is subject to a review process. The rule for such is defined in the PacAdvantage handbook. There are cases when the Customer is not satisfied with some of the decisions made during the administration of the program. When a customer is not satisfied with the decision made they can submit a request for Program Review. Once a decision has been made to grant or deny the request, an Appeal can then be submitted to overturn the decision of the Program Review. Not all decisions are appealable. In any case, all grievances need to be sent to PacAdvantage-Roseville, along with other certain requirements, for making a decision whether to consider the Grievances or to reject them as the case may be.
PacAdvantage-Roseville makes the decision on the initial requests or “Program Reviews” and forwards the response to the customer. Upon receipt of a second request or “Appeal”, if the decision is appealable, Pac Advantage-Roseville forwards the information to PacAdvantage-SF to make a ruling. (If the decision is not appealable, PacAdvantage-Roseville sends a letter regarding such to the customer.) PacAdvantage-SF then returns a ruling and PacAdvantage-Roseville forwards the response to the customer.
This entire process needs to be captured and tracked by the system.
Any transaction within the system has a history. The personnel handling the grievance need to review the history and generate a report regarding the grievance for review.
2.2. Process Description
The objective of the Grievance process is to:

    
    
        1) Maintain a status for all Grievances received from the customer and follow up with the decision made either by PacAdvantage-Roseville or PacAdvantage-SF.
    
    


The following are the other requirements that will be supported and constraints on the proposed system:

    
    
        1) The system would track the initial request from open to close.
        2) The system would track subsequent requests, if a proper appeal, from re-open to close.
        3) Track subsequent requests, if not a proper appeal, for receive dates, remarks and any correspondence.
        4) The system would also have a history of all the transactions to get the report for the Nature of Grievance.
    
    


2.3. Process Flow
Process for Grievances—First Request (or “Program Review”)

    
    
        1) Receive the Grievance from Group and/or Member and/or Agent representing the Group and/or Member.
        2) Categorize the nature of the Grievance.
        3) Review the history and collect all the relevant documents for the Grievance.
        4) Make decision to approve/deny the Grievance.
        5) Close the Grievance.
        6) Send relevant letters.
        7) If the Grievance is in favor of the group or the employee, send notification to Finance and or GMS to take necessary action (Reinstate the Group/Member).
    
    


Process for Grievances—Second Request (or “Appeal”)

    
    
        1) Receive the Grievance from the Group and/or Member and/or Agent representing the Group and/or Member.
        2) Categorize the nature of the Grievance.
        3) Review the history and collect all the relevant documents for the Grievance.
        4) Forward the document with relevant information to PacAdvantage-SF.
        5) Follow up with PacAdvantage-SF regarding the decision on the Grievance.
        6) On receiving the decision convey the decision to the Group and or employee.
        7) Close the Grievance.
        8) Send relevant letters.
        9) If the Grievance is in favor of the group or the employee send notification to Finance and or GMS to take necessary action (Reinstate the Group/Member).
    
    


3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's














Corresponding


Screen ID (SID)
Screen Name
HTML File Name







bpi.enrollment.grievance.
Grievance Search
grievancesearch


appellantsearch




bpi.enrollment.grievance.
Grievance Create
grievancecreate


grievancecreate




bpi.enrollment.grievance.
Grievance Modify
grievancemodify


grievancemodify




bpi.enrollment.grievance.
Grievance Close
grievanceclose


grievanceclose









3.1.1.1. SID, Element Name, Element Type & Purpose
SID: bpi.enrollment.grievance.appellantsearch (See FIG. I-61)
Element Name













Element





Name
Element Type
Label
Purpose







Complainant
Text
Complainant 
To display text


Type

Type



appellantType
Radio button
Complainant 
To select the type 




Type
“Group” or “Member”


Complainant
Text
Complainant 
To display text


ID

ID



appellantId
Text Field
Complainant 
To enter complainant id




ID



Company
Text
Company 
To display text


Name

Name



companyName
Text Field
Company 
To enter company name




Name



First Name
Text
First Name
To display text


firstName
Text Field
First Name
To enter first name


Last Name
Text
Last Name
To display text


lastName
Text Field
Last Name
To enter last name


SSN
Text Field
SSN/Tax ID
To enter SSN or Tax ID


Phone
Text
Phone 
To display text


Number

Number



phoneNumber
Text Field
Phone 
To enter phone number




Number



search
HTML button
Search
To perform Search 





operation


cancel
HTML button
Cancel
To reset the all search 





fields


Search Table
HTML Table

To list the Complainant 





ID, Company Name, 





First Name, Last Name and





Phone number is displayed 





on the screen









3.1.1.2. SID, Element Name, Element Type & Purpose
SID: bpi.enrollment.grievance.grievancecreate (See FIG. I-62)













Element
Element 




Name
Type
Label
Purpose







Complainant
Text
Complainant 
To display text


Type

Type



Complainant
Text
Complainant 
To display complainant type


Type

Type
dynamically


Complainant
Text
Complainant 
To display text


ID

ID



Complainant
Text
Complainant 
To display complainant type


ID

ID
dynamically


Group
HTML 
Group 
To display company name, 


Information
Table
Information
contact name, address, 





phone, effective date,





ROE date, status


Postmark
Text
Postmark Date
To display text


Date





postMarkDate
Calendar
Postmark Date
To enter the postmark date


Received date 
Text
Received date
To display text


receivedDate
Calendar
Received date
To enter the received date


Nature Of
Text
Nature of 
To display text


Grievance

Grievance



natureOf-
List
Nature of 
To list the Nature of 


Grievance

Grievance
Grievance.





Upon selection of 





the Nature of





Grievance, the corresponding





Grievance Type is displayed 





on the screen


Subject of
Text
Subject of 
To display text


Grievance

Grievance



subjectOf- 
List
Subject of 
To list the Subject of 


Grievance

Grievance
Grievance for selection


Urgent
Text
Urgent
To display text


urgent
Check-
Urgent
To select the option of having



box

urgent.


Remarks
Text
Remarks
To display text


remarks
Text 
Remarks
To enter remarks larger 



Area

area is provided


save
HTML 
Save
Submit the data and save 



button

in the database


cancel
HTML 
Cancel
To reset to previous status as 



button

was on loading the page









Screen Validations












Element 
Action/Validation 



Name 
Details
Message







Postmark 
Should default to system date.
Error Dialog Box:


Date
Postmark date can never be a future
“Please choose the 



date and can be one day older than
correct date. Postmark



current date only.
date can be a future date.”


Received 
Should default to system date.
Error Dialog Box:


date
Received date can never be a future
“Please choose the 



date and should be equal to OR
correct date. Received



greater than current date.
date can be a future date.”


Nature of
Default Option should be - Choose
Error Dialog Box:


Grievance
One-- Should list all the types of
“Please choose the 



Natures of Grievances
nature of grievance.


Subject of
Default Option should be - Choose
Error Dialog Box:


Grievance
One-- Should list all the types of
“Please choose the 



subject of Grievances
subject of grievance.


Remarks
Entry Text Area to enter the remarks
None



for the Grievance. The text area




should have scrollbar if the content




within the text area grows.



Save
Should function On clicking the
Error Dialog Box:



Save Button or 
“The value entered 



pressing the Enter
for ‘field name’ is



key with cursor on the “Save
incorrect. Please enter 



Button”
the correct value.”



Save the data to the 
Note: The “field name” 



repository with
name should be



the status of the Grievance as open.
dynamically picked 



Auto generate the grievance ID
based on the name of




the field for which the 




error has occurred.


Cancel
Should reset to the status as was on
None



loading the page on clicking the




cancel button









3.1.1.3. SID, Element Name, Element Type & Purpose
bpi.enrollment.grievance.grievancemodify (See FIG. I-63)













Element
Element 




Name
Type
Label
Purpose







Search by
Text
Search by 
To display text


Complainant

Complainant



searchType
Radio 
Search by 
To select the 



button
Complainant
option of search


Search by
Text
Search by 
To display text


Grievance

Grievance



searchType
Radio 
Search by 
To select the 



button
Grievance
option of search


Grievance ID
Text
Grievance ID
To display text


grievanceID 
Read 
Grievance ID
To display Grievance 



only field

ID. Ability to





search for open 





Grievances


Complainant
Text
Complainant 
To display text


ID

ID



appellantId
Entry 
Complainant 
To enter complainant 



Field
ID
ID. Ability to





search for open





Grievances for the





specific complainant.


search
Button
Search
To search for the 





Grievance ID or the





Complainant 





ID (group or member





id) with open 





grievances


Grievance
HTML 
Grievance 
List the grievances 


Process Table
Table
Process Table
based on the





search criteria.


Process
HTML 
Process
To show the 



Button

grievance selected for





further processing


Grievance
HTML 
Grievance
Table to display 



Table

Postmark Date,





Received Date, 





Nature of Grievance,





Subject of 





Grievance, Appellant





Type, Appellant 





ID, Grievance





Status, Remarks.


Additional
Text
Additional 
To display text


Remarks

Remarks



additional-
Entry 
Additional 
To enter text


Remarks 
Field
Remarks



Forward for
Text
Forward for 
To display text


Approval

Approval



forwardFor-
Check 
Forward for 
To check if 


Approval
box
Approval
forwarding for 





approval


Forward to
Text
Forward to
To display text


forwardedTo
Entry 
Forward to
If “Forward for 



Field

Approval” is





checked then 





this field must be





completed. To enter 





the name of the





person to whom 





the Grievance is to





be forwarded


Forward Date 
Text
Forward Date
To display text


forwardDate
Calendar
Forward Date
If “Forward for 





Approval” is





checked then 





this field must be





completed. Enter 





the forward date


Batch Date
Text
Batch Date
To display text


batchDate
Calendar
Batch Date
To enter batch date


save
HTML 
Save
Save the data and 



button

save in the database


cancel
HTML 
Cancel
To reset to previous 



button

status as was on





loading the page









Screen Validations












Element 




Name
Action/Validation Details
Message







Grievance
Entry field to enter grievance ID and 
Error Message:



on tab should populate the Grievance
“The grievance ID 



based on the Grievance id
not available”


Complainant
Entry fields to enter Complainant ID
Error Message:



and on tab should populate all the
“Complainant ID 



Grievances for the specific appellant.
not available”


Search
Search for the Grievance ID or
None



Appellant ID



Grievance 
The table gets populated based on
None


Process
the search criteria. For Grievance ID



Table
the table shows only one grievance.




For Appellant search the table shows




all the grievances for the specific




Appellant.



Process
Process the specific Row in the table 
NONE



selected



Grievance
Table to display Postmark Date,
None



Received Date, Nature of Grievance,




Subject of Grievance, Appellant




Type, Appellant ID, Grievance




Status, Remarks.



Additional
Entry field for additional remarks
None


Remarks




Forward for
Check box to check if forward or
None


Approval
not.



Forward To
If “Forward for Approval” is
Error Dialog Box:



checked then this field must be
“Please Enter the 



completed. To enter the name of the
Forwarded to persons



person to whom the Grievance is to
name”



be forwarded



Forward 
Allow entering the date or picking
Error Dialog Box:


Date
up from the calendar
“Please Enter the 



If “Forward for Approval” is
Forwarded Date”



checked then this field must be




completed. Enter the forward date



Batch Date
Allow entering the batch date or
None



picking up from the calendar



Save
Should function On clicking the
Error Dialog Box:



Save Button or 
“The value entered 



pressing the Enter
for ‘field name’ is



key with cursor on the “Save
incorrect. Please 



Button”
enter the correct 



Save the data on 
value.”



clicking the save
Note: The “field 



button.
name”




name should be




dynamically picked 




based on the name of




the field for which 




the error has occurred.


Cancel
Reset to the state as was on loading
None



the page









3.1.1.4. SID, Element Name, Element Type & Purpose
SID: bpi.enrollment.grievance.grievanceclose (See FIG. I-64)













Element
Element 




Name
Type 
Label
Purpose







Search by
Text
Search by 
To display text


Complainant

Complainant



searchType
Radio 
Search by 
To select the 



button
Complainant 
option of search


Search by
Text
Search by 
To display text


Grievance

Grievance



searchType
Radio 
Search by 
To select the 



button 
Grievance
option of search


Grievance ID
Text
Grievance ID
To display text


grievanceID 
Entry 
Grievance ID
To enter Grievance 



Field

ID. Ability to





search for 





open Grievances


Complainant 
Text

To display text


ID





complainant 
Text 
Complainant 
To display Complainant 


ID
Field
ID
ID. Ability





to search for open 





Grievances for the





specific complainant


search
Button
Search
To search for the 





Grievance ID or the





Complainant ID





(group or member





id) with open 





grievances


Grievance
HTML 
Grievance 
List the grievances 


Close Table
Table
Close Table
based on the





search criteria.


Grievance
HTML 
Grievance 
Table to display 


Table
Table
Table
Postmark Date,





Received Date, 





Nature of Grievance,





Subject of 





Grievance, Appellant





Type, Appellant 





ID, Grievance





Status, Remarks.


Conclusion
Text
Conclusion
To display text


conclusion
List
Conclusion
List the conclusion 





of appeal as





Approved, 





Denied, or Cancelled


Reason
Text
Reason
To display text


reason
List
Reason
List the Reason 





for the conclusion


otherReason 
Entry 
Other 
To enter reason 



Field
Reason
not included in





Reason List


Batch Date
Text
Batch Date
To display text


batchDate
Calendar
Batch Date
To enter batch date


Save
HTML 
Save
Submit the data and 



button

save in the database









Screen Validations












Element 




Name
Action/Validation Details
Message







Grievance
Entry field to enter grievance ID.
Error Message:




“Grievance ID 




is required”


Complainant
Entry fields to enter Complainant ID. 
Error Message:




“Complainant ID 




is required”


Search
Search for the Grievance ID or
None



Appellant ID



Grievance 
The table gets populated based on
None


Close
the search criteria. For Grievance ID



Table
the table shows only one grievance.




For Appellant search the table shows




all the grievances for the specific




Appellant.



Close
Process the specific Row in the table 
NONE



selected



Conclusion
Default option should be - choose
None



one--. List the conclusions for




closing the grievance as Approved,




Denied or cancelled



Reason
Default option should be - choose
None



one--. List the reasons applicable



Other Reason
If the reason selected is others the
None



enter the other reason



Batch Date
Allow entering the batch date or
None



picking up from the calendar



Submit
Should function On clicking the
Error Dialog Box:



Submit Button or pressing the Enter
“The value entered for 



key with cursor on the “Submit
‘field name’ is



Button”
incorrect. Please enter 



Save the data on clicking the submit
the correct value.”



button.
Note: The 




“field name”




name should be




dynamically picked 




based on the name of




the field for which the 




error has occurred.









3.1.2. Screen Flow
(See FIG. I-65)
4. Business Rule Mapping











Activity
Rules







Appeals 
Appeals and grievance is the screen that needs to be


and grievance
handled by personnel skilled with the operations of the



PacAdvantage and the governing rules.



All appeals are entered and followed up for the outcome



of the appeals. The turn around time for the appeals



should be 3 days at the BPI office for entering the record



and gathering the reports and summarizing the history.









Benefit Partners Inc
Process Specification
Association Master
1. Introduction
1.1. Purpose
The purpose of this document is to describe the process of Association Master. This document identifies how the user interacts with the system, the data to be captured, the business logic to be implemented, and the output of the process.
1.2. Business Use Case Specification Reference











Business Use 
Business Use 


Specification ID
Case Name







BPI_SCOPE_EN
Enrollment


SCOPE_ADD
Addendum to the Scope Document


BPI_SCOPE_EN_01
Business Use case specification- Group Enrollment


BPI_SCOPE_EN_03
Business Use case specification- Create Individual



Association









1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
2.1. Background
Associations are basically a body of groups/members representing certain types of associations within the State of California. Association Groups and Association Members can participate in the PacAdvantage program similar to small employer groups or members. Associations are classified as Guaranteed, Endorsed, PEO's or Chambers. Each of the associations classified have specific business rules when participating in PacAdvantage program. This document identifies the rules and business governing the association groups and members.
2.2. Process Description
The objective of the Association Master is to:

    
    
        1) Create a master record for the association based on the classification of the association and specify the business rules associated with these classifications.
        2) The master record for association includes
        
            General information about the association
            Contact information
            Coverage Information
            Agent information
            Other information like internal work group, membership status etc.
        
        
    
    


2.3. Process Flow
Process for Association Master
Create, modify or inactivate an association master is the basic operations that can be performed on the association master.

    
    
        1) Enter general information about the association. The general information includes
        
            Association Type
            Association Name
            Affiliation ID
            Address
            Suite
            City
            State
            ZIP
        
        
        2) Enter contact information. The contact information includes
        
            Salutation
            First Name
            Middle Initial
            Last Name
            Suffix
            Contact Phone
            Contact Fax
            Email Address
        
        
        3) Enter coverage information. Coverage information includes
        
            Line of coverage offered
            Domestic Partner Coverage
            Rate Type
            Admin Fees Type (Note: This are captured in Carrier Maintenance Module (Rate Classification)
            Agent Fees Type (Note: This are captured in Carrier Maintenance Module (Rate Classification)
            Additional Fees type (Note: This are captured in Carrier Maintenance Module (Rate Classification)
        
        
        4) Enter other information. Other information includes
        
            Internal Work group
            Membership status
            Contract Date
            Association re qualification period
            Special Handling
        
        
    
    


3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's












Screen ID 
Screen 
Corresponding HTML 


(SID)
Name
File Name







enrollment.asso- 
Association 
/bpi/cas/enrollment/association/


ciation.associa-
General Info
associationgeneral/Association-


tiongeneral

GeneralInfo.jsp


enrollment.asso- 
Association 
/bpi/cas/enrollment/association/


ciation.associa-
Coverage Info
associationcoverage/Association-


tioncoverage

CoverageInfo.jsp


enrollment.asso- 
Association 
/bpi/cas/enrollment/association/


ciation.associa-
Other Info
associationother/Association


tionother

OtherInfo.jsp


enrollment.asso- 
Association 
/bpi/cas/enrollment/association/


ciation.associa-
Confirmation
associationconfirm/Association-


tionconfirm

Confirm.jsp


enrollment.asso- 
Internal Work-
/bpi/cas/enrollment/association/


ciation.internal
Group Search
internalworkgroupsearch/Internal- 


workgroupsearch

WorkGroupSearch.jsp


enrollment.asso- 
Association 
/bpi/cas/enrollment/association/


ciation.association-
Search
associationgeneral/Association


generalsearch

GeneralSearch.jsp









3.1.1.1. SID, Element Name, Element Type & Purpose
SID: enrollment.association.associationgeneral
Screen Snap Shot (See FIG. I-66)












Element
Element 



Name
Type
Purpose







General
Header Text
To provide content for header


Information




Association 
Text
To provide text


name




Association 
Entry Field
Enter association name


name




Search
HTML Button
To show pop up 




window to search for the




association name for 




editing the data.


Association 
Text
To provide text


Type




Association 
Drop Down List
List the types of association 


Type

to select from


Address
Sub Header
To provide content for sub header


Information




Address
Text
To provide text


Address
Entry field
Enter the address


Suite
Text
To provide text


Suite
Entry field
Enter the suite number


City
Text
To provide text


City
Entry field
Enter the city name


State
Text
To provide text


State
Drop Down List
List the states in USA for selection


ZIP
Text
To provide text


ZIP
Entry field
Enter the ZIP code


Contact
Sub Header for 
Text for sub header content


Information
contact information



Salutation
Text
To provide text


Salutation
Drop Down List
Select the salutation


First Name
Text
To provide text


First name
Entry field
Enter first name


MI
Text
To provide text


MI
Entry field
Enter Middle initial


Last name
Text
To provide text


Last name
Entry field
Enter last name


Suffix
Text
To provide text


Suffix
Drop down List
To select the suffix


Phone
Text
To provide text


Phone
Entry field
Enter phone number


Extension
Text
To provide text


Extension
Entry field
Enter extension number


FAX
Text
To provide text


Fax
Entry Field
Enter the Fax number


Email
Text
To provide text


Email
Entry field
Enter the email address


Continue
HTML Button
Save and continue to the next screen




BPI_CAS_SCR_EN_007_002


Cancel
Reset Button
Reset to the status as 




was on loading the page









SID: enrollment.association.associationcoverage
Screen Snap Shot (See FIG. I-67)












Element
Element 



Name
Type
Purpose







Coverage
Header 
To provide header for Coverage


Information
Text



Line of
Text
To provide text


coverage




Line of
Check 
Check boxes to select multiple line of coverage


Coverage
boxes
offered


Domestic
Text
To provide text


Partner




Coverage




Domestic
Radio 
To choose yes or no for domestic partner


Partner
Boxes
coverage


Coverage




Coverage Rate 
Text
To provide text


Type




Coverage Rate 
Radio 
To choose if the rate type is blended or non


type
Boxes
blended


Continue
HTML 
Submit button to save the data entered in to the



Button
repository and navigate to the next screen




BPI_CAS_SCR_EN_007_003


Cancel
HTML 
To reset to the status as was on loading the page.



reset




Button









SID: enrollment.association.associationother
Screen Snap Shot (See FIG. I-68)












Element
Element 



Name
Type
Purpose







Other
Header text
To provide text for the header


Information




Internal work 
Text
To provide text


group




Internal work 
Entry field
Enter the work group ID


group




Search
HTML 
Button to search for the work group to be



Button
attached to the association


Membership
Text
To provide text


status




Membership
Drop down 
List the membership status 


status
list
as active, closed or




frozen


Contract Date 
Entry field 
To enter or pick up the 



(Calendar)
association's effective




date


Association 
Entry field 
To enter or pick up the association's 


requalification
(Calendar)
requalification date


period




Batch billing
Text
To provide text


Batch billing
Radio box
To specify if the association 




groups and members




are to billed as one batch


Desired
Text
To provide text


Association




name on the




bill




Desired
Radio Box
To specify if the Association 


Association

name should be on


name on the

the bill or not


bill




Continue
HTML Button
Button to save the information on this page


Clear
HTML reset 
To reset to the status as 



Button
was on loading the page.









SID: enrollment.association.associationconfirm
Screen Snap Shot (See FIG. I-69)
SID: enrollment.association.internalworkgroupsearch
Screen Snap Shot (See FIG. 70)
SID: enrollment.association.associationgeneralsearch
Screen Snap Shot (See FIG. I-71)
3.1.2. Screen Flow
(See FIG. I-72)
4. Business Rule Mapping











Activity 
Rules







Allow Employer 
Are eligible to enroll at any time and follow business


Groups 2-50
rules for Non-Association Small Employer Groups 2-50.



This rules applies for Guaranteed, Endorsed, PEO's and



Chambers


Allow Individual 
Must have a membership number and apply after 60


Members
days (read as waiting period), but within 120 days, of



becoming a member of the Association or of a group



sponsored for coverage. Effective date of coverage will



be within 45 days of receipt of a completed application.



Declines must wait until Open Enrollment. Waives may



enroll within 30 days of losing other employer-



sponsored coverage. The Individual Association



member is required to enroll in all lines of coverage



offered by the Association Master. The Individual



Association member is not eligible for COBRA.



This is applicable only to Guaranteed association


Allow Employer 
Are eligible to enroll at any time and follow business


Groups >100
rules for Small Employer Groups 2-50 EXCEPT for the



size of the group for Guaranteed association (Group size



can be un limited for guaranteed association)


Rates
Rate for each association for various rate classification



are defined in the carrier maintenance module.(Admin



Fees, Agent Commission, Additional Fees and Rate



differential)


Agent
All associations have an Agency and/or Agent(s).



Commissions are applicable to both Group's and



Association Member's. For both, the agent is attached at



the Group/Association member, but can only be chosen



from the particular agents attached to the association.



Agent is selected based on the internal work group



assigned to the agent/agency.


Screen Rules 
Small employer group after identifying the association


for Group
would follow the same navigation as applicable for the



Small employer group. The Group Affiliated to an



association should also have the Membership Number



and the date of membership.


Screen Rules for 
Individual association would follow the same navigation


Individual 
as applicable to the employee after selecting the


Association
association and validating that the association is


members
guaranteed. The only additional things needed are a



“Membership Number” and a “Date of Membership”.



Essentially the “Date of Membership” replaces the



employee “Date of Hire” for an employee.









Benefit Partners Inc
Process Specification
Carrier Issues
1. Introduction
1.1. Purpose
The purpose of this document is to describe the process of Carrier Issues. This document identifies how the user interacts with the system, the data to be captured, the business logic to be implemented, and the output of the process.
1.2. Business Use Case Specification Reference














Business Use 




Specification ID
Business Use Case Name









BPI_SCOPE_EN
Enrollment



SCOPE_ADD
Addendum to the Scope Document










1.3. Definitions, Acronyms & Abbreviations











Term
Explanation







BPI_CAS_FSD_EN
Functional Specification 



Document- Enrollment


BPI_CAS_FSD_EN_001
Process Specification - New 



Business Enrollment


BPI_CAS_FSD_EN_002
Process Specification - Enrollment 



Changes/Add-On


BPI_CAS_FSD_EN_003
Process Specification - COBRA 



Enrollment/Changes


BPI_CAS_FSD_EN_004
Process Specification - ROE/OE


BPI_CAS_FSD_EN_005
Process Specification - Termination/



Reinstatement









2. Process Identification
2.1. Background
Various issues can arise for a member or group once enrolled with a carrier through PacAdvantage. These issues can vary from not receiving identification cards to incomplete transmission upload by the carrier. As PacAdvantage becomes aware of these issues it is their responsibility to resolve the issue in a timely manner acting as a liaison between the member and the carrier. All issues need to be tracked from start to finish by reason for issue and related carrier for reporting on performance standards as well providing information to PacAdvantage-SF regarding recurring issues within a carrier.
Issues can arise at the Group level, for all members on a group and/or all members on a line of coverage. Issues can also arise at the Employee level and/or Dependent level, by member and/or by plan.
Within PacAdvantage there are personnel who specifically handle all carrier related issues. Other representatives within PacAdvantage can receive the initial request, document it as needed and forward it to the Carrier Issue personnel. The Carrier Issue personnel contact the carrier to resolve the issue. They mark the documentation as needed and then close the issue and forward the resolutions back to the initial requestor (Originator). The Originator informs the member/group of resolution.
2.2. Process Description
The objective of the Carrier Issues process is to:

    
    
        1) Maintain a status for all Carrier Issues received from the customer and follow up with the carrier for resolution and inform the customer of resolution.
    
    


The following are the other requirements that will be supported and constraints on the proposed system:

    
    
        1) The system would track the initial request from open to close.
        2) The system would track both the reported issue and the actual issue.
        3) The system would track the final resolution.
        4) The system would also have a history of all the transactions to get the report for the Reported Issue.
    
    


2.3. Process Flow
Process for Carrier Issues

    
    
        1) Representative is notified of the issue by the customer and cannot resolve the issue alone.
        2) Representative initiates a request either from the Group level, Employee level, or Dependent level.
        3) The representative categorizes the reported issue and provides any supporting documentation.
        4) The issue is marked as “Open” for the Carrier Issue personnel to handle.
        5) The Carrier Issue personnel contact the carrier.
        6) The Carrier Issue personnel provide the carrier with necessary information to resolve the issue. (i.e. re-transmission, e-mail of information)
        7) The Carrier Issue personnel mark the issue as “Closed” and inform the Originator.
        8) The originator follows-up with the member.
    
    


3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's
<List SID and the Screen Name and Corresponding HTML File for the Screen.>














Corresponding HTML


Screen ID (SID)
Screen Name
File Name







bpi.enrollment.carrierissue.carrierissuesearch
Carrier Issue Search
carrierissuesearch


bpi.enrollment.carrierissue.carrierissuecreate
Carrier Issue Create
carrierissuecreate


bpi.enrollment.carrierissue.carrierissuemodify
Carrier Issue Modify
carrierissuemodify


bpi.enrollment.carrierissue.carrierissueclose
Carrier Issue Close
carrierissueclose









3.1.1.1. SID, Element Name, Element Type & Purpose
SID: bpi.enrollment.carrierissue.carrierissuesearch (See FIG. I-73)













Element
Element 




Name
Type
Label
Purpose







Customer
Text
Customer Type
To display text


Type





clientType
Radio button
Customer Type
To select the type 





“Group” or “Member”


Customer ID
Text
Customer ID
To display text


clientId
Text Field
Customer ID
To enter complainant





id


Company
Text
Company Name
To display text


Name





companyName
Text Field
Company Name
To enter company 





name


First Name
Text
First Name
To display text


firstName
Text Field
First Name
To enter first name


Last Name
Text
Last Name
To display text


lastName
Text Field
Last Name
To enter last name


SSN
Text Field
SSN/Tax ID
To enter SSN or Tax ID


SSN
Text Field
SSN/Tax ID
To enter SSN or Tax ID


Phone
Text
Phone Number
To display text


Number





phoneNumber 
Text Field
Phone Number
To enter phone number


search
HTML 
Search
To perform Search 



button

operation


cancel
HTML 
Cancel
To reset the all search 



button

fields


Search Table
HTML 

To list the Complainant 



Table

ID, Company Name, 





First Name, Last Name 





and Phone number is 





displayed on the screen









3.1.1.2. SID, Element Name, Element Type & Purpose
SID: bpi.enrollment.carrierissue.carrierissuecreate (See FIG. I-74)













Element 



Element Name
Type
Purpose







Received date
Text
To display text


Received date
Calendar
To enter the received date


Reported Issue
Text
To display text


Reported Issue
List
To list the Reported Issue.


Group
Entry 
To enter Group ID if Client Type is 



Field
Group. Ability to search for Group, 




upon selection or entry of the Group, 




the group's general information is 




displayed (Company Name, Contact 




Name, Address, Phone, Effective 




Date, ROE Date, Status)


Member
Entry 
To enter Member ID if Client Type is 



Field
Member. Ability to search for Member, 




upon selection or entry of the member 




ID, the member's general information 




is displayed (Name, Address, Phone,




Effective Date, ROE Date, Status, 




Benefit Level, Coverage Choice)


Remarks
Text
To display text


Remarks
Entry 
To enter remarks



Field



Submit
HTML
Submit the data and save in the 



button
database


Cancel
HTML
To reset to previous status as was on 



button
loading the page


Cancel
HTML
To reset to previous status as was on 



button
loading the page









Screen Validations












Element Name 
Action/Validation Details
Message







Received date
Should default to system date.
Error Dialog Box:



Received date can never be a future
“Please choose the correct date. Received



date.
date can be a future date.”


Reported Issue
Default Option should be - Choose
Error Dialog Box:



One - Should list all the types of
“Please choose the reported issue.



Reported Issues



Client Type
Option to choose Group or member
None



with radio button group.



Client
Entry field to enter the group ID or
None



member ID based on the Client type




selected. Based on the Client




selected Display the Group or




member information in the HTML




table.



Search
Pop up window to search for the
None



Group or Member based on the




Client type selected.



Group
HTML Table to display the Group
None



Information



Member
HTML Table to display member
None



information



Remarks
Entry Text Area to enter the remarks 
None



for the Carrier Issue. The text area




should have scrollbar if the content




within the text area grows.



Submit
Should function On clicking the
Error Dialog Box:



Submit Button or pressing the Enter
“The value entered for ‘field name’ is



key with cursor on the “Submit
incorrect. Please enter the correct value.”



Button”
Note: The “field name” name should be



Save the data to the repository with 
dynamically picked based on the name of



the status of the Carrier Issue as
the field for which the error has occurred.



open.




Auto generate the Carrier Issue ID



Cancel
Should reset to the status as was on
None



loading the page on clicking the




cancel button









3.1.1.3. SID, Element Name, Element Type & Purpose
SID: bpi.enrollment.carrierissue.carrierissuemodify (See FIG. I-75)












Element Name
Element Type
Purpose







Carrier Issue
Text
To display text


ID




Carrier Issue 
Entry Field
To enter Carrier Issue ID. Ability to 


ID

search for open Carrier Issues


Client
Text
To display text


Client
Entry Field
To enter client ID. Ability to search 




for open Issues for the specific client


Search
Pop Up window
To search for the Carrier Issue ID or 




the Client ID (group or member id) 




with open issues


Carrier Issue 
HTML Table
List the issues based on the search 


Process Table

criteria.


Process
HTML Button
To show the issue selected for further 




processing


Carrier Issue 
HTML Table
Table to display Received Date, 




Reported Issue, Client Type, 




Client ID, Issue Status, Remarks.


Additional
Text
To display text


Remarks




Additional
Entry Field
To enter text


Remarks




Notify Carrier
Text
To display text


Notify Carrier
Radio Button
To check if notifying to carrier


Mode of
Text
To display text


Notification




Mode of
List Box
If “Notify Carrier” is checked then 


Notification

this field must be completed. To 




enter the mode of notification


Date Notified
Text
To display text


Date Notified
Calendar
If “Notify Carrier” is checked then 




this field must be completed. 




Enter the notified date


Batch Date
Text
To display text


Batch Date
Calendar
To enter batch date


Submit
HTML button
Submit the data and save in the 




database


Cancel
HTML button
To reset to previous status as was on 




loading the page









Screen Validations












Element Name
Action/Validation Details
Message







Carrier Issue
Entry field to enter Carrier Issue ID 
Error Message:



and on tab should populate the
“Carrier Issue ID is required”



Carrier Issue based on the Carrier




Issue id



Client
Entry fields to enter Client ID and on
Error Message:



tab should populate all the Carrier
“Client ID is required”



Issues for the specific Client.



Search
search for the Carrier Issue ID or
None



Client ID



Carrier Issue
The table gets populated based on
None


Process Table
the search criteria. For Carrier Issue




ID the table shows only one Carrier




Issue. For Client search the table




shows all the Carrier Issues for the




specific Client.



Process
Process the specific Row in the table
NONE



selected



Carrier Issue
Table to display Received Date,
None



Reported Issue, Client Type, Client




ID, Issue Status, Remarks.



Additional
Entry field for additional remarks
None


Remarks




Notify Carrier
Radio button to select if notify or not
None


Mode of
If “Notify Carrier” is yes then this
Error Dialog Box:


Notification
field must be completed. To enter
“Please Enter the Mode of Notification”



the Mode of Notification for whom




the Issue is to be forwarded



Date Notified
Allow entering the date or picking
Error Dialog Box:



up from the calendar
“Please Enter the Notified Date”



If “Notify Carrier” is yes then this




field must be completed. Enter the




notified date



Batch Date
Allow entering the batch date or
None



picking up from the calendar



Submit
Should function On clicking the
Error Dialog Box:



Submit Button or pressing the Enter
“The value entered for ‘field name’ is



key with cursor on the “Submit
incorrect. Please enter the correct value.”



Button”
Note: The “field name” name should be



Save the data on clicking the submit
dynamically picked based on the name of



button. If the Mode of Notification is
the field for which the error has occurred.



Email, then open new message with




appropriate information. If Mode of




Notification is Fax, then enter




appropriate information for fax.



Cancel
Reset to the state as was on loading
None



the page









3.1.1.4. SID, Element Name, Element Type & Purpose
SID: bpi.enrollment.carrierissue.carrierissueclose (See FIG. I-76)













Element Name
Element Type
Label
Purpose







Search by
Text
Search by Customer
To display text


Customer





searchType
Radio button
Search by Customer
To select the option of search


Search by
Text
Search by Carrrier Issue
To display text


Carrrier Issue





searchType
Radio button
Search by Carrrier Issue
To select the option of search


Carrier Issue ID
Text
Carrier Issue ID
To display text


carrierIssueId
Entry Field
Carrier Issue ID
To enter Carrier Issue ID. Ability to





search for open Carrier Issue


Customer ID
Text

To display text


customerId
Text Field
Customer ID
To display Customer ID. Ability to





search for open Carrier Issue for the





specific Customer


search
Button
Search
To search for the Carrier Issue ID or





the Customer ID (group or member





id) with open carrier issues


Carrier Issue
HTML Table
Carrier Issue Close Table
List the carrier issue based on the


Close Table


search criteria.


Carrier Issue
HTML Table
Carrier Issue Table
Table to display Received Date,


Table


Reported Issue, Client Type, Client





ID, Issue Status, Remarks.


Actual Issue
Text
To display text
Actual Issue


Actual Issue
List
List the Actual Issue
Actual Issue


Retransmission
Text
To display text
Retransmission


Retransmission
Radio button
Select if retransmission
Retransmission




needed or not



Resolution
Text
To display text
Resolution


Resolution
List
List the Resolution of Issue 
Resolution




as Verbally Updated;





Retransmitted, etc.



Resolution
Text
To display text
Resolution Comments


Comments





Resolution
Entry Field
To enter text
Resolution Comments


Comments





Date Carrier
Text
To display text
Date Carrier Resolved


Resolved





Date Carrier
Calendar
To enter date Carrier
Date Carrier Resolved


Resolved

resolved



Batch Date
Text
To display text
Batch Date


Batch Date
Calendar
To enter batch date
Batch Date


Notify
Text
To display text
Notify Originator


Originator





Notify
Radio Button
To select if notifying to 
Notify Originator


Originator

Originator



save
HTML button
Save
Submit the data and save in the





database









Screen Validations












Element Name
Action/Validation Details
Message







Carrier Issue
Entry field to enter Carrier Issue ID
Error Message:



and on tab should populate the
“Carrier Issue ID is required”



Carrier Issue based on the Carrier




Issue id



Customer
Entry fields to enter Client ID and on 
Error Message:



tab should populate all the Carrier
“Customer ID is required”



Issues for the specific Client.



Search
search for the Carrier Issue ID or
None



Client ID



Carrier Issue
The table gets populated based on
None


Process Table
the search criteria. For Carrier Issue




ID the table shows only one Carrier




Issue. For Client search the table




shows all the Carrier Issues for the




specific Client.



Close
Close the specific Row in the table
None



selected



Carrier Issue
Table to display Received Date,
None



Reported Issue, Client Type, Client




ID, Issue Status, Remarks.



Actual Issue
Default option should be the same as




reported issue. List all issues.



Retransmission
Radio button to select if retransmit
None



or not



Resolution
Default option should be - choose




one -. List the resolutions for closing




the issue as Updated, Denied or




cancelled



Resolution
Entry field for additional comments
None


Comments




Date Carrier
Allow entering the date or picking
None


Resolved
up from the calendar




If “Notify Carrier” is yes then this




field must be completed. Enter the




notified date



Batch Date
Allow entering the batch date or
None



picking up from the calendar



Notify Originator
Radio button to select if notify or




not. If yes send pre-formatted email




to Originator.



Submit
Should function On clicking the
Error Dialog Box:



Submit Button or pressing the Enter
“The value entered for ‘field name’ is



key with cursor on the “Submit
incorrect. Please enter the correct value.”



Button”
Note: The “field name” name should be



Save the data on clicking the submit
dynamically picked based on the name of



button. If the Mode of Notification is 
the field for which the error has occurred.



Email, then open new message with




appropriate information. If Mode of




Notification is Fax, then enter




appropriate information for fax.



Cancel
Reset to the state as was on loading
None



the page









3.1.2. Screen Flow
(See FIG. I-77)
4. Business Rule Mapping














Activity
Rules









Carrier Issues
Carrier Issue is the screen that needs to be 




handled by personnel skilled with the




operations of the PacAdvantage and the




coordination of data with the Carriers.




All issues are entered and followed up for the 




resolution of the issue.










Benefit Partners
Process Specification
Billing
1. Introduction
1.1. Purpose
The purpose of this document is to describe the process of Billing. This document identifies how the user interacts with the system, the data to be captured, the business logic to be implemented, and the output of the process.
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









BPI_SCOPE_FI_001
Finance - Business use case 




Specification - Billing










1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
2.1. Background
Billing is the process of creating the invoice for the Customers enrolled in the PacAdvantage program. The Invoice is on broad base classified into two—First Time Invoice (invoice to the group/member that has enrolled as new business) and Running invoice or periodic invoice (To the existing Group/Members).
2.2. Process Description
The objective of the Billing process is to:
1) Generate first time invoice to the groups/members who have enrolled as new business. The invoice should get all the information about the group/member prior to invoicing. Generation of first time invoice is an automated process and should be triggered on completion of group/member enrollment.

    
    
        2) Generate running invoice or periodic invoice to the existing groups/members. All the information about the existing group/members and their real time transaction details are required to invoice correctly.
    
    


This billing sub module also needs to have a feature to incorporate the following.
Suppress periodic Bill for a specific Group/Member or collective group and members
Preview invoice prior to creation of actual invoice.
Suppress late fee for a specific Group/Member or collective group and members
Calculate Reinstatement Fee for a specific Group/Member or collective group and members
Include feature to add dynamic content on the bills sent to the for a specific Group/Member or collective groups and members
Calculate additional fee for Credit card transaction if applicable.

    
    
        Calculate adjustment when there is retrospective change in Benefit Level (for the Carrier Selected) for group/member and make adjustments in the subsequent bill.
    
    


Calculate adjustment if the group/members have termed.
Generate manual invoice and preview invoices before generating them.

    
    
        All billing transactions would be period specific (i.e. the bills would be associated with the month of coverage). Invoices would be run only on a monthly basis, whatever is the billing frequency. For example if the billing frequency opted is quarterly. The excess amount would be adjusted as credits in the subsequent month's invoices.
        Invoice view/preview prior to generation of invoice needs to be provided in the Enrollment module.
    
    


2.3. Process Flow
Process For Billing—First Time Invoice

    
    
        1) Enrollment is completed for the new business prior to generation of First Time Invoice.
        2) All information relevant for billing (Generation of Invoice is gathered) These information are
        
            Group ID
            Group Billing Address
            Billing information for the group like billing frequency, mode of payment and relevant information for mode of payment like EFT or Credit Card.
            Employees and Dependents information
            Member count
            Employer Contribution
            Employee Contribution
            Raw Rate for Each of the Benefit Level for the specific Carrier selected by the employee (for specific Age bracket, Service Area, Coverage Choice with effective date)
            Rate differential based on member count (Group size) with effective date
            Admin fees for the specific group type with effective date.
            Agent commission that is defined in the Agent Info tab for the group if defined. Otherwise the default agent commission specified in the Carrier Maintenance Module (Agent Commission Fees) with effective date.
            Additional fees if any for the specific group type with effective date.
        
        
    
    


Process for Billing—Running Invoice (Periodic Invoice)

    
    
        1) Monthly or periodic invoice is sent to the existing group/members based on the Frequency selected by the group/member and the mode of communication preferred.
        2) Existing billing also gathers all information relevant for billing.
        3) In addition to this it also needs the previous invoice history to calculate the additional fees, late fees, reinstatement fees or as applicable.
        4) The running invoice generated is for the coverage period following the previous invoice period. I.e if the previous invoice was generated in the month of Jan. 5 2002 and for the coverage period February 2002, The invoice generate on Feb. 5 2001 would be for the coverage period March 2002,
        5) Billing should also calculate the Fees required for Credit Card transaction if applicable.
        6) Adjustment for Add On employee/dependent or member.
        7) Adjustment for Termed employee/dependent or member.
        8) Reinstatement fees Termed Group, employee/dependent or member are reinstated.
        9) Invoice once created by the system cannot be cancelled.
    
    


An invoice is considered closed only if the invoice has been reconciled. Hence all open invoices should be considered for late fee calculation.
3. User Interface
3.1. User Interface Screens
3.1.1. Suppress Batch Billing
3.1.1.1. Screen Snapshot (See FIG. J-1)
3.1.1.2. Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Bill Period
Option Box
Bill Period
Bill period for which batch billing is suppressed


Selected
Display Text
Selected 
Displays count of groups selected out of total


Groups

Groups
groups







Filter










Group Id
Text Box
Group Id
To filter groups based on group id


Group Name
Text Box
Group Name
To filter groups based on group name


Group Type
Option Box
Group Type
To filter groups based on group type


Group Size
Text Box
Group Size
To filter groups based on group size


ROE Date
Text Box
ROE Date - To
To filter groups based on ROE date of groups


Range





Effective Date
Text Box
Effective 
To filter groups based on effective date of groups


Range

Date - To



Rate Type
Option Box
Rate Type
To filter groups based on rate type


View
Option Box
View
To filter groups based on whether batch billing is





suppressed or not 


Filter
Command
Filter
Refreshes group selection table based on the filter





entered


Clear Filter
Command
Clear Filter
Clears the filter and displays all groups in the





group selection table


Groups
Selection

For selecting groups for export. Options for


Selection
Table

selection all groups, all groups in a page,





deselecting all and selection inversion are





available to the user.


New
Command
New
Clears the screen


Save
Command
Save
Saves the suppressed groups information to the





database









3.1.1.3. Screen Validations












Element Name
Action/Validation Details
Message







Bill Period
Check to see that billing 
“Please enter a valid 



period is not null
billing period”









3.1.2. Group Auto Bill Suppressing
3.12.1. Screen Snapshot (See FIG. J-2)
3.1.2.2. Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Run Id
Display Text
Import Id
Displays unique system 





generated id for the bill





process run


Bill Period
Option Box
Bill Period
Period for which batch 





billing is run


Run By
Display Text
Run By
Displays id of user who 





initiated the process


New
Command
New
Clears the screen


Process
Command
Process
Starts the batch billing 





process


View Status
Command
View Status
View status of batch 





billing process









3.1.2.3. Screen Validations












Element Name
Action/Validation Details
Message







Bill Period
Check to see that billing period is
“Please enter a valid 



not null
billing period”









3.1.3. Manual Bill
3.1.3.1. Screen Snapshot (See FIG. J-3)
3.1.3.2. Element Name, Element Type & Purpose













Element
Element




Name
Type
Label
Purpose















Bill Details










Bill #
Display Text 
Bill #
Displays unique system generated bill #


Bill Date
Display Text 
Bill Date
Displays bill date


Bill Period
Option Box
Bill Period
Period for which group is billed


Due Date
Display Text 
Due Date
Displays date on which bill is due


Status
Display Text 
Status
Displays the status of bill: Open or Reconciled


Reconciled
Display Text 
Reconciled Date
Displays date on which bill was reconciled


Date










Group Information










Group Id
Text Box
Group Id
Id of the group being billed


Group Type
Display Text 
Group Type
Displays group type


Group Name
Display Text 
Group Name
Displays group name


Association
Display Text 
Association
Displays name of association if group is enrolled


Name

Name
through one


Status
Display Text 
Status
Displays status of group


Rate Type
Display Text 
Rate Type
Displays the rate type for the group: blended or





non-blended







Billing Summary










Prior Bill
Display Text 
Prior period
Displays prior period bill amount for the group


Amount

billed amount



Adjustments
Display Text 
Adjustments
Displays adjustments total for the group




since prior





period



Payments
Display Text 
Payments
Displays payments made by the group from




received
previous bill


Past Due
Display Text 
Past due amount
Displays amount due from previous bill


Current Bill 
Display Text
Current bill
Displays current bill amount




amount



Total Due
Display Text 
Total due
Displays total due from the group







Employer LeveAdjustments










Adjustment
Option Box
Adjustment Type
Type of adjustment


Type





Amount
Text Box
Amount
Adjustment Amount


Period
Option Box
Period
Period for which adjustment entry is posted


Adjustments
Entry Table




Entry Table










Employee Level Adjustments










Employee
Display
Employee Name
Displays name of employee


Name
Column




Period
Display
Period
Displays adjustment period



Column




Plan Name
Display
Plan Name
Displays the name of the plan



Column




Plan Type
Display
Plan Type
Displays plan type



Column




Coverage
Display
Coverage Type
Displays coverage option selected by the


Type
Column

employee


# Members
Display
# Members
Displays member count under the employee's



Column

coverage


Premium
Display
Premium
Displays premium



Column




Admin Fee
Display
Admin Fee
Displays admin fee



Column




Agent Fee
Display
Agent Fee
Displays agent fee



Column




Total Premium
Display
Total Premium
Displays total premium



Column









Employee Level Detail










Employee
Display
Employee Name
Displays name of employee


Name
Column




Plan Name
Display
Plan Name
Displays the name of the plan



Column




Plan Type
Display
Plan Type
Displays plan type



Column




Coverage
Display
Coverage Type
Displays coverage option selected by the


Type
Column

employee


# Members
Display
# Members
Displays member count under the employee's



Column

coverage


Premium
Display
Premium
Displays premium



Column




Admin Fee
Display
Admin Fee
Displays admin fee



Column




Agent Fee
Display
Agent Fee
Displays agent fee



Column




Total Premium
Display
Total Premium
Displays total premium



Column









Bill Summary










Medical
Display Text
Subtotal -
Displays medical premium subtotal


Premium

Medical





Premium



Dental
Display Text
Subtotal - Dental 
Displays dental premium subtotal


Premium

Premium



Vision
Display Text
Subtotal - Vision 
Displays vision premium subtotal


Premium

Premium



CAM
Display Text
Subtotal - CAM
Displays CAM premium subtotal


Premium

Premium



Admin
Display Text
Administration
Displays total of member level admin fee


Member Fee

Member Fee



Agent Member
Display Text
Agent Member
Displays total of member level agent fee


Fee

Fee



Admin Flat
Display Text
Administration
Displays group level admin flat fee


Fee

Flat Fee



Agent Flat Fee
Display Text
Agent Flat Fee
Displays group level agent flat fee


Current Due
Display Text
Total Due
Displays current bill amount




Current Period



Past Due
Display Text
Add Past
Displays amount due from previous bill




Amount Due



Total Due
Display Text
Total Due
Displays total due from the group


New
Command
New
Clears the screen


Create
Command
Create
Creates the bill









3.1.3.3. Screen Validations












Element




Name
Action/Validation Details
Message







Bill Period
Check to see if bill period is not 
“Please enter a valid bill 



null and is valid
period”


Group Id
Check to see if group id is not 
“Please enter a valid group



null and is valid
id”


Adjustment
Check to see that the value for 
“Please enter a valid 


Type
the filed is not null and is valid
adjustment type”


Amount
Check to see that the value for
“Please enter a valid 



the filed is not null and is valid
adjustment amount”


Period
Check to see that the value for 
“Please enter a valid 



the filed is not null and is valid
adjustment period”









3.1.4. Billing Adjustments
3.1.4.1. Screen Snapshot (See FIG. J-4)
3.1.4.2. Element Name, Element Type & Purpose













Element
Element




Name
Type
Label
Purpose







Adjustment Id
Display Text
Adjustment Id
Displays unique system generated id for the





adjustment


Adjustment
Text Box
Adjustment Date
Adjustment Date


Date





Status
Display Text
Status
Status of the adjustment: Open or Reconciled


Group Id
Text Box
Group Id
Id of group for which adjustment entry is made


Group Type
Display Text
Group Type
Displays group type


Group Name
Display Text
Group Name
Displays group name


Association
Display Text
Association
Displays name of association if group is enrolled


Name

Name
through one


Group Status
Display Text
Group Status
Displays status of group


Adjustment
Option Box
Adjustment Type
Type of adjustment


Type





Amount
Text Box
Amount
Adjustment Amount


Period
Option Box
Period
Period for which adjustment entry is posted


New
Command
New
Clears screen for a new adjustment entry


Save
Command
Save
Saves the adjustment entry to the database


Search
Command
Search
Provides search functionality for adjustments









3.1.4.3. Screen Validations












Element 




Name
Action/Validation Details
Message







Group Id
Check to see that the value for
“Please enter a valid group



the filed is not null and is valid
id”


Adjustment
Check to see that the value for
“Please enter a valid 


Type
the filed is not null and is valid
adjustment type”


Amount
Check to see that the value for
“Please enter a valid 



the filed is not null and is valid
adjustment amount”


Period
Check to see that the value for 
“Please enter a valid 



the filed is not null and is valid
adjustment period”









3.2. Interface Flow
N/A
4. Business Rule Mapping











Activity
Rules







I - First Time Invoice
Blended


For Small Employer Group
(New Business) Note: All new business falls under blended



rate only










1.
Check All the member for Small Employer Group



2.
Check the Employee Raw Rate for the Specific Line of Coverage for the (Carrier




Selected) Benefit Level.



3.
Apply formula on the entire employee for all the line of coverage provided by the group




for the (Carrier Selected) Benefit Level (Age Bracket, Coverage Choice and Service




Area for the specific Employee). Refer Formula



4.
The Admin Fees, Agent Commission and Rate Differential Factor are governed by the




effective date. Apply the effective date for these fees with the Effective date for the




Group in deriving the Blended rate for the employees and the total amount payable by




the Group. However the Agent commission is based on the one provided at the group




level in the Agent Information Tab. It overrides the fee provided in the carrier




maintenance agent commission fees.



5.
Check if the initial payment made by the group equals the Total amount as derived




above. If not then check the difference. Allow for Reconciliation up to $2 without and




authorized intervention. For amount between $50-$3 Allow reconciliation based on




security. For amount above $50 allow reconciliation based on ultimate authority. (This




rule governs if the group can be enrolled or not. Hence there should be an invoice




preview that identifies the Cash received and the total amount due for the new business)




This should be viewable by all.



6.
The rate should be picked up based on the rules specified below:




Check the Effective date for the Group (Initial enrollment date)




Check the rate from the rate table whose effective date is latest but less than the




effective date of the Group. (E.g.) Group Effective date Mar. 1, 2001. Rate effective dates




Jan. 1, 2001 and Jul. 1, 2001. In this example since the group effective date is Mar. 1, 2001 the Rate




picked should be Jan. 1, 2001 effective date rate.



7.
Show the Employer Contribution and the Employee Deduction in the invoice summary.




Billing Address should be picked up based on the billing address provided by the group.




If billing address is not provided, then business address should be considered for billing.




Also check the mode of communication. If the group prefers to be mailed emailed or




faxed and accordingly transmit the invoice. Refer Sample Invoice 1 for the Small




Employer Group (New Business)









Note: Small employer may bring in the COBRA members. Bill the COBRA members



separately or along with the Group based on the decision made for billing the COBRA



Group.











If the COBRA members are billed separately. Generate a separate invoice for the each




subscriber COBRA members. Refer Rule for COBRA Member Invoice




However the bill for the COBRA members can be sent to the primary group if that




option is selected.




All COBRA Invoices whether billed to the primary group or the COBRA Group should




have a separate invoice for all the COBRA groups.








For COBRA Members
(New Business) Note: All new business falls under blended rate



only even for COBRA members brought by new business.










1.
Check the entire subscriber COBRA member for Small Employer Group (primary




Group).



2.
Check Coverage Choice for the Subscriber member for each lines of coverage and also




note that these line of coverage are selected by the Primary group.



3.
Check what are the line of coverage picked up be each of the members including the




subscriber member and their dependent.









Note: The rate for the COBRA member should be based on the following rule.











Identify the subscriber member line of coverage selected. The age, service area and the




coverage choice provided by the subscriber member is the governing rate.




If the subscriber does not select the line of coverage that the dependent member have




selected. Check if the dependent member have relation ship as spouse or child/children.




If the Relationship is spouse then the Spouse Age should be the deciding factor for the




rate and the coverage choice opted.




If the relationship is child/children then the eldest dependent member should be the




deciding factor for the rate based on the Age.









Note however in all the above cases the Service Area is governed by the Service area of



the Subscriber COBRA member.



Note: If the Primary COBRA member is a child they have their own Group ID and



their own line of coverage and benefit level.


For Individual
(New Business) Note: All new business falls under blended rate


Association Member
even for the individual association member.










1.
Individual association member can have dependent attached to the member.



2.
The rate for the individual association member is governed by the rate applicable for the




Guaranteed association based on the effective date for the Association.



3.
The individual members can have the same line of coverage as defined by the




association.



4.
The Admin Fee, Agent Commission, Additional fees and rate differential factor is as




applicable for the Association with the effective date.



5.
The calculation formula is the same as applicable for the employee of Small employer




group.



6.
The dependents for the individual association members are governed by what has been




selected by the subscriber individual association member.








Small employer Group
New Business) Note: All new business falls under blended rate


affiliated to association
even for the Small employer group affiliated to an association.










1.
Small employer groups affiliated with an association have the same rules as applicable




to the Small employer group with exception for the rate.



2.
The Admin fees, Agent commission, additional fees and Differential factor for the small




employer groups affiliated with an association are as defined for the Association with




effective date for the Association.



3.
However the Agent commission is based on the one provided at the group level in the




Agent Information Tab. It overrides the fee provided in the carrier maintenance agent




commission fees








II - First Time Invoice Formula
Blended for Small Employer Group



Blended Rate = (Raw Rate * Differential Factor)/(1 − Agent Commission % − Admin



Fee %)


Example






III - First Time Invoice Formula
Blended for COBRA Members


Example






IV - Running Invoice
Blended










1.
For Running invoice all that is applicable for first time invoice is applicable. In addition




to that the running invoice has the following as well:



2.
Late fee if applicable: Late fee charges are 5% on the Amount due in the prior




invoices. The late fee calculation rule is as follows:




Due Date:




Postmark date:




Received date:




If the post mark date for cash receipt is available it should fall on or before due date.




If postmark date is not available then if should check 5 calendar days backward from the




date received and see if it falls within the due date.




If the amount is received within the due date as per the above rules and is short late fee




is still applied for the shortage of premium.




If the above two conditions are not satisfied then late fee is charged for the Group or




member.









Note: Late fee is charged on the prior month's current premium



(e.g.) Due date is 1st of every month or the first business day of the month. Whichever is



applicable. For example Feb. 1, 2001



Date payment received : Feb. 1, 2001 No late fee



Date payment received is Feb. 2, 2001 and post marked Jan. 31, 2001 No late fee



Date payment received is Feb. 3, 2001 and post marked Feb. 2, 2001 late fee applicable



Date payment received is Feb. 6, 2001 and postmarked date not available. Look 5 days behind for



the date for receipt. I.e Feb. 1, 2001 hence no late fees



Date payment received is Feb. 8, 2001 and postmarked date not available. Look 5 days behind for



the date for receipt. I.e Feb. 3, 2001 hence late fees applicable.










3.
Balance forward if applicable: Balance forward is the amount balance from the




previous invoice or shortage of premium.



4.
Billing Adjustment: Billing adjustments can have various categories: Note The




adjustment can be positive or negative based on the coverage period.




Employee Coverage Choice Change




Employee/Dependent Benefit Level(Selected carrier) change




Employee/Dependent Termination




Employee/Dependent Add On




Rate for the Benefit Level Offered by the carrier changes retrospectively. I.e over




writing the previous effective date that was applicable for the group.



5.
Credit Card Payment transaction fee if applicable: Credit card transaction fee is




2.5% of the total amount due for the group/member



6.
NSF Check if applicable: $25 handling fees is charged for the NSF check.



7.
Reinstatement fees: (Reinstatement fees are on the following assumption that on the




date of term all the previous balances on the group are settled.) The group needs to be




reinstated on the date next to the term date. The Amount due for the reinstatement from




the date following the term dates to the current month when the group is reinstated.









(e.g.) Group Term Date: Feb. 31, 2001











Date when the group was reinstated May 10, 2001









Effective reinstatement date is Mar. 1, 2001. Reinstatement fees is calculated for the Period Mar. 1, 2001



I.e. the month when the reinstatement occurred. The invoice contains the premium due for



the next month as well i.e. Jun. 1, 2001. However the current amount due is based on the current



period i.e. from Mar. 1, 2001 to May 31, 2001, Next months period Jun. 31, 2001 and reinstatement fees



Percentage on the premium due when reinstatement occurred (The amount on which the



reinstatement fees is calculated.)



Note: Subsequent billing cycle would contain the Reinstatement Adjustments and



Reinstatement fees on reinstatement for the group/member.



A reinstatement fee is 10% of the premium due when reinstatement occurred.


V - Running
Non- Blended


Invoice




Note: The difference in the rules for non-blended and blended is in the rate calculation



rules. The rest of the processes are same as for the blended.


Formula
Formula for Non - Blended Rates



The formula for the premium calculation for the invoice Non - Blended is as



follows



(Non-Blended)



a) Raw Rate



b) Agent Commission per Member



c) Agent Commission per Group based on group size



d) Admin fee per Member



e) Admin fee per Group based on group size



f) Additional Fees



g) Differential factor



Member Level Fees = Raw Rate + Member Count * (Agent Commission Per



Member + Admin Fee Per Member)



Note (If differential factor is applicable then Raw rate should be factored i.e



Raw Rate * Differential Factor)



Group Level Fees = Agent Commission per Group Size + Admin Fees per



Group size



Total Non Blended Premium Billed to Group =



Member Level Fees + Group Level Fees


Example
Raw Rate = $100



Agent Commission per Member = $10



Agent Commission per Group based on group size = $50 for Group size =>



15



Admin fee per Member = $10



Admin fee per Group based on group size = $50 for Group size =>



15



Additional Fees = 10 % on Raw Rate



Differential factor



Employee1 Member count including employee = 3



Employee2 Member count including employee = 2



Employee3 Member count including employee = 4



Employee4 Member count including employee = 5



Employee5 Member count including employee = 1



Total Member count = 15



Group size (=>15) = 15



Member Level Fee



Employee1 = 100 + 3 (10 + 10) = $160



Employee2 = 100 + 2 (10 + 10) = $140



Employee3 = 100 + 4 (10 + 10) = $180



Employee4 = 100 + 5 (10 + 10) = $200



Employee5 = 100 + 1 (10 + 10) = $120



Member Level Fees = $800



Group Level Fees = $50 + $50 + $100



Total Non Blended Premium Billed to Group =



Member Level Fees + Group Level Fees = $800 + $100 = $900



This formula is for the specific Benefit Level (offered by carrier) for a specific line of



coverage and a specific employee/member.



The total amount billed to group should include all the Rates after applying this formula



for all the employees/members and their line of coverage.


Formula
Formula for Non - Blended Rates


Example
The formula for the premium calculation for the invoice Non Blended for Cal



COBRA is as follows:



Member Premium for Cal COBRA = Raw Rate * (1 + Additional fee %)



Example:



Member Premium for Cal COBRA = 100 * (1 + 0.10) = $110



Amount Billed to COBRA Group = $110



This formula is for the specific Benefit Level (offered by carrier) for a specific line of



coverage and a specific employee/member.



The total amount billed to COBRA Subscriber member should include all the Rates after



applying this formula for all the members and their line of coverage.









Benefit Partners Inc
Process Specification
Cash Receipt
1. Introduction
1.1. Purpose
The purpose of this document is to describe the process of Cash Receipt. This document identifies how the user interacts with the system, the data to be captured, the business logic to be implemented, and the output of the process.
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









BPI_SCOPE_FI_002
Finance - Business use case 




Specification - Cash Receipt










1.3. Definitions, Acronyms & Abbreviations














Term
Explanation









EFT
Electronic Fund Transfer










2. Process Identification
2.1. Background
Cash Receipt is the process of entering the cash received by BPI into the system. The cash receipt can be received in various modes as defined by the business process. Cash Receipt includes Lock Box receipts, Check, Credit Card, EFT and Transfer.
2.2. Process Description
This Cash Receipt sub module also needs to incorporate the following.

    
    
        1) Enter the lock box payment received as a batch process into the system
        2) Enter EFT payment received as a batch process into the system
        3) EFT payment made directly to Wells Fargo Bank
        4) On line payment using the Credit Card and Check
        5) User interface to make payment over phone by Credit card or Check
        6) Credit Card payment with automatic pulling of the cash or manually on request
        7) Handle negative check i.e. NSF's, Refund and Transfer.
        8) Transfer of cash from one group to the other.
    
    


This Cash Receipt sub module also needs to have a feature to incorporate the following.

    
    
        Batch the cash receipt based on the batch number defined.
        There should be ability to batch each of the modes of the payment received into a separate batch.
        For EFT, Credit Card, On Line Check and Lockbox payments there should be ability to upload the files into the system as one batch. Reconciliation will follow once the batch is imported and closed.
        In addition, prior entry of Lock box total entry made needs to tally with the lock box total.
    
    


This document details only one mode of cash entry namely, Manual Batch. Lockbox, EFT and payments through credit cards are detailed in their respective process specification documents.
2.3. Process Flow
Cash receipts into the system can be from the following sources:

    
    
        EFT
        Check received at BPI
        Lock Box file
        On line Credit Card
        Check or Credit card over phone
    
    


The cash received by any of the above mode is batched and entered into the system. The batch number is identified based on the mode of payment receipts. All batches should be identified uniquely with batch number and timestamp.
The Payment received are either entered manually into the system or uploaded into the system from the files available. The batch total and sum of the entries made in each batch should tally before saving the batch.
Batch date should represent the deposit date.
Batch Types are:

    
    
        1. Manual Batch
        2. NSF Batch
        3. Returns Batch
        4. Positive Transfer
        5. Negative Transfer
        6. Lockbox Check
        7. Auto-Batch EFT
        8. Direct Deposit
        9. Wire Transfer
        10. CC over phone
        11. Auto-Batch Credit Card
        12. Online Credit Card
    
    


3. User Interface
3.1. User Interface Screens
3.1.1. Manual Cash Batch
3.1.1.1. Screen Snapshot (See FIG. J-5)
3.1.1.2. Element Name, Element Type & Purpose













Element
Element




Name
Type
Label
Purpose















Batch Information










Batch Id
Display Text
Batch Id
Displays unique system generated id for the batch


Batch Date
Text Box
Batch Date
Batch Date


Batch Total
Display Text
Batch Total
Displays total of all cash entries


Batch Type
Option Box
Batch Type
Type of manual batch. Possible options are





Manual Batch, NSF Batch, Returns Batch,





Positive Transfer, Negative Transfer


Tape Total
Text Box
Tape Total
Tape total of all cash entries


Tape Balance 
Display Text
Tape Balance 
Displays difference between the tape total and





total of cash entries entered


Batch Status 
Display Text 
Batch Status
Displays status of batch: Open or Closed







Check Information










Postmark Date
Text Box
Postmark Date
Date on which the payment was postmarked


Received Date
Text Box
Received Date
Date on which payment was received


Check #
Text Box
Check #
Check number


Check Amount 
Text Box
Check Amount
Check amount







Check Distribution










Group Id
Text Box
Group Id
Group against which payment is allocated


Group Name
Display Text
Group Name
Displays name of selected group


Amount
Text Box
Amount
Amount allocated to the group out of the total





payment amount


Comments
Option Box
Comments
Standard comments for the payment, if any


Others
Text Box
Others
To enter any comments other than the standard





ones


Payment 
Editable Table

Displays all payment entries for the batch for


Entries


editing


New
Command
New
Clears screen for a new batch entry


Save
Command
Save
Saves the batch information to the database


Close
Command
Close
Closes the batch. A batch can not be edited after





closing


Search
Command
Search
To search for saved batches









3.1.1.3. Screen Validations












Element




Name
Action/Validation Details
Message















Batch Information









Batch 
Check to see if batch date 
“Please enter a valid batch date”


Date
is not null and is valid



Batch 
Check to see if valid 
“Please select a valid batch type”


Type
batch type is selected



Tape 
Check to see if tape total 
“Please enter a valid tape total”


Total
is not null and is valid








Check Information









Postmark 
Check to see if postmark
“Please enter a valid postmark date”


Date
date is not null and is 




valid



Received
Check to see if the 
“Please enter a valid received date”


Date
received date is not null 




and is valid



Check #
Check to see if check 
“Please enter a valid check number”



number is not null and is




valid



Check 
Check to see if check 
“Please enter a valid check amount”


Amount
amount is not null and is




valid








Check Distribution









Group Id
Check to see if group id is 
“Please enter a valid group id”



not null and is valid



Amount
Check to see if amount is
“Please enter a valid amount”



not null and is valid









3.2. Interface Flow
N/A
4. Business Rule Mapping











Activities
Rules







Batch Entry
Unique id should be created for each batched. The batch



total should be tallied to the individual sum before saving



the batch. The batch id should be uniquely generated 



prior to creation of batch. Each cash receipt should have



the postmark date, date received and the system date (I.e 



the date when the batch is created) and batch total. The 



line items within each batch should have a feature to 



Split the payment for multiple group ids if required.



Batch date should be the deposit data.



Any entries made to the batch can be saved prior to 



completion of the batch entries. However there would be 



a status for the batch which would indicate if the batch is



closed or not. Modification can be done only to the batches



that are open. Any batch that is closed cannot be modified. 



If there is an erroneous entry for the batch and the batch 



is saved. Only Transfer can be done and it is not allowed 



to delete the batch that are closed. Only the batches that are 



closed can be reconciled.


Batch by File
The batch that are created by uploading the files like for 


Uploads
Lockbox, EFT or Credit Card will have an identification 



that payment for this batch was made by Lockbox, EFT



or Credit Card. These batches are always closed.


Negative
NSF would be entered into the system and there would


Check (NSF)
be an indicator indicating that this batch is a NSF batch.


Transfer
Cash transfer may be due to the reason that the Cash has 



been wrongly enter for the group to which the cash does 



not belong. In such cased entering negative cash receipt 



for the Group for whom the cash has been wrongly entered 



and making positive cash to the group to whom the cash



belongs makes the cash adjustment. There should be a 



positive and negative cash adjustment.


Returns
Refund would be a batch and would be handled similar to



the NSF Check.









Benefit Partners Inc
Process Specification
Cash Reconciliation
1. Introduction
1.1. Purpose
The purpose of this document is to describe the process of Cash Reconciliation. This document identifies how the user interacts with the system, the data to be captured, the business logic to be implemented, and the output of the process.
1.2. Business Use Case Specification Reference











Business Use Specification ID
Business Use Case Name







BPI_SCOPE_FI_003
Finance - Business use case 



Specification - Cash Reconciliation









1.3. Definitions, Acronyms & Abbreviations














Term
Explanation









EFT
Electronic Fund Transfer










2. Process Identification
2.1. Background
Cash Reconciliation is the process of reconciling the cash receipts to individual invoices and reconciling the amount paid by the group.
The objective of the Cash Reconciliation process is to reconcile:

    
    
        1) Billed amounts and cash receipt
        2) Cash to negative cash
        3) Adjustment to cash
        4) Adjustment to billed amounts
        5) Billed amount to itself if the total due results in zero
        6) Adjustment to Adjustment
    
    


2.2. Process Flow and Description
Process for Cash Reconciliation:

    
    
        Reconciliation is the process of matching one to one the cash received on hand and the invoices that are open. The cash are received by numerous ways as described in BPI_CAS_FSD_FI—02 (Cash Receipt). The invoice is generated for the various groups/members based on the premium due. These invoices are matched with the cash receipts and reconciled.
    
    


The rule for reconciliation should be as follows:

    
    
        1. Look for the Negative Cash available and reconcile it with the positive cash (for NSF checks).
        2. Look for the oldest unreconciled invoice and reconcile with the oldest cash.
    
    


The reconciliation process should look through all the invoices that have not been reconciled for a specific group and reconcile the invoice that has the earliest date with the cash received. It should also match the Cash receipt with the invoice amount.
Note: reconciliation process is started automatically when the cash receipt batch is closed and it reconciles the cash received with the invoices.

    
    
        Billed amounts and cash receipt: This reconciliation process is to reconcile the invoice that has not yet been reconciled for the specific group and check if the invoice is earliest un reconciled invoice for the specific group and reconcile the invoice with the cash received form the group/member.
        Cash to negative cash: This is the process of reconciling the negative cash with the positive cash received from the group. This case arises when there is a NSF check and the group's invoice has been reconciled. The bank usually notifies NSF check and then NSF Cash receipt entry is created in the system. Now on receipt of a replacement check against the NSF check the NSF check is reconciled with the replacement check provided the amount tallies.
        Adjustments to Cash: This is the process of reconciling the cash receipt with the adjustment that may be available in the next invoice. Example: If the group has received the invoice for the next month and they have an employee termed this month after the generation of invoice. The generated invoice would not identify this adjustment for the termed employees as the employee was termed after creation of invoice. But the Group may deduct the adjustments for the termed employee and send the cash that would be short as they would sent the check with the adjustments. Hence this process should identify such conditions and adjust the cash receipt for the invoice with adjustment taken in to account. The next invoice would show the cash receipt and the adjustment for the employees termed. This process can also be coined as “Reconciled but not billed”.
        Adjustment to billed amounts: This process identifies the invoices that are already billed to the group and any adjustments that are not made in the current invoice needs to be adjusted in the next invoice with the adjustments made.
        Billed amount to itself if the total due results in zero: This is process identifies if the group is termed and the invoice is already created for the group for the next month. Invoice would be created for the termed group on group termination and would adjust that with previous invoice. There would always be a final invoice for the termed groups showing adjustments that would include refund, or short fall or zero balance.
        Adjustment to Adjustment: This process is for adjusting the late fee with late fee is waived, Reinstatement fees with reinstatement fee waive as the case may be. If the Late fee is shown in the previous invoice that can be adjusted by waiving late fee or reinstatement fees as applicable. Example: Late fees may be $25.00 and waive late fees would be $−25.00. Here adjustment to adjustment would be $25 to $25. Also adjustment needs to be made on invoice with invoice.
    
    


3. User Interface
3.1. User Interface Screens
3.1.1. Manual Reconciliation
3.1.1.1. Screen Snapshot (See FIG. J-6)
3.1.1.2. Element Name, Element Type & Purpose













Element
Element




Name
Type
Label
Purpose















Group Information










Group Id
Display Text
Group Id
Displays id of the group


Group Type
Display Text
Group Type
Displays group type


Group Name
Display Text
Group Name
Displays group name


Association
Display Text
Association
Displays name of association 


Name

Name
if group is enrolled through 





one


Status
Display Text
Status
Displays status of group


Rate Type
Display Text
Rate Type
Displays the rate type for the 





group: blended or non-





blended


Left to
Display Text
Left to 
Displays amount left to be 


balance

balance
reconciled







Bill Information










Bill #
Display
Bill #




Column




Coverage
Display
Coverage 



Period
Column
Period



Due Date
Display
Due Date




Column




Bill Date
Display
Bill Date




Column




Bill Total
Display
Bill Total




Column




Total Due
Display
Total Due




Column









Adjustments Information










Adjustment Id
Display
Adj. Id




Column




Adjustment
Display
Adj. Type



Type
Column




Adjustment
Display
Adj. Date



Date
Column




User Id
Display
User Id




Column




Coverage
Display
Cvrg Month



Month
Column




Amount
Display
Amount




Column









Cash Receipts










Batch Id
Display
Batch Id




Column




Postmarked
Display
Date PM



Date
Column




Date Received
Display
Date Recd




Column




Check #
Display
Check #




Column




Batch Type
Display
Batch Type




Column




Payment
Display
Pmt Amt



Amount
Column




Unused
Display
Unused Amt



Amount
Column




Comments
Display
Comments




Column




Post
Command
Post
Post reconciliation entries


Reconciliation

Recon-





ciliation



Clear
Command
Clear
Clears screen for a new





import.


Search
Command
Search
Provides functionality to 





search groups









3.1.1.3. Screen Validations
Note: Reconciliation can have any of the possible combination provided below:

    
    
        1) Invoice to Invoice
        2) Invoice to Cash receipt
        3) Invoice to Adjustment
        4) Cash receipt to cash receipt
        5) Cash receipt to adjustment
        6) Adjustment to adjustment
    
    


Hence, the validation for the amount left to balance is done based on any of the combination selected from the check boxes.
Note: Adjustments would be shown only under special conditions where term has been initiated after generation of invoices and the group pays short taking this adjustments into account.
3.1.2. Billing & Payments History
3.1.2.1. Screen Snapshot (See FIG. J-7)
3.1.2.2. Element Name, Element Type & Purpose













Element
Element




Name
Type
Label
Purpose















Group Information










Group Id
Display Text
Group Id
Displays id of the group


Group Type
Display Text
Group Type
Displays group type


Group Name
Display Text
Group Name
Displays group name


Association 
Display Text
Association
Displays name of association 


Name

Name
if group is enrolled through





one


Status
Display Text
Status
Displays status of group


Rate Type
Display Text
Rate Type
Displays the rate type for the





group: blended or non-





blended







Bill Information










Bill #
Display
Bill #




Column




Coverage
Display
Coverage 



Period
Column
Period



Due Date
Display
Due Date




Column




Bill Date
Display
Bill Date




Column




Bill Total
Display
Bill Total




Column




Total Due
Display
Total Due




Column









Adjustments Information










Adjustment 
Display
Adj. Id



Id
Column




Adjustment
Display
Adj. Type



Type
Column




Adjustment
Display
Adj. Date



Date
Column




User Id
Display
User Id




Column




Coverage
Display
Cvrg Month



Month
Column




Amount
Display
Amount




Column









Cash Receipts










Batch Id
Display
Batch Id




Column




Postmarked
Display
Date PM



Date
Column




Date 
Display
Date Recd



Received
Column




Check #
Display
Check #




Column




Batch Type
Display
Batch Type




Column




Payment
Display
Pmt Amt



Amount
Column




Unused
Display
Unused Amt



Amount
Column




Comments
Display
Comments




Column




Search
Command
Search
Provides functionality to 





search groups









3.1.2.3. Screen Validations
NA
3.2. Interface Flow
N/A
4. Business Rule Mapping











Activities
Rules







Automated
Automatic Reconciliation would be done on closing the batch for the cash receipt. If the


Reconciliation
cash receipt batch were closed then it would start the reconciliation process.



The following process would be auto reconciled:



Billed amounts and cash receipt



Adjustment to cash



Billed amount to itself if the total due results in zero



Adjustment to billed amounts


Reconciliation
Reconciliation process would look for the earliest un reconciled invoice and reconciles it


for the Existing
provided it is less than $+_2.00.


Groups
Reconciliation would be as per the following sequence.



Look for the Negative Cash available and reconcile it with the positive cash (for NSF



checks).



Look for the oldest unreconciled invoice and reconcile with the oldest un-reconciled



cash and so on.



On Reconciliation the entire invoice, cash receipts would have a status as reconciled.


Manual
This process would trigger reconciliation manually based on authority or if the user is trying


Reconciliation
to reconcile and specific cash receipts with the invoice as the case may be. Manual



reconciliation can be does only for those invoices that has not reconciled automatically


Manual
Cash to negative cash


Reconciliation
Adjustment to Adjustment



Any reconciliation that is not completed by automatic reconciliation process would be



reconciled manually.


Formula for
General formula for reconciliation would be as follows:


reconciliation
Billed amounts and cash receipt = (Invoice Amount − Cash Receipt)



Adjustment to cash = (Adjustment − Cash Receipts)



Billed amount to itself if the total due results in zero = (Invoice Amount + Invoice Amount)



Adjustment to billed amounts = (Adjustment Amount + Invoice Amount)



Cash to negative cash = (Cash receipt + cash receipt)



Adjustment to Adjustment = (Adjustment + adjustment)



General formula = (Invoice Amount + Adjustment Amount − Cash Receipt Amount)



Example



Invoice = $1000.00, Cash receipt = $−100.00, Cash receipt = $918.00,



Adjustment = $−100.00, Adjustment = $−80.00



Amount that can be Reconciled = 1000 − (−100) − (800) + (−100) + (−80) = 1000 + 100 − 918



−100 − 80 = $2.00 This $2.00 is balance forward for the subsequent invoice.


New Business
Excluding COBRA and Individual Association Members who follow the reconciliation rules


Reconciliation
as per the Existing Group, the new business groups is auto reconcile if within $ +−2.00. If



the amount is short by $100.00 the invoice and the cash receipt would be reconciled and the



short fall would be balance forward in the next invoice. PacAdvantage Fund (A Cash



Receipt Batch auto generated by the system) would adjust this short fall. This would be



based on authority (Finance/GMS).



Also for the new business the auto reconciliation process would apply to reconcile the



Invoice Generated on successful enrollment with the cash receipt as initial enrollment



payment.









Benefit Partners Inc
Process Specification
Risk Adjustment
1. Introduction
1.1. Purpose
The purpose of this document is to describe the process of Risk Adjustment. This document identifies how the user interacts with the system, the data to be captured, the business logic to be implemented, and the output of the process.
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









BPI_SCOPE_FI_007
Finance - Business use case




Specification - Risk Adjustment










1.3. Definitions, Acronyms & Abbreviations














Term
Explanation









EFT
Electronic Fund Transfer










2. Process Identification
2.1. Background
Risk Adjustment is the process of accessing the risk borne by each of the Carrier in paying for the claims submitted to them by members.
Risk adjustment factor is assigned to the Carrier. Based on these factors the carrier may be classified as Payers, Receivers or None (if no factor is assigned).
Payers are the one who pays in the risk adjustment amount to the Pool. Receivers are the one who receives the Risk Adjustment amount from the pool.
These risk adjustment factors are pre-defined by PacAdvantage.
2.2. Process Description
The objective of the Risk Adjustment process is to:

    
    
        1) Provide for upload of Risk Adjustment (RA) factors in the form of text files into PX2 system
    
    


The uploaded data would subsequently be used in cash disbursement reports for suggesting the amount to be paid out to carriers after application of RA factors.
The following are the other requirements that will be supported and constraints on the proposed system:

    
    
        1) The system will maintain a log of all zip codes and service area imports. The log information will include the user, the day & time of import, the file path & format and the status of the import.
    
    


2.3. Process Flow
Process for Upload of Risk Adjustment Factors

    
    
        1) The import file and an effective date for import are all input from the user.
        2) The system checks to see if the file data is per the format expected. If not, an error is reported.
        3) If data already exists for an effective date, the system prompts to the user as to whether it should overwrite the data or cancel the import.
        4) The system imports Risk Adjustment factors to its database.
    
    


3. User Interface
3.1. User Interface Screens
3.1.1. Risk Adjustment Factors Import
3.1.1.1. Screen Snapshot (See FIG. J-8)
3.1.1.2. Element Name, Element Type & Purpose













Element
Element




Name
Type
Label
Purpose







Import Id
Display Text
Import Id
Displays unique id for





the import


Status
Display Text
Status
Displays status of





import


Imported By
Display Text
Imported By
Displays id of user who





did the import


Import Date
Display Text
Import Date
Displays date on which





import was done


Import File
Text Box
Import File
Full path of the file to





be imported


Effective Date
Text Box
Effective Date
Date on which the RA





factors becomes effective


New
Command
New
Clears screen for a new





import.


Import
Command
Import 
Starts the import process


Search
Command
Search
Provides functionality 





for search of imports









3.1.1.3. Screen Validations












Element 




Name
Action/Validation Details
Message







Import 
Check to see that the value 
“Please enter a valid 


File Name
for the field is not null
import file name”


Effective 
Check to see that the value for 
“Please enter a valid 


Date
the filed is not null and is valid
effective date”









3.2. Interface Flow
N/A
4. Business Rule Mapping











Activities
Rules







Risk
The formula for risk Adjustment factor is as given below:


Assessment
Raw Rate = Premium Amount (Raw Rate for Medical Line


Formula
of coverage and the benefit level for the specific carrier 



opted by the member)



Adjustment Factor = Fixed dollar amount per member count 



(can be negative or positive based on whether the Carrier 



is receiver or payer) 



Positive is the receiver and negative is the payer.



Risk Adjustment amount = Raw rate + (Risk Adjustment



factor * member count for that plan)



Example



Adjustment Factor = $ + 5.00 for Aetna (receiver)



Adjustment Factor = $ − 2.00 for Health Net (payer)



Employee 1 = $400 with (4 member inclusive of 



employee) Aetna



Employee 2 = $300 with (2 member inclusive of 



employee) Health net



Employee 3 = $200 with (1 member inclusive of 



employee) Health net



For Health net



300 + (−2 * 2) + 200 + (−2 * 1) = 304 + 202 = 494.00



For Aetna



400 + (5 * 4) = $420.00





Note:


the adjustment factor has an effective date attach to it. Normally it is loaded once in 6 months.






Benefit Partners Inc
Functional Specification Document
Mail Merge
1. Introduction
1.1. Purpose
The purpose of this document is to describe the functional requirements for the Mail Merge module. This document provides a brief description of the module functionality and identifies all the integration points with other modules.
This document is to be read in conjunction with the BPI Scope document, which identifies all the business use cases for the proposed system. For each business use case or a set of logically related use cases, a detailed process specification document is prepared. The process specification document identifies how the user interacts with the system, the data to be captured, the business logic to be implemented, and the output for each business use case. This document consists of forward references to all the process specifications associated with the Mail Merge module.
1.2. Scope Document Reference
This section provides the scope document references for the module.












Scope Document




Reference
Document Description
Version







BPI_SCOPE
Scope Document for BPI
1.0


BPI_SCOPE_ADD
Addendum to the BPI scope document
1.0









1.3. Process Specification Document Reference
This section provides the forward references to the process specification document for the module.

















Process Specification 
Document Description
Version



Document Reference










1.4. Definitions, Acronyms and Abbreviations











Term
Explanation







Mail Merge
Mail merge is the process of populating predefined



templates with dynamic data to extract business 



correspondences like quotes, letters to groups, agents etc.









2. Module Functionality
2.1. Brief Description
The Mail Merge module addresses the functionality of the system where it needs to generate business correspondences using predefined templates. The templates are basically RTF files with placeholders for dynamic data in them. The output is usually a RTF file, but at times this could be a PostScript or a PDF document. The diagram below illustrates the mail merge process. (See FIG. K-1)
Benefit Partners, Inc uses a lot of mail merge templates for their business correspondences. There are around 150 templates that are in use today.
The proposed system will also maintain a log of mail merge letters generated. The log information includes the template id, timestamp, triggering application, user generating the letter, and to whom the letter is addressed (i.e., which group or member or agent).
3. Letter Regeneration
3.1. Brief Description
Benefit Partners, Inc would like to have functionality where a letter can be reproduced exactly as the original at a later point in time without having to store a whole electronic copy of the original letter. This functionality would be achieved by storing just the dynamic text that goes into generation of the original letter and the template used for the original letter in a persistent medium. When a letter has to be reproduced the template used for the original letter and the dynamic text are retrieved from the persistent medium and merged to produce a copy of the original letter.
3.2. Storing the Template
The proposed functionality requires the template used for generation of the original letter, to be available at the time of reproducing the letter. This would be achieved by versioning the templates whenever there is a change to template. All the versions of a template would be maintained, as electronic copies, for achieving the proposed functionality. The current version to be used for each template would be specifiable in a configuration file (XML).
3.3. Storing the Dynamic Text
The dynamic that goes into generated letter would be stored as an entity (column) in a database table. The dynamic text would be stored as a key-value pair that maps each placeholder in the template with the data that goes in the placeholder. The likely database structure for the table that holds the dynamic data is shown in the “Data Structures” section.
3.3.1 Implementation Notes
Since the size of the dynamic text is relatively huge and varying for different letters, it would be stored as a long field in the database. Most of the database implementations (especially IBM DB2 UDB) suggest that a table containing long fields be placed on a separate storage disk in order to avoid a performance hit. With an idea on the average number of letters generated by Benefit Partners, Inc, it is estimated that the data size growth would be at the rate of 3.5-5 GB per year.
3.4. Reproducing a Letter
The proposed functionality would require a new application to reproduce a letter. The user would be able to search previously generated letters using different parameters like date and time of generation of original letter, type of letter (welcome, term, reinstate etc), intended addressee etc. The system would fetch the version of template used, retrieve the dynamic text from the database and reproduces the letter.
3.4.1 User Interface (See FIG. K-2)
3.4.1.1 Screen Fields Explanation













Element
Element




Name
Type
Label
Purpose







Period
Text 
Letters 
To specify a criteria for searching 



Boxes
generated
letters based on generated date




between . . .
and time


Type 
Option 
Type 
To specify a criteria for searching


of letter
Box
of letter
letters based on the type of letter.





Letter types are welcome, term, 





add-on etc


Addressee
Text Box
Addressee
To specify a criteria for searching





letters based on letter addressee. A





lookup option is provided to search





groups, employees, agents etc.


Searched
Display 

Displays letters that match the 


Letters List
Table

search criteria.


Generate
Command
Generate
Reproduces selected letters.


Selected

Selected









4. Mail Merge Templates
The following table lists out the mail merge templates to be used in the proposed system.
Note: Unless specified otherwise, delivery mode is addressee's preferred mode of communication.

















Category/


Trigger 

Dlry


#
Module
ID
Description
Process
A/M
Mode





















1.
Group
001
New group welcome
New Biz
A







Enrollment




2.
Group
002
Notification of adding new
EE Add-on
A






employee





3.
Group
003
Notification of adding
DEP Add-on
A






dependent when employee is








already enrolled





4.
Group
004
Missing information for new
New Biz
A






group
Enrollment




5.
Employee (add-
005
Missing information for new
EE Add-on/
A




on/changes)

employee adding to existing
Changes







group





6.
Group
006
Denial to enroll add-on
EE/DEP Add-
A






(employee or dependent)
on




7.
Group
007
Notification of employee
EE Term
A






and/or dependent term





8.
Group
008
Notification of group changes 
GRP Changes
A






processed





9.
Group
009
Notification of overdue
Cash
A






premium
Reconciliation
&








M



10.
Group
011
Notification of employee or
EE/DEP
A






dependent changes processed
Changes




11.
Group
012
Notification of employee

M






retroactive termination





12.
Group
013
Missing info request dependent
DEP Add-on/
A







Changes




13.
Group
014
Denial of reinstatement
GRP
A







Reinstatement




14.
Group
015
Approval of reinstatement
GRP
A







Reinstatement




15.
Cobra and
016
Request for missing
COBRA
A




CalCobra

information
Enrollment




16.
Group
017
Termination for non-payment
GRP
A






of premium with reinstatement
Termination




17.
Group
018
Termination for non-payment
GRP
A






of premium with no
Termination







reinstatement option





18.
Group
019
New group not qualified
New Biz
A






(declined)
Enrollment




19.
Employee (add-on)
020
Notification of add-on
EE Add-on
A






employee to existing group





20.
Employee
021
Notification of employee term
EE Term
A




(termination)







21.
Employee (group
022
Notification of retroactive
GRP Term
A




termination)

group term due to shortage of








premium





22.
Employee (group
023
Notification of group term
GRP Term
A




termination)







23.
Employee
024
Notification of employee
EE/DEP
A




(changes)

changes processed
Changes





Dependent

Changes processed for








dependent





24.
Employee (group
025
Notification that group has
GRP Changes
A




termination of line

terminated a line of coverage






of coverage)







25.
Employee
026
Notification of retro-
EE Term
A




(termination)

termination





26.
Employee (group
027
Notification to employee of
GRP
A




reinstatement)

group's reinstatement
Reinstatement




27.
Group
028
Group Requalification approval
ROE Process
A



28.
Group
029
Termination for non-
ROE Process
A






requalification





29.
Employee
031
Notification to employee of
DEP Add-on
A




(dependent new

dependent enrollment when






enrollment)

employee is already enrolled





30.
Group
032
Notification of termination of
GRP Changes
A






line of coverage





31.
Group
037
Voluntary termination
GRP Term
A



32.
Group
038
Missing information at ROE or
ROE Process
A






O/E





33.
Agent
040
New agent welcome letter
Agent Creation
A



34.
Employee (add-on)
041
CalCobra initial notification
EE Add-on
A
USPS





(always sent 2 business days








after letter 020. Must be








mailed USPS





35.
Group
042
Denial of group change
GRP Changes
A



36.
Group
043
Denial of change for employee
EE/DEP
A






or dependent
Changes




37.
Employee
044
Notification of CalCobra rights 
EE Term
A
USPS



(termination

(always send 2 business days








after letter 007. Must be








mailed USPS.





38.
Agent (group,
046
Cover letter for agents

A




employee or

regarding group, employee, and






dependent)

dependent correspondence.





39.
Group
052
Notification of waiver of late
Late fee waive
A






fee





40.
Group
053
Manual letter Declaration of

M






Eligibility for over age 23








Dependent Child





41.
Group
054
Manual letter Certification of

M






Corporate Wage Earner of Self








Employed Income





42.
Group
055
Manual letter Termination due

M






to Shortage of premium





43.
Group
057
Manual letter Notification of

M






employee on disability





44.
Group
058
Manual letter Verification of

M






employee on un-paid leave





45.
Association
060
Individual member termed due
ROE Process
A




(requalification)

to non-requalification





46.
Cobra and
070
New Cobra/CalCobra welcome
COBRA
A




CalCobra

letter
Enrollment




47.
Cobra and
071
Cobra/CalCobra terming due to
Automated
A




CalCobra

ending of continuation period.
Process







Letter needs to be sent 60 days








prior to the coverage end date.





48.
CalCobra
072
CalCobra Voluntary
Cal-COBRA
A






termination prior to
Term







continuation end date





49.
Cobra
073
Cobra Voluntary termination
COBRA Term
A






prior to continuation end date





50.
Cobra and
074
Termination due to non-
COBRA Term
A




CalCobra

payment of initial








Cobra/CalCobra premium





51.
Cobra and
075
45 day premium notice
Automated
A




CalCobra


Process




52.
Cobra and
076
Ineligible for Cobra/CalCobra
COBRA
A




CalCobra


Enrollment




53.
Employee
078
Employee term notice with no
EE Term
A






Cobra option





54.
Grievance
080
Group denial of late fee waive
Late fee waive
A



55.
Grievance
081
Group denial of copay change
Appeals &
A






for employee/dependent
Grievances




56.
Grievance
082
Group denial of reinstatement
Appeals &
A






for non-payment
Grievances




57.
Grievance
083
Group denial of retroactive
Appeals &
A






effective date
Grievances




58.
Grievance
084
Group denial of retro-
Appeals &
A






termination date
Grievances




59.
Grievance
085
Group denial of enrollment for
Appeals &
A






employee or dependent
Grievances




60.
Grievance
086
Group denial for carrier change 
Appeals &
A






for employee/dependent
Grievances




61.
Grievance
087
Group denial to add a newborn
Appeals &
A






dependent
Grievances




62.
Grievance
088
Group denial for a retro-active
Appeals &
A






carrier transfer for employee or 
Grievances







dependent





63.
Grievance
089
Group denial to add domestic
Appeals &
A






partner coverage
Grievances




64.
Grievance
090
Group denial of 2nd review or
Appeals &
A






appeal
Grievances




65.
Dependent
092
Manual letter

M






Declaration of eligibility for








over age 23 dependent





66.
Agent (Sales and
100
Event followup






Marketing







67.
Agent (Sales and
101
Enrollment meeting

M




Marketing)

questionnaire








Need to tie information to a








lead





68.
Agent (Sales and
102
Business tracking report

M




Marketing)







69.
Agent (Sales and
103
Lead Form

M




Marketing)







70.
Agent (Sales and
104
Broker Survey letter

M




Marketing)







71.
Agent (sales and
105
BSS intro to agent

M




marketing)







72.
Agent (sales and
106
Follow-up on agent intro

M




Marketing)







73.
Agent (Sales and
107
Letterhead - blank

M




Marketing)







74.
Agent (sales and
108
Fax coversheet - blank






marketing)







75.
Agent
109
Tax ID number request

M




(commissions)







76.
Agent
110
Request W9

M




(commissions)







77.
Agent
111
Vehicle collection order

M




(commission)







78.
Agent
112
Broker of record dispute

M




(commission)







79.
Agent
113
Broker collection letter

M




(commission)







80.
Agent
114
License expiration letter

M




(commission)







81.
Agent
116
Debit 1

M




(commissions)







82.
Agent
117
Debit 2

M




(Commission)







83.
Agent
118
Debit 3

M




(Commission)







84.
Agent
119
Francise Tax Board

M




(Commissions)

withholding





85.
Group
120
Manual letter. Agent license

M






expired; group need to select








new agent.





86.
Group
121
Manual letter. $ Owed due to

M






denial of retro-term of








EE/dependent





87.
Group
122
Manual letter. $ Owed -

M






EE/dependent will be termed.





88.
Group
124
Manual letter. Federal Cobra

M






election form





89.
Agent
125
Requalification reminder letter

M




(requalification)

to agent, contains a list of








groups who have not returned








material.





90.
Agent (group non-
126
Overdue premiums for groups.

M




payment of

Contains a list of agent's






premium)

groups.





91.
Group
127
Manual letter Electronic Funds

M






Transfer Election Form





92.
Supply ordering
127A
Pick list for fulfilling supply

M






requests





93.
CalCobra only
128
Notification that Employer has
GRP Changes
A






termed a line of coverage.








(Sent to CalCobra when line of








coverage is termed)





94.
CalCobra only
129
Notification that Employer has
GRP Changes
A






added a line of coverage. (Sent








to CalCobra when adding the








line of coverage at the








employer master.)





95.
Association
131
Notification of dependent term
Assocn
A




individual member


Member DEP








Term




96.
Association
132
Denial to enroll dependent
Assocn
A




Individual member


Member DEP








Add-on




97.
Association
133
Voluntary Termination
Assocn
A




Individual member


Member Term




98.
Association
134
Missing information request at
Assocn
A




Individual member

ROE or OE
Member ROE








Process




99.
Association
135
Denial of change request
Assocn
A




Individual member


Member








Changes




100.
Association
136
Notification of dependent retro- 
Assocn





Individual member

term
Member DEP








Term




101.
Association
137
Notification of Overdue
Cash
A




Individual Member

premium
Reconciliation
&








M



102.
Association
138
Individual member group
Assocn
A




Individual member

termination for NPOP with
Member Term







reinstatement option





103.
Association
139
Denial of reinstatement
Assocn
A




Individual member


Member








Reinstatement




104.
Association
140
Dependent add-on welcome
Assocn
A




Individual member

letter
Member DEP








Add-on




105.
Association
141
Missing information request at 
Assocn
A




Individual member

new business or dependent add
Member








Enrollment or








DEP Add-on




106.
Association
142
Individual member group
Assocn
A




Individual member

termination with no
Member Term







reinstatement option





107.
Association
143
Individual member new group
Assocn
A




Individual member

not eligible
Member








Enrollment




108.
Association
144
Manual Letter. Individual

M




Individual member

member premium shortage not








received





109.
Association
145
Manual letter. Outstanding

M




Individual member

premium due on termed








individual member group





110.
Association
146
Manual letter. $ Owed due to

M




Individual member

denial of retro-term of








dependent.





111.
Association
147
Manual Letter. $ Owed -

M




individual member

dependent will be termed.





112.
Association
148
Individual member notification 
Assocn
A




Individual member

of retro-term
Member Term




113.
Association
149
Individual member welcome
Assocn
A




Individual member


Member








Enrollment




114.
Employee/Dependent
150
Cal-COBRA Election Form
EE/DEP Term
A



115.
Dependent
151
Notification of dependent
DEP Term
A




(termination)

termination





116.
Association
152
Approval of Individual
Assocn
A




Individual member

Association member
Member







reinstatement
Reinstatement




117.
Group (Dependent
153
Notification of dependent term 
DEP Term
A




termination)

to Group





118.
Group (Dependent
154
Notification of dependent
DEP Term
A




retro termination)

retroactive term to Group





119.
Group (Dependent
155
Dependent add on denial
DEP Add-on
A




add on denial)

Notification letter





120.
Grievance
156
Review Denial of Employee

A






Retroactive Effective date





121.
Grievance
157
Review Denial of Dependent

A






Retroactive Effective date





122.
Grievance
158
Review Denial of Dependent

A






Retroactive Termination date








for employee





123.
Grievance
159
Review Denial of dependent

A






late enrollee





124.
Grievance
160
Manual letter. Claim form

A






return letter to Employee





125.
Grievance
161
Manual letter. Claim form

A






return letter to Association








member





126.
Grievance
162
Manual letter. Dependent

A






Claim form return letter to








Employee





127.
Grievance
163
Manual letter. Claim form

A






return letter to Association








member's Dependent





128.
Group
164
Notification of Group Premium
Group Term
A






Shortage Retro Term





129.
Employee
165
Employee notification of
DEP Term
A




(Dependent Retro

Dependent Retro Term






Term







130.
Cobra Calcobra
166
Cobra Cal cobra notification of 
Group Term
A






group's Retro Term





131.
Group (Cobra and
167
Parent Group Cover Letter for

A




Cal Cobra group)

Cobra member





132.
Group
167A
Group Cover Letter

A



133.
Association
168
Association Cover Letter

A




(Association








Individual member







134.
Employee
169
Denial of Dependent changes
DEP Changes
A




(Dependent changes








denial)














Benefit Partners Inc
Process Specification
Reports
1. Introduction
1.1. Purpose
The purpose of this document is to describe the process of Reports and reporting the information and the data available in the system. This document identifies how the user interacts with the system, the data to be captured, the business logic to be implemented, and the output of the process.
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









BPI_SCOPE_REP
Reports










1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
2.1. Background
2.2. Process Description
The objective of the Reports is to provide information captured in the system to the user in a presentable manner.
The reports can be single, two-dimensional and multi dimensional providing the information to the decision-maker.
The objective of reporting is to paint that picture by analyzing and interpreting vast quantities of data-customer demographics, cross-sales, service calls, Internet experiences and online transactions—turning information into insight and developing conclusive, fact-based strategies to gain that competitive edge.
Reports are categorized based on the modules and the purpose of the reports.
2.3. Process Flow
All reports can be classified based on the following criteria:

    
    
        Purpose of Report: Briefly outline the intended use and the purpose of the report and what information it is to provide.
        Intended Audience/Delivery To: This specifies the intended audience for the report and to whom the report is to be delivered. The can be ranging from President, Vice President Operations, Managers and CFO's and BPI Team.
        Frequency of reports (Monthly, Weekly daily etc.): The frequencies of reports are based on whether the reports are Automated or Manual. All automated reports would have the frequency for delivery (Monthly, Weekly etc.). Manual reports does not have any frequency and can also be called as adhoc report, which is reported on the screen in the form of HTML when, required by the user.
        Mode of Delivery: All automated reports are delivered via email to the users defined as the intended audience. Adhoc reports are viewable on the screen and can be printed in HTML format.
        Output Format (HTML, XL or RTF): Output Format can be XL, HTML or RTF. The formats are based on the report type. All reports that are automated are in XL format. The reports that are manual or Adhoc are in HTML format.
        User Interface required for the report or not: Adhoc Reports and manual reports require user interface to generate the report. These reports are generated in HTML format.
        Automated reports does not require User interface.
        Input to the system (Input parameters): This defines the input parameters required to generate the Report. Input can be based on single parameter, Multiple parameters with and/or Conditions.
        Expected Output of the report (Output Parameters): This defines the output of the report. The output can be single dimensional or multi dimensional.
        Output can also be based on certain logic's, calculation and comparative reports or derivative of two or more reports summarized.
    
    


The reports that are generated automatically should be delivered to the intended audience via email. Also all the generated reports should be store under some file path in a systematic manner (may be time stamp and report ID) and logged in file or Database (preferably in database) so that we can retrieve the reports retrospectively from this file path.
3. User Interface
3.1. User Interface Screens
3.1.1. Reports: BPI_SCR_REP_INPUT
3.1.1.1. Screen Snapshot
This is a generalized screen for all the reports. This screen can be split into two parts, one as an input parameter to obtain the desired report and the second part is the report itself. (See FIG. L-1)
3.1.1.2. Element Name, Element Type & Purpose













Element



Element Name
Type
Purpose







Module ID
Text
Describes the name of the module the




report is extracted from.


Report name
Text
Name of the report


Report ID
Text
ID of the Report


Parameters
Text
Specifies the input parameters for the report


Parameter 
Entry Field
Specifies the entry fields for the parameters


Entries




Fetch report
HTML 
Button to fetch the report based on the 



Button
input criteria









3.1.1.3. Screen Validations












Element Name
Action/Validation Details
Message







Parameter
Entry Field for the parameters, E.g.
Error Message:


Entries
group ID, Group name, from Date,
“The data you have 



To Date etc. that is required to build
entered is in correct”



the dynamic reports.
Please enter the 



Note: The number of parameters
correct data.”



depends on the report in question.




The report output can be based on




the input criteria. The input criteria




are provided to narrow down the




search results or narrow down to a




specific output for the report.









3.1.2. Help Menu















Element Name
Purpose
Valid Values









Parameter Entries
Describe the
Based on specific Reports




parameters used





for the report.










3.2. User Interface Screens
3.2.1. Reports: BPI_SCR_REP_OUTPUT
3.2.1.1. Screen Snapshot (See FIG. L-2)
This is a generalized screen for all the reports. This screen can be split into two parts, one as an input parameter to obtain the desired report and the second part is the report itself.
3.2.1.2. Element Name, Element Type & Purpose













Element



Element Name
Type
Purpose







Module Name
Text
Describes the name of the module 




the report is extracted from.


Report name
Text
Name of the report


Report ID
Text
ID of the Report


Report Description
Text
Brief Description of the report


Report
HTML 
HTML Table Containing the Report



Table



Back
HTML 
Button to navigate back to the Previous 



Button
Page. (INPUT for the Report)









3.2.1.3. Screen Validations















Element Name
Action/Validation Details
Message









Report
The HTML Table for the report is 
None




dynamic and based on the report can





be single or multi dimensional.




Back
HTML Button to navigate to the
None




previous screen (Input Screen)










3.2.2. Help Menu












Element Name
Purpose
Valid Values







Report
Shows the
Based on the report the output 



generated reports
can be single of multi dimensional.









4. Business Rule Mapping
4.1. Module Name: Carrier Maintenance
4.1.1. Report ID: BPI_CAS_REP_CM—001













Report ID
BPI_CAS_REP_CM_001


Report Name
Rates in different format


Purpose of
This report is used to show the rates for 


Report
the various health products offered by Carrier


Delivery To
Carriers and All BPI users


Frequency
Non periodic


Mode of
None


Delivery



Output Format
XL or HTML


User Interface 
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
1. Eff_Date



2. Carrier_ID



3. Plan_Type_ID



4. Benefit_ID


Output of the 
Product Name, Product Name, Rates for Employee 


Report
Only, Employee and Spouse, Employee and



Dependents, Employee, Spouse and Dependents.









4.1.2. Report ID: BPI_CAS_REP_CM—002













Report ID
BPI_CAS_REP_CM_002


Report Name
Comparison on the current rates provided 



by the carrier with past rate.


Purpose of
This report is to compare the current rate offered by 


Report
the carrier with their previous rates based on



a specified period.


Delivery To
PacAdvantage and All BPI users


Frequency
Non periodic


Mode of
None


Delivery



Output Format
XL or HTML


User Interface 
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
1. Eff_Date



2. Carrier_ID



3. Plan_Type_ID



4. Benefit_ID



5. Eff_Date1



6. Carrier_ID1



7. Plan_Type_ID1



8. Benefit_ID1


Output of the
Product Name, Product Name, Rates for Employee 


Report
Only, Employee and Spouse, Employee and



Dependents, Employee, Spouse and Dependents.









4.1.3. Report ID: BPI_CAS_REP_CM—003













Report ID
BPI_CAS_REP_CM_003


Report Name
Plan availability


Purpose of
This report is used to show the plan availability 


Report
for the specified carrier in a Zip's available in



California.


Delivery To
Carriers and All BPI users


Frequency
Non periodic


Mode of
None


Delivery



Output Format
XL or HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
1. Eff_Date



2. Plan ID


Output of the
Product Name, Carrier name, 


Report
ZIP, Effective Date and Rating Region.









4.1.4. Report ID: BPI_CAS_REP_CM—005













Report ID
BPI_CAS_REP_CM_005


Report Name
ZIP Codes with No Coverage


Purpose of
This report is used to show the Zip's in 


Report
California where there is no coverage.


Delivery To
Carriers and All BPI users


Frequency
Non periodic


Mode of
None


Delivery



Output Format
XL or HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
EFF_DATE,



LOC_ID.


Output of the
ZIP, Effective Date of Plan non-Availability.


Report









4.1.5. Report ID: BPI_CAS_REP_CM—006













Report ID
BPI_CAS_REP_CM_006


Report Name
Plan Changes - Member Effected


Purpose of
When there is a change in the plan availability 


Report
in a specific ZIP code and or County or whenever



a plan ceases to exist report about the entire member 



in the specific ZIP or County with that plan



should be listed.


Delivery To
Carriers and All BPI users


Frequency
Non periodic


Mode of
Email


Delivery



Output Format
XL


User Interface 
No


Required Yes/



No



Automated or
Automated/Should be triggered by Plan changes


Manual



Input to report
EFF_DATE,



PLAN_ID


Output of the
Group name, Group ID, Member Name, Member 


Report
SSN or Unique ID, Member Benefit Level,



Coverage Choice, ZIP, County, Service Area









4.1.6. Report ID: BPI_CAS_REP_CM—007













Report ID
BPI_CAS_REP_CM_007


Report Name
Consolidated report on Rate Classification sorted 



by Rate Type (Admin, Agent Commission,



Additional fees and Differential Factor)


Purpose of
To report on the Fees structure for the rate 


Report
Classification based on the Admin fees, Agent



Commission Additional fees and differential factor.


Delivery To
Adhoc


Frequency
Non periodic


Mode of
none


Delivery



Output Format
HTML


User Interface 
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
PARAMEFFDATE


Output of the
Rate Type - Blended:


Report
Group Type, Agent Commission, Admin Fee,



Rate Type - Non Blended:



LOC Type, Group Type, Group Size, Per 



Member Flat Amt, Per Group Flat Amt,



Differential Factor:



Group size down limit, Group size up limit, 



Differential factor.









4.2. Module Name: Sales and Marketing
4.2.1. Report ID: BPI_CAS_REP_SM—001













Report ID
BPI_CAS_REP_SM_001


Report Name
Sold Group Details for Period Specified


Purpose of
This report is used to show the Total Groups 


Report
sold for a specified effective date and also show the



cumulative sales up to date


Delivery To
BSS Manager, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL or HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual and Automated


Manual



Input to report
Effective Date


Output of the
Group Name, Group ID, Writing Agent Name, 


Report
Marketing Source, Contact Date, Active



Subscribers Count, Active Dependent Count









4.2.2. Report ID: BPI_CAS_REP_SM—002













Report ID
BPI_CAS_REP_SM_002


Report Name
Sold Group Details for Period 



Specified based on Group Type


Purpose of
This report is used to show the Total Groups sold 


Report
for a specified effective date and also show the



cumulative sales up to date for a specific group type


Delivery To
BSS Manager, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL or HTML


User Interface 
Yes


Required Yes/



No



Automated or
Manual and Automated


Manual



Input to report
Effective Date, Group Type


Output of the
Group Name, Group ID, Writing Agent Name, 


Report
Marketing Source, Contact Date, Subscribers



Count, Dependent Count









4.2.3. Report ID: BPI_CAS_REP_SM—003













Report ID
BPI_CAS_REP_SM_003


Report Name
Average Group Size


Purpose of
This report is used to show the average group size, 


Report
i.e. employees/group for Small Employer



Group


Delivery To
BSS Manager, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL or HTML


User Interface 
Yes


Required Yes/



No



Automated or
Manual and Automated


Manual



Input to report
Effective Date


Output of the
Group Name, Group ID, Writing Agent Id, 


Report
Marketing Source, Contact Date, Subscribers Count,



Dependent Count









4.2.4. Report ID: BPI_CAS_REP_SM—004













Report ID
BPI_CAS_REP_SM_004


Report Name
Comparison between case sold Current 



Months and Previous Year Current Month


Purpose of 
This report is used to compare the Case 


Report
sold in the current month with the cash sold in the



previous year current month.


Delivery To
BSS Manager, Vice President Operations, President


Frequency
Monthly


Mode of
email


Delivery



Output Format
XL or HTML


User Interface 
Yes


Required Yes/



No



Automated or
Manual/Automated


Manual



Input to report
Effective Date


Output of the
Group Type, Current New Groups, Current New 


Report
Subscribers, Current New Dependents, Current



New Member, Prior Year Current New Groups, Prior 



Year Current New Subscribers, Prior Year



Current New Dependents, Prior Year Current New 



Members, This Month New Subscribers % of



Total, This Month New Groups % of Total, 



% of Change from Prior Year









4.2.5. Report ID: BPI_CAS_REP_SM—005













Report ID
BPI_CAS_REP_SM_005


Report Name
Group Enrollment With line of Coverage


Purpose of
This report is used to identify the groups enrolled 


Report
with each line of coverage based on effective date.


Delivery To
BSS Manager, Vice President Operations, President


Frequency
Monthly


Mode of
email


Delivery



Output Format
XL or HTML


User Interface 
Yes


Required Yes/



No



Automated or
Manual/Automated


Manual



Input to report
Effective Date


Output of the
Group Type, Year To Date Groups, Year To Date 


Report
Subscribers, Year To Date Dependents, Year



To Date Members, Current New Groups, Current 



New Subscribers, Current New Dependents,



Current New Members, Current Terminated Groups, 



Current Terminated Subscribers, Current



Terminated Dependents, Current Terminated 



Members, Net Gain/Loss Groups, Net Gain/Loss



Subscribers, Net Gain/Loss Dependents, 



Net Gain/Loss Members









4.2.6. Report ID: BPI_CAS_REP_SM—006













Report ID
BPI_CAS_REP_SM_006


Report Name
Leads by Source for Specified Period


Purpose of
This report is used to identify the leads generated 


Report
based on the source sub type for the specified period.


Delivery To
BSS Manager, Vice President Operations, President


Frequency
Weekly, Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface 
Yes


Required Yes/



No



Automated or
Manual/Automated


Manual



Input to report
Date


Output of the
Source Code, Last 12 Months Lead Given, Last 


Report
12 Months Lead Sold, Last 12 Months Close



Ratio, Last 90 Days Lead Given, Last 90 days Lead 



Sold, Last 90 Days Close Ratio, This Month



Lead Given, This Month Lead Sold, 



This Month Close Ratio,









4.2.7. Report ID: BPI_CAS_REP_SM—007













Report ID
BPI_CAS_REP_SM_007


Report Name
New Lead tracking for brokers


Purpose of
This report is used to track the new 


Report
agent and leads.


Delivery To
BSS Manager, Vice President 



Operations, President


Frequency
Weekly, Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface 
Yes


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Agent Name, Last 12 Months Lead Given, Last 


Report
12 Months Lead Sold, Last 12 Months Close



Ratio, Last 90 Days Lead Given, Last 90 days Lead 



Sold, Last 90 Days Close Ratio, This Month



Lead Given, This Month Lead Sold, This Month 



Close Ratio,









4.2.8. Report ID: BPI_CAS_REP_SM—008













Report ID
BPI_CAS_REP_SM_008


Report Name
Quote Tracking


Purpose of
This report is used to track the quotes generated 


Report
per week to the quotes converted to sales.


Delivery To
BSS Manager, Vice President Operations, 



President


Frequency
Weekly, Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface 
Yes


Required Yes/No



Automated or
Automated


Manual



Input to report
Date


Output of the
For Quote Generation and Groups Sold 


Report
(Last 30 days, Last 90 days, Last 120 day 



and Last 365 days)









4.2.9. Report ID: BPI_CAS_REP_SM—009
















Report ID
BPI_CAS_REP_SM_009



Report Name
Quote With 10 or More employees



Purpose of
This report is used to track the quotes with 10 



Report
or more employees for follow up.



Delivery To
Sales Team



Frequency
Monthly



Mode of
Email



Delivery




Output Format
XL



User Interface
No



Required Yes/No




Automated or
Automated



Manual




Input to report
Date



Output of the
Quote No, Company Name, Agent Name, EE 



Report
Count, Quote Date, Quote Rev, Lead No, 




Source Sub Type










4.2.10. Report ID: BPI_CAS_REP_SM—010













Report ID
BPI_CAS_REP_SM_010


Report Name
Sales with 10 of More employees


Purpose of
This report is used to track the sales with 10 or more


Report
employees for follow up and customer service.


Delivery To
Sales team, GMS Team


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface
No


RequiredYes/No



Automated or
Automated


Manual



Input to report
Date


Output of the
Group Number, Company Name, Writing Agent, 


Report
Employee Count, Effective Date, Quote Number, 



Lead Number, Source Sub Type









4.2.11. Report ID: BPI_CAS_REP_SM—011













Report ID
BPI_CAS_REP_SM_011


Report Name
Quote by Sales Rep/Work Group


Purpose of
This report is used to track the quote generated 


Report
by sales rep belonging to a specific work group.


Delivery To
BSS Manager, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface
No


Required Yes/No



Automated or
Automated


Manual



Input to report
Date


Output of the
Work Group Name, Date Quoted, Company Name, 


Report
Agent ID, Marketing Source, Proposed Effective 



Date, EE count.









4.2.12. Report ID: BPI_CAS_REP_SM—012













Report ID
BPI_CAS_REP_SM_012


Report Name
Agent Extract


Purpose of
This report is used to extract information about the 


Report
agents up to date


Delivery To
BSS Manager, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface
No


Required Yes/No



Automated or
Automated


Manual



Input to report
Date


Output of the
Agent ID, Agent Name, Company Name, Gender, 


Report
Address, Suite, city, State, Zip, County ID, Phone,



Fax, Email, DOB, Agent Tax ID, Work Group, 



Commission Groups, Writing Groups, Internal Reps









4.2.13. Report ID: BPI_CAS_REP_SM—013













Report ID
BPI_CAS_REP_SM_012


Report Name
Agent Extract


Purpose of
This report is used to extract information about the


Report
agents up to date


Delivery To
BSS Manager, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface 
No


Required Yes/No



Automated or
Automated


Manual



Input to report
Date


Output of the
Agent ID, Agent Name, Company Name, Gender, 


Report
Address, Suite, city, State, Zip, County ID,



Phone, Fax, Email, DOB, Agent Tax ID, Work Group, 



Commission Groups, Writing Groups, Internal Reps









4.2.14. Report ID: BPI_CAS_REP_SM—014













Report ID
BPI_CAS_REP_SM_014


Report Name
Quarterly Sales By County


Purpose of
This report is used to provide Quarterly sales done by 


Report
outside sales rep by county


Delivery To
BSS Manager, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface
No


Required Yes/No



Automated or
Automated


Manual



Input to report
Date


Output of the
County ID, County Name, Current Group ID, Current 


Report
Effective Date, Current Subscriber's Total,



Current Dependent's Total, Current Member's Total,



Year to Date Group's Total, Year to Date



Subscriber's Total, Year to Date Dependent's Total, 



Year to Date Member's Total









4.2.15. Report ID: BPI_CAS_REP_SM—015













Report ID
BPI_CAS_REP_SM_015


Report Name
Enrollment for an Agent


Purpose of
This report is used to provide enrollment done by an 


Report
agent and the group demographics 



(for Active Groups Only)


Delivery To
BSS Manager, Vice President Operations, President


Frequency
Monthly


Mode of
None


Delivery



Output Format
XL, HTML


User Interface 
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
Date,



Agent Id


Output of the
Group Id, Group Name, Address, Suite, City, State, 


Report
Zip, Phone, Email, Effective Date, Group ROE 



Cycle, EE count, DEP count









4.2.16. Report ID: BPI_CAS_REP_SM—016













Report ID
BPI_CAS_REP_SM_016


Report Name
Enrollment for an Agencies


Purpose of
This report is used to provide enrollment done by an 


Report
agency and associated writing agent, the group



demographics (for Active Groups Only)


Delivery To
BSS Manager, Vice President Operations, President


Frequency
Monthly


Mode of
None


Delivery



Output Format
XL, HTML


User Interface
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
Date,



Agency Id


Output of the
Group ID, Group Name, Address, Suite, City, State, 


Report
Zip, Phone, Email, Writing Agent ID, Effective 



Date, Group ROE Cycle, EE count, DEP count









4.2.17. Report ID: BPI_CAS_REP_SM—017













Report ID
BPI_CAS_REP_SM_017


Report Name
Association Available


Purpose of
This report is used to provide information about the 


Report
association and association groups and individual 



member.


Delivery To
BSS Manager, Vice President Operations, President


Frequency
Monthly


Mode of
None


Delivery



Output Format
XL, HTML


User Interface
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
Date,



Association ID


Output of the
Group Id, Group Name, Address, Suite, City, State, 


Report
Zip, Phone, Email, Writing Agent ID, Group 



Effective Date, Group ROE Cycle, EE count, 



DEP count









4.2.18. Report ID: BPI_CAS_REP_SM—018













Report ID
BPI_CAS_REP_SM_018


Report Name
List of Agent with Agencies along with Group


Purpose of
This report is used to provide information on a 


Report
agencies and the groups and members attached 



to the agent/agencies


Delivery To
All BPI


Frequency
Adhoc/Monthly


Mode of
None


Delivery



Output Format
HTML


User Interface
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
Date,



Agency Id


Output of the
Group ID, Group Name, Address, Suite, City, 


Report
State, Zip, Phone, Email, Group Effective Date,



Group ROE Cycle, EE count, DEP count









4.2.19. Report ID: BPI_CAS_REP_SM—019













Report ID
BPI_CAS_REP_SM_019


Report Name
Agent with Group/member Counts


Purpose of
This report is used to provide information on a 


Report
agent with Group and member count.


Delivery To
All BPI


Frequency
Adhoc/Monthly


Mode of
None


Delivery



Output Format
HTML


User Interface
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
Date


Output of the
Agent ID, New Agent, Agent Name, Agent Type, 


Report
Group Count, Member Count, BSU Rep,



Group Type, Period









4.2.20. Report ID: BPI_CAS_REP_SM—020













Report ID
BPI_CAS_REP_SM_020


Report Name
Sold Cases by Sales Reps


Purpose of
To see what groups have sold for the month.


Report



Delivery To
Weekly/Monthly totals to each BSU rep in



their work group.


Frequency
Monthly/Weekly


Mode of
email


Delivery



Output Format
XL or HTML


User Interface
Yes


Required Yes/No



Automated or
Manual and Automated


Manual



Input to report
Date


Output of the
Agent ID, New Agent, Agent Name, Agent 


Report
Type, Group ID, Group Name, BSU Rep,



GroupType, EE members, Quote Date,



Effective Date, Finalized Date, Rate Tier









4.2.21. Report ID: BPI_CAS_REP_SM—021













Report ID
BPI_CAS_REP_SM_021


Report Name
Lead Tracking


Purpose of
To see history of the BSU reps leads.


Report



Delivery To
BSS Manager, Vice President Operations, President



Weekly to each BSU rep in their work group.


Frequency
Monthly/Weekly


Mode of
email


Delivery



Output Format
XL or HTML


User Interface
Yes


Required Yes/No



Automated or
Manual and Automated


Manual



Input to report
Date


Output of the
Agent ID, Agent Name, Company, Date Lead 


Report
Added, Source, BSU Rep, Quote Process Date, 



Group Size, Lead Follow Up Date, Lead Status, 



Enrolled Date









4.2.22. Report ID: BPI_CAS_REP_SM—022













Report ID
BPI_CAS_REP_SM_022


Report Name
Hot and Cold Agents


Purpose of
To report on the agent based on the agents business 


Report
with PacAdvantage


Delivery To
BSS Manager, Vice President Operations, President



Weekly to each BSU rep in their work group.


Frequency
Adhoc


Mode of
none


Delivery



Output Format
HTML


User Interface
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
Date


Output of the
Agent Id, New Agent, Agent Name, Agent Type, 


Report
Business Generated Leads/Conversion, Member



Count, Workgroup, Period









4.2.23. Report ID: BPI_CAS_REP_SM—023













Report ID
BPI_CAS_REP_SM_023


Report Name
Agent Profile


Purpose of
To report on the agent Profile statue


Report



Delivery To
BSS Manager, Vice President Operations, President



Weekly to each BSU rep in their work group.


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
Date


Output of the
Agent Id, New Agent, Agent First Name, Agent Last


Report
Name, Agent Type, Agent Profile Information, Status, 



Bsu Rep









4.3. Module Name: Enrollment
4.3.1. Report ID: BPI_CAS_REP_EN—001













Report ID
BPI_CAS_REP_EN_001


Report Name
Enrollment By Plan


Purpose of
This report is used to provide information on enrollment 


Report
by Benefit Level for each line of coverage


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Effective Date


Output of the
Plan Name, Plan Type, Line of Coverage, prior month 


Report
Total members, Current month New Subscriber, Current 



month dependent, current termination, current month net 



gain and loss, total members active last month + net gain



and loss, number of members Currently enrolled, This 



month new subscription % and % change from previous 



month.









4.3.2. Report ID: BPI_CAS_REP_EN—002













Report ID
BPI_CAS_REP_EN_002


Report Name
Enrollment By Counties


Purpose of
This report is used to provide information on enrollment 


Report
by Counties for each line of coverage


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
State, County, Plan Type, Line of Coverage, Active 


Report
Member last period, New Subscriber Current Month, New 



Dependent Current Month, Terminated Current Month, 



Net gain/Loss, System generated Currently Enrolled 



Count. Currently Enrolled Active Subscribers and Active 



Dependents.









4.3.3. Report ID: BPI_CAS_REP_EN—003













Report ID
BPI_CAS_REP_EN_003


Report Name
Enrollment By Association


Purpose of
This report is used to provide information on enrollment 


Report
by Association Name


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Association ID, Group Name, Association name, Number 


Report
of New Groups, Subscribers, dependents, Total Number 



of Groups, Subscribers and dependent up to date.









4.3.4. Report ID: BPI_CAS_REP_EN—004













Report ID
BPI_CAS_REP_EN_004


Report Name
Enrollment By Counties


Purpose of
This report is used to provide information on enrollment


Report
by Counties


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Group Type, County Name,


Report
(Total Enrolled) # of Groups, Total Active Subscriber,



Total Active Dependent (New Enrollment for Current



Period) New Subscriber, New Dependent, This period



terms Net gain/Loss, # of Groups, # of COBRA, # of 



Association









4.3.5. Report ID: BPI_CAS_REP_EN—005













Report ID
BPI_CAS_REP_EN_005


Report Name
Monthly Individual Application received and processes


Purpose of
This report is used to provide information on Applica-


Report
tions received and processed on weekly/monthly basis.



(This report is based on mail room entry)


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL, HTML


User Interface
Yes


Required Yes/



No



Automated or
Automated, Manual


Manual



Input to report
Applications received Date


Output of the
Line Of Coverage, Small Employer Group - Subscribers, 


Report
Small Employer Group - Dependents, COBRA Sub-



scribers, COBRA dependents, Association Subscribers 



and Association dependents.









4.3.6. Report ID: BPI_CAS_REP_EN—006













Report ID
BPI_CAS_REP_EN_006


Report Name
Total Enrollment By Benefit Level (Carrier Offered)


Purpose of
This report is used to provide information on total enroll-


Report
ment based on the benefit level offered by carriers. 



(Small Employer Groups)


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL,


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Effective Date


Output of the
Plan Name, Plan Type, Active Last Period, This Period 


Report
New Subscribers, This Period New Dependents, This 



Period Terminated, This Period Net Gain Loss, Active 



Subscribers, Active Dependents









4.3.7. Report ID: BPI_CAS_REP_EN—007













Report ID
BPI_CAS_REP_EN_007


Report Name
Applications Declined by reasons


Purpose of 
This report is used to provide information on Applica-


Report
tions declined based on specific reasons.


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL,


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Reasons for Decline, # of Subscriber Application, # of 


Report
Dependent Application, COBRA Subscriber Application,



COBRA Dependent Application, Association Subscriber 



Application, Association Dependent Applications.









4.3.8. Report ID: BPI_CAS_REP_EN—008













Report ID
BPI_CAS_REP_EN_008


Report Name
Group applications Declined by reasons


Purpose of
This report is used to provide information on Group


Report
Applications declined based on specific reasons.


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL,


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Reasons for Decline, # of Group Application, # of Asso-


Report
ciation Application, # of COBRA Application.









4.3.9. Report ID: BPI_CAS_REP_EN—009













Report ID
BPI_CAS_REP_EN_009


Report Name
Member Termination Summary


Purpose of
This report is used to provide information on Members


Report
Termed.


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL,


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Group Type, Subscriber Terminated this Period, Dependent


Report
Terminated this period, Members Terminated this period









4.3.10. Report ID: BPI_CAS_REP_EN—010













Report ID
BPI_CAS_REP_EN_010


Report Name
Group Termination Summary


Purpose of
This report is used to provide information on Groups 


Report
Termed.


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL,


User Interface 
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Group Type, No of Groups terminated this period, 


Report
Subscriber Terminated this period, Dependent Terminated 



this period, Members Terminated this period.









4.3.11. Report ID: BPI_CAS_REP_EN—011













Report ID
BPI_CAS_REP_EN_011


Report Name
New Group Summary


Purpose of
This report is used to provide information on New 


Report
Groups Enrolled during Current Period


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL,


User Interface 
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the 
Group Type, New Groups, New Subscribers, New 


Report
Dependents, New members









4.3.12. Report ID: BPI_CAS_REP_EN—012













Report ID
BPI_CAS_REP_EN_012


Report Name
New Employees and Add-On Summary


Purpose of
This report is used to provide information on New 


Report
Employees and Add On's


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL,


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Group Type, New Subscribers, New Dependents, 



New members Report









4.3.13. Report ID: BPI_CAS_REP_EN—013













Report ID
BPI_CAS_REP_EN_013


Report Name
Group Termination details for a specific group size.


Purpose of
This report is used to provide information on termed 


Report
Groups by Group Size


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL,


User Interface 
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Small Employer Group Term reasons, Writing Agent, 


Report
Group Size (<=4, 5-9, 10-14, 15-24, 25-29, 30>=) Total



Groups, Total Members, Total Subscriber and Total 



Dependent.









4.3.14. Report ID: BPI_CAS_REP_EN—014













Report ID
BPI_CAS_REP_EN_014


Report Name
Member Demographics by Age Bucket


Purpose of
This report is used to provide information on Member 


Report
demographics by age bucket


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL,


User Interface 
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Age and gender, Line of Coverage, Group type, New 


Report
Subscriber this period, New Dependent This period, 



New Member this period, Total Subscriber, total 



dependent, total member Age of enrolled member 



(<=29, 30-39, 40-49, 50-59, 60-64, 65>=)









4.3.15. Report ID: BPI_CAS_REP_EN—015













Report ID
BPI_CAS_REP_EN_015


Report Name
Member Demographics for Newly Enrolled members


Purpose of
This report is used to provide information on newly 


Report
enrolled member by member demographics


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL,


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Age and gender, Line of Coverage, Group type, New 


Report
Subscriber this period, New Dependent This period,



New Member this period 



Age of Newly enrolled subscriber



Age of enrolled member



(<=29, 30-39, 40-49, 50-59, 60-64, 65>=)









4.3.16. Report ID: BPI_CAS_REP_EN—016













Report ID
BPI_CAS_REP_EN_016


Report Name
Employee Demographics by Coverage Choice.


Purpose of
This report is used to provide information on enrolled 


Report
employee by coverage choice.


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL,


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Loc, Coverage Choice (Employee only, Employee and 


Report
Children, Employee Spouse, Employee family)



New Subscriber, New Dependent, New member this 



period.



Total Enrollments



Subscriber, Dependent, Member Currently Enrolled up 



to date, 



Age of enrolled Subscriber



(<=29, 30-39, 40-49, 50-59, 60-64, 65>=)









4.3.17. Report ID: BPI_CAS_REP_EN—017













Report ID
BPI_CAS_REP_EN_017


Report Name
Group Enrollment by group type with and without agent


Purpose of
This report is used to provide information on enrolled 


Report
Group with/without agent.


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL,


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Group Type, With agent or without agent, Group 


Report
Count, Total active subscribers, Total active



Dependents, This Period New groups, This



period new Subscribers, This period Add ons, This



period terms, Net gain and loss, No of SEG Groups,



No of Cobras, No of Associations.









4.3.18. Report ID: BPI_CAS_REP_EN—018













Report ID
BPI_CAS_REP_EN_018


Report Name
Aging Report for Pending status


Purpose of
This report is used to provide information on performance 


Report
by duration for Received applications and pending up to



date. (i.e. how many applications and what



type are in pend status.


Delivery To
VP Finance, Vice President Operations, President


Frequency
Daily


Mode of
Email


Delivery



Output Format
XL, HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
Date


Output of the
Process Type, Reference_ID, Date Started, Started 


Report
By, Work group, Days in Pending Status.









4.3.19. Report ID: BPI_CAS_REP_EN—020













Report ID
BPI_CAS_REP_EN_020


Report Name
Group Enrolled by Group Size


Purpose of
This report is used to provide information on group 


Report
enrolledby group size


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Group Size, Group Name, Writing Agent, Group 


Report
Count, Subscribers Count, Dependent Count,



Total Member Count,



(Group Size as (<=4, 5-9, 10-14, 15-24, 25-29, 30>=))









4.3.20. Report ID: BPI_CAS_REP_EN—021













Report ID
BPI_CAS_REP_EN_021


Report Name
Define Contribution


Purpose of
This report is used to provide information on group 


Report
enrolled by Contribution Type for Small Employer 



Group


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Employer Defined Contribution, Product Type, 


Report
Contribution Type, Contribution Amount, Groups



Current Month, Groups Calendar Year to Date









4.3.21. Report ID: BPI_CAS_REP_EN—023













Report ID
BPI_CAS_REP_EN_023


Report Name
Report on Other's Remarks form all the screens


Purpose of
This report is used to provide information on New 


Report
remarks that needs to be added in to the system


Delivery To
IT, VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Manual


Delivery



Output Format
XL , HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
Screen ID


Output of the
Module Name, Element Name, Remarks/Others


Report









4.3.22. Report ID: BPI_CAS_REP_EN—024













Report ID
BPI_CAS_REP_EN_024


Report Name
Summary Report


Purpose of
This report is used to provide information on summary 


Report
of Enrollment as on date


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL,


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Group type, Current Group Count, Current Subscriber 


Report
Count, Current Dependent Count, Current Member



Count, Year-to-date Group Count, Year-to-date



Subscriber Count, Year-to-date Dependent Count,



Year-to-date Member Count.









4.3.23. Report ID: BPI_CAS_REP_EN—026













Report ID
BPI_CAS_REP_EN_026


Report Name
Employee and Members by Line of Coverage


Purpose of
This report is used to provide information on employees 


Report
lives by line of coverage and member per group by line 



of coverage.


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL,


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Line of Coverage, Employees Count, Dependent 


Report
Counts, member Counts



Number of Members Per group/Line of Coverage.









4.3.24. Report ID: BPI_CAS_REP_EN—027













Report ID
BPI_CAS_REP_EN_030


Report Name
Un Insured Groups and employees


Purpose of
This report is used to provide information on Groups and 


Report
Employees Enrolling without prior coverage.


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL,


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date.


Output of the
Employee Count Active up to date without prior Coverage, 


Report
Employee Count up to date without prior Coverage



Current Employee Count without prior coverage, Current 



Employee Count Termed without prior coverage.









4.3.25. Report ID: BPI_CAS_REP_EN—030













Report ID
BPI_CAS_REP_EN_030


Report Name
Un Insured Groups and employees


Purpose of
This report is used to provide information on Groups and 


Report
Employees Enrolling without prior coverage.


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL,


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date.


Output of the
Employee Count Active up to date without prior Coverage, 


Report
Employee Count up to date without prior Coverage



Current Employee Count without prior coverage, Current 



Employee Count Termed without prior coverage.









4.3.26. Report ID: BPI_CAS_REP_EN—031













Report ID
BPI_CAS_REP_EN_031


Report Name
Prior Insurance Carrier


Purpose of
This report is used to provide information on Employees 


Report
with prior coverage information.


Delivery To
VP Finance, Vice President Operations, President


Frequency
Ad hoc


Mode of
Manual


Delivery



Output Format
XL, HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
Date


Output of the
Prior Coverage carrier name, Employee Count


Report









4.3.27. Report ID: BPI_CAS_REP_EN—032













Report ID
BPI_CAS_REP_EN_032


Report Name
ROE Report


Purpose of
This report is used to provide information on Ad On, 


Report
Change after and before ROE


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report



Output of the
Group Id, ROE Status, ROE Result, Date Received Requal 


Report
Info, Date Postmark Requal info type, No of Employees,



No of COBRA'S.









4.3.28. Report ID: BPI_CAS_REP_EN—033













Report ID
BPI_CAS_REP_EN_033


Report Name
Carrier issues by Carrier and By issues


Purpose of
This report is used to provide information on Carrier 


Report
Issues by Issues and By Carrier


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Carrier Name, Carrier Issue Reported, Carrier Issue - 


Report
Actual, Date Received, Date Resolved, Total Days To 



process









4.3.29. Report ID: BPI_CAS_REP_EN—034













Report ID
BPI_CAS_REP_EN_034


Report Name
Appeals and Grievances


Purpose of
This report is used to provide information on Appeals 


Report
and Grievances


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Date


Output of the
Nature of Appeals, Appellant Type, Appellant Name, 


Report
Group No, Date Received, Date Closed, Conclusion









4.3.30. Report ID: BPI_CAS_REP_EN—035













Report ID
BPI_CAS_REP_EN_035


Report Name
COBRA Enrollment by COBRA Type


Purpose of
This report is used to provide information on COBRA 


Report
Enrollment by COBRA type and by Line of Coverage


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface 
No


Required Yes/No



Automated or
Automated


Manual



Input to report
Date


Output of the
COBRA Type, No of New COBRA's Groups 


Report
Subscribers & Dependents - for Current and



Enrolled Total









4.3.31. Report ID: BPI_CAS_REP_EN—036













Report ID
BPI_CAS_REP_EN_036


Report Name
Disabled Dependent


Purpose of
This report is used to provide information 


Report
on Disabled Dependent


Delivery To
VP Finance, Vice President Operations, President


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL


User Interface 
No


Required Yes/No



Automated or
Automated


Manual



Input to report
Date


Output of the
Group Id, Group Name, Disabled Type, 


Report
Disabled Dependent Count









4.3.32. Report ID: BPI_CAS_REP_EN—037













Report ID
BPI_CAS_REP_EN_037


Report Name
Employee Status up to date


Purpose of
This report is used to provide information 


Report
on Employee Status up to date.


Delivery To
All BPI


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface 
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
Group ID


Output of the
Group Id, Group Name, Employee 


Report
SSN, Employee Name, 



Employee Status Up to date, Effective Date









4.3.33. Report ID: BPI_CAS_REP_EN—038













Report ID
BPI_CAS_REP_EN_038


Report Name
Employer/Group Status (Including COBRA and 



Small Employer and Individual Association



Member and Association group)


Purpose of
This report is used to provide information on 


Report
Group Level Status up to date.


Delivery To
All BPI


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface 
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
Group ID


Output of the
Group ID, Group Type, Employee Status Up to date, 


Report
Effective Date, Employee Count, Member Count.









4.3.34. Report ID: BPI_CAS_REP_EN—039













Report ID
BPI_CAS_REP_EN_039


Report Name
COBRA/Cal COBRA Status up to date


Purpose of 
This report is used to provide information on 


Report
COBRA/Cal COBRA Status up to date.


Delivery To
All BPI


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface 
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
GROUP ID


Output of the
Parent Group Id, Parent Group Name, Anniversary 


Report
Date, COBRA Group Id, COBRA Group



Name, COBRA type, Status Up to Date, Effective 



Date, Member Count, COBRA Tenure,



COBRA End Date









4.3.35. Report ID: BPI_CAS_REP_EN—040













Report ID
BPI_CAS_REP_EN_040


Report Name
Association Group and Member Counts


Purpose of
This report is used to provide information on 


Report
a specific association and the Groups and



individual members affiliated with the Association


Delivery To
All BPI


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report 
Association ID


Output of the
Association ID, Association name, Association 


Report
Type, Association Group Type, Group



ID/Member ID, Employee SSN, Employee Name, 



Status Up to Date, Effective Date of Status,



Anniversary Date, Employee Count, Member Count









4.3.36. Report ID: BPI_CAS_REP_EN—041













Report ID
BPI_CAS_REP_EN_041


Report Name
Carrier Issues for a specific Carrier (Member Level)


Purpose of
This report is used to provide information on 


Report
Carrier Issues on a specific carrier.


Delivery To
All BPI


Frequency
Adhoc


Mode of
None


Delivery



Output Format 
HTML


User Interface
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
Carrier ID


Output of the
Carrier ID, Carrier Name, List of Member for 


Report
the carrier specified with SSN # or ID, Date of



Birth, Effective Date with the carrier, Plan Opted 



by Member, Transmission status, Transmission



Date.









4.3.37. Report ID: BPI_CAS_REP_EN—042













Report ID
BPI_CAS_REP_EN_042


Report Name
Carrier Issues for a specific Carrier (Group Level)


Purpose of
This report is used to provide information on Carrier 


Report
Issues on a specific carrier (Group Level).


Delivery To
All BPI


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface 
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
Carrier ID


Output of the
Carrier ID, Carrier Name, Group ID, Group name, 


Report
Effective Date, Member Count, Transmission



status, Transmission Date.









4.3.38. Report ID: BPI_CAS_REP_EN—043













Report ID
BPI_CAS_REP_EN_043


Report Name
Report on Transaction History for 



Enrollment (Group Level)


Purpose of
This report is used to provide information 


Report
on the History of all the transactions and changes



(Enrollment) made on the group up to date.


Delivery To
All BPI


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface 
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
Group ID


Output of the
Group Id, Group Name, Group Type, Nature of 


Report
Transaction, Transaction Description, Effective



Date, User Id









4.3.39. Report ID: BPI_CAS_REP_EN—044













Report ID
BPI_CAS_REP_EN_044


Report Name
Report on Transaction History for 



Enrollment (Employee Level)


Purpose of
This report is used to provide information on 


Report
the History of all the transactions and changes



(Enrollment) made on the employee up to date.


Delivery To
All BPI


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface 
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
Group ID


Output of the
Group Id, Group Name, Group Type, Employee ID, 


Report
Employee SSN, Nature of Transaction,



Transaction Description Effective Date, User Id









4.3.40. Report ID: BPI_CAS_REP_EN—045













Report ID
BPI_CAS_REP_EN_045


Report Name
Report on Transaction History for 



Enrollment (Dependent Level)


Purpose of
This report is used to provide information on the 


Report
History of all the transactions and changes



(Enrollment) made on the dependent up to date.


Delivery To
All BPI


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface 
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
Group ID


Output of the
Group ID, Group name, Group Type, Employee ID/


Report
SSN, Dependent Id Dependent SSN, Nature



of Transaction, Transaction Description, 



Effective Date, User Id









4.3.41. Report ID: BPI_CAS_REP_EN—046













Report ID
BPI_CAS_REP_EN_046


Report Name
Agent Change record for a specific group


Purpose of
This report is used to provide information on the 


Report
Agent Change record for a specific group


Delivery To
All BPI


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface 
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
Date


Output of the
Agent ID, Agent Name, Effective Change Date


Report









4.3.42. Report ID: BPI_CAS_REP_EN—047













Report ID
BPI_CAS_REP_EN_047


Report Name
Report on ROE/OE on Groups


Purpose of
This report is used to provide information on the 


Report
Groups that underwent or is in process for ROE/OE.


Delivery To
All BPI


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface 
Yes


Required Yes/No



Automated or
Manual


Manual



Input to report
Date


Output of the
Group Id, Group Name, Group Type, Effective Date, 


Report
Process (ROE or OE), ROE/OE Date.









4.3.43. Report ID: BPI_CAS_REP_EN—048













Report ID
BPI_CAS_REP_EN_048


Report Name
Report on Blended Vs Non Blended Group


Purpose of 
This report is used to provide information 


Report
on the Blended Vs Non Blended Group.


Delivery To
All BPI


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface 
Yes


Required Yes/No



Automated or
Manual


Manual



Input to reportDate



Output of the
Group Id, Group Name, Group Type, Effective Date, 


Report
Blended/Non Blended, Blended Group



Count, Non Blended group Count









4.3.44. Report ID: BPI_CAS_REP_EN—051













Report ID
BPI_CAS_REP_EN_051


Report Name
Reports on Group schedule to be termed.


Purpose of
This is to report on the Groups whose 


Report
are scheduled to be termed.


Delivery To
VP Operations, GMS Manager


Frequency
Monthly


Mode of
email


Delivery



Output Format
XL


User Interface 
No


Required Yes/No



Automated or
Automated


Manual



Input to report
Date


Output of the
Group ID, Group name, Group Type, Work Group, 


Report
Terminated Date, Term Process initiation



Date, Term Reasons, Days Pending









4.3.45. Report ID: BPI_CAS_REP_EN—052













Report ID
BPI_CAS_REP_FI_044


Report Name
Enrollment Transmission Status


Purpose of
This report is used to show the status for the transmission


Report
for various external transmissions for a specified duration


Delivery To
IT


Frequency
Non periodic


Mode of
None


Delivery



Output Format
XL or HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
From Date



To Date


Output of the
Transmission Time and Date, Process Period, Data Format


Report
Transmission Type, File Size, Record Count, Status.









4.4. Module Name: Finance
4.4.1. Report ID: BPI_CAS_REP_FI—001













Report ID
BPI_CAS_REP_FI_001


Report Name
Pending Commission


Purpose of
To report on the list of commissions reconciled


Report
but unpaid at the month-end.


Delivery To
CFO, Manager Finance


Frequency
Monthly, Adhoc


Mode of
Email


Delivery



Output Format
XL, HTML


User Interface
Yes


Required Yes/



No



Automated or
Automated, Manual


Manual



Input to report
Agent ID


Output of the
Agent ID, Agent name (Commission Payee), Period 


Report
End Date, Billing Period, Group ID, Month Period 



Ending, Writing Agent ID, Writing Agent name, Mem-



ber Counts for the Group, Line of Coverage, Com-



mission Split Percent, Flat Fee (Group Level), Per 



Member Fees, Total Fees Payable, Monthly Premium 



amount, Blended/Non Blended.









4.4.2. Report ID: BPI_CAS_REP_FI—002













Report ID
BPI_CAS_REP_FI_002


Report Name
Agent Owing PacAdvantage Money


Purpose of
To report on the list of agents who must pay back com-


Report
mission to the PacAdvantage. Represents receivable



to PacAdvantage at the month-end.


Delivery To
CFO, Manager Finance


Frequency
Monthly, Adhoc


Mode of
Email


Delivery



Output Format
XL, HTML


User Interface
Yes


Required Yes/



No



Automated or
Automated, Manual


Manual



Input to report



Output of the
Agent ID, Agent Type, Commission Address Block, 


Report
B/F Amount (Balance Forward)









4.4.3. Report ID: BPI_CAS_REP_FI—003













Report ID
BPI_CAS_REP_FI_003


Report Name
Cash Batches


Purpose of
To report on the list of cash batches entered during the


Report
month in question.


Delivery To
CFO, Manager Finance


Frequency
Monthly, Adhoc


Mode of
Email


Delivery



Output Format
XL, HTML


User Interface
Yes


Required Yes/



No



Automated or
Automated, Manual


Manual



Input to report
Start Date,



End Date,



Batch Type


Output of the
Batch Number, Deposit Date, Tape Total, Batch Total,


Report
Batch Type, Batch Status, User ID









4.4.4. Report ID: BPI_CAS_REP_FI—004













Report ID
BPI_CAS_REP_FI_004


Report Name
MRMIB Blended Rate Comparison


Purpose of
To report on medical and dental member counts associated


Report
with blended rate invoices reconciled during the month.



Used to allocate cash reconciled between blended and 



non-blended.


Delivery To
CFO, Manager Finance


Frequency
Monthly, Adhoc


Mode of
Email


Delivery



Output Format
XL, HTML


User Interface 
Yes


Required Yes/



No



Automated or
Automated, Manual


Manual



Input to report
Date,


Output of the
Group Id, Invoice Period, Current medical count, Current 


Report
dental count, prior medical count, prior dental count, 



Reconciled date









4.4.5. Report ID: BPI_CAS_REP_FI—005













Report ID
BPI_CAS_REP_FI_005


Report Name
A/R Totals by Group


Purpose of
To report on customer account balance on the month-


Report
end.


Delivery To
CFO, Manager Finance


Frequency
Monthly, Adhoc


Mode of
Email


Delivery



Output Format
XL, HTML


User Interface 
Yes


Required Yes/



No



Automated or
Automated, Manual


Manual



Input to report



Output of the
Group ID, A/R, Unbilled, Un App Cash, Total A/R, 


Report
Current, 30 Days, 60 Days, 90 Days, over 120









4.4.6. Report ID: BPI_CAS_REP_FI—006













Report ID
BPI_CAS_REP_FI_006


Report Name
Reconciled not Billed Break Down


Purpose of
To report on distribution of adjustment and members 


Report
associated with those adjustments used in reconciliation



that has not yet appeared on an invoice and will appear 



in the next invoice.


Delivery To
CFO, Manager Finance


Frequency
Monthly, Adhoc


Mode of
Email


Delivery



Output Format
XL, HTML


User Interface
Yes


Required Yes/



No



Automated or
Automated, Manual


Manual



Input to report
Adjustment Period


Output of the
HEALTH PLAN PREMIUMS - GROSS


Report
 ADD: CAL COBRA FEES



 LESS: RISK ADJUSTMENT WITHHELD



 HEALTH PLAN PREMIUMS - NET



 AGENT COMMISSIONS



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



GROUP DIRECT FEES



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



ADMINISTRATIVE FEES



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



 LATE FEES



 REINSTATEMENT FEES



 NSF FEES



 COBRA FEES



 VARIANCE +/− $2.00



 OTHER FEES



TOTAL PREMIUM



RISK ADJUSTMENT PAYABLE (MEMO)



MEMBERS



 MEDICAL



 DENTAL



 VISION



 CAM









4.4.7. Report ID: BPI_CAS_REP_FI—007













Report ID
BPI_CAS_REP_FI_007


Report Name
Reconciled not Billed Break Down Details (Group Level)


Purpose of
To report on distribution of adjustment and members as-


Report
sociated with those adjustments used in reconciliation 



that has not yet appeared on an invoice and will appear in



the next invoice. This done for individual groups.


Delivery To
CFO, Manager Finance


Frequency
Monthly, Adhoc


Mode of
Email


Delivery



Output Format
XL, HTML


User Interface 
Yes


Required Yes/



No



Automated or
Automated, Manual


Manual



Input to report
Adjustment Period


Output of the
GROUP NO,


Report
GROUP NAME,



GROUP EFF_DATE,



GROUP TYPE,



AGENT NO,



BILLING PERIOD,



INVOICE DATE,



RECONCILIED DATE,



CURRENT MONTH PREMIUM,



PRIOR PERIOR ADJ'S,



PLAN_ID,



HEALTH PLAN PREMIUM,



CAL COBRA FEES,



RISK ADJ WITHHELD,



HEALTH PLAN PREMIUMS - GROSS



 ADD: CAL COBRA FEES



 LESS: RISK ADJUSTMENT WITHHELD



 HEALTH PLAN PREMIUMS - NET



 AGENT COMMISSIONS



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



GROUP DIRECT FEES



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



ADMINISTRATIVE FEES



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



 LATE FEES



 REINSTATEMENT FEES



 NSF FEES



 COBRA FEES



 VARIANCE +/− $2.00



OTHER FEES



TOTAL PREMIUM



RISK ADJUSTMENT PAYABLE (MEMO)



MEMBERS



 MEDICAL



 DENTAL



 VISION



 CAM









4.4.8. Report ID: BPI_CAS_REP_FI—008













Report ID
BPI_CAS_REP_FI_008


Report Name
A/R Break Down (Carrier Level)


Purpose of
To report on distribution of amount appearing on un-


Report
reconciled invoices along with the member count.


Delivery To
CFO, Manager Finance


Frequency
Monthly, Adhoc


Mode of
Email


Delivery



Output Format
XL, HTML


User Interface
Yes


Required Yes/



No



Automated or
Automated, Manual


Manual



Input to report
Bill Period


Output of the
HEALTH PLAN PREMIUMS - GROSS


Report
 ADD: CAL COBRA FEES



 LESS: RISK ADJUSTMENT WITHHELD



 HEALTH PLAN PREMIUMS - NET



 AGENT COMMISSIONS



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



GROUP DIRECT FEES



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



ADMINISTRATIVE FEES



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



 LATE FEES



 REINSTATEMENT FEES



 NSF FEES



 COBRA FEES



 VARIANCE +/− $2.00



 OTHER FEES



TOTAL PREMIUM



RISK ADJUSTMENT PAYABLE (MEMO)



MEMBERS



 MEDICAL



 DENTAL



 VISION



 CAM









4.4.9. Report ID: BPI_CAS_REP_FI—009













Report ID
BPI_CAS_REP_FI_009


Report Name
A/R Break Down Details (Group Level)


Purpose of
To report on distribution of amount appearing on unrec-


Report
onciled invoices along with the member count. This



done for individual groups


Delivery To
CFO, Manager Finance


Frequency
Monthly, Adhoc


Mode of
Email


Delivery



Output Format
XL, HTML


User Interface
Yes


Required Yes/



No



Automated or
Automated, Manual


Manual



Input to report
Period


Output of the
GROUP NO,


Report
GROUP NAME,



GROUP EFF_DATE,



GROUP TYPE,



AGENT NO,



BILLING PERIOD,



INVOICE DATE,



RECONCILIED DATE,



CURRENT MONTH PREMIUM,



PRIOR PERIOR ADJ'S,



PLAN_ID,



HEALTH PLAN PREMIUM,



CAL COBRA FEES,



RISK ADJ WITHHELD,



HEALTH PLAN PREMIUMS - GROSS



 ADD: CAL COBRA FEES



 LESS: RISK ADJUSTMENT WITHHELD



 HEALTH PLAN PREMIUMS - NET



 AGENT COMMISSIONS



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



GROUP DIRECT FEES



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



ADMINISTRATIVE FEES



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



 LATE FEES



 REINSTATEMENT FEES



 NSF FEES



 COBRA FEES



 VARIANCE +/− $2.00



OTHER FEES



TOTAL PREMIUM



RISK ADJUSTMENT PAYABLE (MEMO)



MEMBERS



 MEDICAL



 DENTAL



 VISION



 CAM









4.4.10. Report ID: BPI_CAS_REP_FI—010













Report ID
BPI_CAS_REP_FI_010


Report Name
Billing Distribution (Carrier Level)


Purpose of
To report on distribution on amount and member counts 


Report
appearing on invoices generated during the month.


Delivery To
CFO, Manager Finance


Frequency
Monthly, Adhoc


Mode of
Email


Delivery



Output Format
XL, HTML


User Interface
Yes


Required Yes/



No



Automated or
Automated, Manual


Manual



Input to report
From Date



To Date


Output of the
HEALTH PLAN PREMIUMS - GROSS


Report
 ADD: CAL COBRA FEES



 LESS: RISK ADJUSTMENT WITHHELD



 HEALTH PLAN PREMIUMS - NET



 AGENT COMMISSIONS



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



GROUP DIRECT FEES



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



ADMINISTRATIVE FEES



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



 LATE FEES



 REINSTATEMENT FEES



 NSF FEES



 COBRA FEES



 VARIANCE +/− $2.00



 OTHER FEES



TOTAL PREMIUM



RISK ADJUSTMENT PAYABLE (MEMO)



MEMBERS



 MEDICAL



 DENTAL



 VISION



 CAM









4.4.11. Report ID: BPI_CAS_REP_FI—011













Report ID
BPI_CAS_REP_FI_011


Report Name
Billing Distribution Detail (Group Level)


Purpose of
To report on distribution on amount and member counts


Report
appearing on invoices generated during the month. This



is done for the individual group


Delivery To
CFO, Manager Finance


Frequency
Monthly, Adhoc


Mode of
Email


Delivery



Output Format
XL, HTML


User Interface
Yes


Required Yes/



No



Automated or
Automated, Manual


Manual



Input to report
From Date



To Date


Output of the
GROUP NO,


Report
GROUP NAME,



GROUP EFF_DATE,



GROUP TYPE,



AGENT NO,



BILLING PERIOD,



INVOICE DATE,



RECONCILIED DATE,



CURRENT MONTH PREMIUM,



PRIOR PERIOR ADJ'S,



PLAN_ID,



HEALTH PLAN PREMIUM,



CAL COBRA FEES,



RISK ADJ WITHHELD,



HEALTH PLAN PREMIUMS - GROSS



 ADD: CAL COBRA FEES



 LESS: RISK ADJUSTMENT WITHHELD



 HEALTH PLAN PREMIUMS - NET



 AGENT COMMISSIONS



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



GROUP DIRECT FEES



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



ADMINISTRATIVE FEES



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



 LATE FEES



 REINSTATEMENT FEES



 NSF FEES



 COBRA FEES



 VARIANCE +/− $2.00



OTHER FEES



TOTAL PREMIUM



RISK ADJUSTMENT PAYABLE (MEMO)



MEMBERS



 MEDICAL



 DENTAL



 VISION



 CAM









4.4.12. Report ID: BPI_CAS_REP_FI—012













Report ID
BPI_CAS_REP_FI_012


Report Name
Cash balancing (Carrier Level)


Purpose of
To report on distribution of the Dollars associated with


Report
all the invoices reconciled during the current period 



(Week, Month).


Delivery To
CFO, Manager Finance


Frequency
Monthly, Weekly, Adhoc


Mode of
Email


Delivery



Output Format
XL, HTML


User Interface
Yes


Required Yes/



No



Automated or
Automated, Manual


Manual



Input to report
From Date



To Date


Output of the
HEALTH PLAN PREMIUMS - GROSS


Report
 ADD: CAL COBRA FEES



 LESS: RISK ADJUSTMENT WITHHELD



 HEALTH PLAN PREMIUMS - NET



 AGENT COMMISSIONS



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



GROUP DIRECT FEES



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



ADMINISTRATIVE FEES



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



 LATE FEES



 REINSTATEMENT FEES



 NSF FEES



 COBRA FEES



 VARIANCE +/− $2.00



 OTHER FEES



TOTAL PREMIUM



RISK ADJUSTMENT PAYABLE (MEMO)



MEMBERS



 MEDICAL



 DENTAL



 VISION



 CAM









4.4.13. Report ID: BPI_CAS_REP_FI—013













Report ID
BPI_CAS_REP_FI_013


Report Name
Cash balancing (Group Level)


Purpose of
To report on distribution of the Dollars associated with


Report
all the invoices reconciled during the current period



(Week, Month) for individual benefit level.


Delivery To
CFO, Manager Finance


Frequency
Monthly, Weekly, Adhoc


Mode of
Email


Delivery



Output Format
XL, HTML


User Interface
Yes


Required Yes/



No



Automated or
Automated, Manual


Manual



Input to report
From Date



To Date


Output of the
GROUP NO,


Report
GROUP NAME,



GROUP EFF_DATE,



GROUP TYPE,



AGENT NO,



BILLING PERIOD,



INVOICE DATE,



RECONCILIED DATE,



CURRENT MONTH PREMIUM,



PRIOR PERIOR ADJ'S,



PLAN_ID,



HEALTH PLAN PREMIUM,



CAL COBRA FEES,



RISK ADJ WITHHELD,



HEALTH PLAN PREMIUMS - GROSS



 ADD: CAL COBRA FEES



 LESS: RISK ADJUSTMENT WITHHELD



 HEALTH PLAN PREMIUMS - NET



 AGENT COMMISSIONS



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



GROUP DIRECT FEES



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



ADMINISTRATIVE FEES



 FLAT FEES



 MEDICAL - NON-BLENDED



 DENTAL - NON-BLENDED



 MEDICAL - BLENDED



 DENTAL - BLENDED



 VISION - BLENDED



 CAM - BLENDED



 LATE FEES



 REINSTATEMENT FEES



 NSF FEES



 COBRA FEES



 VARIANCE +/− $2.00



OTHER FEES



TOTAL PREMIUM



RISK ADJUSTMENT PAYABLE (MEMO)



MEMBERS



 MEDICAL



 DENTAL



 VISION



 CAM









4.4.14. Report ID: BPI_CAS_REP_FI—014













Report ID
BPI_CAS_REP_FI_014


Report Name
Un Reconciled Cash


Purpose of
To report on List of unreconciled cash items at the


Report
end of the month.


Delivery To
CFO, Manager Finance


Frequency
Monthly, Weekly, Adhoc


Mode of
Email


Delivery



Output Format
XL, HTML


User Interface
Yes


Required Yes/



No



Automated or
Automated, Manual


Manual



Input to report
Start Date



End Date


Output of the
Crec No, Group No, Date, Amount, Status, Term Date


Report









4.4.15. Report ID: BPI_CAS_REP_FI—015
















Report ID
BPI_CAS_REP_FI_015



Report Name
Cash Receipt Report



Purpose of
To report on List of cash items in each cash batch



Report




Delivery To
CFO, Manager Finance



Frequency
Monthly, Weekly, Adhoc



Mode of
Email



Delivery




Output Format
HTML



User Interface
Yes



Required Yes/




No




Automated or
Manual



Manual




Input to report
Batch Number



Output of the
ID, Date, Check No, Amount, Rec (Reconciled),



Report
Group ID and Group name.










4.4.16. Report ID: BPI_CAS_REP_FI—016













Report ID
BPI_CAS_REP_FI_016


Report Name
Group and Premium transmitted to the Carrier


Purpose of
To report on the Groups and the premium transmitted 


Report
to the carriers based on the member. (Premium 



Transmission based on members


Delivery To
GMS, Finance


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
Start Date



End Date


Output of the
Employer Tax ID, Group ID, Employer Tax ID, 


Report
Employee ID, Carrier ID, Year ID, Plan Code, 



Premium Code, Premium Billed Amt (as Sent), 



Premium Billed Amt (Translated), Premium Applied



Date, Premium Due Date, Geographic Area.









4.4.17. Report ID: BPI_CAS_REP_FI—017













Report ID
BPI_CAS_REP_FI_017


Report Name
Employee Level Adjustments based on Changes


Purpose of
To report on the employee level adjustments based on 


Report
changes. (Employee Add On, Employee Term, De-



pendent Add On, Dependent Term, Change of Benefit



Level, Change of Coverage Choice (Employee Only,



Employee Spouse etc.)


Delivery To
GMS, Finance


Frequency
Adhoc


Mode of
none


Delivery



Output Format
HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
Start Date



End Date


Output of the
Group ID, Group Name, Employee ID, Employee SSN,


Report
Adjustment Amount, Effective Date, Adjustment Period,



Adjustment Type, Adjustment Status.









4.4.18. Report ID: BPI_CAS_REP_FI—018













Report ID
BPI_CAS_REP_FI_018


Report Name
Fees Applied or Waived on Group Level


Purpose of
To report on all types of fees applied and or waived


Report
for a specific group during the defined period.


Delivery To
GMS, Finance


Frequency
Adhoc


Mode of
none


Delivery



Output Format
HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
Start Date



End Date


Output of the
Group ID, Group Name, Fees Type, Fees Amount, 


Report
Invoice Number, Invoice Date, Reconciliation Status.









4.4.19. Report ID: BPI_CAS_REP_FI—019













Report ID
BPI_CAS_REP_FI_019


Report Name
Premium History on Group/Employee Level


Purpose of
To report on the premium collected from group


Report
(broken down to employee) up to date


Delivery To
GMS, Finance


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
Group ID


Output of the
Invoice ID, Invoice Date, Group ID, Total Inv,


Report
Total Due.









4.4.20. Report ID: BPI_CAS_REP_FI—020













Report ID
BPI_CAS_REP_FI_020


Report Name
Group Not paid “Accounts receivable total by Group”


Purpose of 
To report on the groups not paid - Sort by Agent


Report



Delivery To
GMS, Finance


Frequency
Adhoc


Mode of
none


Delivery



Output Format
HTML


User Interface 
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report



Output of the
Agent ID, Agent Name, Invoice Amount Due,


Report
Period Outstanding, Group ID, Group Name.









4.4.21. Report ID: BPI_CAS_REP_FI—021













Report ID
BPI_CAS_REP_FI_021


Report Name
Group paid short


Purpose of
To report on the groups paid short - Sort by Agent


Report



Delivery To
GMS, Finance


Frequency
Adhoc


Mode of
none


Delivery



Output Format
HTML


User Interface 
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report



Output of the
Agent ID, Agent Name, Amount Due, Period


Report
Outstanding, Group ID, Group Name, Amount



Received, Amount Received, Amount short, Due Date.









4.4.22. Report ID: BPI_CAS_REP_FI—022
















Report ID
BPI_CAS_REP_FI_022



Report Name
Group for Refund



Purpose of
To report on the groups for Refund



Report




Delivery To
GMS, Finance



Frequency
Adhoc



Mode of
none



Delivery




Output Format
HTML



User Interface 
Yes



Required Yes/




No




Automated or
Manual



Manual




Input to report




Output of the
Group ID, Group name, Agent ID, Agent name,



Report
Refund Amount, reasons for Refund.










4.4.23. Report ID: BPI_CAS_REP_FI—025













Report ID
BPI_CAS_REP_FI_025


Report Name
Prepaid Commission


Purpose of
To report on distribution of next month's invoices


Report
reconciled and paid in current


Delivery To
CFO, Manager Finance


Frequency
Monthly, Adhoc


Mode of
email


Delivery



Output Format
XL, HTML


User Interface 
Yes


Required Yes/



No



Automated or
Automated/Manual


Manual



Input to report
Year Month


Output of the
Group ID, Group Effective Date, Group Type, Bill


Report
Period, Invoice Date, Reconciled Date, Flat Fees, 



Medical Blended, Other, Medical Member Fees, 



Dental Blended, Dental Member Fees, Vision Blended,



CAM Blended, Total.









4.4.24. Report ID: BPI_CAS_REP_FI—026













Report ID
BPI_CAS_REP_FI_026


Report Name
Un Applied (Open) Commission Adjustment


Purpose of
To report on commission adjustments to Apply to the


Report
next commission run. (These are not yet applied and



may change)


Delivery To
CFO, Commission Specialist


Frequency
Adhoc


Mode of
none


Delivery



Output Format
XL/HTML


User Interface 
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
Start Date



End Date


Output of the
Commission Adjustment ID, Date of Adjustment,


Report
Type (1099, Amount, Both), Adjustment Amount,



Description, Agent name and Agent ID









4.4.25. Report ID: BPI_CAS_REP_FI—027
















Report ID
BPI_CAS_REP_FI_027



Report Name
Invoice and Payment History



Purpose of
To report on invoice and payment history



Report
and date both reconciled



Delivery To
GMS and Finance



Frequency
Adhoc



Mode of
None



Delivery




Output Format
HTML



User Interface
Yes



Required Yes/




No




Automated or
Manual



Manual




Input to report
Group ID



Output of the
Type, Date, Amount, Reconciled



Report










4.4.26. Report ID: BPI_CAS_REP_FI—028













Report ID
BPI_CAS_REP_FI_028


Report Name
Commission Register


Purpose of
To report on the results of semi monthly Commission


Report
run


Delivery To
Commission Specialist and CFO


Frequency
Semi monthly after Commission Run


Mode of
Email


Delivery



Output Format
XL


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Commission Period


Output of the
Check Number, Check Date, Check Amount, Com-


Report
mission Amount, prior balance Forward amount,



Commission Fees, Total Adjustment, 1099 Amount,



B/F Amount, Agent Id, Commission period, Com-



mission payee



(B/F - Balance Forward usually relating to negative



balance)









4.4.27. Report ID: BPI_CAS_REP_FI—029













Report ID
BPI_CAS_REP_FI_029


Report Name
Summary of unpaid Commission


Purpose of
To preview all commission to be paid this period.


Report
Includes current period and those payable from



the prior periods (previously pended). Sum of



Current amount will be equal to the cash balance



report for the commissions for the same period.


Delivery To
Commission Specialist and CFO


Frequency
Run after each Commission Run


Mode of
Email


Delivery



Output Format
XL


User Interface
no


Required Yes/



No



Automated or
Automated


Manual



Input to report
Commission Period


Output of the
Agent ID, Commission payee, type, Period End Date,


Report
Period, Commission fees.









4.4.28. Report ID: BPI_CAS_REP_FI—031













Report ID
BPI_CAS_REP_FI_031


Report Name
Agent License Expiration date


Purpose of
To report on agent and their license expiration date


Report



Delivery To
Commission specialist


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
Date


Output of the
Agent ID, Agent Name, Effective Date, Address, 


Report
City, Phone, License No, Expiration Date, Status









4.4.29. Report ID: BPI_CAS_REP_FI—032













Report ID
BPI_CAS_REP_FI_032


Report Name
Listing of groups by Agent


Purpose of
To report on list of all groups associated with


Report
an agent sort by status.


Delivery To
Commission specialist, GMS, Finance and CFO


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
Agent ID


Output of the
Group Id, Group Name, Effective Date, Group Status,


Report
Agent id, Agent Name.









4.4.30. Report ID: BPI_CAS_REP_FI—033













Report ID
BPI_CAS_REP_FI_033


Report Name
Listing of an agent's groups and reconciliation history 



for the last 4 months invoices with current commission 



payable.


Purpose of
To report on the group's recent history, agent and total 


Report
commission payable by agent and to show what 



commissions are currently payable. (Should be able to sort)


Delivery To
Commission specialist, GMS, Finance and CFO and agent


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
Date



Agent ID


Output of the
Agent Id, Agent Name, Agent License, Group Id, Group 


Report
Name, Enrolled Status, Invoices For 30 Days, Invoices For 



60 Days, Invoices For 90 Days, Invoices For 120 Days,









4.4.31. Report ID: BPI_CAS_REP_FI—035













Report ID
BPI_CAS_REP_FI_035


Report Name
Cash Extract


Purpose of
To report on individual payments entered to identify and


Report
trace on group level


Delivery To
GMS, Finance


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
Start Date



End Date


Output of the
Cash Receipt Id, Group Id, Cash Rec Date, Amount, 


Report
Batch, Batch Date









4.4.32. Report ID: BPI_CAS_REP_FI—036













Report ID
BPI_CAS_REP_FI_036


Report Name
New Business


Purpose of
To report all new business entered, by day


Report



Delivery To
Customer Service, Finance, Management


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
Start Date



End Date


Output of the
Group ID, Group Name, Date Received, Check Amount, 


Report
Effective Date, Status









4.4.33. Report ID: BPI_CAS_REP_FI—038













Report ID
BPI_CAS_REP_FI_038


Report Name
Operating Account Daily cash Activity


Purpose of
To summarize cash activity in system and through the bank


Report



Delivery To
Finance, Accounting manager, CFO


Frequency
Monthly, Adhoc


Mode of
Email


Delivery



Output Format
XL HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual/Auto


Manual



Input to report
Date


Output of the
Date, Manual Batch, NSF Batch, Returns Batch, Positive 


Report
Transfer, Negative Transfer, Lockbox Check, Auto-Batch



EFT, Direct Deposit, Wire Transfer, CC Over Phone,



Auto-Batch Credit Card, Online Credit Card, TR to 



4159 297506, TR to 4159 297456, Interest Received









4.4.34. Report ID: BPI_CAS_REP_FI—040
















Report ID
BPI_CAS_REP_FI_040



Report Name
Recap pf A/R & A/P



Purpose of
To summarize for entry to financials



Report




Delivery To
Accounting Manager, CFO



Frequency
Monthly



Mode of
Email



Delivery




Output Format
XL HTML



User Interface
No



Required Yes/




No




Automated or
Auto



Manual




Input to report
Bill Period



Output of the
Code Number, Carrier, Un reconciled, 



Report
Reconciled/Unbilled, Total










4.4.35. Report ID: BPI_CAS_REP_FI—041













Report ID
BPI_CAS_REP_FI_041


Report Name
Deferred revenue & Expense & Worksheet for journal 



entries


Purpose of
To itemize amounts for deferred revenue and expenses 


Report
(for financials) and journal entries for these.


Delivery To
Accounting Manager, CFO


Frequency
Monthly


Mode of
Email


Delivery



Output Format
XL HTML


User Interface
No


Required Yes/



No



Automated or
Auto


Manual



Input to report



Output of the
Account No, Description, Deferred Revenue


Report









4.4.36. Report ID: BPI_CAS_REP_FI—042













Report ID
BPI_CAS_REP_FI_042


Report Name
Check with Commission Statement


Purpose of
To pay agents and report commission activity for a period.


Report



Delivery To
Mail house (electronically), agents


Frequency
Semi-Monthly


Mode of
None


Delivery



Output Format
Paper check, HTML, electronic file to mail house.


User Interface
No


Required Yes/



No



Automated or
Automated


Manual



Input to report
Agent ID, Commission Period


Output of the
Group Id, Group Name, Month Paid, Effective Date, 


Report
Product Type, Total Member, Split Percentage, Flat Fee,



PM Fee, Total Fees, Monthly Premium, % Com, 1099 



Amount.









4.4.37. Report ID: BPI_CAS_REP_FI—044













Report ID
BPI_CAS_REP_FI_044


Report Name
Finance Transmission Status


Purpose of
This report is used to show the status for the transmission 


Report
for various external transmissions for a specified duration


Delivery To
IT


Frequency
Non periodic


Mode of
None


Delivery



Output Format
XL or HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
From Date



To Date


Output of the
Transmission Time and Date, Process Period, Data Format 


Report
Transmission Type, File Size, Record Count, Status.









4.5. Module Name: Miscellaneous (Security, Work Group, Supply Request and Associates)
4.5.1. Report ID: BPI_CAS_REP_MISC—001













Report ID
BPI_CAS_REP_ MISC_001


Report Name
User Access right report from Security


Purpose of
This report is used to provide information on the user 


Report
name, user roles, user groups and access rights


Delivery To
All BPI


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
User ID


Output of the
User ID, User name, User roles, User group, Resource, 


Report
Access rights.









4.5.2. Report ID: BPI_CAS_REP_MISC—002













Report ID
BPI_CAS_REP_MISC_002


Report Name
Report on Work group


Purpose of
This report is used to provide information on the work 


Report
groups and the Groups and member counts per work 



group


Delivery To
All BPI


Frequency
Adhoc


Mode of
None


Delivery



Output Format
HTML


User Interface
Yes


Required Yes/



No



Automated or
Manual


Manual



Input to report
Work group ID


Output of the
Work Group ID, Work Group Name, Group Count, 


Report
Member Count









5. Interface Flow
This outlines the menu for the reports. (See FIG. L-3)
6. Data Structures
Not Applicable
















Data Element Name
Data Element Type










6.1. Back End Validations
Not applicable
















Field Element Name
Back End Validation










7. Non-Functional Requirements
















Non Functional Requirement
Details










8. Access Control List















User ID
Job Description
Functionality
Access Level









Benefit Partners Inc
Process Specification
Campaign
1. Introduction
1.1. Purpose
This functional specification document addresses the part of the sales and marketing system that would assign and track the marketing campaigns, which are made by BPI as part of their marketing efforts.
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









BPI_SCOPE_SM.DOC
Sales & Marketing



BPI_SCOPE_SM_01
Create Sales Rep Master










1.3. Definitions, Acronyms & Abbreviations















Term
Explanation









2. Process Identification
2.1. Process Description & Flow
A marketing campaign is an initiative where an identifiable segment of potential employer groups are targeted through the media like the radio, newspaper, mailers etc. Benefit Partners organizes for the marketing campaigns through third parties or by itself periodically.
The details of a campaign initiative are captured in the system through the campaign master.
The campaign master provides information on the campaign, duration and the personnel associated with the campaign. The media through which a campaign is done is captured in the system using the source type and source subtype.
The source type defines the media through which a campaign can be conducted and the source sub type provides the information on the subcategory that may come under the source type.
The source type and source sub type are configurable and must be created in sequence of source type followed by source subtype. For associated source type and source subtype for a campaign, the details get reflected on the campaign master only if it is captured prior to creation the campaign master.
Creation and modification of a campaign master leads to generation of email to the internal and external sales reps.
The source type can be used as an input for marketing methods in the agent profile and as source in the employer group master on enrollment.
The responses received from a marketing campaign are captured in Employer Group Master.
This would typically help in analyzing the responses made to the marketing campaign and also provide necessary tracking information for future market campaign planning and decision-making on the effectiveness of the campaign. This would provide a tracking mechanism that would measure the affect that an ad or ad campaign has on brand and/or company awareness, interest, attitude and enrollment conversions.
The internal sales rep makes a request for the welcome packets through the supply request
The flow diagram describes a typical flow on a campaign. The source type, source subtype and campaign can also be modified, viewed and inactivated.
2.2. Process Flow Diagram (See FIG. M-1)
3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's












Screen ID

Corresponding HTML File


(SID)
Screen Name
Name







utl.campaign.sourcetype
Source type
/bpi/cas/marketing/campaign/




SourceType.jsp


utl.campaign.sourcesubtype
Source sub 
/bpi/cas/marketing/campaign/



type
SourceSubType.jsp


uti.campaign.create
Campaign
/bpi/cas/marketing/campaign/




CampaignMaster.jsp


utl.campaign.search
Search 
/bpi/cas/marketing/campaign/



Campaign
CampaignSearch.jsp


utl.campaign.view
View 
/bpi/cas/marketing/campaign/



Campaign
CampaignView.jsp









3.1.2. User Interface ID: Source Type
3.1.2.1. Screen name: Source Type (BPI_CAS_SM_SCR—001—001) (See FIG. M-2)
3.1.2.2. SID, Element Name, Element Type & Purpose













Element
Element




Name
Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the screen being


“Source

“Source Type”
navigated


Type”





Source Type
Text
Source Type
Text For “Source Type”


Source Type
Entry Field
Source Type
Entry field for entering the source type


Entry Field

Entry Field



Input Source
Text
Input Source
Text for “Input Source”


Input Source
List
Input Source
List with values Yes/No - Default No


List

List



Add
HTML Button
Add
Button for adding the Source Type/Input





Source information in to the HTML table.





Changes with label “Modify” when the row in





the table is on edit mode.


Table
HTML table
Table
For displaying all the information added by





pressing the add button, in the form of rows,





for every add operation/Rows retrieved from





the permanent repository


Delete
Button
Delete
To delete the rows checked



(HTML





Button)




Check All
Text Link
Check All
To check all the check boxes in the table


Clear All
Text Link
Clear All
To un check all the check boxes checked in





the table/does not function when all the





checkboxes in the table are unchecked


Delete
Check box
Delete
To check the items for deletion


Edit
Button
Edit
To edit the rows entered by “Add”/



(HTML

“Modify”/displayed from permanent



Button)

repository against the row selected for





editing


Save
Button
Save
Save the information to the repository



(HTML





Submit





button)




Cancel
Button
Cancel
Reset information as described in the





scenarios









3.1.2.3. Front End Validations












Element




Name
Action/Validation Details
Error Message Text







Source
Mandatory Entry
When the Add HTML Button is


Type
Becomes non editable when on modify mode
pressed with an empty entry on the


Entry
for data from permanent repository
source type entry field, an Error


Field

Dialog Box pops up with the message




“Please enter the source type before




adding to the table” with “yes” option




On press of Yes Button, The cursor




must be placed on the source type




entry field


Input
Default - No
Not Applicable


Source




List




Add
On Clicking the add button or pressing the
When the Add HTML Button is



enter key field with the cursor positioned on the
pressed with an empty entry on the



Add button, the data gets added to the table.
source type entry field, an Error



Validation checks are done to not allow null
Dialog Box pops up with the message



value on the source type entry field.
“Please enter the source type before



Must not allow duplicate entries on the source
adding to the table” with “yes” option.



type.
On press of Yes Button, The cursor



Must not allow the length of the field entry 
must be placed on the source entry



to go beyond as per the database design 
field



for the column
For duplicate entries, Error dialog 




box - “Duplicate values not allowed.




Please enter again”


Modify
On Clicking modify button or the pressing the
None



enter key field with the cursor position on the




modify button, The data gets added to the




table.



Table
Should have column header and each




subsequent row should be identified by




alternate color combinations. i.e. First row




should have color ‘x’ and the next row should




have color ‘y’. The next row should have color




‘x’ again and so on. The size of any text inside




any cell should be wrapped if the text becomes




too long.




The letters must be green in color for the rows




retrieved from the permanent repository and




red for the rows in temporary storage.




All the letters of the row on edit must be in dark




gray.



Delete
Should function with enter key cursor
Error Dialog Box: “Please choose the



positioned on the “Delete” button or on mouse
row or rows to be deleted.” with “yes”



click
option



Delete button should work on multiple deletes




based on the check box or boxes selected. If




the user clicks on the delete button without




checking any of the check box should throw




error message.




Success: Deletes the row or rows from the




table (temporary storage)



Check
On clicking the “Check All” link should check all
Not Applicable


All
the check boxes in the HTML table.



Clear All
On clicking the “Clear All” link should uncheck
Not Applicable



all the checked check boxes in the HTML table.



Edit
Should function with Enter Key Cursor




positioned on the “Edit” button or on mouse




click.




Refer Interface flow on scenarios - “edit data”



Save
Should function with enter key cursor
Not Applicable



positioned on the “Save” button or on mouse




click.




On saving the data the data gets saved to the




permanent repository.



Cancel
All the data entered is reset with empty/initial
Not Applicable



values in the data entry fields as the case may




be (Text Field, List etc).




If a row is already modified and added to the




table on the screen and the Cancel button is




pressed, the row remains with the modified




values



Browser
When a user tries to close the window with out
Error Dialog box message: “Do you


Window
saving data into the permanent repository, a
want to save all changes before



dialog box pops up
closing/leaving the window? ” with a




“Yes” and “No” option.




On press of “Yes” leads to saving of




information and “No” leads to the




source type screen with the original




values









3.1.3. User Interface ID: Source Sub Type
3.1.3.1. Screen name: Source Sub Type (BPI_CAS_SM_SCR—001—002) (See FIG. M-3)
3.1.3.2. SID, Element Name, Element Type & Purpose













Element
Element




Name
Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the screen being


“Source Sub

“Source Sub
navigated


Type”

Type”



Source Type
Text
Source Type
Text For “Source Type”


Source Type
Non Editable
Source Type
Search with a List of all active source types


List
field with
List
retrieved from the permanent repository.



search




Source Sub
Text
Source Sub
Text For “Source Sub Type”


Type

Type



Source Sub
Entry Field
Source Sub
Entry field for entering the source sub type


Type Entry

Type Entry



Field

Field



Description
Text
Description
Text for “Description”


Description
Entry Field
Description
Entry field for entering the description


Entry Field

Entry Field



Add
HTML Button
Add
Button for adding the Source Type/Source





Sub Type information in to the HTML table.





Changes with label “Modify” when the row in





the table is on edit mode.


Table
HTML table
Table
For displaying all the information added by





pressing the add button in the form of rows,





for every add operation/rows retrieved from





the permanent repository


Delete
Button
Delete
To delete the rows checked



(HTML





Button)




Check All
Text Link
Check All
To check all the check boxes in the table


Clear All
Text Link
Clear All
To un check all the check boxes checked in





the table/does not function when all the





checkboxes in the table are unchecked


Delete
Check box
Delete
To check the items for deletion


Edit
Button
Edit
To edit the rows entered by “Add”, “Modify”,



(HTML

displayed from permanent repository against



Button)

the row selected for editing


Save
Button
Save
Save the information to the repository



(HTML





Button)




Cancel
Button
Cancel
Cancel information as described in the





scenarios









3.1.3.3. Front End Validations












Element




Name
Action/Validation Details
Error Message Text







Source
Mandatory Entry
When the Add/Modify HTML Button


Sub
Becomes non editable when on modify mode
is pressed with an empty entry on the


Type
for data from permanent repository
source sub type entry field, an Error


Entry

Dialog Box pops up with the


Field

message “Please enter the source




sub type before adding to the table”




with “yes” option




On press of Yes Button, The cursor




must be placed on the source sub




type entry field


Source
Default - “Choose One” with list of all active
When the Add/Modify HTML Button


Type
source types
is pressed without choosing a source


List
Becomes non editable when on modify mode
type, an Error Dialog Box pops up



for data from permanent repository
with the message “Please choose




the source type before adding to the




table” with “yes” option




On press of Yes Button, The user is




allowed to choose a source type with




the original values still available for




the source sub type.


Add
On Clicking add button or the pressing the
When the Add HTML Button is



enter key field with the cursor position on the
pressed with an empty entry on the



Add button, The data gets added to the table.
source sub type entry field, an Error



Validation checks are done to not allow null
Dialog Box pops up with the



value on the source sub type entry field.
message “Please enter the source



Must not allow duplicate entries for a
sub type before adding to the table”



combination of source type and source subtype
with “yes” option.



Must not allow the length of the field entry 
When the Add HTML Button is



to go beyond as per the database design for the
pressed without choosing a source



column
type, an Error Dialog Box pops up




with the message “Please choose




the source type before adding to the




table” with “yes” option




For duplicate entries, Error dialog




box - “Duplicate values not allowed.




Please enter again”


Modify
On Clicking Modify button or the pressing the
When the “Modify” HTML Button is



enter key field with the cursor position on the
pressed with an empty entry on the



Modify button, the data gets added to the table.
source sub type entry field, an Error



Validation checks are done to not allow null
Dialog Box pops up with the



value on the source sub type entry field
message “Please enter the source



Must not allow duplicate entries for a
sub type before adding to the table”



combination of source type and source subtype
with “yes” option.



Must not allow the length of the field entry to go
On press of Yes Button, The cursor



beyond as per the database design for the
must be placed on the source entry



column
field




For duplicate entries, Error dialog 




box - “Duplicate values not allowed.




Please enter again”


Table
Should have column header and each




subsequent row should be identified by




alternate color combinations. i.e. First row




should have color ‘x’ and the next row should




have color ‘y’. The next row should have color




‘x’ again and so on. The size of any text inside




any cell should be wrapped if the text becomes




too long.




The letters must be green in color for the rows




retrieved from the permanent repository and




red for the rows in temporary storage.




All the letters of the row on edit must be in dark




gray.



Delete
Should function with enter key cursor
Error Dialog Box: “Please choose



positioned on the “Delete” button or on mouse
the row or rows to be deleted.” with



click
“yes” option



Delete button should work on multiple deletes




based on the check box or boxes selected. If




the user clicks on the delete button without




checking any of the check box should throw




error message.




Success: Deletes the row or rows from the




table (temporary storage)



Check
On clicking the “Check All” link should check all
Not Applicable


All
the check boxes in the HTML table.



Clear All
On clicking the “Clear All” link should uncheck
Not Applicable



all the checked check boxes in the HTML table.



Edit
Should function with Enter Key Cursor




positioned on the “Edit” button or on mouse




click.




Refer Interface flow on (source subtype)




scenarios - “edit data”



Save
Should function with enter key cursor
Not Applicable



positioned on the “Save” button or on mouse




click.




On saving the data the data gets saved to the




permanent repository.



Cancel
All the data entered is Cancel with empty/initial
Not Applicable



values in the data entry fields as the case may




be (Text Field, List etc).




If a row is already modified and added to the




table on the screen and the Cancel button is




pressed, the row remains with the modified




values









3.1.4. User Interface ID: Campaign Master—Create
3.1.4.1. Screen name: Campaign Master—Create (BPI_CAS_SM_SCR—001—003) (See FIG. M-4)
3.1.4.2. SID, Element Name, Element Type & Purpose













Element
Element




Name
Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the screen being


“Campaign

“Campaign
navigated


Master”

Master”



Campaign
Text
Campaign
Text For “Campaign Name”


Name

Name



Campaign
Entry field
Campaign
Entry field for entering the campaign name


Name

Name



Entry Field

Entry Field



Description
Text
Description
Text for “Description”


Description
Entry Field
Description
Entry field for entering the description


Entry Field

Entry Field



Source Type
Text
Source Type
Text for “Source Type”


Source Type
Non Editable
Source Type
Provides a list of active source types



Field with





Search




Sub Type
Text
Sub Type
Text for “Source Sub Type”


Source Sub
Non editable
Source Sub
Provides a List of active source subtypes for


Type
Field with
Type
a selected source type



Search




Import
HTML Button
Import
HTML Button with Import Label leads to





import screen for importing the data for the





campaign data.


Associated
Text
Associated
Text for “Associated Workgroups”


Workgroups

Workgroups



Associated
Combo Box
Associated
Contains the agent list added on selection


Workgroups

Workgroups
from the “Associated Workgroups” - Child


Combo Box

Combo Box
work groups available


Associated
List
Associated
List of Active workgroups - child 


Workgroups

Workgroups
work groups from database


List

List



Duration
Text
Duration
Text for “Duration”


From Date
Text
From Date
Text for “From”


To Date
Text
To Date
Text for “To”


From Date
Calendar
From Date
Calendar for From Date


To Date
Calendar
To Date
Calendar for To Date


Save
HTML Button
Save
Button for saving the data









3.1.4.3. Front End Validations












Element




Name
Action/Validation Details
Error Message Text







Campaign
Mandatory Entry
When the “Save” HTML Button is


Name

pressed with an empty entry on the


Entry

campaign name, an Error Dialog Box


Field

pops up with the message “Please




enter the Campaign Name” with




“yes” option.




On press of Yes Button, The cursor




must be placed on the campaign




name entry field


Import
Must be visible only if the source type



Button
selected has input source option as




yes



Save
On clicking the save button or pressing the
When the save HTML Button is



enter key field with the cursor positioned on
pressed with an empty entry on the



the save button, The data gets inserted to the
Campaign, an error dialog box pops



permanent repository.
up with the message “Please enter



Validation checks are done to not allow null
the campaign name” If campaign



value on the campaign name.
name is not filled up and placement



Must not allow duplicate entries for a
of cursor in respective field.



combination of campaign for a from date and
For duplicate entries, Error dialog



to date for a combination of source type and
box - “Duplicate values not allowed.



source subtype
Please enter again”



Must not allow the length of the field entry to
For Invalid dates (from



go beyond as per the database design for the
date - beyond - to date) or



column 
(To date - before - from date) - Error




dialog box -



Must choose the Source Type, Sub Type.
“Please check the validity of 



From date must not be less than the system
from and to dates” with Yes option



date - caution message
For invalid dates (from date, to date



From date must not be beyond the to date or
less than the system date) - caution



to date must not be before the from date.
message in an error dialog box -



To date must not be lesser than system date -
“Dates selected is before the system



caution message
date - is it valid entry?” with yes and




no option. If Yes - acceptable and if -




No - not acceptable.




If the source type is not selected,




then on press of the save button




leads to error dialog box with error




message “Choose Source Type”




with Yes option




If the source subtype is not selected,




then on press of the save button




leads to the error dialog box with




error message “choose the source




subtype” with Yes option




On press of Yes on both cases, goes




to the screen with the original values




and enables the user to choose the




Source Type or Source Subtype









3.1.5. User Interface ID: Modify Campaign Master
3.1.5.1. Screen name: Modify Campaign Master

    
    
        Step 1 (BPI_CAS_SM_SCR—001—004) (See FIG. M-5)
        Step 2 (BPI_CAS_SM_SCR—001—005) (See FIG. M-6)
    
    


3.1.5.2. SID, Element Name, Element Type & Purpose

    
    
        Step—1:
    
    















Element
Element




Name
Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the screen being navigated


“Search 

“Search 



Campaign

Campaign



Master”

Master”



Campaign
Text
Campaign
Text For “Campaign Name”


Name

Name



Campaign
Entry Field
Campaign
Text field for entering Campaign name.


Name

Name



Campaign ID
Text
Campaign ID
Text for Campaign Id


Campaign ID
Entry Field
Campaign ID
Text field for entering campaign id


Search
Button
Search
Search for Campaigns


Cancel
Button
Cancel
Cancel the operation


Modify
Button
Modify
To edit the current record


View/Delete
Button
View/Delete
To View the current record









    
    
        Step—2:
    
    















Element
Element




Name
Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the screen being


“Modify

“Modify
navigated


Campaign

Campaign



Master”

Master”



Campaign
Text
Campaign
Text For “Campaign Name”


Name

Name



Campaign
Entry Field 
Campaign
Text for modifying Campaign name.


Name

Name



Description
Text
Description
Text for “Description”


Description
Entry Field 
Description
Entry field for modifying the description


Entry Field

Entry Field



Source Type
Text
Source Type
Text for “Source Type”


Source Type
List
Source Type
Search feature with a List of active source





types with default source type saved during





the creation of the campaign master


Sub Type
Text
Sub Type
Text for “Source Sub Type”


Source Sub
List
Source Sub
Search feature with a list of active source


Type

Type
subtypes for a selected source type with the





default value of the sub type saved during





the creation of the campaign master.


Import
HTML Button
Import
HTML Button for Import


Associated
Text
Associated
Text for “Associated Workgroups”


workgroups

workgroups



Associated
Combo Box
Associated
Contains the workgroups list added on


Workgroups

Workgroups
selection from the “Associated Workgroups” -


Combo Box

Combo Box
child workgroups available for category





“Campaign” - saved during the creation of





the campaign master


Associated
List
Associated
List of Active workgroups from database


Workgroups

Workgroups
minus the workgroup list - child 


List

List
workgroups in the combo box


Duration
Text
Duration
Text for “Duration”


From Date
Text
From Date
Text for “From”


To Date
Text
To Date
Text for “To”


From Date
Calendar
From Date
Calendar for From Date and showing the





date saved during the creation of the





campaign master


To Date
Calendar
To Date
Calendar for To Date and showing the date





saved during the creation of the campaign





master


Update
HTML Button 
Modify
Button for modifying data









3.1.5.3. Front End Validations












Element




Name
Action/Validation Details
Error Message Text







Modify in
Must choose a campaign
When the modify button is pressed


step 1

without choosing the campaign, error


screen

dialog “Choose a campaign” with a




yes option.


Campaign
Non Editable Campaign Name field



Name




Text




Import
Must be enabled only if the campaign



Button
master create record has an input




source



Modify
On clicking “Modify” button or pressing the
When the “Modify” HTML Button is



enter key field with the cursor positioned on
pressed with an empty entry on the



the “Modify” button, the data gets modified to
Campaign, an error dialog box pops



the permanent repository and makes the data
up with the message “Please enter



of an input file of the previous entry inactive.
the campaign name”



Validation checks are done to not allow null
For duplicate entries, Error dialog



value on the campaign name.
box - “Duplicate values not allowed.



Must not allow duplicate entries for a
Please enter again”



combination of campaign for a from date and
For Invalid dates (from date - 



to date for a combination of source type and
beyond - to date) or (To date - 



source subtype
before - from date) - Error dialog box -



Must not allow the length of the field entry to
“Please check the validity of from



go beyond as per the database design for the
and to dates” with Yes option



column
For invalid dates (from date, to date



From date must not be less than the system
less than the system date) - caution



date - caution message
message in an error dialog box -



From date must not be beyond the to date or
Dates selected is before the system



to date must not be before the from date.
date - is it valid entry?” with yes and



To date must not be lesser than system date -
no option. If Yes - acceptable and if



caution message
No - not acceptable.




If the source type is not selected,




then on press of the save button




leads to error dialog box with error




message “Choose Source Type”




with Yes option




If the source subtype is not selected,




then on press of the save button




leads to the error dialog box with




error message “choose the source




subtype” with Yes option




On press of Yes on both cases, goes




to the screen with the original values




and enables the user to choose the




Source Type or Source Subtype









3.1.6. User Interface ID: View Campaign Master
This screen below captures the information for viewing campaign master

    
    
        Step—1: Choose the campaign for viewing navigates to the view campaign master screen
        Step—2: View the campaign master
    
    


3.1.6.1. Screen Name: View Campaign Master (BPI_CAS_SM_SCR—001—006) (See FIG. M-7)
(See FIG. M-8)
3.1.6.2. SID, Element Name, Element Type & Purpose

    
    
        Step—1:
    
    















Element
Element




Name
Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the screen being


“Search

“Search
navigated


Campaign

Campaign



Master”

Master”



Campaign
Text
Campaign
Text For “Campaign Name”


Name

Name



Campaign
Entry Field
Campaign
Text field for entering Campaign name.


Name

Name



Campaign ID
Text
Campaign ID
Text for Campaign Id


Campaign ID
Entry Field
Campaign ID
Text field for entering campaign id


Search
Button
Search
Search for Campaigns


Cancel
Button
Cancel
Cancel the operation


Modify
Button
Modify
To edit the current record


View/Delete
Button
View/Delete
To View the current record









    
    
        Step—2:
    
    















Element
Element




Name
Type
Label
Purpose







Main Header 
Text
Main Header 
To give the heading for the screen being


“View

“View Campaign
navigated


Campaign

Master”



Master”





Campaign
Text
Campaign
Text For “Campaign Name”


Name

Name



Campaign
Text
Campaign
Non Editable field for viewing campaign


Name

Name
name


Description 
Text
Description
Text for “Description”


Description 
Text
Description
Non Editable field for viewing the description


Source Type 
Text
Source Type
Text for “Source Type”


Source Type
Text
Source Type
Non Editable field for viewing the Source





Type


Source Sub
Text
Source Sub
Text for “Source Sub Type”


Type

Type



Source Sub
Text
Source Sub
Non Editable field for viewing the 


Type

Type
Source Sub Type


Associated
Text
Associated
Text for “Associated Workgroups”


Workgroups

Workgroups



Associated
Non Editable
Associated
Contains the Workgroup list active for the


Workgroups
Combo Box
Workgroups
campaign


Combo Box

Combo Box



Duration
Text
Duration
Text for “Duration”


From Date
Text
From Date
Text for “From”


To Date
Text
To Date
Text for “To”


From Date
Text
From Date
Shows the from date for the campaign


To Date
Text
To Date
Shows the to date for the campaign









3.1.6.3. Front End Validations












Element




Name
Action/Validation Details
Error Message Text







View in
Must choose a campaign
When the view button is pressed


step 1

without choosing the campaign, error


screen

dialog “Choose a campaign” with a




yes option.









3.1.7. Screen Flow (See FIG. M-9)
4. Business Rule Mapping
Source Type











Activity
Rules







Create Source Type
Should have unique Id for a source Type - 10



digits with an increment of 1, Say 0000000001,



0000000002, 0000000003 and so on.









Source Sub Type











Activity
Rules







Create Source Sub Type
Should have unique Id 10 digit for a source sub



type with an increment of 1, Say 0000000001,



0000000002, 0000000003 and so on.









Campaign











Activity
Rules







Create Campaign Master
Should have unique Id 10 digit for a campaign 



with an increment of 1, Say 0000000001, 



0000000002, 0000000003 and so on.









Benefit Partners Inc
Process Specification
Sales Master
1. Introduction
1.1. Purpose
This functional specification document addresses the part of the sales and marketing system that would deal with creation of master records for sales like the Lead master, Agent/Agency master.
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









BPI_SCOPE_SM_002
Agent Master



BPI_SCOPE_SM_003
Agency Master



BPI_SCOPE_SM_006
Lead Master










1.3. Definitions, Acronyms & Abbreviations















Term
Explanation









2. Process Identification
2.1. Process Description & Flow (See FIG. 10)
The user creates the sales masters which shall include lead master, agent master and agency master and has the ability to view, delete and modify apart from create function.
user can navigate to the screens from the content area or from the menus
The users also maintain tracking information of a lead in a lead master.
3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's
<List SID and the Screen Name and Corresponding HTML File for the Screen.>














Corresponding HTML File


Screen ID (SID)
Screen Name
Name







sales.leadmaster.creategeninfo
Lead Master Page 1 of 2
LeadMasterCreate1.jsp


sales.leadmaster.createotherinfo
Lead Master Page 2 of 2
LeadMasterCreate2.jsp


sales.leadmaster.search
Search Lead Master
LeadMasterSearch.jsp


sales.leadmaster.view
View Lead Master
LeadMasterView.jsp


sales.agentmaster.creategeninfo
Agent Master Page 1 of 2
AgentMasterCreate1.jsp


sales.agentmaster.createotherinfo
Agent Master Page 2 of 2
AgentMasterCreate2.jsp


sales.agentmaster.search
Search Agent Master
AgentMasterSearch.jsp


sales.agentmaster.view
View Agent Master
AgentMasterView.jsp


sales.agencymaster.creategeninfo
Agency Master Page 1 of 2
AgencyMasterCreategeninfo.jsp


sales.agencymaster.createotherinfo
Agency Master Page 2 of 2
AgencyMasterCreateotherinfo.jsp


sales.agencymaster.search
Search Agency Master
AgencyMasterSearch.jsp


sales.agencymaster.view
View Agency Master
AgencyMasterView.jsp


sales.leadmaster.leadtrack
Lead Tracking
LeadTrack.jsp









3.1.2. User Interface ID: Create Lead Master
3.1.2.1. Screen Name: Create Lead Master (BPI_CAS_SM_SCR—002—001, BPI_CAS_SM_SCR—002—002 & BPI_CAS_SM_SCR—002—003)
This screen below captures the information for creating lead master.

    
    
        Step 1: Fill the mandatory information in page1. Click “Next” to navigate to page2.
        Step 2: Fill the mandatory information in page2 and click “Save” to save the Lead Master data.
        Step 3: Saving of Lead data takes you to Confirmation page.
    
    


Page1 (BPI_CAS_SM_SCR—002—001) (See FIG. M-11)
Page2 (BPI_CAS_SM_SCR—002—002) (See FIG. M-12)
Confirmation page (BPI_CAS_SM_SCR—002—003) (See FIG. M-13)
3.1.2.2. SID, Element Name, Element Type & Purpose













Element
Element
Element



Name
Type
Type
Purpose







Lead Type
Text
Lead Type
Text showing “Lead Type”


Group Type
Text
Group Type
Text showing “Group Type”


Group Type
Select Feature
Group Type
To select “Group Type”


Association ID
Text
Association ID
Text showing 





“Association ID”


Association ID
Select Feature
Association ID
To select “Associations”, 





if the Group Type 





selected is either





Guaranteed Association or 





Endorsed Association or





PEO Association or 





Chamber Association.


Member Type
Text
Member Type
Text for “Member Type”


Member Type
Radio Button
Member Type
To select either Individual 





Member or Association 





Member if Group Type 





selected is a Guaranteed





Association who offers





both Individual and





Association Member coverage


Source Sub
Text
Source Sub
Text for “Source Sub 


Type

Type
Type”


Source Sub
Non Editable
Source Sub
Search feature for a source 


Type Search
Entry field
Type Search
Type Field


Field

Field



Sub Header
Text
Sub Header
To give the heading for 


“General

“General
the sub section


Information”

Information”



Company
Text
Company
Text for “Company Name”.


Company
Entry Field
Company
Entry field for company.


DBA
Text
DBA
Text for “DBA”.


DBA
Entry Field
DBA
Entry field for dba.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting a state in US.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Sub Header
Text
Sub Header
To give the heading for 


“Contact

“Contact
the sub section


Information”

Information”



Sub Header
Text
Sub Header
To give the heading for 


“Contact-1”

“Contact-1”
the sub section


Salutation
Text
Salutation
Text for “Salutation”


Salutation
Select Feature
Salutation
Select feature for selecting 





a salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for 





selecting a state in US.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn”


Extn
Entry Field
Extn
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Email
Text
Email
Text for “Email”


Email
Entry Field
Email
Entry Field for Email.


Sub Header
Text
Sub Header
To give the heading for 


“Contact-2”

“Contact-2”
the sub section


First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting 





a state in US.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn”


Extn
Entry Field
Extn
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Email
Text
Email
Text for “Email”


Next
HTML Button
Next
Takes the user to next screen.


Cancel
HTML Button
Cancel
Resets the Data to 





original values


Email
Entry Field
Email
Entry Field for Email.


Sub Header 
Text
Sub Header 
To give the heading for 


“Associated

“Associated
the sub section


Personnel”

Personnel”



None
Radio
None
Default radio option.


Agent
Radio
Agent
Radio for associated agent


Agent
Non-Editable
Agent
Shows the number of



Text

associated agent.


Agent-Popup
Image
Agent-Popup
Clicking this will open a





new window, using which 





user can assign agents 





for this Lead.


Agency
Radio
Agency
Radio for associated agency


Agency
Non-Editable
Agency
Shows the number of 



Text

associated agency(s).


Agency-Popup
Image
Agency-Popup
Clicking this will open 





a new window, using





which user can assign





agency(s) for this Lead.


Internal
Text
Internal
Text for “Internal 


Workgroup

Workgroup
Workgroup”


Internal
Select Feature
Internal
Shows the internal 


Workgroup

Workgroup
workgroups. User can select a 





internal workgroup for this lead.


BSS Rep
Text
BSS Rep
Text for “BSS Rep”


BSS Rep
Select Feature
BSS Rep
Shows the BSS Rep 





(Associates) 





for the selected internal 





workgroup. User can 





select a BSS Rep for this Lead.


Sub Header
Text
Sub Header
To give the heading for 


“Past Plan

“Past Plan
the sub section


Details”

Details”



Number of
Text
Number of
Text for “Number of 


Employees

Employees
Employees”


Number of
Entry Field
Number of
Entry field for entering the 


Employees

Employees
number of employees


Entry Field

Entry Field



Plan Type
Text
Plan Type
Text for “Plan Type”


Plan Type
Drop Down
Plan Type
List for selecting 


entry field
List
entry field
the Plan Type used by the 





company at present-Picks up





values based on the plan types





defined in the CM Module


Current
Text
Current 
Text for “Current Carrier”


Carrier

Carrier



Current Carrier
Drop Down 
Current Carrier
List for selecting the current 


Entry field
List
Entry field
carrier-picks up 





values from the list 





carriers available in the CM Module


Deductible
Text
Deductible
Text for “Deductible”


Deductible
Entry Field
Deductible
Entry field for entering the 


Entry field

Entry field
Deductible at present


Co Pay
Text
Co Pay
Text for “Co Pay Amount”


Amount

Amount



Co Pay
Entry Field
Co Pay
Entry field for entering 


Amount Entry

Amount 
the Co Pay Amount at 


field

Entry field
present


Benefit level in
Text
Benefit level 
Text for “Benefit Level In 


network

in network
Network”


Benefit Level
Entry Field
Benefit Level 
Entry field for entering the 


in network

in network 
current carrier


Entry field

Entry field



Benefit Level
Text
Benefit Level
Text for “Benefit Level Out of 


Out of

Out of 
Network”


Network

Network



Benefit Level
Entry Field
Benefit Level
Entry field for entering the 


Out of

Out of 
Benefit level out of 


Network

Network
network


Employer
Text
Employer
Text for “Employer 


Contribution

Contribution
Contribution”


Employer
Entry Field
Employer
Entry field for entering the 


Contribution

Contribution
employer contribution


Entry Field

Entry Field



Approximately
Text
Approximately
Text for “Approximately 


Monthly

Monthly
Monthly Premium”


Premium

Premium



Approximately
Entry Field
Approximately
Entry field for entering the 


Monthly

Monthly
Approximately


Premium Entry

Premium Entry
Monthly Premium at 


Field

Field
present.


Renewal Date
Text
Renewal Date
Text for “Renewal Date”


Renewal Date
Entry Field
Renewal Date
Entry field for entering Date.


Renewal Date
Image
Renewal Date
User Can click on this image 


Image

Image
and select the date 





using calendar window.


Sub Header
Text
Sub Header
To give the heading for 


“Other

“Other
the sub section


Information”

Information”



Best Time to
Text
Best Time to
Text for “Best Time to Call”


Call

Call



Best Time to
Entry field
BestTime to
entry field for entering the 


Call

Call
best time to call.


Comments
Text
Comments
Text for “Comments”


Comments
Entry field
Comments
Entry Field for the comments


Entry Field

Entry Field



Mode of
Text
Mode of
Text for “”Mode of 


Communication

Communication
Communication


Mode Of
List
Mode Of
List providing the list of mode of 


Communication

Communication
communication —Shall include Email,





Fax, USPS


Previous
HTML Button
Previous
Takes user to the Previous page.


Save
HTML Button
Save
Saves the Data.


Cancel
HTML Button
Cancel
Resets the Data to original values









3.1.2.3. Front End Validations












Element
Action/Validation
Error Message 


Name
Details
Text







Group Type
Mandatory.
Error Dialog Box on Save “Is




Required”.


Association
For Guaranteed Association or Endorsed
Error Dialog Box on Save “Is


ID
Association or PEO Association or Chamber
Required”



Association, Association is Mandatory



Member Type
For Guaranteed Association, Member Type is




Mandatory



Company
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save


Name
Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”


Zip
Mandatory. Accepts exactly 5 numeric digits.
Error Dialog Box “Accepts




exactly 5 digits number only”.


Contact1 First
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save


Name
Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”


Contact1 Zip
Mandatory. Accepts exactly 5 numeric digits.
Error Dialog Box “Accepts




exactly 5 digits number only”.


Internal
Mandatory.
Error Dialog on Save “Is


workgroup

Required”.









3.1.2.4. Screen Flow
The following are the scenarios the user may come across when operating on the screen:











Scenario
Description







Next
The User can navigate to the next screen (page2).


Previous
The User can navigate to the previous screen (page1).


Save
The system checks for all the validations for all the 



mandatory information filled up, the system successfully 



saves the data.



Upon saving the data, shows a Confirmation page to the user.


Cancel
The User can have the information reset to the original values









3.1.3. User Interface ID: Search Lead Master
3.1.3.1. Screen Name: Search Lead Master (BPI_CAS_SM_SCR—002—004)
This screen below captures the information for searching an existing “Lead”.

    
    
        Step 1: Enter the mandatory lead information and click the search button. This page will display the result of search. User can choose a lead and navigate to either “Modify” screen or “View/Delete” screen. (See FIG. M-14)
    
    


3.1.3.2. SID, Element Name, Element Type & Purpose













Element
Element




Name
Type
Label
Purpose







Main Header
Text
Main Header 
To give the heading for 


“Lead Search”

“Lead Search”
the screen


Lead ID
Text
Lead ID
Text for “Lead ID”


Lead ID
Entry Field
Lead ID
Entry field for lead id


Lead Type
Text
Lead Type
Text For “Lead ID”


Lead Type
Select 
Lead Type
Select Feature for selecting 



Feature

the Group Type


First Name
Text
First Name
Text For “First Name”


First Name
Entry Field
First Name
Entry field for First Name


Last Name
Text
Last Name
Entry field for Last Name


Last Name
Entry Field
Last Name
Entry field for Last Name


Company
Text
Company
Text For “First “Company”


Company
Entry Field
Company
Entry field for Company


Phone
Text
Phone
Entry field for “Phone”


Phone
Entry Field
Phone
Entry field for Phone


Lead Button
Radio
Lead Button
Used to select the lead for 


Radio
Button
Radio
modifying or 





viewing/deleting.


Modify
HTML 
Modify
Leads to the modify screen 



Button

of the selected lead


View/Delete
HTML 
View/Delete
Leads to the view/delete 



Button

screen of the selected









3.1.3.3. Front End Validations












Element
Action/Validation 
Error Message 


Name
Details
Text







Lead ID
Mandatory. Any one of the fields 
Error Dialog Box on Search



in the search screen is mandatory. 
“Accepts Alphanumeric 



Accepts Alphanumeric values only
values only.”









3.1.3.4. Screen Flow
The following are the scenarios the user may come across when operating on the search screen.











Scenario
Description







Search
The system checks for all the validations for all the mandatory 



information. Fetches the lead(s) that matches with the search



conditions.


Cancel
Clears the search fields









3.1.4. User Interface ID: Modify Lead Master
3.1.4.1. Screen Name: Modify Lead Master (BPI_CAS_SM_SCR—002—005, BPI_CAS_SM_SCR—002—006 & BPI_CAS_SM_SCR—002—007)
This screen below captures the information for modifying lead master.

    
    
        Step—1: Using search screen (BPI_CAS_SM_SCR—002—004), search the available Lead(s).
        Step—2: Select a Lead and click “Modify” to navigate to page1.
        Step—3: Modify the lead information and click “Next” to navigate you to page2.
        Step—4: Click the “Save” to save the modified lead information.
        Step—5: Saving of Lead data takes you to Confirmation page.
    
    


Page1 (BPI_CAS_SM_SCR—002—005) (See FIG. M-15)
Page2 (BPI_CAS_SM_SCR—002—006) (See FIG. M-16)
Confirmation Page (BPI_CAS_SM_SCR—002—007) (See FIG. M-17)
3.1.4.2. SID, Element Name, Element Type & Purpose













Element
Element
Element



Name
Type
Type
Purpose







Lead Type
Text
Lead Type
Text showing “Lead 





Type”


Group Type
Text
Group Type
Text showing “Group 





Type”


Group Type
Select 
Group Type
To select “Group Type”



Feature




Association ID
Text
Association ID
Text showing “Association 





ID”


Association ID
Select 
Association ID
To select “Associations”, 



Feature

if the Group Type selected 





is either Guaranteed 





Association or 





Endorsed Association or 





PEO Association or





Chamber Association.


Member Type
Text
Member Type
Text for “Member Type”


Member Type
Radio 
Member Type
To select either Individual 



Button

Member or Association 





Member if Group Type 





selected is a





Guaranteed Association 





who offers both Individual 





and Association Member 





coverage


Source Sub
Text
Source Sub
Text for “Source Sub 


Type

Type
Type”


Source Sub
Non 
Source Sub
Search feature for a 


Type Search
Editable
Type Search
source Type Field


Field
Entry field
Field



Sub Header
Text
Sub Header
To give the heading for the 


“General

“General
sub section


Information”

Information”



Company
Text
Company
Text for “Company 





Name”.


Company
Entry Field
Company
Entry field for company.


DBA
Text
DBA
Text for “DBA”.


DBA
Entry Field
DBA
Entry field for dba.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street 





address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select 
State
Select feature for selecting 



Feature

a state in US.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Sub Header
Text
Sub Header
To give the heading for the 


“Contact

“Contact
sub section


Information”

Information”



Sub Header
Text
Sub Header
To give the heading for the 


“Contact-1”

“Contact-1”
sub section


Salutation
Text
Salutation
Text for “Salutation”


Salutation
Select 
Salutation
Select feature for selecting 



Feature

a salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Street Address
Text
Street Address 
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street 





address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select
State
Select feature for selecting 



Feature

a state in US.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn”


Extn
Entry Field
Extn
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Email
Text
Email
Text for “Email”


Email
Entry Field
Email
Entry Field for Email.


Sub Header
Text
Sub Header
To give the heading for the 


“Contact-2”

“Contact-2”
sub section


First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Street Address
Text
Street Address 
Text for “Street Address”.


Street Address 
Entry Field
Street Address 
Entry field for street 





address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select 
State
Select feature for selecting 



Feature

a state in US.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn”


Extn
Entry Field
Extn
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Email
Text
Email
Text for “Email”


Next
HTML 
Next
Takes the user to next 



Button

screen.


Cancel
HTML 
Cancel
Resets the Data to original 



Button

values


Email
Entry Field
Email
Entry Field for Email.


Sub Header 
Text
Sub Header 
To give the heading for 


“Associated

“Associated
the sub section


Personnel”

Personnel”



None
Radio
None
Default radio option.


Agent
Radio
Agent
Radio for associated agent


Agent
Non-Edit-
Agent
Shows the number of



able Text

associated agent.


Agent-Popup
Image
Agent-Popup
Clicking this will open a 





new window, using 





which user can assign 





agents for this Lead.


Agency
Radio
Agency
Radio for associated 





agency


Agency
Non-Edit-
Agency
Shows the number of 



able Text

associated agency(s).


Agency-Popup
Image
Agency-Popup
Clicking this will open a 





new window, using which 





user can assign agency(s) 





for this Lead.


Internal
Text
Internal
Text for “Internal 


Workgroup

Workgroup
Workgroup”


Internal
Select 
Internal
Shows the internal 



Feature

workgroups.


Workgroup

Workgroup
User can select a internal





workgroup for this lead.


BSS Rep
Text
BSS Rep
Text for “BSS Rep”


BSS Rep
Select 
BSS Rep
Shows the BSS Rep 



Feature

(Associates) for the





selected internal 





workgroup. User can select 





a BSS Rep for this Lead.


Sub Header
Text
Sub Header
To give the heading for the


“Past Plan

“Past Plan
sub section


Details”

Details”



Number of
Text 
Number of
Text for “Number of 


Employees

Employees
Employees”


Number of
Entry Field
Number of
Entry field for entering the 


Employees

Employees
number of employees


Entry Field

Entry Field



Plan Type
Text
Plan Type
Text for “Plan Type”


Plan Type
Drop Down
Plan Type
List for selecting the


entry field
List
entry field
Plan Type used by the 





company at present- Picks 





up values based on the 





plan types defined in 





the CM Module


Current
Text
Current Carrier
Text for “Current Carrier”


Carrier





Current
Drop Down
Current Carrier
List for selecting the 


Carrier Entry
List
Entry field
current carrier- picks 


field


up values 





from the list carriers 





available in the CM 





Module


Deductible
Text
Deductible
Text for “Deductible”


Deductible
Entry Field
Deductible
Entry field for entering the 


Entry field

Entry field
Deductible at present


Co Pay
Text
Co Pay
Text for “Co Pay Amount”


Amount

Amount



Co Pay
Entry Field
Co Pay
Entry field for entering 


Amount Entry

Amount Entry
the Co Pay 


field

field
Amount at present


Benefit level in
Text
Benefit level in
Text for “Benefit Level In 


network

network
Network”


Benefit Level
Entry Field
Benefit Level in
Entry field for entering the 


in network

network Entry
current carrier


Entry field

field



Benefit Level
Text
Benefit Level
Text for “Benefit Level 


Out of

Out of Network
Out of Network”


Network





Benefit Level
Entry Field
Benefit Level
Entry field for entering the 


Out of

Out of Network
Benefit level out of 


Network


network


Employer
Text
Employer
Text for “Employer 


Contribution

Contribution
Contribution”


Employer
Entry Field
Employer
Entry field for entering the 


Contribution

Contribution
employer contribution


Entry Field

Entry Field



Approximately
Text
Approximately
Text for “Approximately 


Monthly

Monthly
Monthly Premium”


Premium

Premium



Approximately
Entry Field
Approximately
Entry field for entering 


Monthly

Monthly
the Approximately


Premium Entry

Premium Entry
Monthly Premium at 


Field

Field
present.


Renewal Date
Text
Renewal Date
Text for “Renewal Date”


Renewal Date
Entry Field
Renewal Date
Entry field for entering 





Date.


Renewal Date
Image
Renewal Date
User Can click on this 


Image

Image
image and select the date





using calendar window.


Sub Header
Text
Sub Header
To give the heading for 


“Other

“Other
the sub section


Information”

Information”



Best Time to
Text
Best Time to
Text for “Best Time to 


Call

Call
Call”


Best Time to
Entry field
Best Time to
entry field for entering the 


Call

Call
best time to call.


Comments
Text
Comments
Text for “Comments”


Comments
Entry field
Comments
Entry Field for the 


Entry Field

Entry Field
comments


Mode of
Text
Mode of
Text for “”Mode of 


Communication

Communication
Communication


Mode Of
List
Mode Of
List providing the list of 


Communication

Communication
mode of





communication —Shall 





include Email, Fax, USPS


Previous
HTML 
Previous
Takes user to the Previous 



Button

page.


Save
HTML 
Save
Saves the Data.



Button




Cancel
HTML 
Cancel
Resets the Data to original



Button

values









3.1.4.3. Front End Validations












Element
Action/Validation 
Error Message 


Name
Details
Text







Group Type
Mandatory.
Error Dialog Box on Save 




“Is Required”.


Association
For Guaranteed Association or 
Error Dialog Box on Save 


ID
Endorsed Association or PEO 
“Is Required”



Association or Chamber 




Association, Association is 




Mandatory



Member Type
For Guaranteed Association, 




Member Type is Mandatory



Company
Mandatory. Accepts all 
Error Dialog Box on Save


Name
alphanumeric and Special 
“Accepts all alphanumeric 



characters except double 
and Special characters



quotes.
except double quotes”


Zip
Mandatory. Accepts exactly 
Error Dialog Box 



5 numeric digits.
“Accepts exactly 




5 digits number only”.


Contact1 First
Mandatory. Accepts all 
Error Dialog Box on Save


Name
alphanumeric and Special
“Accepts all alphanumeric 



characters except double 
and Special 



quotes.
characters except




double quotes”


Contact1 Zip
Mandatory. Accepts exactly 
Error Dialog Box 



5 numeric digits.
“Accepts exactly 5 digits 




number only”. 


Internal
Mandatory.
Error Dialog on 


workgroup

Save “Is Required ”.









3.1.4.4. Screen Flow
The following are the scenarios the user may come across when operating on the screen:











Scenario
Description







Next
The User can navigate to the next screen (page2).


Previous
The User can navigate to the previous screen (page1).


Save
The system checks for all the validations for all the 



mandatory information filled up, the system successfully 



saves the data.



Upon saving the data, shows a Confirmation page to the user.


Cancel
The User can have the information reset to the original values









3.1.5. User Interface ID: View & Delete Lead Master
3.1.5.1. Screen Name: View & Delete Lead Master (BPI_CAS_SM_SCR—002—008 & BPI_CAS_SM_SCR—002—009)
This screen below captures the information for view/delete lead master.

    
    
        Step—1: Using search screen (BPI_CAS_SM_SCR—002—004), search the available Lead(s).
        Step—2: Select a Lead and click “View/Delete” to navigate to view/delete page.
        Step—3: Click the “Delete” to delete the lead information.
        Step—4: Deletion of Lead data takes you to Confirmation page.
    
    


View/Delete Page (BPI_CAS_SM_SCR—002—08) (See FIG. M-18)
Confirmation Page (BPI_CAS_SM_SCR—002—09) (See FIG. M-19)
DB Admin should only do Delete Lead Master. The “inactivation” of a Lead Master should change the status of Lead as “Dead”. The only other case for “Delete” as noted here would be to get rid of erroneous information added to the system; for this we should prompt for specific reasons as to why the Lead is being deleted. Upon deletion, the status of Lead is changed to “2” in DB.
3.1.5.2. SID, Element Name, Element Type & Purpose













Element
Element




Name
Type
Label
Purpose







Lead ID
Text
Lead ID
Text showing “Lead ID”


Lead ID
Read-only 
Lead ID
Shows the value of 



Text

“Lead ID”


Sub Header
Text
Sub Header
To give the heading 


“Master
“Master

for the sub section


Information”
Information”




Group Type
Text
Group Type
Text showing “Group 





Type”


Group Type
Read-only 
Group Type
Shows the value of 



Text

“Group Type”


Association
Text
Association
Text showing 


Type

Type
“Association ID”


Association
Read-only 
Association
Shows the value of 


Type
Text
Type
“Association Type”


Member Type
Text
Member Type
Text for “Member Type”


Member Type
Read-only 
Member Type
Shows the value of 



Text

“Member Type”


Source Sub
Text
Source
Sub Text for “Source Sub 


Type

Type
Type”


Source Sub
Read-only 
Source Sub
Shows the value of 


Type Search
Text
Type Search
“Source sub type”


Field

Field



Sub Header
Text
Sub Header
To give the heading for 


“General

“General
the sub section


Information”

Information”



Company
Text
Company
Text for “Company 





Name”.


Company
Read-only 
Company
Shows the value of 



Text

company.


DBA
Text
DBA
Text for “DBA”.


DBA
Read-only 
DBA
Shows the value of dba.



Text




Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Read-only 
Street Address
Shows the value of street



Text

address.


Suite
Text
Suite
Text for “Suite”


Suite
Read-only 
Suite
Shows the value of Suite.



Text




City
Text
City
Text for “City”


City
Read-only 
City
Shows the value of City.



Text




State
Text
State
Text for “State”


State
Read-only 
State
Shows the value of state



Text




Zip
Text
Zip
Text for “Zip”


Zip
Read-only 
Zip
Shows the value for Zip.



Text




Phone
Text
Phone
Text for “Phone”


Phone
Read-only 
Phone
Shows the value for Phone.



Text




Fax
Text
Fax
Text for “Fax”


Fax
Read-only 
Fax
Shows the value for Fax.



Text




Sub Header
Text
Sub Header
To give the heading for 


“Contact

“Contact
the sub section


Information”

Information”



Sub Header
Text
Sub Header
To give the heading for 


“Contact-1”

“Contact-1”
the sub section


Salutation
Text
Salutation
Text for “Salutation”


Salutation
Read-only 
Salutation
Shows the value for 



Text

salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Read-only 
First Name
Shows the value for 



Text

First Name.


MI
Text
MI
Text for “MI”


MI
Read-only 
MI
Shows the value for MI.



Text




Last Name
Text
Last Name
Text for “Last Name”


Last Name
Read-only 
Last Name
Shows the value for Last 



Text

Name.


Street Address
Text
Street Address 
Text for “Street Address”.


Street Address
Read-only 
Street Address 
Shows the value for street 



Text

address.


Suite
Text
Suite
Text for “Suite”


Suite
Read-only 
Suite
Shows the value for Suite.



Text




Zip
Text
Zip
Text for “Zip”


Zip
Read-only 
Zip
Shows the value for Zip.



Text




City
Text
City
Text for “City”


City
Read-only 
City
Shows the value for City.



Text




State
Text
State
Text for “State”


State
Read-only 
State
Shows the value for state



Text 




Phone
Text
Phone
Text for “Phone”


Phone
Read-only 
Phone
Shows the value for Phone.



Text




Extn.
Text
Extn.
Text for “Extn”


Extn
Read-only 
Extn
Shows the value for Extn.



Text 




Fax
Text
Fax
Text for “Fax”


Fax
Read-only 
Fax
Shows the value for Fax.



Text




Email
Text
Email
Text for “Email”


Email
Read-only 
Email
Shows the value for Email.



Text




Sub Header
Text
Sub Header
To give the heading for the 


“Contact-2”

“Contact-2”
sub section


First Name
Text
First Name
Text for “First Name”


First Name
Read-only 
First Name
Shows the value for 



Text

First Name.


MI
Text
MI
Text for “Ml”


MI
Read-only 
MI
Shows the value for MI.



Text 




Last Name
Text
Last Name
Text for “Last Name”


Last Name
Read-only 
Last Name
Shows the value for 



Text

Last Name.


Street Address
Text
Street Address 
Text for “Street Address”.


Street Address
Read-only 
Street Address 
Shows the value for street 



Text 

address.


Suite
Text
Suite
Text for “Suite”


Suite
Read-only 
Suite
Shows the value for Suite.



Text




Zip
Text
Zip
Text for “Zip”


Zip
Read-only 
Zip
Shows the value for Zip.



Text




City
Text
City
Text for “City”


City
Read-only 
City
Shows the value for City.



Text




State
Text
State
Text for “State”


State
Read-only 
State
Shows the value for State.



Text




Phone
Text
Phone
Text for “Phone”


Phone
Read-only 
Phone
Shows the value for Phone.



Text




Extn.
Text
Extn.
Text for “Extn”


Extn
Read-only 
Extn
Shows the value for Extn.



Text




Fax
Text
Fax
Text for “Fax”


Fax
Read-only 
Fax
Shows the value for Fax.



Text




Email
Text
Email
Text for “Email”


Email
Read-only 
Email
Shows the value for Email.



Text




Sub Header 
Text
Sub Header 
To give the heading for the 


“Associated

“Associated
sub section


Personnel”

Personnel”



Agent
Text
Agent
Text for “Agent”


Agent
Read-only 
Agent
Shows the number of 



Text

associated agent.


Agency
Text
Agency
Text for “Agency”


Agency
Read-only 
Agency
Shows the number of 



Text

associated agency(s).


Internal
Text
Internal
Text for “Internal 


Workgroup

Workgroup
Workgroup”


Internal
Read-only 
Internal
Shows the value for 


Workgroup
Text
Workgroup
internal workgroups.


BSS Rep
Text
BSS Rep
Text for “BSS Rep”


BSS Rep
Read-only 
BSS Rep
Shows the value for BSS 



Text

Rep (Associates).


Sub Header
Text
Sub Header
To give the heading for 


“Past Plan

“Past Plan
the sub section


Details”

Details”



Number of 
Text
Number of 
Text for “Number of 


Employees

Employees
Employees”


Number of
Read-only 
Number of
Shows the value for 


Employees
Text
Employees
number of employees


Entry Field

Entry Field



Plan Type
Text
Plan Type
Text for “Plan Type”


Plan Type
Read-only 
Plan Type
Shows the value for 


entry field
Text
entry field
Plan Type.


Current
Text
Current Carrier
Text for “Current Carrier”


Carrier





Current
Read-only 
Current Carrier
Shows the value for 


Carrier Entry
Text
Entry field
current carrier


field





Deductible
Text
Deductible
Text for “Deductible”


Deductible
Read-only 
Deductible
Shows the value for 


Entry field
Text
Entry field
Deductible at present


Co Pay
Text
Co Pay
Text for “Co Pay Amount”


Amount

Amount



Co Pay
Read-only 
Co Pay
Shows the value for Co 


Amount Entry
Text
Amount Entry
Pay Amount at present


field

field



Benefit level in 
Text
Benefit level in 
Text for “Benefit Level In 


network

network
Network”


Benefit Level
Read-only 
Benefit Level in
Shows the value for 


in network
Text
network Entry
current carrier


Entry field

field



Benefit Level
Text
Benefit Level
Text for “Benefit Level 


Out of

Out of Network
Out of Network”


Network





Benefit Level
Read-only 
Benefit Level
Shows the value for 


Out of
Text
Out of Network
Benefit level out of 


Network


network


Employer
Text
Employer
Text for “Employer 


Contribution

Contribution
Contribution”


Employer
Read-only 
Employer
Shows the value for 


Contribution
Text
Contribution
employer contribution


Entry Field

Entry Field



Approximately
Text
Approximately
Text for “Approximately 


Monthly

Monthly
Monthly Premium”


Premium

Premium



Approximately
Read-only 
Approximately
Shows the value for 


Monthly
Text
Monthly
Monthly 


Premium Entry

Premium Entry
Premium at present.


Field

Field



Renewal Date
Text
Renewal Date
Text for “Renewal Date”


Renewal Date
Read-only 
Renewal Date
Shows the value for 



Text

Renewal Date.


Sub Header
Text
Sub Header
To give the heading for the 


“Other

“Other
sub section


Information”

Information”



Best Time to
Text
Best Time to
Text for“Best Time to 


Call

Call
Call”


Best Time to
Read-only 
Best Time to
Shows the value for the 


Call
Text
Call
best time to call.


Comments
Text
Comments
Text for “Comments”


Comments
Read-only 
Comments
Shows the value for 


Entry Field
Text
Entry Field
comments


Mode of
Text
Mode of
Text for—Mode of 


Communication

Communication
Communication


Mode Of
Read-only 
Mode Of
Shows the value for mode 


Communication
Text
Communication
of communication


New Lead
HTML 
New Lead
Takes the user to “Create 



Button

Lead Master” screen


Delete
HTML 
Delete
Deletes the Lead Master in 



Button

database.









3.1.5.3. Front End Validations
None
3.1.5.4. Screen Flow
The following are the scenarios the user may come across when operating on the step2 screen.














Scenario
Description









New Lead
Used to Navigate to “Create Lead Master” screen.



Delete
Inactivates (Delete) the Record.










3.1.6. User Interface ID: Create Agent Master
3.1.6.1. Screen Name: Create Agent Master (BPI_CAS_SM_SCR—002—010, BPI_CAS_SM_SCR—002—011 & BPI_CAS_SM_SCR—002—012)
This screen below captures the information for creating agent master.

    
    
        Step—1: Fill the mandatory information in page1. Click “Next” to navigate to page2.
        Step—2: Fill the mandatory information in page2 and click “Save” to save the Agent Master data.
        Step—3: Saving of Agent data takes you to Confirmation page.
    
    


Page1 (BPI_CAS_SM_SCR—002—010) (See FIG. M-20)
Page2 (BPI_CAS_SM_SCR—002—011) (See FIG. M-21)
Confirmation page (BPI_CAS_SM_SCR—002—012) (See FIG. M-22)













Element Name 
Element Type
Label
Purpose







Sub Header
Text
Sub Header
To give the heading for the sub section


“Agent

“Agent



Information”

Information”



First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Company
Text
Company
Text for “Company Name”.


Name

Name



Company
Entry Field
Company
Entry field for company.


Name

Name



DBA
Text
DBA
Text for “DBA”.


DBA
Entry Field
DBA
Entry field for dba.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting a state in U.S.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Entry Field
Extn.
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Mode of
Text
Mode of
Text for “Mode of Communication”


communication

communication



Mode of
Entry Field
Mode of
Entry Field for Mode of Communication.


Communication

Communication



Gender
Text
Gender
Text for “Gender”


Gender
Select Feature
Gender
Select feature for gender.


Email
Text
Email
Text for Email.


Email
Entry Field
Email
Entry Field for “Email”


Date of Birth
Text
Date of Birth
Text for Email.


Date of Birth
Entry Field
Date of Birth 
Entry Field for Date of Birth.


Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact

“Contact



Information”

Information”



Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact - 1”

“Contact - 1”



Salutation
Text
Salutation
Text for “Salutation”


Salutation
Select Feature
Salutation
Select feature for selecting a salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting a state in U.S.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Entry Field
Extn.
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Email
Text
Email
Text for Email.


Email
Entry Field
Email
Entry Field for “Email”


Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact - 2”

“Contact - 2”



Salutation
Text
Salutation
Text for “Salutation”


Salutation
Select Feature
Salutation
Select feature for selecting a salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting a state in U.S.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Entry Field
Extn.
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Email
Text
Email
Text for Email.


Email
Entry Field
Email
Entry Field for “Email”


Next
HTML Button
Next
Takes user to the Next page.


Cancel
HTML Button
Cancel
Resets the Data to original values


Broker Type
Text
Broker Type
Text for “Broker Type”


Broker Type
Radio Buttons
Broker Type
Statewide, Regional and Unknown (default)


Sub Header

Sub Header



“Additional

“Additional



Preferences”

Preferences”



Exclude from
Check box
Exclude from
If checked then Yes.


Broadcast

Broadcast



Messaging

Messaging



Exclude from
Check box
Exclude from
If checked then yes.


overdue

overdue



premium

premium



notices

notices



Exclude from
Check box
Exclude from
If checked then Yes


Employee/

Employee/



Member Term

Member Term



Letters

Letters



Exclude from
Check Box
Exclude from
If checked then Yes


Employee/

Employee/



Member Add-on

Member Add-on



Term Letters

Term Letters



Sub Header 
Text
Sub Header 
To give the heading for the sub section


“Associated

“Associated



Personnel”

Personnel”



Agent
Text
Agent
Text for “Agent Workgroup”


Workgroup

Workgroup



Agent
Non-Editable
Agent
Shows the number of associated agent.



Text




Agent-Popup
Image
Agent-Popup
Clicking this will open a new window, using





which user can assign agents for this Lead.


Agency
Text
Agency
Text for “Agency Workgroup”


Workgroup

Workgroup



Agency
Non-Editable
Agency
Shows the number of associated agency(s).



Text




Agency-Popup
Image
Agency-Popup
Clicking this will open a new window, using





which user can assign agency(s) for this





Lead.


Internal
Text
Internal
Text for “Internal Workgroup”


Workgroup

Workgroup



Internal
Select Feature 
Internal
Shows the internal workgroups. User can


Workgroup

Workgroup
select a internal workgroup for this lead.


BSS Rep
Text
BSS Rep
Text for “BSS Rep”


BSS Rep
Select Feature 
BSS Rep
Shows the BSS Rep (Associates) for the





selected internal workgroup. User can select





a BSS Rep for this Lead.


Sub Header 
Text
Sub Header 
Text for License Information


“License

“License



Information”

Information”



Tax ID/SSN
Text
Tax ID/SSN
Text For “Tax ID/SSN”


TaxID/SSN
Entry field
TaxID/SSN
Entry field for entering the TAX ID/SSN


Entry Field

Entry Field



License
Text
License
Text for “License Number”


Number

Number



License
Calendar
License
Calendar


Expiration

Expiration



E&O Number
Text
E&O Number
Text for “E&O”


E&O Number
Entry Field
E&O Number
Entry field for E&O Number


E&O
Text
E&O
Text for “E&O Expiration List”


Expiration

Expiration



E&O
Editable
E&O 
Calendar for E&O expiration calendar


Expiration
text/Calendar
Expiration



Sub Header 
Text
Sub Header 
To give the heading for the subsection


“Bank

“Bank



Information”

Information”



Preferred Mode 
Text
Preferred Mode
Text for “Preferred Mode of Payment”


of Payment

of Payment



Preferred Mode
Radio Button
Preferred Mode 
Check or ACH


of Payment

of Payment



Bank Name
Text
Bank Name
Text for Bank Name


Bank Name
Entry Field
Bank Name
Entry field for Bank Name


Account
Text
Account
Text for Account Number


Number

Number



Account
Entry field
Account
Entry Field For Account Number


Number

Number



Routing
Text
Routing
Text for Routing Number


Number

Number



Routing
Entry field
Routing
Entry Field for Routing Number


Number

Number



Account Type
Text
Account Type
Text for Account Type


Account Type 
Select feature
Account Type 
Select feature to select the type of account


Name on the
Text
Name on the
Text for “Name on the account”


Account

Account



Name on the
Entry Field
Name on the
Entry field for “Name on the Account”


Account

Account



Payee Name
Text
Payee Name
Text for Payee Name


Payee Name
Entry field
Payee Name
Entry Field for Payee Name


Requires
Check Box
Requires
Check box for “requires special handling”


Special

Special
if checked - means Yes


Handling

Handling



Previous
HTML Button
Previous
Takes user to the Previous page.


Save
HTML Button
Save
Saves the Data.


Cancel
HTML Button
Cancel
Resets the Data to original values









3.1.6.2. SID, Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Sub Header
Text
Sub Header
To give the heading for the sub section


“Agent

“Agent



Information”

Information”



First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Company
Text
Company
Text for “Company Name”.


Name

Name



Company
Entry Field
Company
Entry field for company.


Name

Name



DBA
Text
DBA
Text for “DBA”.


DBA
Entry Field
DBA
Entry field for dba.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting a state in U.S.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Entry Field
Extn.
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Mode of
Text
Mode of
Text for “Mode of Communication”


communication

communication



Mode of
Entry Field
Mode of
Entry Field for Mode of Communication.


Communication

Communication



Gender
Text
Gender
Text for “Gender”


Gender
Select Feature
Gender
Select feature for gender.


Email
Text
Email
Text for Email.


Email
Entry Field
Email
Entry Field for “Email”


Date of Birth
Text
Date of Birth
Text for Email.


Date of Birth
Entry Field
Date of Birth
Entry Field for Date of Birth.


Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact

“Contact



Information”

Information”



Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact - 1”

“Contact - 1”



Salutation
Text
Salutation
Text for “Salutation”


Salutation
Select Feature
Salutation
Select feature for selecting a salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting a state in U.S.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Entry Field
Extn.
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Email
Text
Email
Text for Email.


Email
Entry Field
Email
Entry Field for “Email”


Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact - 2”

“Contact - 2”



Salutation
Text
Salutation
Text for “Salutation”


Salutation
Select Feature
Salutation
Select feature for selecting a salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting a state in U.S.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Entry Field
Extn.
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Email
Text
Email
Text for Email.


Email
Entry Field
Email
Entry Field for “Email”


Next
HTML Button
Next
Takes user to the Next page.


Cancel 
HTML Button
Cancel
Resets the Data to original values


Broker Type
Text
Broker Type
Text for “Broker Type”


Broker Type
Radio Buttons
Broker Type
Statewide, Regional and Unknown (default)


Sub Header

Sub Header



“Additional

“Additional



Preferences”

Preferences”



Exclude from
Check box
Exclude from
If checked then Yes.


Broadcast

Broadcast



Messaging

Messaging



Exclude from
Check box
Exclude from
If checked then yes.


overdue

overdue



premium

premium



notices

notices



Exclude from
Check box
Exclude from
If checked then Yes


Employee/

Employee/



Member Term

Member Term



Letters

Letters



Exclude from
Check Box
Exclude from
If checked then Yes


Employee/

Employee/



Member Add-on

Member Add-on



Term Letters

Term Letters



Sub Header 
Text
Sub Header 
To give the heading for the sub section


“Associated

“Associated



Personnel”

Personnel”



Agent
Text
Agent
Text for “Agent Workgroup”


Workgroup

Workgroup



Agent
Non-Editable
Agent
Shows the number of associated agent.



Text




Agent-Popup
Image
Agent-Popup
Clicking this will open a new window, using





which user can assign agents for this Lead.


Agency
Text
Agency
Text for “Agency Workgroup”


Workgroup

Workgroup



Agency
Non-Editable
Agency
Shows the number of associated agency(s).



Text




Agency-Popup
Image
Agency-Popup
Clicking this will open a new window, using





which user can assign agency(s) for this





Lead.


Internal
Text
Internal
Text for “Internal Workgroup”


Workgroup

Workgroup



Internal
Select Feature
Internal
Shows the internal workgroups. User can


Workgroup

Workgroup
select a internal workgroup for this lead.


BSS Rep
Text
BSS Rep
Text for “BSS Rep”


BSS Rep
Select Feature 
BSS Rep
Shows the BSS Rep (Associates) for the





selected internal workgroup. User can select





a BSS Rep for this Lead.


Sub Header 
Text
Sub Header 
Text for License Information


“License

“License



Information”

Information”



Tax ID/SSN
Text
Tax ID/SSN
Text For “Tax ID/SSN”


TaxID/SSN
Entry field
TaxID/SSN
Entry field for entering the TAX ID/SSN


Entry Field

Entry Field



License
Text
License
Text for “License Number”


Number

Number



License
Calendar
License
Calendar


Expiration

Expiration



E&O Number
Text
E&O Number
Text for “E&O”


E&O Number
Entry Field
E&O Number
Entry field for E&O Number


E&O
Text
E&O
Text for “E&O Expiration List”


Expiration

Expiration



E&O
Editable
E&O
Calendar for E&O expiration calendar


Expiration
text/Calendar
Expiration



Sub Header
Text
Sub Header 
To give the heading for the subsection


“Bank

“Bank



Information”

Information”



Preferred Mode 
Text
Preferred Mode
Text for “Preferred Mode of Payment”


of Payment

of Payment



Preferred Mode
Radio Button
Preferred Mode 
Check or ACH


of Payment

of Payment



Bank Name
Text
Bank Name
Text for Bank Name


Bank Name
Entry Field
Bank Name
Entry field for Bank Name


Account
Text
Account
Text for Account Number


Number

Number



Account
Entry field
Account
Entry Field For Account Number


Number

Number



Routing
Text
Routing
Text for Routing Number


Number

Number



Routing
Entry field
Routing
Entry Field for Routing Number


Number

Number



Account Type
Text
Account Type
Text for Account Type


Account Type
Select feature 
Account Type
Select feature to select the type of account


Name on the
Text
Name on the
Text for “Name on the account”


Account

Account



Name on the
Entry Field
Name on the
Entry field for “Name on the Account”


Account

Account



Payee Name
Text
Payee Name
Text for Payee Name


Payee Name
Entry field
Payee Name
Entry Field for Payee Name


Requires
Check Box
Requires
Check box for “requires special handling” if


Special

Special
checked - means Yes


Handling

Handling



Previous
HTML Button
Previous
Takes user to the Previous page.


Save
HTML Button
Save
Saves the Data.


Cancel
HTML Button
Cancel
Resets the Data to original values









3.1.6.3. Front End Validations












Element Name
Action/Validation Details
Error Message Text







First Name
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save



Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”.


Last Name
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save



Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”.


Company
Mandatory. Accepts all alphanumeric and 
Error Dialog Box on Save


Name
Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”


Zip
Mandatory. Accepts exactly 5 numeric digits.
Error Dialog Box “Accepts




exactly 5 digits number only”.


Contact1 First
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save


Name
Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”


Contact1 Last
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save


Name
Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”


Contact1 Zip
Mandatory. Accepts exactly 5 numeric digits.
Error Dialog Box “Accepts




exactly 5 digits number only”.


Internal
Mandatory.
Error Dialog on Save “Is


workgroup

Required”.









3.1.6.4. Screen Flow
The user enters the information on the agent master
The following are the scenarios the user may come across when operating on the screen














Scenario
Description









Save
Saves the agent data and shows the user 




confirmation page.



Next
Navigates to the page2.



Previous
Navigates to the page1.



Cancel
Resets the information










3.1.7. User Interface ID: Search Agent Master
3.1.7.1. Screen Name: Search Agent Master (BPI_CAS_SM_SCR—002—013)
This screen below captures the information for searching an existing “Agent”.

    
    
        Step—1: Enter the mandatory agent information and click the search button. This page will display the result of search. User can choose a agent and navigate to either “Modify” screen or “View/Delete” screen. (See FIG. M-23)
    
    


3.1.7.2. SID, Element Name, Element Type & Purpose













Element
Type 




Name 
Element
Label
Purpose







Main Header 
Text
Main Header 
To give the heading 


“Agent 

“Agent 
for the screen


Search”

Search”



Agent ID
Text
Agent ID
Text For “Agent ID”


Agent ID
Entry Field
Agent ID
Entry field for agent id


First Name
Text
First Name
Text For “First Name”


First Name
Entry Field
First Name
Entry field for First Name


Last Name
Text
Last Name
Text for Last Name


Last Name
Entry Field
Last Name
Entry field for Last Name


Company
Text
Company
Text For “First “Company”


Company
Entry Field
Company
Entry field for Company


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry field for Phone


Tax ID
Text
Tax ID
Text For “Tax ID”


Tax ID
Select 
Tax ID
Entry field for Tax



Feature




Agent Button
Radio 
Agent Button
Used to select the agent for 


Radio
Button
Radio
modifying or viewing/deleting.


Modify
HTML 
Modify
Agents to the modify screen 



Button

of the selected agent


View/Delete
HTML 
View/Delete
Agents to the view/delete 



Button

screen of the selected









3.1.7.3. Front End Validations












Element Name
Action/Validation Details
Error Message Text







Agent ID
Mandatory. Any one of 
Error Dialog Box on 



the fields in the search 
Search



screen is mandatory. 
“Accepts 



Accepts Alphanumeric 
Alphanumeric 



values only
values only.”









3.1.7.4. Screen Flow
The following are the scenarios the user may come across when operating on the search screen.














Scenario
Description









Search
The system checks for all the validations for all the 




mandatory information. Fetches the agent(s) that




matches with the search conditions.



Cancel
Clears the search fields










3.1.8. User Interface ID: Modify Agent Master
3.1.8.1. Screen Name: Modify Agent Master (BPI_CAS_SM_SCR—002—014, BPI_CAS_SM_SCR—002—015 & BPI_CAS_SM_SCR—002—016)
This screen below captures the information for modifying agent master.

    
    
        Step—1: Using search screen (BPI_CAS_SM_SCR—002—013), search the available Agent(s).
        Step—2: Select a Agent and click “Modify” to navigate to page1.
        Step—3: Modify the Agent information and click “Next” to navigate you to page2.
        Step—4: Click the “Save” to save the modified agent information.
        Step—5: Saving of Agent data takes you to Confirmation page.
    
    


Page1 (BPI_CAS_SM_SCR—002—014) (See FIG. M-24)
Page2 (BPI_CAS_SM_SCR—002—015) (See FIG. M-25)
Confirmation Page (BPI_CAS_SM_SCR—002—016) (See FIG. M-26)
3.1.8.2. SID, Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Sub Header
Text
Sub Header
To give the heading for the sub section


“Agent

“Agent



Information”

Information”



First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Company 
Text
Company
Text for “Company Name”.


Name

Name



Company 
Entry Field
Company
Entry field for company.


Name

Name



DBA
Text
DBA
Text for “DBA”.


DBA
Entry Field
DBA
Entry field for dba.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting a state in U.S.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Entry Field
Extn.
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Mode of
Text
Mode of
Text for “Mode of Communication”


communication

communication



Mode of
Entry Field
Mode of
Entry Field for Mode of Communication.


Communication

Communication



Gender
Text
Gender
Text for “Gender”


Gender
Select Feature
Gender
Select feature for gender.


Email
Text
Email
Text for Email.


Email
Entry Field
Email
Entry Field for “Email”


Date of Birth
Text
Date of Birth
Text for Email.


Date of Birth
Entry Field
Date of Birth
Entry Field for Date of Birth.


Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact

“Contact



Information”

Information”



Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact - 1”

“Contact - 1”



Salutation
Text
Salutation
Text for “Salutation”


Salutation
Select Feature
Salutation
Select feature for selecting a salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting a state in U.S.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Entry Field
Extn.
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Email
Text
Email
Text for Email.


Email
Entry Field
Email
Entry Field for “Email”


Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact - 2”

“Contact - 2”



Salutation
Text
Salutation
Text for “Salutation”


Salutation
Select Feature
Salutation
Select feature for selecting a salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting a state in U.S.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Entry Field
Extn.
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Email
Text
Email
Text for Email.


Email
Entry Field
Email
Entry Field for “Email”


Next
HTML Button
Next
Takes user to the Next page.


Cancel
HTML Button
Cancel
Resets the Data to original values


Broker Type
Text
Broker Type
Text for “Broker Type”


Broker Type
Radio Buttons
Broker Type
Statewide, Regional and Unknown (default)


Sub Header

Sub Header



“Additional

“Additional



Preferences”

Preferences”



Exclude from
Check box
Exclude from
If checked then Yes.


Broadcast

Broadcast



Messaging

Messaging



Exclude from
Check box
Exclude from 
If checked then yes.


overdue

overdue



premium

premium



notices

notices



Exclude from
Check box
Exclude from 
If checked then Yes


Employee/

Employee/



Member Term

Member Term



Letters

Letters



Exclude from
Check Box
Exclude from 
If checked then Yes


Employee/

Employee/



Member Add-on

Member Add-on



Term Letters

Term Letters



Sub Header 
Text
Sub Header 
To give the heading for the sub section


“Associated

“Associated



Personnel”

Personnel”



Agent
Text
Agent
Text for “Agent Workgroup”


Workgroup

Workgroup



Agent
Non-Editable
Agent
Shows the number of associated agent.



Text




Agent-Popup
Image
Agent-Popup
Clicking this will open a new window, using





which user can assign agents for this Lead.


Agency
Text
Agency
Text for “Agency Workgroup”


Workgroup

Workgroup



Agency
Non-Editable
Agency
Shows the number of associated agency(s).



Text




Agency-Popup
Image
Agency-Popup 
Clicking this will open a new window, using





which user can assign agency(s) for this





Lead.


Internal
Text
Internal
Text for “Internal Workgroup”


Workgroup

Workgroup



Internal
Select Feature
Internal
Shows the internal workgroups. User can


Workgroup

Workgroup
select a internal workgroup for this lead.


BSS Rep
Text
BSS Rep
Text for “BSS Rep”


BSS Rep
Select Feature
BSS Rep
Shows the BSS Rep (Associates) for the





selected internal workgroup. User can





select a BSS Rep for this Lead.


Sub Header 
Text
Sub Header 
Text for License Information


“License

“License



Information”

Information”



Tax ID/SSN
Text
Tax ID/SSN
Text For “Tax ID/SSN”


TaxID/SSN
Entry field
TaxID/SSN
Entry field for entering the TAX ID/SSN


Entry Field

Entry Field



License
Text
License
Text for “License Number”


Number

Number



License
Calendar
License
Calendar


Expiration

Expiration



E&O Number
Text
E&O Number
Text for “E&O”


E&O Number
Entry Field
E&O Number
Entry field for E&O Number


E&O Expiration
Text
E&O Expiration
Text for “E&O Expiration List”


E&O Expiration
Editable
E&O Expiration
Calendar for E&O expiration calendar



text/Calendar




Sub Header
Text
Sub Header 
To give the heading for the subsection


“Bank

“Bank



Information”

Information”



Preferred Mode 
Text
Preferred Mode
Text for “Preferred Mode of Payment”


of Payment

of Payment



Preferred Mode
Radio Button
Preferred Mode 
Check or ACH


of Payment

of Payment



Bank Name
Text
Bank Name
Text for Bank Name


Bank Name
Entry Field
Bank Name
Entry field for Bank Name


Account
Text
Account
Text for Account Number


Number

Number



Account
Entry field
Account
Entry Field For Account Number


Number

Number



Routing
Text
Routing
Text for Routing Number


Number

Number



Routing
Entry field
Routing
Entry Field for Routing Number


Number

Number



Account Type
Text
Account Type
Text for Account Type


Account Type
Select feature
Account Type
Select feature to select the type of account


Name on the
Text
Name on the
Text for “Name on the account”


Account

Account



Name on the
Entry Field
Name on the
Entry field for “Name on the Account”


Account

Account



Payee Name
Text
Payee Name
Text for Payee Name


Payee Name
Entry field
Payee Name
Entry Field for Payee Name


Requires
Check Box
Requires
Check box for “requires special handling” 


Special

Special
if checked - means Yes


Handling

Handling



Previous
HTML Button
Previous
Takes user to the Previous page.


Save
HTML Button
Save
Saves the Data.


Cancel
HTML Button
Cancel
Resets the Data to original values









3.1.8.3. Front End Validations












Element Name
Action/Validation Details
Error Message Text







First Name
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save



Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”.


Last Name
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save



Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”.


Company
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save


Name
Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”


Zip
Mandatory. Accepts exactly 5 numeric digits.
Error Dialog Box “Accepts




exactly 5 digits number only”.


Contact1 First 
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save


Name
Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”


Contact1 Last
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save


Name
Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”


Contact1 Zip
Mandatory. Accepts exactly 5 numeric digits.
Error Dialog Box “Accepts




exactly 5 digits number only”.


Internal
Mandatory.
Error Dialog on Save “Is


workgroup

Required”.









3.1.8.4. Screen Flow
The user enters the information on the agent master
The following are the scenarios the user may come across when operating on the screen














Scenario
Description









Save
Saves the agent data and shows the user 




confirmation page.



Next
Navigates to the page2.



Previous
Navigates to the page1.



Cancel
Resets the information










3.1.9. User Interface ID: View & Delete Agent Master
3.1.9.1. Screen Name: View & Delete Agent Master
(BPI_CAS_SM_SCR—002—017 & BPI_CAS_SM_SCR—002—018)
This screen below captures the information for view/delete agent master.

    
    
        Step—1: Using search screen (BPI_CAS_SM_SCR—002—013), search the available Agent(s).
        Step—3: Select a Agent and click “View/Delete” to navigate to view/delete page.
        Step—3: Click the “Delete” to delete the agent information.
        Step—4: Deletion of Agent data takes you to Confirmation page.
    
    


View/Delete Page (BPI_CAS_SM_SCR—002—017) (See FIG. M-27)
Confirmation Page (BPI_CAS_SM_SCR—002—018) (See FIG. M-28)
3.1.9.2. SID, Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Sub Header
Text
Sub Header
To give the heading for the sub section


“Agent

“Agent



Information”

Information”



First Name
Text
First Name
Text for “First Name”


First Name
Read-only Text
First Name
Display the value for First Name.


MI
Text
MI
Text for “MI”


MI
Read-only Text
MI
Display the value for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Read-only Text
Last Name
Display the value for Last Name.


Company
Text
Company
Text for “Company Name”.


Name

Name



Company
Read-only Text
Company
Display the value for company.


Name

Name



DBA
Text
DBA
Text for “DBA”.


DBA
Read-only Text
DBA
Display the value for dba.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Read-only Text
Street Address
Display the value for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Read-only Text
Suite
Display the value for Suite.


City
Text
City
Text for “City”


City
Read-only Text
City
Display the value for City.


State
Text
State
Text for “State”


State
Read-only Text
State
Display the value for state.


Zip
Text
Zip
Text for “Zip”


Zip
Read-only Text
Zip
Display the value for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Read-only Text
Phone
Display the value for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Read-only Text
Extn.
Display the value for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Read-only Text
Fax
Display the value for Fax.


Mode of
Text
Mode of
Text for “Mode of Communication”


communication

communication



Mode of
Read-only Text
Mode of
Display the value for Mode of Communication.


Communication

Communication



Gender
Text
Gender
Text for “Gender”


Gender
Read-only Text
Gender
Display the value for gender.


Email
Text
Email
Text for Email.


Email
Read-only Text
Email
Display the value for “Email”


Date of Birth 
Text
Date of Birth 
Text for Email.


Date of Birth 
Read-only Text
Date of Birth 
Display the value for Date of Birth.


Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact

“Contact



Information”

Information”



Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact - 1”

“Contact - 1”



Salutation
Text
Salutation
Text for “Salutation”


Salutation
Read-only Text
Salutation
Display the value for salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Read-only Text
First Name
Display the value for First Name.


MI
Text
MI
Text for “MI”


MI
Read-only Text
MI
Display the value for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Read-only Text
Last Name
Display the value for Last Name.


Company
Text
Company
Text for “Company Name”.


Name

Name



Company
Read-only Text
Company
Display the value for company.


Name

Name



DBA
Text
DBA
Text for “DBA”.


DBA
Read-only Text
DBA
Display the value for dba.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Read-only Text
Street Address
Display the value for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Read-only Text
Suite
Display the value for Suite.


City
Text
City
Text for “City”


City
Read-only Text
City
Display the value for City.


State
Text
State
Text for “State”


State
Read-only Text
State
Display the value for state.


Zip
Text
Zip
Text for “Zip”


Zip
Read-only Text
Zip
Display the value for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Read-only Text
Phone
Display the value for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Read-only Text
Extn.
Display the value for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Read-only Text
Fax
Display the value for Fax.


Email
Text
Email
Text for Email.


Email
Read-only Text
Email
Display the value for “Email”


Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact - 2”

“Contact - 2”



Salutation
Text
Salutation
Text for “Salutation”


Salutation
Read-only Text
Salutation
Display the value for salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Read-only Text
First Name
Display the value for First Name.


MI
Text
MI
Text for “MI”


MI
Read-only Text
MI
Display the value for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Read-only Text
Last Name
Display the value for Last Name.


Company
Text
Company
Text for “Company Name”.


Name

Name



Company
Read-only Text
Company
Display the value for company.


Name

Name



DBA
Text
DBA
Text for “DBA”.


DBA
Read-only Text
DBA
Display the value for dba.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Read-only Text
Street Address
Display the value for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Read-only Text
Suite
Display the value for Suite.


City
Text
City
Text for “City”


City
Read-only Text
City
Display the value for City.


State
Text
State
Text for “State”


State
Read-only Text
State
Display the value for state.


Zip
Text
Zip
Text for “Zip”


Zip
Read-only Text
Zip
Display the value for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Read-only Text
Phone
Display the value for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Read-only Text
Extn.
Display the value for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Read-only Text
Fax
Display the value for Fax.


Email
Text
Email
Text for Email.


Email
Read-only Text
Email
Display the value for “Email”


Next
HTML Button
Next
Takes user to the Next page.


Cancel
HTML Button
Cancel
Resets the Data to original values


Broker Type
Text
Broker Type
Text for “Broker Type”


Broker Type
Read-only Text
Broker Type
Display the value for Broker Type


Sub Header

Sub Header
Display the checked values


“Additional

“Additional



Preferences”

Preferences”



Sub Header
Text
Sub Header
To give the heading for the sub section


“Associated

“Associated



Personnel”

Personnel”



Agent
Text
Agent
Text for “Agent Workgroup”


Workgroup

Workgroup



Agent
Non-Editable
Agent
Shows the number of associated agent.



Text




Agency
Text
Agency
Text for “Agency Workgroup”


Workgroup

Workgroup



Agency
Non-Editable
Agency
Shows the number of associated agency(s).



Text




Internal
Text
Internal
Text for “Internal Workgroup”


Workgroup

Workgroup



Internal
Read-only Text
Internal
Shows the internal workgroups.


Workgroup

Workgroup



BSS Rep
Text
BSS Rep
Text for “BSS Rep”


BSS Rep
Read-only Text
BSS Rep
Shows the BSS Rep (Associates) for the selected





internal workgroup.


Sub Header 
Text
Sub Header 
Text for License Information


“License

“License



Information”

Information”



Tax ID/SSN
Text
Tax ID/SSN
Display the value for “Tax ID/SSN”


TaxID/SSN
Read-only Text
TaxID/SSN
Entry field for entering the TAX ID/SSN


Entry Field

Entry Field



License
Text
License
Display the value for “License Number”


Number

Number



License
Read-only Text
License
Calendar


Expiration

Expiration



E&O Number
Text
E&O Number
Text for “E&O”


E&O Number
Read-only Text
E&O Number
Display the value for E&O Number


E&O
Text
E&O
Text for “E&O Expiration List”


Expiration

Expiration



E&O
Read-only Text
E&O
Display the value for E&O expiration


Expiration

Expiration



Sub Header 
Text
Sub Header 
To give the heading for the subsection


“Bank

“Bank



Information”

Information”



Preferred Mode
Text
Preferred Mode 
Text for “Preferred Mode of Payment”


of Payment

of Payment



Preferred Mode
Read-only Text 
Preferred Mode 
Display the value for Mode of payment


of Payment

of Payment



Bank Name
Text
Bank Name
Text for Bank Name


Bank Name
Read-only Text 
Bank Name
Display the value for Bank Name


Account
Text
Account
Text for Account Number


Number

Number



Account
Read-only Text 
Account
Display the value for Account Number


Number

Number



Routing
Text
Routing
Text for Routing Number


Number

Number



Routing
Read-only Text
Routing
Display the value for Routing Number


Number

Number



Account Type
Text
Account Type
Text for Account Type


Account Type
Read-only Text 
Account Type
Display the value for type of account


Name on the
Text
Name on the
Text for “Name on the account”


Account

Account



Name on the
Read-only Text 
Name on the
Display the value for “Name on the Account”


Account

Account



Payee Name
Text
Payee Name
Text for Payee Name


Payee Name
Read-only Text 
Payee Name
Display the value for Payee Name


Requires
Read-only Text
Requires
Display the value for “requires special handling” 


Special

Special
if checked - means Yes


Handling

Handling



Previous
HTML Button
Previous
Takes user to the Previous page.


Save
HTML Button
Save
Saves the Data.


Cancel
HTML Button
Cancel
Resets the Data to original values









3.1.9.3. Front End Validations
None.
3.1.9.4. Screen Flow
The following are the scenarios the user may come across when operating on the step 2 screen.














Scenario
Description









New Agent
Used to Navigate to “Create Agent Master” screen.



Delete
Inactivates (Delete) the Record.










3.1.10. User Interface ID: Create Agency Master
3.1.10.1. Screen Name: Create Agency Master (BPI_CAS_SM_SCR—002—019, BPI_CAS_SM_SCR—002—020 & BPI_CAS_SM_SCR—002—021)
This screen below captures the information for creating agency master.

    
    
        Step—1: Fill the mandatory information in page1. Click “Next” to navigate to page2.
        Step—2: Fill the mandatory information in page2 and click “Save” to save the Agency Master data.
        Step—3: Saving of Agency data takes you to Confirmation page.

Page1 (BPI_CAS_SM_SCR—002—019) (See FIG. M-29)

Page2 (BPI_CAS_SM_SCR—002—020) (See FIG. M-30)

Confirmation page (BPI_CAS_SM_SCR—002—021) (See FIG. M-31)

    
    


3.1.10.2. SID, Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Sub Header
Text
Sub Header
To give the heading for the sub section


“General

“General



Information”

Information”



Company
Text
Company
Text for “Company Name”.


Name

Name



Company
Entry Field
Company
Entry field for company.


Name

Name



DBA
Text
DBA
Text for “DBA”.


DBA
Entry Field
DBA
Entry field for dba.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting a state in US.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Mode of
Text
Mode of
Text for “Mode of Communication”


communication

communication



Mode of
Entry Field
Mode of
Entry Field for Mode of Communication.


Communication

Communication



Date of Birth
Text
Date of Birth
Text for Email.


Date of Birth
Entry Field
Date of Birth
Entry Field for Date of Birth.


Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact

“Contact



Information”

Information”



Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact - 1”

“Contact - 1”



Salutation
Text
Salutation
Text for “Salutation”


Salutation
Select Feature
Salutation
Select feature for selecting a salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting a state in US.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Entry Field
Extn.
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Email
Text
Email
Text for Email.


Email
Entry Field
Email
Entry Field for “Email”


Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact - 2”

“Contact - 2”



Salutation
Text
Salutation
Text for “Salutation”


Salutation
Select Feature
Salutation
Select feature for selecting a salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting a state in US.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Entry Field
Extn.
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Email
Text
Email
Text for Email.


Email
Entry Field
Email
Entry Field for “Email”


Next
HTML Button
Next
Takes user to the Next page.


Cancel
HTML Button
Cancel
Resets the Data to original values


Broker Type
Text
Broker Type
Text for “Broker Type”


Broker Type
Radio Buttons 
Broker Type
Statewide, Regional and Unknown (default)


Sub Header

Sub Header



“Additional

“Additional



Preferences”

Preferences”



Exclude from
Check box
Exclude from
If checked then Yes.


Broadcast

Broadcast



Messaging

Messaging



Exclude from
Check box
Exclude from
If checked then yes.


overdue

overdue



premium

premium



notices

notices



Exclude from
Check box
Exclude from
If checked then Yes


Employee/

Employee/



Member Term

Member Term



Letters

Letters



Exclude from
Check Box
Exclude from
If checked then Yes


Employee/

Employee/



Member Add-on

Member Add-on



Term Letters

Term Letters



Sub Header 
Text
Sub Header 
To give the heading for the sub section


“Associated

“Associated



Personnel”

Personnel”



Agent
Text
Agent
Text for “Agent Workgroup”


Workgroup

Workgroup



Agent
Non-Editable
Agent
Shows the number of associated agent.



Text




Agent-Popup
Image
Agent-Popup
Clicking this will open a new window, using





which user can assign agents for this Lead.


Internal
Text
Internal
Text for “Internal Workgroup”


Workgroup

Workgroup



Internal
Select Feature 
Internal
Shows the internal workgroups. User can


Workgroup

Workgroup
select a internal workgroup for this lead.


BSS Rep
Text
BSS Rep
Text for “BSS Rep”


BSS Rep
Select Feature 
BSS Rep
Shows the BSS Rep (Associates) for the





selected internal workgroup. User can select





a BSS Rep for this Lead.


Sub Header 
Text
Sub Header 
Text for License Information


“License

“License



Information”

Information”



Tax ID/SSN
Text
Tax ID/SSN
Text For “Tax ID/SSN”


TaxID/SSN
Entry field
TaxID/SSN
Entry field for entering the TAX ID/SSN


Entry Field

Entry Field



License
Text
License
Text for “License Number”


Number

Number



License
Calendar
License
Calendar


Expiration

Expiration



E&O Number
Text
E&O Number
Text for “E&O”


E&O Number
Entry Field
E&O Number
Entry field for E& O Number


E&O
Text
E&O
Text for “E & O Expiration List”


Expiration

Expiration



E&O
Editable
E&O
Calendar for E&O expiration calendar


Expiration
text/Calendar
Expiration



Sub Header 
Text
Sub Header 
To give the heading for the subsection


“Bank

“Bank



Information”

Information”



Preferred Mode
Text
Preferred Mode 
Text for “Preferred Mode of Payment”


of Payment

of Payment



Preferred Mode
Radio Button
Preferred Mode 
Check or ACH


of Payment

of Payment



Bank Name
Text
Bank Name
Text for Bank Name


Bank Name
Entry Field
Bank Name
Entry field for Bank Name


Account
Text
Account
Text for Account Number


Number

Number



Account
Entry field
Account
Entry Field For Account Number


Number

Number



Routing
Text
Routing
Text for Routing Number


Number

Number



Routing
Entry field
Routing
Entry Field for Routing Number


Number

Number



Account Type
Text
Account Type
Text for Account Type


Account Type
Select feature 
Account Type
Select feature to select the type of account


Name on the
Text
Name on the
Text for “Name on the account”


Account

Account



Name on the
Entry Field
Name on the
Entry field for “Name on the Account”


Account

Account



Payee Name
Text
Payee Name
Text for Payee Name


Payee Name
Entry field
Payee Name
Entry Field for Payee Name


Requires
Check Box
Requires
Check box for “requires special handling” 


Special

Special
if checked - means Yes


Handling

Handling



Previous
HTML Button
Previous
Takes user to the Previous page.


Save
HTML Button
Save
Saves the Data.


Cancel
HTML Button
Cancel
Resets the Data to original values









3.1.10.3. Front End Validations












Element Name
Action/Validation Details
Error Message Text







Company
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save


Name
Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”


Zip
Mandatory. Accepts exactly 5 numeric digits.
Error Dialog Box “Accepts




exactly 5 digits number only”.


Contact1 First
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save


Name
Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”


Contact1 Last
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save


Name
Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”


Contact1 Zip
Mandatory. Accepts exactly 5 numeric digits.
Error Dialog Box “Accepts




exactly 5 digits number only”.


Internal
Mandatory.
Error Dialog on Save “Is


workgroup

Required”.









3.1.10.4. Screen Flow
The user enters the information on the agent master
The following are the scenarios the user may come across when operating on the screen














Scenario
Description









Save
Saves the agent data and shows the user 




confirmation page.



Next
Navigates to the page2.



Previous
Navigates to the page1.



Cancel
Resets the information










3.1.11. User Interface ID: Search Agency Master
3.1.11.1. Screen Name: Search Agency Master (BPI_CAS_SM_SCR—002—022)
This screen below captures the information for searching an existing “Agency”.

    
    
        Step—1: Enter the mandatory agent information and click the search button. This page will display the result of search. User can choose a agent and navigate to either “Modify” screen or “View/Delete” screen. (See FIG. M-32)
    
    


3.1.11.2. SID, Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Main Header 
Text
Main Header 
To give the heading for the screen


“Agent Search”

“Agent Search”



Agency ID
Text
Agency ID
Text For “Agency ID”


Agency ID
Entry Field
Agency ID
Entry field for agency id


Agency Name
Text
Agency Name
Text For “Agency Name”


Agency Name
Entry Field
Agency Name
Entry field for Agency Name


Phone
Text
Phone
Entry field for “Phone”


Phone
Entry Field
Phone
Entry field for Phone


Tax ID
Text
Tax ID
Text For “Tax ID”


Tax ID
Select Feature
Tax ID
Entry field for Tax


Lead Button
Radio Button
Lead Button
Used to select the agency for modifying or


Radio

Radio
viewing/deleting.


Modify
HTML Button
Modify
Leads to the modify screen of the selected





agency


View/Delete
HTML Button
View/Delete
Leads to the view/delete screen of the





selected









3.1.11.3. Front End Validations












Element Name
Action/Validation Details
Error Message Text







Agency ID
Mandatory. Any one of the fields 
Error Dialog Box on 



in the search screen is mandatory. 
Search “Accepts 



Accepts Alphanumeric
Alphanumeric



values only
values only.”









3.1.11.4. Screen Flow
The following are the scenarios the user may come across when operating on the search screen.














Scenario
Description









Search
The system checks for all the validations for all 




the mandatory information. Fetches the agency(s) 




that matches with the search conditions.



Cancel
Clears the search fields










3.1.12. User Interface ID: Modify Agency Master
3.1.12.1. Screen Name: Modify Agency Master
(BPI_CAS_SM_SCR—002—023, BPI_CAS_SM_SCR—002—024 & BPI_CAS_SM_SCR—002—025)
This screen below captures the information for modifying agency master.

    
    
        Step—1: Using search screen (BPI_CAS_SM_SCR—002—013), search the available Agency(s).
        Step—2: Select a Agency and click “Modify” to navigate to page1.
        Step—3: Modify the Agency information and click “Next” to navigate you to page2.
        Step—4: Click the “Save” to save the modified agency information.
        Step—5: Saving of Agency data takes you to Confirmation page.
    
    


Page1 (BPI_CAS_SM_SCR—002—023) (See FIG. M-33)
Page2 (BPI_CAS_SM_SCR—002—024) (See FIG. M-34)
Confirmation Page (BPI_CAS_SM_SCR—002—025) (See FIG. M-35)
3.1.12.2. SID, Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Sub Header 
Text
Sub Header 
To give the heading for the sub section


“General

“General



Information”

Information”



Company
Text
Company
Text for “Company Name”.


Name

Name



Company
Entry Field
Company
Entry field for company.


Name

Name



DBA
Text
DBA
Text for “DBA”.


DBA
Entry Field
DBA
Entry field for dba.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting a state in US.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Mode of
Text
Mode of
Text for “Mode of Communication”


communication

communication



Mode of
Entry Field
Mode of
Entry Field for Mode of Communication.


Communication

Communication



Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact

“Contact



Information”

Information”



Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact - 1”

“Contact - 1”



Salutation
Text
Salutation
Text for “Salutation”


Salutation
Select Feature
Salutation
Select feature for selecting a salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting a state in US.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Entry Field
Extn.
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Email
Text
Email
Text for Email.


Email
Entry Field
Email
Entry Field for “Email”


Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact - 2”

“Contact - 2”



Salutation
Text
Salutation
Text for “Salutation”


Salutation
Select Feature
Salutation
Select feature for selecting a salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Entry Field
First Name
Entry Field for First Name.


MI
Text
MI
Text for “MI”


MI
Entry Field
MI
Entry Field for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Entry Field
Last Name
Entry Field for Last Name.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Entry Field
Street Address
Entry field for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Entry Field
Suite
Entry Field for Suite.


City
Text
City
Text for “City”


City
Entry Field
City
Entry Field for City.


State
Text
State
Text for “State”


State
Select Feature
State
Select feature for selecting a state in US.


Zip
Text
Zip
Text for “Zip”


Zip
Entry Field
Zip
Entry Field for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry Field for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Entry Field
Extn.
Entry Field for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Entry Field
Fax
Entry Field for Fax.


Email
Text
Email
Text for Email.


Email
Entry Field
Email
Entry Field for “Email”


Next
HTML Button
Next
Takes user to the Next page.


Cancel
HTML Button
Cancel
Resets the Data to original values


Broker Type
Text
Broker Type
Text for “Broker Type”


Broker Type
Radio Buttons 
Broker Type
Statewide, Regional and Unknown (default) 


Sub Header

Sub Header



“Additional

“Additional



Preferences”

Preferences”



Exclude from
Check box
Exclude from
If checked then Yes.


Broadcast

Broadcast



Messaging

Messaging



Exclude from
Check box
Exclude from
If checked then yes.


overdue

overdue



premium

premium



notices

notices



Exclude from
Check box
Exclude from
If checked then Yes


Employee/

Employee/



Member Term

Member Term



Letters

Letters



Exclude from
Check Box
Exclude from
If checked then Yes


Employee/

Employee/



Member Add-on

Member Add-on



Term Letters

Term Letters



Sub Header 
Text
Sub Header
To give the heading for the sub section


“Associated

“Associated



Personnel”

Personnel”



Agent
Text
Agent
Text for “Agent Workgroup”


Workgroup

Workgroup



Agent
Non-Editable
Agent
Shows the number of associated agent.



Text




Agent-Popup
Image
Agent-Popup
Clicking this will open a new window, using





which user can assign agents for this Lead.


Internal
Text
Internal
Text for “Internal Workgroup”


Workgroup

Workgroup



Internal
Select Feature 
Internal
Shows the internal workgroups. User can


Workgroup

Workgroup
select a internal workgroup for this lead.


BSS Rep
Text
BSS Rep
Text for “BSS Rep”


BSS Rep
Select Feature 
BSS Rep
Shows the BSS Rep (Associates) for the





selected internal workgroup. User can select





a BSS Rep for this Lead.


Sub Header 
Text
Sub Header 
Text for License Information


“License

“License



Information“”

Information”



Tax ID/SSN
Text
Tax ID/SSN
Text For “Tax ID/SSN”


TaxID/SSN
Entry field
TaxID/SSN
Entry field for entering the TAX ID/SSN


Entry Field

Entry Field



License
Text
License
Text for “License Number”


Number

Number



License
Calendar
License
Calendar


Expiration

Expiration



E&O Number
Text
E&O Number
Text for “E&O”


E&O Number
Entry Field
E&O Number
Entry field for E&O Number


E&O
Text
E&O
Text for “E&O Expiration List”


Expiration

Expiration



E&O
Editable
E&O
Calendar for E&O expiration calendar


Expiration
text/Calendar
Expiration



Sub Header 
Text
Sub Header 
To give the heading for the subsection


“Bank

“Bank



Information”

Information”



Preferred Mode
Text
Preferred Mode 
Text for “Preferred Mode of Payment”


of Payment

of Payment



Preferred Mode
Radio Button
Preferred Mode
Check or ACH


of Payment

of Payment



Bank Name
Text
Bank Name
Text for Bank Name


Bank Name
Entry Field
Bank Name
Entry field for Bank Name


Account
Text
Account
Text for Account Number


Number

Number



Account
Entry field
Account
Entry Field For Account Number


Number

Number



Routing
Text
Routing
Text for Routing Number


Number

Number



Routing
Entry field
Routing
Entry Field for Routing Number


Number

Number



Account Type
Text
Account Type
Text for Account Type


Account Type
Select feature 
Account Type
Select feature to select the type of account


Name on the
Text
Name on the 
Text for “Name on the account”


Account

Account



Name on the
Entry Field
Name on the
Entry field for “Name on the Account”


Account

Account



Payee Name
Text
Payee Name
Text for Payee Name


Payee Name
Entry field
Payee Name
Entry Field for Payee Name


Requires
Check Box
Requires
Check box for “requires special handling” 


Special

Special
if checked - means Yes


Handling

Handling



Previous
HTML Button
Previous
Takes user to the Previous page.


Save
HTML Button
Save
Saves the Data.


Cancel
HTML Button
Cancel
Resets the Data to original values









3.1.12.3. Front End Validations












Element Name
Action/Validation Details
Error Message Text







Company
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save


Name
Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”


Zip
Mandatory. Accepts exactly 5 numeric digits.
Error Dialog Box “Accepts




exactly 5 digits number only”.


Contact1 
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save


First Name
Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”


Contact1 
Mandatory. Accepts all alphanumeric and
Error Dialog Box on Save


Last Name
Special characters except double quotes.
“Accepts all alphanumeric and




Special characters except




double quotes”


Contact1 Zip
Mandatory. Accepts exactly 5 numeric digits. 
Error Dialog Box “Accepts




exactly 5 digits number only”.


Internal
Mandatory.
Error Dialog on Save “ Is


workgroup

Required ”.









3.1.12.4. Screen Flow
The user enters the information on the agent master
The following are the scenarios the user may come across when operating on the screen














Scenario
Description









Save
Saves the agent data and shows the 




user confirmation page.



Next
Navigates to the page2.



Previous
Navigates to the page1.



Cancel
Resets the information










3.1.13. User Interface ID: View & Delete Agency Master
3.1.13.1. Screen Name: View & Delete Agency Master
(BPI_CAS_SM_SCR—002—026 & BPI_CAS_SM_SCR—002—027)
This screen below captures the information for view/delete agency master.

    
    
        Step—1: Using search screen (BPI_CAS_SM_SCR—002—013), search the available Agency(s).
        Step—2: Select a Agency and click “View/Delete” to navigate to view/delete page.
        Step—3: Click the “Delete” to delete the agency information.
        Step—4: Deletion of Agency data takes you to Confirmation page.
    
    


View/Delete Page (BPI_CAS_SM_SCR—002—026) (See FIG. M-36)
Confirmation Page (BPI_CAS_SM_SCR—002—027) (See FIG. M-37)
3.1.13.2. SID, Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Sub Header
Text
Sub Header
To give the heading for the sub section


“General

“General



Information”

Information”



Company
Text
Company
Text for “Company Name”.


Name

Name



Company
Read-only Text
Company
Display the value for company.


Name

Name



DBA
Text
DBA
Text for “DBA”.


DBA
Read-only Text
DBA
Display the value for dba.


Street Address
Text
Street Address
Text for “Street Address”.


Street Address
Read-only Text
Street Address
Display the value for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Read-only Text
Suite
Display the value for Suite.


City
Text
City
Text for “City”


City
Read-only Text
City
Display the value for City.


State
Text
State
Text for “State”


State
Read-only Text
State
Display the value for state.


Zip
Text
Zip
Text for “Zip”


Zip
Read-only Text
Zip
Display the value for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Read-only Text
Phone
Display the value for Phone.


Fax
Text
Fax
Text for “Fax”


Fax
Read-only Text
Fax
Display the value for Fax.


Mode of
Text
Mode of
Text for “Mode of Communication”


communication

communication



Mode of
Read-only Text
Mode of
Display the value for Mode of Communication.


Communication

Communication



Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact

“Contact



Information”

Information”



Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact - 1”

“Contact - 1”



Salutation
Text
Salutation
Text for “Salutation”


Salutation
Read-only Text
Salutation
Display the value for salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Read-only Text
First Name
Display the value for First Name.


MI
Text
MI
Text for “MI”


MI
Read-only Text
MI
Display the value for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Read-only Text
Last Name
Display the value for Last Name.


Street Address 
Text
Street Address 
Text for “Street Address”.


Street Address 
Read-only Text
Street Address
Display the value for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Read-only Text
Suite
Display the value for Suite.


City
Text
City
Text for “City”


City
Read-only Text
City
Display the value for City.


State
Text
State
Text for “State”


State
Read-only Text
State
Display the value for state.


Zip
Text
Zip
Text for “Zip”


Zip
Read-only Text
Zip
Display the value for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Read-only Text
Phone
Display the value for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Read-only Text
Extn.
Display the value for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Read-only Text
Fax
Display the value for Fax.


Email
Text
Email
Text for Email.


Email
Read-only Text
Email
Display the value for “Email”


Sub Header
Text
Sub Header
To give the heading for the sub section


“Contact - 2”

“Contact - 2”



Salutation
Text
Salutation
Text for “Salutation”


Salutation
Read-only Text
Salutation
Display the value for salutation.


First Name
Text
First Name
Text for “First Name”


First Name
Read-only Text
First Name
Display the value for First Name.


MI
Text
MI
Text for “MI”


MI
Read-only Text
MI
Display the value for MI.


Last Name
Text
Last Name
Text for “Last Name”


Last Name
Read-only Text
Last Name
Display the value for Last Name.


Street Address 
Text
Street Address
Text for “Street Address”.


Street Address 
Read-only Text
Street Address
Display the value for street address.


Suite
Text
Suite
Text for “Suite”


Suite
Read-only Text
Suite
Display the value for Suite.


City
Text
City
Text for “City”


City
Read-only Text
City
Display the value for City.


State
Text
State
Text for “State”


State
Read-only Text
State
Display the value for state.


Zip
Text
Zip
Text for “Zip”


Zip
Read-only Text
Zip
Display the value for Zip.


Phone
Text
Phone
Text for “Phone”


Phone
Read-only Text
Phone
Display the value for Phone.


Extn.
Text
Extn.
Text for “Extn.”


Extn.
Read-only Text
Extn.
Display the value for Extn.


Fax
Text
Fax
Text for “Fax”


Fax
Read-only Text
Fax
Display the value for Fax.


Email
Text
Email
Text for Email.


Email
Read-only Text
Email
Display the value for “Email”


Next
HTML Button
Next
Takes user to the Next page.


Cancel
HTML Button
Cancel
Resets the Data to original values


Broker Type
Text
Broker Type
Text for “Broker Type”


Broker Type
Read-only Text
Broker Type
Display the value for Broker Type


Sub Header

Sub Header
Display the checked values


“Additional

“Additional



Preferences”

Preferences”



Sub Header 
Text
Sub Header
To give the heading for the sub section


“Associated

“Associated



Personnel”

Personnel”



Agent
Text
Agent
Text for “Agent Workgroup”


Workgroup

Workgroup



Agent
Non-Editable
Agent
Shows the number of associated agent.



Text




Internal
Text
Internal
Text for “Internal Workgroup”


Workgroup

Workgroup



Internal
Read-only Text
Internal
Shows the internal workgroups.


Workgroup

Workgroup



BSS Rep
Text
BSS Rep
Text for “BSS Rep”


BSS Rep
Read-only Text
BSS Rep
Shows the BSS Rep (Associates) for the selected





internal workgroup.


Sub Header 
Text
Sub Header 
Text for License Information


“License

“License



Information”

Information”



Tax ID/SSN
Text
Tax ID/SSN
Display the value for “Tax ID/SSN”


TaxID/SSN
Read-only Text
TaxID/SSN
Entry field for entering the TAX ID/SSN


Entry Field

Entry Field



License
Text
License
Display the value for “License Number”


Number

Number



License
Read-only Text
License
Calendar


Expiration

Expiration



E&O Number
Text
E&O Number
Text for “E&O”


E&O Number
Read-only Text
E&O Number
Display the value for E&O Number


E&O
Text
E&O
Text for “E&O Expiration List”


Expiration

Expiration



E&O
Read-only Text
E&O
Display the value for E&O expiration


Expiration

Expiration



Sub Header 
Text
Sub Header 
To give the heading for the subsection


“Bank

“Bank



Information”

Information”



Preferred Mode 
Text
Preferred Mode
Text for “Preferred Mode of Payment”


of Payment

of Payment



Preferred Mode
Read-only Text
Preferred Mode
Display the value for Mode of payment


of Payment

of Payment



Bank Name
Text
Bank Name
Text for Bank Name


Bank Name
Read-only Text
Bank Name
Display the value for Bank Name


Account
Text
Account
Text for Account Number


Number

Number



Account
Read-only Text
Account
Display the value for Account Number


Number

Number



Routing
Text
Routing
Text for Routing Number


Number

Number



Routing
Read-only Text
Routing
Display the value for Routing Number


Number

Number



Account Type
Text
Account Type 
Text for Account Type


Account Type
Read-only Text
Account Type
Display the value for type of account


Name on the
Text
Name on the
Text for “Name on the account”


Account

Account



Name on the
Read-only Text
Name on the
Display the value for “Name on the Account”


Account

Account



Payee Name
Text
Payee Name
Text for Payee Name


Payee Name
Read-only Text
Payee Name
Display the value for Payee Name


Requires
Read-only Text
Requires
Display the value for “requires special handling” 


Special

Special
if checked - means Yes


Handling

Handling



Previous
HTML Button
Previous
Takes user to the Previous page.


Save
HTML Button
Save
Saves the Data.


Cancel
HTML Button
Cancel
Resets the Data to original values









3.1.13.3. Front End Validations
None.
3.1.13.4. Screen Flow
The following are the scenarios the user may come across when operating on the step 2 screen.











Scenario
Description







New Agency
Used to Navigate to “Create Agency Master” screen.


Delete
Inactivates (Delete) the Record.









3.1.14. User Interface Id: Lead Tracking
3.1.14.1. Screen Name: Lead Tracking (BPI_CAS_SM_SCR—002—028)
This screen below captures the lead tracking information of a lead and the lead tracking shall be a tab in lead master screens (See FIG. M-38)
3.1.14.2. SID, Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the screen being navigated


“Lead

“Lead



Tracking”

Tracking”



Sub Header 
Text
Sub Header 
To give the sub heading


“Tracking

“Tracking



Information”

Information”



Present Status
Text
Present Status
Text For “Present Status”


Present Status
Non Editable
Present Status
Non Editable field showing status code and



Entry Fields

present status which may be updateable due to





change in selection on screen


Present Desc
Text
Present Desc
Text For “ Present Desc”


Present Desc
Non Editable
Present Desc
Non Editable field present description which may



Entry Fields

be updateable due to change in selection on screen


Sub Header
Text
Sub Header
To give the heading for the screen being navigated


“Call Status”

“Call Status”



Radio Buttons
Radio Buttons
Radio Buttons
“Made Contact” ,“Disconnected Number”, “Wrong





Number”, “Unreachable”.


Sub Header
Text
Sub Header
To give the heading for the screen being navigated


“Contact

“Contact



Result”

Result”



Radio Buttons
Radio Buttons
Radio Buttons
“Qualified” and “Non-Qualified Lead”


Sub Header 
Text
Sub Header 
To give the heading for the screen being navigated


“Qualified Lead

“Qualified Lead



Result”

Result”



Radio Buttons 
Radio Buttons 
Radio Buttons 
“Produced Quote”, “Not Interested”, “No Quote





at this time”


Sub Header
Text
Sub Header
To give the heading for the screen being navigated


“Non-Qualified

“Non-Qualified



Lead

Lead Reasons”



Reasons”





Radio Buttons 
Radio Buttons 
Radio Buttons 
“<2 Eligible Employees”, “ >50 Eligible





Employees”


Sub Header
Text
Sub Header
To give the heading for the screen being navigated


“Not Interested

“Not Interested



Reasons”

Reasons”



Radio Buttons
Radio Buttons 
Radio Buttons
“Not up for renewal ”, “ Doesn't want/need/Provide





Insurance”


Sub Header
Text
Sub Header
To give the heading for the screen being navigated


“Post Quote

“Post Quote



Result”

Result”



Sold Group ID
Text
Sold Group ID 
Text for “Sold Group ID”


Sold Group ID
Non Editable
Sold Group ID 
Entry field for “Sold Group ID”



Field




Radio Buttons 
Radio Buttons
Radio Buttons
“Enrolling”, “Not Enrolling”, “Sold”


Sub Header
Text
Sub Header
To give the heading for the screen being navigated


“Status Log &

“Status Log &



Notes”

Notes”



Status
Text
Status
Text for “Status”


Status
Non Editable
Status




Field




Notes
Text
Notes
Text for “Notes”


Notes
Text Area
Notes
Text Area for Notes


Follow Up
Text
Follow Up date
Text for Follow Up date


date





Follow Up
Calendar
Follow Up date



date





Add
HTML Button
Add
Button for adding data in the temporary repository


HTML Table
Scrollable
HTML Table
Table containing added values from the status log



HTML Table

and notes


Save
HTML Button
Save
For saving into the repository









3.1.14.3. Front End Validations













S No
Present Status
Code
Present Status Description








New
1
New Lead. The source of the lead could be a data





upload of leads





New entries on a call from a group If there is a new





entry on a call from a group, the status should be





“New” with the Source Sub Type determining





“Inbound Call.”



Dead
2
The Lead is a dead lead



Re Call
3
When a call is made to the lead and the lead is





found to reachable on a call but the rep is not able





to make contact/wherever a recall has to be made



Prospect -No 
4
When a lead is contacted and is found eligible - and



Quote/

the lead shows interest but doesn't want a quote



Materials





Prospect -
5
When a lead is contacted and is found eligible - and



Quote/Materials

the lead shows interest and wants a quote



Sent





Post Quote - 
6
If the present status is not “Dead” then allow change



Enrolling

to enrolling status if the lead is in the process of





enrolling (there could be instances where status 3





and/or 4 and/or 5 have been skipped all-together)



Post Quote - 
7
The lead has enrolled and has been assigned a



Sold

group number









The present status shall be New (1) for a lead where the lead is new to the system and has not been followed up. The data is one that is uploaded into the system. There could be instances where the lead master is created when a lead calls up and this lead's status must be “New”
There shall be 6 sections Call status, Contact Result, Not-Qualified Lead Reasons, Qualified Lead Result, Not Interested Reason, Post Quote Result.
“Call Status” section is enabled when the Status is New (1) or Re-Call (3)
The Call status would have the radio buttons “Disconnected Number”, “Wrong Number”, “Unreachable”, “Made Contact”.














Select Radio Button
Result









Disconnected Number
Change Status - Dead (2), Log



Wrong Number
Change Status - Dead (2), Log



Unreachable
Change Status - Recall (3), Log



Made Contact
Enable Section “Contact Result”










Contact Result
The contact result section shall have the following radio buttons “Qualified Lead” and “Non-Qualified Lead”











Select Radio Button
Result







Qualified Lead
Enable section “Qualified Lead Result”


Non-Qualified Lead 
Enable section “Non-Qualified Lead



Reasons”









Non-Qualified Lead Reasons
The Non Qualified Reasons section shall have the following radio buttons “<2 eligible employees” and “>50 Eligible Employees”














Select Radio Button
Result









<2 eligible employees
Change status = Dead (2)/Log



>5 Eligible employees
Change status = Dead (2)/Log










Qualified Lead Result
The “Qualified Lead Result” section shall have the following radio buttons “Produced Quotes”, “No Quote at his Time”, “Not Interested”














Select Radio Button
Result









Produced Quotes
Change Status = Prospect -




Quote/Materials Sent (5)



No Quote at this Time
Change Status = Prospect -No 




Quote/Materials (4)



Not Interested
Enable section - “Not Interested”




Reasons”










Not Interested Reasons
The “Not Interested Reasons” section shall have the following options “Not up for renewal”, “Doesn't Want/Need/Provide Insurance”.











Select Radio Button
Result







Not up for renewal - Call again
Change Status - Recall (3)/Log


Doesn't Want/Need/Provide 
Change Status - Dead (2) /Log


Insurance









Post Quote
The Post Quote section shall have the following radio buttons














Select Radio Button
Result









Enrolling
Change Status - Post Quote Enrolling




(6)/Log



Not Enrolling
Change Status - Dead (2)/Show an




entry field for entering the reasons/log



Sold
Change Status - Sold - Show an entry




field for entering the group number 




(7)/log










Log
This section will contain the following
Status Log Non Editable Entry field with System Date
Notes Text Area
Follow-up Date—Calendar
Add function
Table that would have columns—Log—Log date—Notes—Follow up Date
The Status Log area would automatically have status entries based on whatever choices are made on the screen/maintain log. The Notes Text Area shall contain the space for entering any notes during a call. The next follow up date would be a calendar for choosing the next follow up date.
There could be times when the status has not changed and the log would be empty but notes may be there. In such instances the notes is only added to the table along with follow up date
On adding the information, the information on the Log, Log Date, Notes and Follow up date gets added to the table and the user must save the information to have the data saved in the permanent repository,
When ever the user comes to the lead tracking, the previously made notes/log must be non editable.
The user must add the log entries/Notes or must be displayed with an error dialog “Kindly add the Status Log & Notes”
The user will not be allowed to quit without saving the information
When a user logs in, based on the access control The user is provided with a screen with a button “Things to do today” which shall also be part of the Menu.
The user is provided with the user information to choose from and on selection of the same and confirming the user goes into the “Things to do Today Area”
The user would be provided with a report and with the functionality to print the same.
The report content shall be based on the following based on the follow-up date made by the user in all leads
Details Of lead—Company Name, Contact Name, Phone, Status and “Lead Info” button which on pressing would lead to the opening of the lead master in another window.
A check box to confirm a call has been made
The report would be in scrollable table with check all, clear all feature.
The user must save the information to make the updates in the database
If the user has not completed all calls for the follow up day mentioned, must have the incomplete calls information under pending calls section when the user logs in the next day.
3.1.14.4. Screen Flow
4. Business Rule Mapping














Activity
Rules









Create Lead ID
Auto generated ID with values 0000000001 




to 9999999999



Create Agent
Auto generated ID with values AG0000001




to AG99999999



Create Agency 
Auto generated ID with values AG00000001 




to AG99999999










Benefit Partners Inc
Process Specification
Agent Profile
1. Introduction
1.1. Purpose
This functional specification document addresses the part of the sales and marketing system that would facilitate the creation of agent profile.
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









None
None










1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
2.1. Process Description & Flow
Agent Profile facilitates in creating the profile of agents and ranking them accordingly. The results of this ranking would enable the sales & marketing team to focus on the agents from a better business perspective. The data generated out of an agent profile study leads to identify agent potential and necessary sales strategy.
The prerequisite for creating an agent profile for an agent is that the agent must have an entry in the Agent master.
3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's














Corresponding HTML 


Screen ID (SID)
Screen Name
File Name







utl.agentprofile.create
Agent Profile
AgentProfile.jsp


utl.agentprofile.view
View Agent Profile
AgentProfileView.jsp


utl.agentprofile.search
Search Agent Profile
AgentProfileSearch.jsp









3.1.2. User Interface ID: Create Agent Profile
3.1.2.1. Screen Name: Create Agent Profile (BPI_CAS_SM_SCR—003—001) (See FIG. M-39)
(See FIG. M-40)
3.1.2.2. SID, Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the screen being


“Create Agent

“Create Agent 
navigated


Profile”

Profile”



Workgroup Name
Text
Workgroup Name
Text for “Agent ID”


Workgroup Name
Drop down
Workgroup Name
Should list all the workgroup names within



list

the system





The first option should be -- Choose One -. 





Subsequent workgroup name should





be listed in alphabetical order


Agent ID
Text
Agent ID
Text for “Agent ID”


Agent ID
Drop down
Agent ID
Search Window showing the agent ids for



list 

the selected Child groups .The search





feature shall contain the details of agents





like agent ID, Agent name, Zip Code and





the present rating based on.statistics





available.





The user is also allowed to enter/query for





a search based on the entry for an agent id.


Agent Name
Text
Agent Name
Text for “Agent Name”


Agent Name
Dynamic text
Agent Name
When you select a particular agent id you





should get the Agent name.


Company Name
Text
Company Name
Text for “Agent Name”


Company Name
Dynamic text
Company Name
When you select a particular agent id you





should get the company name.


Sub Header
Text
Sub Header
Heading for “Present Rating”


“Present Rating”

“Present Rating”



Present Rating 1
Non Editable
Present Rating 1
Text for rating - 1, 2, 3, 4



Text




Present Rating 2
Non Editable
Present Rating 2
Text for rating - Inactive, Quoter, Active &



Text

Producer


Sub Header
Text
Sub Header
Heading for “Profile Information”


“Profile

“Profile



Information”

Information”



Text for “ Do you
Text
Text for “ Do you
Text for“ Do you currently sell health


currently 

currently sell
Insurance?”


sell health

health



Insurance?”

Insurance?”



Radio Button with
Radio Button
Radio Button with
Radio Button with “Yes” Label


Yes label

Yes label



Radio Button with
Radio Button
Radio Button with
Radio Button with “No” Label


No label

No label



Text for “ Do you
Text
Text for “ Do you
Text for “ Do you currently sell Pac


sell Pac

sell Pac
Advantage?”


Advantage?”

Advantage?”



Radio Button with
Radio Button
Radio Button with
Radio Button with “Yes” Label


Yes label

Yes label



Radio Button with
Radio Button
Radio Button with
Radio Button with “No” Label


No label

No label



Radio Button with
Radio Button
Radio Button with
Radio Button with “Unknown” Label Shall


Unknown label

Unknown label
be default


Text for “what
Text
Text for “what
Text for“ what insurance Types dealing


Insurance Types

Insurance Types
with?”


dealing with?

dealing with?



Check Box
Check Box
Check Box
Check Box for selection


selection for

selection for



 1) Life

  9) Life



 2) Home

 10) Home



 3) P&C

 11) P&C



 4) Disability

 12) Disability



 5) Auto

 13) Auto



 6) Securities

 14) Securities



 7) Health

 15) Health



 8) Others

 16) Others



Text for
Text
Text for
Text for “Percentage time focused on


“Percentage time

“Percentage time
selling health insurance”


focused on

focused on



selling health

selling health



insurance”

insurance”



Entry field for
Entry Field
Entry field for
Entry field accepting Positive percentage


“Percentage time

“Percentage time
values till 100


focused on

focused on



selling health

selling health



insurance”

insurance”



Text for “Average
Text
Text for “Average
Text for “Average Group Size (with In Pac


Group Size (with

Group Size (with
Advantage)”


In Pac

In Pac



Advantage)”

Advantage)”



Entry field for
Entry Field
Entry field for
Entry Field showing information on


“Average Group

“Average Group
average group size in Pac Advantage


Size (with In Pac

Size (with In Pac



Advantage)”

Advantage)”



Text for “Average
Text.
Text for “Average
Text for “Average Group Size (outside Pac


Group Size

Group Size
Advantage)


(outside Pac

(outside Pac



advantage)

advantage)



Entry Field for
Entry Field
Entry Field for
Entry Field for entering information on


“Average Group

“Average Group
average group size outside Pac Advantage


Size (outside Pac

Size (outside Pac



advantage)”

advantage)”



Text for “Years in
Text
Text for “Years in
Text for “Years in Business”


Business”

Business”



Entry field for
Entry Field
Entry field for
Entry Field entering “Years in Business”


“Years in

“Years in



Business”

Business”



Text for 
Text 
Text for 
Text for “% of staff concentrating on health


“% of staff

“% of staff
Insurance”


concentrating on

concentrating on



health Insurance”

health Insurance”



Entry field for 
Entry Field
Entry field for 
Entry field for entering “% of staff


“% of staff

“% of staff
concentrating on health Insurance”


concentrating on

concentrating on



health Insurance”

health Insurance”



Sub Heading
Text
Sub Heading
Sub Heading


For “Subjective

For “Subjective
for “Subjective Rating”


Rating”

Rating”



Text for “Broker
Text
Text for “Broker
Text for “Broker Knowledge of Pac


Knowledge of

Knowledge of
Advantage”


Pac Advantage”

Pac Advantage”



Text for “Broker
Text
Text for “Broker
Text for “Broker Potential”


Potential”

Potential”



Text for “Broker
Text
Text for “Broker
Text for “Broker Loyalty & Confidence with


Loyalty &

Loyalty &
Pac Advantage”


Confidence with

Confidence with



Pac Advantage”

Pac Advantage”



Radio Button
Radio Button
Radio Button
Radio Button selection


selection

selection



 1) 0

  7) 0



 2) 1

  8) 1



 3) 2

  9) 2



 4) 3

 10) 3



 5) 4

 11) 4



 6) 5

 12) 5



Sub Heading
Text
Sub Heading
Text for “Other Information”


“Other

“Other



Information”

Information”



Text for
Text
Text for
Text for “Marketing Methods’


“Marketing

“Marketing



Methods”

Methods”



List for marketing
List
List for marketing
List for marketing methods


methods

methods



Text for “No 1
Text
Text for “No 1
Text for “No 1 Selling Plan”


Selling Plan”

Selling Plan”



List for “No 1
List
List for “No 1
List for No 1 Selling Plan


Selling Plan ”

Selling Plan ”



Text for “No 2
Text
Text for “No 2
Text for “No 2 Selling Plan”


Selling Plan”

Selling Plan”



List for “No 2
List
List for “No 2
List for No 2 Selling Plan


Selling Plan ”

Selling Plan ”



Save Button
HTML Button
Save Button
Saves the information


Cancel Button
HTML Button
Cancel Button
Resets to Original values









3.1.2.3. Front End Validations












Element




Name
Action/Validation Details
Error Message Text







Save
All fields are non mandatory
When the save HTML Button is



The following fields must be 
pressed with an invalid entry, an



positive numeric entries
error dialog box pops up with 




the message “ Please enter valid



Percentage of time focused 
numeric values” with “yes” 



on health insurance(0-100)
option On press of Yes Button, 




The cursor must be placed on 



Average Groups size 
the corresponding first entry 



(within Pac Advantage) 
field



Average group size 




(not within PacAdvanatge)




Years in Business (0-999)




% Of staff concentrating on




health insurance (0-100)









3.1.2.4. Screen Flow
When the user first calls for the step 1 screen, the user is displayed with the choose child work group search feature. The child work group shall contain only those child workgroups, which belong to the category “Agents”. The child workgroups contain a non-editable entry field with search option.
The following are the scenarios the user may come across when operating on the screen











Scenario
Description







On Entering the
The List of Child work groups be displayed. The child work groups shall


screen
contain only those child work groups which are under the category “Agent”


After selecting a
The user after selecting the child workgroup, it gets the agents and will be


child work group
displayed.


After selecting a
Agent ID with search feature in the screen snapshot, present rating and


agent id
average group size for Pac advantage is populated with the real time values



on selection of an agent id.



All subjective rating will have default values of Unknown.



For queries- “Do you currently sell health Insurance?” and “Do you sell Pac



Advantage?” - default values is “Yes”



Marketing Methods, No 1 Selling Plan and No 2 Selling Plan would default



with ‘Choose One ” Option and the values shall be picked up from the product



profile ID from the carrier master.


Save
Saves data into the permanent repository on saving the information after the



validation checks and goes to the confirmation page


Cancel
Resets values to original values


Close the browser
The browser window cannot be closed/user can't navigate to another page


without saving/
without saving the data. The user is prompted with the option of either saving


Navigating to
the data and closing/leaving the window or not saving the data and closing/leaving


another page
the window.


without saving



Close the browser/
The browser window can be closed/user can leave once all the data is saved


leave the page
in the permanent repository.


after saving









3.1.3. User Interface ID: Search Agent Profile
3.1.3.1. Screen Name: Search Agent Profile (BPI_CAS_SM_SCR—003—002)
This screen below captures the information for searching an existing “Agent Profile”.

    
    
        Step—1: Enter the mandatory agent information and click the search button. This page will display the result of search. User can choose a agent and navigate to either “Modify” screen or “View” screen. (See FIG. M-41)
    
    


3.1.3.2. SID, Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Main Header 
Text
Main Header 
To give the heading for the screen


“Agent Search”

“Agent Search”



Agent ID
Text
Agent ID
Text For “ Agent ID”


Agent ID
Entry Field
Agent ID
Entry field for agent id


First Name
Text
First Name
Text For “First Name”


First Name
Entry Field
First Name
Entry field for First Name


Last Name
Text
Last Name
Text for Last Name


Last Name
Entry Field
Last Name
Entry field for Last Name


Company
Text
Company
Text For “First ”Company”


Company
Entry Field
Company
Entry field for Company


Phone
Text
Phone
Text for “Phone”


Phone
Entry Field
Phone
Entry field for Phone


Tax ID
Text
Tax ID
Text For “ Tax ID”


Tax ID
Select Feature
Tax ID
Entry field for Tax


Agent Button 
Radio Button
Agent Button
Used to select the agent for modifying or


Radio

Radio
viewing/deleting.


Modify
HTML Button
Modify
Agents to the modify screen of the selected





agent


View/Delete
HTML Button
View/Delete
Agents to the view/delete screen of the





selected









3.1.3.3. Front End Validations












Element




Name
Action/Validation Details
Error Message Text







Agent ID
Mandatory. Any one of the 
Error Dialog Box on Search



fields in the search screen 
“Accepts Alphanumeric 



is mandatory. Accepts 
values only.”



Alphanumeric values only









3.1.3.4. Screen Flow
The following are the scenarios the user may come across when operating on the search screen.














Scenario
Description









Search
The system checks for all the validations for all the 




mandatory information. Fetches the agent(s) 




that matches with the search conditions.



Cancel
Clears the search fields










3.1.4. User Interface ID: Modify Agent Profile
3.1.4.1. Screen Name: Modify Agent Profile (BPI_CAS_SM_SCR—003—003) (See FIG. M-42)
(See FIG. M-43)
3.1.4.2. SID, Element Name, Element Type & Purpose
This screen contains the default values—the values created in the database on creation of agent profile














Element




Element Name
Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the screen being


“Modify Agent

“Modify Agent
navigated


Profile”

Profile”



Agent ID
Text
Agent ID
Text for “Agent ID”


Agent ID
Non Editable
Agent ID
Text for Agent for selected agent profile



Text




Sub Header
Text
Sub Header
Heading for “Present Rating”


“Present Rating”

“Present Rating”



Present Rating 1
Non Editable
Present Rating 1
Text for rating - 1, 2, 3, 4



Text




Present Rating 2
Non Editable
Present Rating 2
Text for rating - Inactive, Quoter, Active &



Text

Producer


Sub Header
Text
Sub Header
Heading for “Profile Information”


“Profile

“Profile



Information”

Information”



Text for “Do you
Text
Text for “Do you
Text for “Do you currently sell health


currently sell

currently sell
Insurance”


health

health



Insurance?”

Insurance?”



Radio Button with
Radio Button
Radio Button with
Radio Button with “Yes” Label


Yes label

Yes label



Radio Button with
Radio Button
Radio Button with
Radio Button with “No” Label


No label

No label



Text for “Do you
Text
Text for “Do you
Text for “Do you currently sell Pac


currently sell Pac

currently sell Pac
Advantage?”


Advantage?”

Advantage?”



Radio Button with
Radio Button
Radio Button with
Radio Button with “Unknown” Label


Unknown label

Unknown label



Radio Button with
Radio Button
Radio Button with
Radio Button with “Yes” Label


Yes label

Yes label



Radio Button with
Radio Button
Radio Button with
Radio Button with “No” Label


No label

No label



Text for “what
Text
Text for “what
Text for “what insurance Types dealing


Insurance Types

Insurance Types
with?”


dealing with?

dealing with?



Check Box
Check Box
Check Box
Check Box for selection


selection for

selection for



 Life

 Life



 Home

 Home



 P&C

 P&C



 Disability

 Disability



 Auto

 Auto



 Securities

 Securities



 Health

 Health



 Others

 Others



Text for
Text
Text for
Text for “Percentage time focused on


“Percentage time

“Percentage time
Health Insurance”


focused on

focused on



Health Insurance”

Health Insurance”



Entry field for
Entry Field
Entry field for
Entry field accepting Positive 


“Percentage time

“Percentage time
percentage values till 1100


focused on health

focused on health



Insurance”

Insurance”



Text for “Average
Text
Text for “Average
Text for “Average Group Size (with In Pac


Group Size (with

Group Size (with
Advantage)”


In Pac

In Pac



Advantage)”

Advantage)”



Entry field for
Entry Field
Entry field for
Entry Field showing information on


“Average Group

“Average Group
average group size in Pac Advantage


Size (with In Pac

Size (with In Pac



Advantage)”

Advantage)”



Text for “Average
Text
Text for “Average
Text for “Average Group Size (outside Pac


Group Size

Group Size
Advantage)


(outside Pac

(outside Pac



advantage)

advantage)



Entry Field for
Entry Field
Entry Field for
Entry Field for entering information on


“Average Group

“Average Group
average group size outside Pac Advantage


Size (outside Pac

Size (outside Pac



advantage)”

advantage)”



Text for “Years in
Text
Text for “Years in
Text for “Years in Business”


Business”

Business”



Entry field for
Entry Field
Entry field for
Entry Field entering “Years in Business”


“Years in

“Years in



Business”

Business”



Text for “% of
Text
Text for “% of
Text for “% of staff concentrating on health


staff

staff
Insurance”


concentrating on

concentrating on



health Insurance”

health Insurance”



Entry field for “%
Entry Field
Entry field for “%
Entry field for entering “% of staff


of staff

of staff
concentrating on health Insurance”


concentrating on

concentrating on



health Insurance”

health Insurance”



Sub Heading
Text
Sub Heading
Sub Heading


For “Subjective

For “Subjective
for “Subjective Rating”


Rating”

Rating”



Text for “Broker
Text
Text for “Broker
Text for “Broker Knowledge of Pac


Knowledge of

Knowledge of
Advantage”


Pac Advantage”

Pac Advantage”



Text for “Broker
Text
Text for “Broker
Text for “Broker Potential”


Potential”

Potential”



Text for “Broker
Text
Text for “Broker
Text for “Broker Loyalty & Confidence with


Loyalty &

Loyalty &
Pac Advantage”


Confidence with

Confidence with



Pac Advantage”

Pac Advantage”



Radio Button
Radio Button
Radio Button
Radio Button selection


selection

selection



 Unknown

 Unknown



 Neutral

 Neutral



 Neutral+

 Neutral+



 Mild

 Mild



 Positive

 Positive



 Positive+

 Positive+



 Very Positive

 Very Positive



Sub Heading
Text
Sub Heading
Text for “Other Information”


“Other

“Other



Information”

Information”



Text for
Text
Text for
Text for “Marketing Methods”


“Marketing

“Marketing



Methods”

Methods”



List for marketing
List
List for marketing
List for marketing methods


methods

methods



Text for “No 1
Text
Text for “No 1
Text for “No 1 Selling Plan”


Selling Plan”

Selling Plan”



List for “No 1
List
List for “No 1
List for No 1 Selling Plan


Selling Plan”

Selling Plan”



Text for “No 2
Text
Text for “No 2
Text for “No 2 Selling Plan”


Selling Plan”

Selling Plan”



List for “No 2
List
List for “No 2
List for No 2 Selling Plan


Selling Plan”

Selling Plan”



Modify
HTML Button
Modify
Modifies the data


Cancel
HTML Button
Cancel
Resets to the original created values









3.1.4.3. Front End Validations












Element




Name
Action/Validation Details
Error Message Text







Modify
All fields are non mandatory
When the modify HTML Button is



The following fields must be 
pressed with an invalid entry, an 



positive numeric entries
error dialog box pops up with



Percentage of time focused 
the message “Please enter valid 



on health Insurance (0-100)
numeric values” with “yes” option



Average Groups size (with 
On press of Yes Button, The cursor



in Pac Advantage)
must be placed on the corre-



Average group size (not 
sponding entry field



with in PacAdvanatge)




Years in Business (0-999)




% Of staff concentrating on 




health insurance (0-100)









3.1.4.4. Screen Flow











Scenario
Description







On entering
All values default to the created values. Non-editable text 


the screen
includes the agent id and present ratings, which is dynamic.


Modify
Modifies data in the permanent repository on saving the 



information after the validation checks and goes to the 



confirmation page









3.1.5. User Interface ID: View Agent Profile
3.1.5.1. Screen Name: View Agent Profile (BPI_CAS_SM_SCR—003—004) (See FIG. M-44)
3.1.5.2. SID, Element Name, Element Type & Purpose
This screen contains only the values—the values created in the database on creation/modification of agent profile
All the values are NOT EDITABLE














Element




Element Name
Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the screen being


“View Agent

“View Agent
navigated


Profile”

Profile”



Agent ID
Text
Agent ID
Text for “Agent ID”


Agent ID
Non Editable
Agent ID
Non Editable Text showing the agent ID for



Text

the associated agent profile ID


Sub Header
Text
Sub Header
Heading for “Present Rating”


“Present Rating”

“Present Rating”



Present Rating 1
Non Editable
Present Rating 1
Text for rating - 1,2,3,4



Text




Present Rating 2
Non Editable
Present Rating 2
Text for rating - Inactive, Quoter, Active &



Text

Producer


Sub Header
Text
Sub Header
Heading for “Profile Information”


“Profile

“Profile



Information”

Information”



Text for “Do you
Text
Text for “Do you
Text for “Do you currently sell health


currently sell

currently sell
Insurance?”


health

health



Insurance?”

Insurance?”



Radio Button with
Radio Button
Radio Button with
Radio Button with “Yes” Label


Yes label

Yes label



Radio Button with
Radio Button
Radio Button with
Radio Button with “No” Label


No label

No label



Text for “Do you
Text
Text for “Do you
Text for “Do you currently sell Pac


currently sell Pac

currently sell Pac
Advantage?”


Advantage?”

Advantage?”



Radio Button with
Radio Button
Radio Button with
Radio Button with “Unknown” Label


Unknown label

Unknown label



Radio Button with
Radio Button
Radio Button with
Radio Button with “Yes” Label


Yes label

Yes label



Radio Button with
Radio Button
Radio Button with
Radio Button with “No” Label


No label

No label



Text for “what
Text
Text for “what
Text for “what insurance Types dealing


Insurance Types

Insurance Types
with?”


dealing with?”

dealing with?”



Check Box
Check Box
Check Box
Check Box for selection


selection for

selection for



 Life

 Life



 Home

 Home



 PFC

 PFC



 F&C

 F&C



 Disability

 Disability



 Auto

 Auto



 Securities

 Securities



 Health

 Health



 Others

 Others



Text for
Text
Text for
Text for “Percentage of time focused on


“Percentage of

“Percentage of
health insurance”


time focused on

time focused on



health Insurance”

health Insurance”



Non Editable
Non Editable
Non Editable
Non Editable Entry field accepting Positive


Entry field for
Entry Field
Entry field for
percentage values till 100


“Percentage of

“Percentage of



health insurance

health insurance



sold vs. Total

sold vs. Total



Products sold”

Products sold”



Text for “Average
Text
Text for “Average
Text for “Average Group Size (with In Pac


Group Size (with

Group Size (with
Advantage)”


In Pac

In Pac



Advantage)”

Advantage)”



Non Editable
Non Editable
Non Editable
Non Editable Entry Field showing


Entry field for
Entry Field
Entry field for
information on average group size in Pac


“Average Group

“Average Group
Advantage


Size (with In Pac

Size (with In Pac



Advantage)”

Advantage)”



Text for “Average
Text
Text for “Average
Text for “Average Group Size (outside Pac


Group Size

Group Size
Advantage)


(outside Pac

(outside Pac



advantage)

advantage)



Non Editable
Non Editable
Non Editable
Non Editable Entry Field for entering


Entry Field for
Entry Field
Entry Field for
information on average group size outside


“Average Group

“Average Group
Pac Advantage


Size (outside Pac

Size (outside Pac



advantage)”

advantage)”



Text for “Years in
Text
Text for “Years in
Text for “Years in Business”


Business”

Business”



Non Editable
Non Editable
Non Editable
Non Editable Entry Field entering “Years


Entry field for
Entry Field
Entry field for
in Business”


“Years in

“Years in



Business”

Business”



Text for “% of
Text
Text for “% of
Text for “% of staff concentrating on health


staff

staff
Insurance”


concentrating on

concentrating on



health Insurance”

health Insurance”



Non Editable
Non Editable
Non Editable
Non Editable Entry field for entering 


Entry field for “%
Entry Field
Entry field for “%
“% of staff concentrating on health Insurance”


of staff

of staff



concentrating on

concentrating on



health Insurance”

health Insurance”



Sub Heading
Text
Sub Heading
Sub Heading


For “Subjective

For “Subjective
for “Subjective Rating”


Rating”

Rating”



Text for “Broker
Text
Text for “Broker
Text for “Broker Knowledge of Pac


Knowledge of

Knowledge of
Advantage”


Pac Advantage”

Pac Advantage”



Text for “Broker
Text
Text for “Broker
Text for “Broker Potential”


Potential”

Potential”



Text for “Broker
Text
Text for “Broker
Text for “Broker Loyalty & Confidence with


Loyalty &

Loyalty &
Pac Advantage”


Confidence with

Confidence with



Pac Advantage”

Pac Advantage”



Radio Button
Radio Button
Radio Button
Radio Button selection


selection

selection



 Unknown

 Unknown



 Neutral

 Neutral



 Neutral+

 Neutral+



 Mild

 Mild



 Positive

 Positive



 Positive+

 Positive+



 Very Positive

 Very Positive



Sub Heading
Text
Sub Heading
Text for “Other Information”


“Other

“Other



Information”

Information”



Text for
Text
Text for
Text for “Marketing Methods’


“Marketing

“Marketing



Methods”

Methods”



Non Editable field
Non Editable
Non Editable field
Non Editable field for marketing methods


for marketing
field
for marketing



methods

methods



Text for “No 1
Text
Text for “No 1
Text for “No 1 Selling Plan”


Selling Plan”

Selling Plan”



Non Editable field
Non Editable
Non Editable field
Non Editable field for No 1 Selling Plan


for “No 1 Selling
field
for “No 1 Selling



Plan”

Plan”



Text for “No 2
Text
Text for “No 2
Text for “No 2 Selling Plan”


Selling Plan”

Selling Plan”



Non Editable field
Non Editable
Non Editable field
Non Editable field for No 2 Selling Plan


for “No 2 Selling
field
for “No 2 Selling



Plan”

Plan”









3.1.5.3. Front End Validations
None.
3.1.5.4. Screen Flow











Scenario
Description







On Entering 
All values default to the Non Editable created/modified 


the screen
values. Present rating would be dynamic.









4. Business Rule Mapping
The agent is evaluated with the following ratings. The ratings are established on 2 accounts. One is when the user enters the screen—displays the present rating and another on completion on save operation. The system does an automatic rating of the agent and the same can be viewed by reports and on modify operation. The sales rep on entering the values saves the data and the ratings are picked up based on entries made (ratings described below). The cumulative ratings are stored in the database for reporting purposes.











Activity
Rules







Create Agent profile
Should have unique Id 4 digit for a agent profile



record with an increment of 1, Say 1000, 1001, 1002



and so on.









Present Rating for Pac Advantage Business












PacAdvantage Business
Broker Potential
Value







Zero sold cases and zero quotes in last 12 months
Inactive
1


Zero sold cases and 1+ quotes in last 12 months
Quoter
2


New agent or old agent with renewed interest 
Prospect
3


(other than the balance 4)




1+ sold cases in last 12 months
Active
4


1+ sold cases and 1+ quotes in last 12 months 
Producer
5


(consistently quoting and selling)









Average Group size with in Pac Advantage—Picks up the real time value from the database for the agent.
Profile Information Ratings
















Corresponding Rank Value














Item
Type
Description
1
2
3
4
5





Do you currently sell health insurance?
Y/N
Manual Enter
N
Y
N/A
N/A
N/A


Percentage of time focused on health Insurance
%
Manual Enter
<60%
61-70%
71-80%
81-90%
90-100%


Average Group Size (outside PacAdvanatge)
Int
Manual Enter
>50   
1-5 
6-10 
11-15   
>15


Average Group Size (within PacAdvanatge)
Int
System Calc
>50   
1-5 
6-10 
11-15   
>15


Date Business Began (years in business)
Date
Manual Enter
>15   
<2
2-5   
5-10 
10-15    


% of Staff concentrating on health?
%
Manual Enter
<60%
61-70%
71-80%
81-90%
90-100%









Subjective Ratings
Broker Relationship and Loyalty: Sales Reps opinion of this broker's loyalty to and confidence in PacAdvantage as a program and concept as well as their confidence in PacAdvantage administrative abilities and responsiveness.
0. (Unknown)—No Data available
1. (Neutral)
Neutral Impression of PacAdvantage. Sells PacAdvantage if there are no other choices available.
2. (Neutral Plus)
Agent has a somewhat favorable but guarded impression of PacAdvantage program and it's responsiveness. Sells PacAdvantage when group has too many Kaiser enrollees, when pricing is favorable, or when program is specifically requested but prefers to sell other health products or competing programs.
3. (Mild Positive)
The agent has a positive impression of PacAdvantage program. Sees value in choice concept. Confident in the administration of the PacAdvantage program, but often sells competing products.
4. (Positive Plus)
Agent is fully confident of PacAdvantage administration and concept. Sells us in most situations; may occasionally sell a competing product.
5. (Very Positive)
Agent promotes the choice concept. Has total confidence in PacAdvantage product, service and administration. Sells PacAdvantage before all other products and competing programs. Broker Knowledge Of PacAdvantage: Sales Reps opinion of this broker's knowledge of choice. Includes PacAdvantage and other choice based product concepts (i.e. CC, BC). Ranks brokers' confidence in being able to independently sell and promote PacAdvantage and related programs.
0. (Unknown)—No Data available
1. (Neutral) Agent has little or no knowledge of PacAdvantage or other choice programs and products.
2. (Neutral Plus) Knows a little about PacAdvantage and other choice programs, but focus and preference is for other health products. Requires significant coaching on basics of our product, the choice concept and PacAdvantage administration.
3 (Mild Positive)
Agent understands basics of choice programs and PA, but may not be familiar with many administrative details of PA, (i.e. enrollment guidelines, participation rules, paperwork requirements, etc.). Does not know all the situations were Pac Advantage or other choice programs can “fit” (answer: just about everywhere). Requires some coaching on the product and concept.
4. (Positive Plus)
Agent is pretty familiar with PA and its admin rules. Knows most, but not all situations where choice programs work.
They can freely and independently discuss and promote PA or other programs with clients, but may require assistance from time to time.
5. (Very Positive)
Agent Broker has very good understanding of choice based programs and concepts and has a solid grasp of most PA administrative details. Familiar with all the situations where PA or other choice based programs “fit”. Can confidently sell Pac Advantage or other choice programs with little or no assistance.
Broker Potential
Sales Reps opinion of this broker's involvement or interest in all OTHER HEALTH INSURANCE programs, besides PacAdvantage, and the reps assessment of this broker's NEW SALES potential for PA.
0. (Unknown)—No data Available
1 (Neutral) Inactive or broker does very little health insurance. Broker has indicated little or no interest in new group health selling. Does not sell any or very few other group health insurance products.
2. (Neutral Plus)
Broker sells some group health insurance cases upon request, (three or more annually) but it is not the primary focus of business.
3. (Mild positive)
Broker has other some health business, (more than 10 cases) and focus is at least 10% on group health. Actively promotes small business health insurance to clients. May primarily work with competing programs but have potential to produce some PacAdvantage Business.
4. (Positive Plus)
Broker has a significant amount of existing small group business (20 or more groups). Actively interested in selling more group health to all current and prospective clients. Focus is 30% or more on group health.
5. (Very Positive)
Broker sells a lot of health insurance and/or has access to a significant amount of small group health insurance business. Focus is at least 50% or more on group health. May have involvement with larger groups, or association business. May be selling some or a significant amount of PacAdvantage, but has potential to produce even more. May be a current top PA producer OR a significant producer for competing plan(s), (i.e., Cal Choice, Blue Cross, Kaiser direct). “Significant” is defined as 10 or more new sales annually.
Cumulative Ratings Stored in Database: Based on the points system @1-5 the cumulative values are stored in the database and is used for reporting purposes.
A Backend subroutine runs at 1200 at night everyday to calculate the Present rating of the agent based on quotes made, cases sold, average group size. This data would be calculated and updated against individual agents and shown in Step 2 screen when accessed.
Benefit Partners Inc
Process Specification
Create Quotes
1. Introduction
1.1. Purpose
The purpose of this document is to describe the process of Create Quotes. This document identifies how the user interacts with the system, the data to be captured, the business logic to be implemented, and the output of the process.
1.2. Business Use Case Specification Reference













Business Use Specification ID
Business Use Case Name








BPI_SCOPE_SM
External Communication



BPI_SCOPEP_SM_005
Create Quote Master



BPI_SCOPEP_SM_006
Create Lead Master









1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
2.1. Background
Quotes are provided for potential business entities as well as existing business entities. Quotes can be requested for small Employer Groups or Alternate Groups (Individual Association Member, Association Group, COBRA etc.) as well as for employees of those groups.
2.2. Process Description
The objective of the Create Quotes process is to:

    
    
        1) Provide functionality to create, view and modify quotes
    
    


The process should support collecting and storing configurable information for quoting purposes. A quote should be unique for each Group and Lead to allow history of data provided for a quote. The process should also support the versioning of each quote output.
The following are the other requirements that will be supported and constraints on the proposed system:

    
    
        1) The system should allow for updates using current enrollment for existing groups and members
        2) The system should allow for quoting specific carriers for an employee or for all employees
        3) The system should allow for excluding certain carriers from a quote
        4) The system should allow for calculating the rate differential based on the following entry fields: total eligible employees, total waiving, total declining, total COBRAs
        5) The system should allow for quoting based on blended and non-blended fee structure
        6) The system should allow for configurable agent fees
        7) The system should allow the user to choose output types including:
        
            (a) Group Rate Summary
            (b) Group Rate Summary and Worksheet
            (c) Group Rate Summary, Worksheet and EE Pages
            (d) Employee Quote
            (e) COBRA Quote (Cal or Fed)
            (f) Individual Association Member Quote
            (g) ROE Quote
        
        
        8) System should allow for configurable effective dates of quotes based on current date and/or enrollment effective date if it is an existing group
        9) The system should have a functionality to list out all missing information for a quote. It should also have the functionality to print/fax/email this to the agent/prospective group who requested for the quote. At this point in time, the user should be able to save the quote for retrieval at a later point in time.
    
    


2.3. Process Flow
Process for Create, View and Modify Quotes

    
    
        1) Enter Tracking Dates
        2) Choose Lead ID or Group ID; agent information if any gets auto-populated
        3) Choose all line if coverage to quote; alternately use default coverage
        4) Define contribution for employee/dependent by line of coverage; alternately use default contribution
        5) Choose fee type (blended/non-blended). This would default, if Lead, to blended, if Group, to whichever fee structure the group is on)
        6) Re-configure agent fee, if applicable
        7) Create employee list; for existing groups this gets auto-populated using current enrollment; for prospective groups this information can be uploaded from a comma-separated (CSV) data file.
        8) Adjust employee totals as needed
        
            i. # waiving
            ii. #declining
            iii. #COBRAs
        
        
        9) Quote/exclude specific carriers
        10) Choose quote type
        
            i. Group
            ii. Employee
            iii. Individual
            iv. COBRA
        
        
        11) Choose output type
        
            i. Group Summary
            ii. Group Summary and Worksheet
            iii. Group Summary, Worksheet and employee pages
        
        
        12) Specify effective date for quote
        13) Choose mode of output
        
            i. View
            ii. Email
            iii. Fax
            iv. Print for mailing (in the mailroom)
        
        
        14) For print, email, fax options, choose “Send to whose attention” in a pop-up window
        
            i. Agent's attention
            ii. Group's Attention
        
        
    
    
    iii. Other—For “Other”, enter “attention to”, address and/or email address and/or fax #


3. User Interface
3.1. User Interface Screens
3.1.1. Create Quotes
3.1.1.1. Screen Snapshot
Screen 1—1 (See FIG. M-45)
Screen 1—2 (See FIG. M-46)
Screen 2—1 (See FIG. M-47)
Screen 2—2 (See FIG. M-48)
Screen 3—1 (See FIG. M-49)
Screen 3—2 (See FIG. M-50)
Screen 4—1 (See FIG. M-51)
Screen 4—2 (See FIG. M-52)
Screen 5—1 (See FIG. M-53)
3.1.1.2. Element Name, Element Type & Purpose
Screen1













Element
Element




Name
Type
Label
Purpose















Quote Information










Quote Number
Display Text
Quote #
Unique id for a quote. There will be only one





quote associated with each group/lead.


Revision
Display Text
Rev
Revision # of the quote


Quote Date
Display Text
Date
Quote Date


Lead/Group
Display Text
Type
Type of the lead/group to whom quote is


Type


generated


Lead/Group Id
Display Text
Lead/Group Id
Id of the lead/group to whom quote is generated


Lead/Group
Display Text
Lead/Group
Name of the lead/group to whom quote is


Name

Name
generated







Lead/Group Information










Quoting For
Radio Boxes
Quote For
To specify whether quoting for lead or an 





existing group


Lead/Group Id 
Text Box
Lead/Group Id
To specify the id of lead/group quoted


Populate
Link
Populate Current
To populate the current enrollment details for a


Current

Enrollment
group. Shown only when the quote is for 


Enrollment


existing group.


Other Revisions 
Option Box
Other Revisions
To populate the other version of the quote.





Shown only when the quote has more than one





version.







General Information










Quote Date
Text Box
Quote Date
To specify quote date


Mode of
Option Box
Mode of Request
Mode in which request for quote was received;


Request


possible values are: USPS, Phone, Fax, Email


Request
Text Box
Postmark Date
Postmark date of request for quote


Postmark Date





Request
Text Box
Receive Date
Date on which request for quote was received


Receive Date





Rate Type
Radio Boxes
Rate Type
To specify the rate type used for quoting.





Possible values are: Blended and non-blended


Agent
Text Box
Agent
To specify agent commission to be used for


Commission

Commission
quoting.


Effective Date
Text Box
Effective Date
To specify an effective date for the quote







Group Information










Group Name
Display Text
Group Name
Displays name of the lead/group being quoted


Contact Name
Display Text
Contact Name
Displays name of contact for the lead/group


Address
Display Text
Address
Displays address of lead/group


Phone
Display Text
Phone
Displays phone # of the lead/group


Effective Date
Display Text
Effective Date
Displays effective in case of quoting for a group


ROE Date
Display Text
ROE Date
Displays ROE date in case of quoting for





a group


Status
Display Text
Status
Displays status in case of quoting for a group







Agent Information










Agent Id
Display Text
Agent Id
Displays id of agent associated with lead/agent


Agent Name
Display Text
Agent Name
Displays name of agent associated with





lead/agent


Address
Display Text
Address
Displays address of agent associated with





lead/agent


Phone
Display Text
Phone
Displays phone # of agent associated with





lead/agent


Fax
Display Text
Fax
Displays fax # of agent associated with 





lead/agent


E-mail
Display Text
E-mail
Displays email address of agent associated with


lead/agent





Workgroup
Display Text
Workgroup
Displays workgroup associated with lead/agent







Coverage & Contribution Information










Use default
Check Box
Use default
To specify that quote has to be generated using


coverage and

coverage and
default coverage and contribution


contribution

contribution



Contribution
Option Box
Contribution
To specify contribution type for medical.


Type/Medical

Type/Medical



Specified 
Option Box
Specified 
To specify a plan when option is “% specified


Plan/Medical

Plan/Medical
plan” for medical.


Value for EE
Text Box
Value for EE 
To specify contribution % or value for medical.


($/%)/Medical

($/%)/Medical



Value for Dep
Text Box
Value for Dep
To specify contribution % or value for medical.


($/%)/Medical

($/%)/Medical



Contribution
Option Box
Contribution
To specify contribution type for Dental.


Type/Dental
Type/Dental




Specified 
Option Box
Specified 
To specify a plan when option is “% specified


Plan/Dental

Plan/Dental
plan” for Dental.


Value for EE
Text Box
Value for EE 
To specify contribution % or value for Dental.


($/%)/Dental

($/%)/Dental



Value for Dep
Text Box
Value for Dep
To specify contribution % or value for Dental.


($/%)/Dental

($/%)/Dental



Contribution
Option Box
Contribution
To specify contribution type for Vision.


Type/Vision

Type/Vision



Specified 
Option Box
Specified 
To specify a plan when option is “% specified


Plan/Vision

Plan/Vision
plan” for Vision.


Value for EE
Text Box
Value for EE 
To specify contribution % or value for Vision.


($/%)/Vision

($/%)/Vision



Value for Dep
Text Box
Value for Dep
To specify contribution % or value for Vision.


($/%)/Vision

($/%)/Medical



Contribution
Option Box
Contribution
To specify contribution type for CAM.


Type/CAM

Type/CAM



Specified 
Option Box
Specified 
To specify a plan when option is “% specified


Plan/CAM

Plan/CAM
plan” for CAM.


Value for EE
Text Box
Value for EE 
To specify contribution % or value for CAM.


($/%)/CAM

($/%)/CAM



Value for Dep
Text Box
Value for Dep
To specify contribution % or value for CAM.


($/%)/CAM

($/%)/CAM



New
Command
New
To clear the screen for new quote entry


Save
Command
Save
To save details of quote to database


Search
Command
Search
To search for a specific quote









Screen2













Element
Element




Name
Type
Label
Purpose















Quote Information










Quote Number
Display Text
Quote #
Unique id for a quote. There will be only one





quote associated with each group/lead.


Revision
Display Text
Rev
Revision # of the quote


Quote Date
Display Text
Date
Quote Date


Lead/Group
Display Text
Type
Type of the lead/group to whom quote is


Type


generated


Lead/Group Id 
Display Text
Lead/Group Id
Id of the lead/group to whom quote is generated


Lead/Group
Display Text
Lead/Group
Name of the lead/group to whom quote is


Name

Name
generated







Employee Information










Quote Specific
Column
Quote Specific
To indicate employees when using “quote



Check Box

specific employees” option


Employee
Column Text
Employee Name
Name of employee


Name
Box




Sort by
Link
Sort A-Z
To sort the employee details by employee name


Ascending


in ascending order.


Sort by
Link
Sort Z-A
To sort the employee details by employee name


Descending


in descending order.


Age/DOB
Column
Age/DOB
Age/DOB of employee



Check Box




Coverage
Column
Tier
Coverage choice selected by employee


Choice
Option Box




#Members
Column Text
#
# of members covered under employee (including



Box

the employee)


Zip
Column Text
Zip
Zip code of residence of employee



Box




County
Column
County
County of residence of employee



Option Box




Medical Plan
Column
Medical Plan
Medical plan selected by employee, if any



Option Box




Dental Plan
Column
Dental Plan
Dental plan selected by employee, if any



Option Box




Vision Plan
Column
Vision Plan
Vision plan selected by employee, if any



Option Box




CAM Plan
Column
CAM Plan
CAM plan selected by employee, if any



Option Box




Size
Text Box

To alter the size of the employee info entry table.


Set Size
Command
Set Size
Adds/deletes row(s) in employee information





entry table depending on the size entered.


Delete
Command
Delete
Deletes a row from employee information entry





table


Upload
Link
Upload
To upload a flat file containing employee


Employee Info

Employee Info
information


Total
Display Text
Total Employees
Displays count of employees entered in the


Employees


employee information table.


Total Waiving
Text Box
Total Waiving
Total # of waiving employees


Total Declining
Text Box
Total Declining
Total # of declining employees


Total COBRAs
Text Box
Total COBRAs
Total # of COBRA members with the group


Rate
Radio
Rate Differential
To specify whether the RAF is calculated by the


Differential
Buttons
Factor
system or entered by the user.


Factor





Rate
Text Box
Rate Differential
Rate Differential Factor


Differential

Factor



Factor





Refresh
Command
Refresh
To calculate the RAF a fresh when the RAF is





calculated by the system.


New
Command
New
To clear the screen for new quote entry


Save
Command
Save
To save details of quote to database


Search
Command
Search
To search for a specific quote









Screen 3













Element
Element




Name
Type
Label
Purpose















Quote Information










Quote Number
Display Text
Quote #
Unique id for a quote. There will be only one





quote associated with each group/lead.


Revision
Display Text
Rev
Revision # of the quote


Quote Date
Display Text
Date
Quote Date


Lead/Group
Display Text
Type
Type of the lead/group to whom quote is


Type


generated


Lead/Group Id
Display Text
Lead/Group Id
Id of the lead/group to whom quote is generated


Lead/Group
Display Text
Lead/Group
Name of the lead/group to whom quote is


Name

Name
generated







Contribution Information


Medical










Quote Medical
Check Box
Quote Medical
To include the quote for medical.


Contribution
Check Box
Contribution
To include the contribution summary to quote


Summary

Summary
output.


Employer
Check Box
Employer
To include the % lowest cost HMO contribution


Summary/%

Summary/%
in Employer summary.


Lowest Cost

Lowest Cost



HMO

HMO



Employer
Check Box
Employer
To include the % lowest cost Plan contribution 


Summary/%

Summary/%
in Employer summary.


Lowest Cost

Lowest Cost



Plan

Plan



Employer
Check Box
Employer
To include the % Specified Plan contribution in


Summary/%

Summary/%
Employer summary.


Specified Plan

Specified Plan



Employer
Check Box
Employer
To include the Flat $ Amount contribution in


Summary/Flat

Summary/Flat $ 
Employer summary.


$ Amount

Amount



Employee
Check Box
Employee
To include the % lowest cost HMO contribution


Quotes/%

Quotes/%
in Employee Quotes.


Lowest Cost

Lowest Cost



HMO

HMO



Employee
Check Box
Employee
To include the % lowest cost Plan contribution in


Quotes/%

Quotes/%
Employee Quotes.


Lowest Cost

Lowest Cost



Plan

Plan



Employee
Check Box
Employee
To include the % Specified Plan contribution in


Quotes/%

Quotes/%
Employee Quotes.


Specified Plan

Specified Plan



Employee
Check Box
Employee
To include the Flat $ Amount contribution in


Quotes/Flat $

Quotes/Flat $
Employee Quotes.


Amount

Amount



Value for
Text Box
Value for
To specify contribution % for Lowest cost HMO


Employee/%

Employee/%
for employee.


Lowest Cost

Lowest Cost



HMO

HMO



Value for
Text Box
Value for
To specify contribution % for Lowest Cost Plan


Employee/%

Employee/%
for employee.


Lowest Cost

Lowest Cost



Plan

Plan



Value for
Text Box
Value for
To specify contribution % for Specified Plan for


Employee/%

Employee/%
employee.


Specified Plan

Specified Plan



Value for
Text Box
Value for
To specify contribution value for Flat $ Amount


Employee/Flat

Employee/Flat
for employee.


$ Amount

$ Amount



Value for
Text Box
Value for
To specify contribution % for Lowest cost HMO


Dependent/%

Dependent/%
for dependent.


Lowest Cost

Lowest Cost



HMO

HMO



Value for
Text Box
Value for
To specify contribution % for Lowest Cost Plan


Dependent/%

Dependent/%
for dependent.


Lowest Cost

Lowest Cost



Plan

Plan



Value for
Text Box
Value for
To specify contribution % for Specified Plan for


Dependent/%

Dependent/%
dependent.


Specified Plan

Specified Plan



Value for
Text Box
Value for
To specify contribution value for Flat $ Amount


Dependent/Flat

Dependent/Flat 
for dependent.


$ Amount

$ Amount



Specified Plan
Option Box
Specified Plan
To specify a plan when option is “% specified





plan”







Dental










Quote Dental
Check Box
Quote Dental
To include the quote for dental.


Contribution
Check Box
Contribution
To include the contribution summary to quote


Summary

Summary
output.


Employer
Check Box
Employer
To include the % lowest cost Plan contribution in


Summary/%

Summary/%
Employer summary.


Lowest Cost

Lowest Cost



Plan

Plan



Employer
Check Box
Employer
To include the % Specified Plan contribution in


Summary/%

Summary/%
Employer summary.


Specified Plan

Specified Plan



Employer
Check Box
Employer
To include the Flat $ Amount contribution in


Summary/Flat 

Summary/Flat $
Employer summary.


$ Amount

Amount



Employee
Check Box
Employee
To include the % lowest cost Plan contribution in


Quotes/%

Quotes/%
Employee Quotes.


Lowest Cost

Lowest Cost



Plan

Plan



Employee
Check Box
Employee
To include the % Specified Plan contribution in


Quotes/%

Quotes/%
Employee Quotes.


Specified Plan

Specified Plan



Employee
Check Box
Employee
To include the Flat $ Amount contribution in


Quotes/Flat $

Quotes/Flat $
Employee Quotes.


Amount

Amount



Value for
Text Box
Value for
To specify contribution % for Lowest Cost Plan


Employee/%

Employee/%
for employee.


Lowest Cost

Lowest Cost



Plan

Plan



Value for
Text Box
Value for
To specify contribution % for Specified Plan for


Employee/%

Employee/%
employee.


Specified Plan

Specified Plan



Value for
Text Box
Value for
To specify contribution value for Flat $ Amount


Employee/Flat

Employee/Flat
for employee.


$ Amount

$ Amount



Value for
Text Box
Value for
To specify contribution % for Lowest Cost Plan


Dependent/%

Dependent/%
for dependent.


Lowest Cost

Lowest Cost



Plan

Plan



Value for
Text Box
Value for
To specify contribution % for Specified Plan for


Dependent/%

Dependent/%
dependent.


Specified Plan

Specified Plan



Value for
Text Box
Value for
To specify contribution value for Flat $ Amount


Dependent/

Dependent/Flat
for dependent.


Flat $ Amount

$ Amount



Specified Plan
Option Box
Specified Plan
To specify a plan when option is “% specified





plan”







Vision










Quote Vision
Check Box
Quote Vision
To include the quote for vision.


Contribution
Check Box
Contribution
To include the contribution summary to quote


Summary

Summary
output.


Employer
Check Box
Employer
To include the % lowest cost Plan contribution in


Summary/%

Summary/%
Employer summary.


Lowest Cost

Lowest Cost



Plan

Plan



Employer
Check Box
Employer
To include the % Specified Plan contribution in


Summary/%

Summary/%
Employer summary.


Specified Plan

Specified Plan



Employer
Check Box
Employer
To include the Flat $ Amount contribution in


Summary/Flat

Summary/Flat $
Employer summary.


$ Amount

Amount



Employee
Check Box
Employee
To include the % lowest cost Plan contribution in


Quotes/%

Quotes/%
Employee Quotes.


Lowest Cost

Lowest Cost



Plan

Plan



Employee
Check Box
Employee
To include the % Specified Plan contribution in


Quotes/%

Quotes/%
Employee Quotes.


Specified Plan

Specified Plan



Employee
Check Box
Employee
To include the Flat $ Amount contribution in


Quotes/Flat $

Quotes/Flat $
Employee Quotes.


Amount

Amount



Value for
Text Box
Value for
To specify contribution % for Lowest Cost Plan


Employee/%

Employee/%
for employee.


Lowest Cost

Lowest Cost



Plan

Plan



Value for
Text Box
Value for
To specify contribution % for Specified Plan for


Employee/%

Employee/%
employee.


Specified Plan

Specified Plan



Value for
Text Box
Value for
To specify contribution value for Flat $ Amount


Employee/Flat

Employee/Flat
for employee.


$ Amount

$ Amount



Value for
Text Box
Value for
To specify contribution % for Lowest Cost Plan


Dependent/%

Dependent/%
for dependent.


Lowest Cost

Lowest Cost



Plan

Plan



Value for
Text Box
Value for
To specify contribution % for Specified Plan for


Dependent/%

Dependent/%
dependent.


Specified Plan

Specified Plan



Value for
Text Box
Value for
To specify contribution value for Flat $ Amount


Dependent/

Dependent/Flat 
for dependent.


Flat $ Amount

$ Amount



Specified Plan 
Option Box
Specified Plan
To specify a plan when option is “% specified





plan”







CAM










Quote CAM
Check Box
Quote CAM
To include the quote for CAM.


Contribution
Check Box
Contribution
To include the contribution summary to quote


Summary

Summary
output.


Employer
Check Box
Employer
To include the % lowest cost Plan contribution in


Summary/%

Summary/%
Employer summary.


Lowest Cost

Lowest Cost



Plan

Plan



Employer
Check Box
Employer
To include the % Specified Plan contribution in


Summary/%

Summary/%
Employer summary.


Specified Plan

Specified Plan



Employer
Check Box
Employer
To include the Flat $ Amount contribution in


Summary/Flat

Summary/Flat $ 
Employer summary.


$ Amount

Amount



Employee
Check Box
Employee
To include the % lowest cost Plan contribution in


Quotes/%

Quotes/%
Employee Quotes.


Lowest Cost

Lowest Cost



Plan

Plan



Employee
Check Box
Employee
To include the % Specified Plan contribution in


Quotes/%

Quotes/%
Employee Quotes.


Specified Plan

Specified Plan



Employee
Check Box
Employee
To include the Flat $ Amount contribution in


Quotes/Flat $

Quotes/Flat $
Employee Quotes.


Amount

Amount



Value for
Text Box
Value for
To specify contribution % for Lowest Cost Plan


Employee/%

Employee/%
for employee.


Lowest Cost

Lowest Cost



Plan

Plan



Value for
Text Box
Value for
To specify contribution % for Specified Plan for


Employee/%

Employee/%
employee.


Specified Plan

Specified Plan



Value for
Text Box
Value for
To specify contribution value for Flat $ Amount


Employee/Flat

Employee/Flat
for employee.


$ Amount

$ Amount



Value for
Text Box
Value for
To specify contribution % for Lowest Cost Plan


Dependent/%

Dependent/%
for dependent.


Lowest Cost

Lowest Cost



Plan

Plan



Value for
Text Box
Value for
To specify contribution % for Specified Plan for


Dependent/%

Dependent/%
dependent.


Specified Plan

Specified Plan



Value for
Text Box
Value for
To specify contribution value for Flat $ Amount


Dependent/

Dependent/Flat 
for dependent.


Flat $ Amount

$ Amount



Specified Plan
Option Box
Specified Plan
To specify a plan when option is “% specified





plan”


New
Command
New
To clear the screen for new quote entry


Save
Command
Save
To save details of quote to database


Search
Command
Search
To search for a specific quote









Screen 4













Element
Element




Name
Type
Label
Purpose















Quote Information










Quote Number
Display Text 
Quote #
Unique id for a quote. There will be only one





quote associated with each group/lead.


Revision
Display Text 
Rev
Revision # of the quote


Quote Date
Display Text 
Date
Quote Date


Lead/Group
Display Text 
Type
Type of the lead/group to whom quote is


Type


generated


Lead/Group Id
Display Text 
Lead/Group Id
Id of the lead/group to whom quote is generated


Lead/Group
Display Text 
Lead/Group
Name of the lead/group to whom quote is


Name

Name
generated







Quote Generation Options










Generate
Radio
Generate
To specify what type of quote to be generated.



Buttons

Possible values are: Standard Quote, Interim





Quote


Quote for
Check Box
Quote for
If this option is set, the quote is generated only


specified plans

specified plans
for plans specified by employee


only

only



Exclude

Exclude
To exclude certain plans from being quoted


Specified Plans

Specified Plans



Quote For
Radio
Quote For
To specify to whom the quote output is being



Buttons

generated. Possible values are: Group,





Employee(s), Cal-COBRA(s), Fed-COBRA(s)


When quoting
Radio
When quoting
To specify what quote sheets to be included in


for groups,
Buttons
for groups,
quote output.


include

include



Mode of output 
Radio
Mode of output
To specify the mode of quote output. Possible



Buttons

values are: View, Email, Fax, Print in mailroom.


Send to whose
Radio
Send to whose
To specify to whose attention the quote is to be


attention
Buttons
attention
sent. Possible values are: Agent's Attn., Group's





Attn., Other.


Attention to
Text Box
Attention to
To specify the attention to whom when the “Send





to whose attention”, is others.


Address 1
Text Box
Address 1
To specify the address 1 when the “Send to





whose attention”, is others.


Address 2
Text Box
Address 2
To specify the address 2 when the “Send to





whose attention”, is others.


Email
Text Box
Email
To specify the email when the “Send to whose





attention”, is others.


Fax
Text Box
Fax
To specify the fax when the “Send to whose





attention”, is others.


Include
Check Box
Include program 
To indicate whether the program brochure is to be


program

brochure
included in the quote output.


brochure





New
Command
New
To clear the screen for new quote entry


Save
Command
Save
To save details of quote to database


Search
Command
Search
To search for a specific quote









Screen 5













Element
Element




Name
Type
Label
Purpose















Quote Information










Quote Number
Display Text
Quote #
Unique id for a quote. There will be only one





quote associated with each group/lead.


Revision
Display Text
Rev
Revision # of the quote


Quote Date
Display Text
Date
Quote Date


Lead/Group
Display Text
Type
Type of the lead/group to whom quote is


Type


generated


Lead/Group Id 
Display Text
Lead/Group Id 
Id of the lead/group to whom quote is 





generated


Lead/Group
Display Text
Lead/Group
Name of the lead/group to whom quote is


Name

Name
generated







Missing Information










Missing entity
Display Text
Missing Entity
Name of the missing entity


Message
Display Text
Message
Message.


New
Command
New
To clear the screen for new quote entry


Save
Command
Save
To save details of quote to database


Search
Command
Search
To search for a specific quote









3.1.1.3. Screen Validations
Screen1












Element Name
Action/Validation Details
Message















Lead Group Information









Quoting For
Check to see that a valid option is
“Required information is missing”



selected for the field



Lead/Group Id
Check to see that a valid value is
“Required information is missing”



entered for the field








General Information









Quote Date

“Required information is missing”


Mode of Request
Check to see that a valid option is 
“Required information is missing”



selected for the field



Request Postmark
Check to see that a valid value is
“Required information is missing”


Date
entered for the field



Request Receive
Check to see that a valid value is
“Required information is missing”


Date
entered for the field



Rate Type
Check to see that a valid option is 
“Required information is missing”



selected for the field



Agent Commission
Check to see that a valid value is
“Required information is missing”



entered for the field



Effective Date
Check to see that a valid value is
“Required information is missing”



entered for the field









Screen2












Element Name
Action/Validation Details
Message















Employee Information









Age/DOB
Check to see that a valid 
“Required information 



value is entered for the 
is missing”



field



Coverage 
Check to see that a valid 
“Required information 


Option
option is selected for the 
is missing”



field



Number of
Check to see that a valid 
“Required information 


Members
value is entered for the 
is missing”



field









Screen4












Element Name
Action/Validation Details
Message















Quote Generation Options









Generate
Check to see that a 
“Required information 



valid option is selected 
is missing”



for the field



Quote For
Check to see that a 
“Required information 



valid option is selected 
is missing”



for the field



When quoting for
Check to see that a 
“Required information 


groups, include
valid option is selected 
is missing”



for the field



Mode of output
Check to see that a 
“Required information 



valid option is selected 
is missing”



for the field



Send to whose
Check to see that a 
“Required information 


attention
valid option is selected 
is missing”



for the field









3.2. Interface Flow
N/A
4. Business Rule Mapping











Activity
Rules

















Generate 
 1.
A lead or a group will be associated with (a


Quote

maximum of) one quote number. Changes to the




quote will be saved as revisions.



 2.
For an existing group, fee type (blended or non-




blended), coverage & contribution information and




employees information gets defaulted from current




enrollment.



 3.
Default coverage and contribution is: Line of




coverage - Medical; Contribution for employees -




50% of lowest cost HMO plan; Contribution for




dependents - None



 4.
For each line of coverage, the contribution type for




dependents (if any) has to be same as that for the




employee. Only the contribution percentage or




value can change.



 5.
Quote for an individual association member should




include only one employee.



 6.
If zip code is not provided for an employee, the zip




code of the group is used for rate calculation.



 7.
Number of employees willing to enroll should




satisfy the participation rule i.e., number of declines




to (employee count − number of waiving + number




of declines − number of COBRA) should be less




than 30%.



 8.
Employer's contribution towards employee




premium should be at least 50% of the group's




average premium for all enrolled employees based




on the lowest cost employee-only plan available.



 9.
Effective date for quote will default to 1st of next




month if current date is lesser than or equal to the




25th of the month and 1st of the next following




month after the 25th.



10.
Premium rates are calculated based on the logic as




detailed in “Process Specification for Billing -




BPI_CAS_FSD_FI_001”.









Benefit Partners Inc
Process Specification
Supply Request
External
1. Introduction
1.1. Purpose
This functional specification document addresses the part of the Core Administration System that would facilitate the sending of Supply Requests or any handbooks to employer groups or the members of a group.
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









None
None










1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
2.1. Process Description
A Supply Request consists of all handbooks, rate books, forms and application, complementary, super directories that are sent to the employer groups and its members through the mailroom.
2.2. Process Flow (See FIG. N-1)
3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's












Screen ID (SID)
Screen Name
Corresponding HTML File Name







utl.supplyrequest.external
Supply Request External 
ExternalSupplyRequest.jsp


utl.supplyrequestview.external
Supply Request External View
ExternalSupplyRequestView.jsp


utl.supplyrequestresult.external
Supply Request External
ExternalSupplyRequestResult.jsp


utl.supplyconfirm.external
Supply Request External 
ExternalSupplyRequestMailConfirm.jsp



Confirmation









3.1.2. User Interface Id: Supply Request—External
3.1.2.1. Screen Name: Supply Request—External (BPI_CAS_UTL_SCR—001—001) (See FIG. N-2)
3.1.2.2. SID, Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the screen being


“External Supply

“External Supply 
navigated


Request”

Request”



Text items as
Text
Text items as
To provide information as shown in the


shown in the

shown in the
screen along with Qty Text and in Boxes as


screen for Pre

screen for Pre
shown in the screen snapshot


selected

selected



packages,

packages,



Handbooks, Rate

Handbooks,



Books, Forms

Rate Books,



and Applications,

Forms and



Complementary,

Applications,



Super Directories

Complementary,





Super





Directories



Qty Entry Field
Entry Field
Qty Entry Field
Entry field for Quantity for all items


Agent/Employer
Text
Agent/Employer
Text for Agent/Employer Group.


Group ID

Group ID
Must not show up if accessed directly from





the menu


Agent/Employer
Dynamic
Agent/Employer
Needs to pick up the agent ID or the supply


Group ID
Text
Group ID
request ID. Must not show up if accessed





directly from the menu


Company Name
Text
Company Name
Text for “Company Name”


Text

Text



Company Name
Entry Field
Company Name
Entry Field For Company Name


Entry Field

Entry Field



Address Text
Text
Address Text
Text for “Address”


Address Entry
Entry Field
Address Entry
Entry Field For Address


Field

Field



Suite Text
Text
Suite Text
Text for “Suite”


Suite Entry Field 
Entry Field
Suite Entry Field
Entry Field For Suite


City Text
Text
City Text
Text for “City”


City Entry Field
Entry Field
City Entry Field 
Entry Field For City


State Text
Text
State Text
Text for “State”


State Entry Field 
List
State Entry
List for States - with default CA




Field



Zip Code Text
Text
Zip Code Text
Text for “Zip Code”


Zip Code Entry
Entry Field
Zip Code Entry
Entry Field For Zip Code


Field

Field



Customer
Text
Customer
Text for “Customer Request Date”


Request Date

Request Date



Customer
Entry Field
Customer
Calendar


Request Date

Request Date



Ship Via
Text
Ship Via
Text for “Ship Via”


Radio Buttons
Radio button
Radio Buttons 
Radio Buttons for Mail Room and Will 


selection for Ship

selection for
Call - Default None


Via

Ship Via



Special
Text
Special
Text for “Special Instructions”


Instruction Text

Instruction Text



Special
Text Area
Special
Text Area For Special Instructions


Instructions Entry

Instructions



Field

Entry Field



Confirm
Check Box
Confirm
Check Box for “Confirm Fulfillment by Email”


Fulfillment by

Fulfillment by



Email

Email



Save
Button
Save
Save the information to the repository



(HTML





Submit





button)




Cancel
Button
Cancel
Reset information as described in the





scenarios









3.1.2.3. Front End Validations












Element Name
Action/Validation Details
Error Message Text







Save
Should function with enter key cursor positioned
Mandatory Entries:



on the “Save” button or on mouse click.
1) Choose anyone item with Qty



On saving the data the data gets saved to the
Error dialog Box - “Item Quantity -



permanent repository. And send an email to the
At least one entry is needed” with Close



mailroom along with a confirmation page to the 
Button



user
2) For Company Name



Mandatory Entry
Error Dialog Box “Company Name -



1) Choose any one item with Qty
Is required” with Close option and



2) Company Name
on press of Close button leads to



3) Address
the Company name field



4) City
3) For Address



5) Zip Code
Error Dialog Box “Address - Is



6) Agent/Employer Group ID
required.” with Close option and on



7) State
press of Close button leads to the



8) Suite
Address field




4) For City




Error Dialog Box “Please enter the




City” with Yes option and on press




of Yes button leads to the City field




5) For Zip Code




Error Dialog Box “Zip - Is required.”




with Close option and on press of




Close button leads to the Zip code




field




6) For Agent/Employer Group ID




Error Dialog Box “Agent/Employer




Group ID - Is required.” with Close




option and on press of Close button




leads to the Agent/employer Group




ID field.




7) For State




Error Dialog Box “State - Is




required.” with Close option and on




press of Close button leads to the




State field.




8) For Suite




Error Dialog Box “Suite - Is




required.” with Close option and on




press of Close button leads to the




Suite field


Cancel
All the data entered is reset with empty in the




data entry fields as the case may be (Text Field,




List etc).









3.1.2.4. Screen Flow
The user enters the information on the workgroup name and description.
The following are the scenarios the user may come across when operating on the screen











Scenario
Description







Pre-Population
The ID/address fields must be prepopulated with



the address details if the user navigates to the sup-



ply request screen from Agent Master, Agency 



Master, Employer Group Master (Sales & 



Enrollment).


Save
Pressing the save button leads to saving the data



in the repository, sending an email to mailroom



and confirmation to the user who has checked the



confirmation by email check box



Email Content - Subject: Supply Request



Dear Mail Room Staff,



Please forward the following to the address 



mention below



Items - Qty



Comments



Address



Ship Via



Thanks



< ID of the person who has made the request>


Close the browser 
The browser window cannot be closed/user can't 


without saving/
navigate to another page without saving the data.


Navigating to
The user is prompted with the option of either sav-


another page
ing the data and closing/leaving the window or not


without saving
saving the data and closing/leaving the window.


Close the browser/ 
The browser window can be closed/user can leave


leave the page
once all the data is saved in the permanent repository.


after saving



Cancel
All the data entered is reset with empty in the data



entry fields as the case may be (Text Field, List etc).









3.1.3. User Interface Id: External Supply Request Mail Room Confirmation
3.1.3.1. Screen Name: Supply Request Mail Room Confirmation
(BPI_CAS_UTL_SCR—001—002) (See FIG. N-3)
3.1.3.2. SID, Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Main Header
Text
Main Header 
To give the heading for the screen being


“Supply

“Supply
navigated


Request-Mail

Request-Mail



Room

Room



Confirmation”

Confirmation”



Message
Text
Message
Text For “The following are the pending Supply





Requests. On fulfilling the request, check the





row and press save to confirm”


Check All
Link
Check All
Checks all the check Boxes


Clear All
Link
Clear All
Clears All or any Checked Boxes


Save
HTML Button
Save
Save Button


Cancel
HTML Button
Cancel
Cancel Button









3.1.3.3. Front End Validations















Element
Action/Validation 




Name
Details
Error Message Text









Save
Must choose at least 
Error Dialog Box - “Please




one check Box
Check at least one row” with





yes option










3.1.3.4. Screen Flow
The following are the scenarios the user may come across when operating on the screen











Scenario
Description







On Entering the 
Provides a list of all pending requests


screen



Check All
Checks all the check Boxes


Clear All
Clears all the Check Boxes/Or any checked boxes


Save
Saves all the updates made and send email to the 



personnel who made the request where the 



confirmation on fulfillment by Email check 



Box is checked. The user Email details are



picked up from the security framework



Email:



Subject: Supply Request Fulfillment”



Dear “Name”



We have fulfilled your request <Supply Request id> 



on “date of saving the fulfillment request”



Thanks



Mailroom


Cancel
Resets the screen with original values before a save









3.1.4. User Interface Id: Supply Request Confirmation
3.1.4.1. Screen Name: Supply Request Confirmation
(BPI_CAS_UTL_SCR—001—003)
3.1.4.2. SID, Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the screen being


“Supply Request

“Supply
navigated


Confirmation”

Request





Confirmation”



Message
Text
Message
Text For “The Supply Request has been





forwarded to the mail room”


Message
Text
Message
Text For “The Reference confirmation number is”


Dynamic Text
Text
Dynamic Text
Dynamic Value Text for “<Supply Request ID>”


Do you want to
Text
Do you want
Text for “Do you want to create more requests?”


create more

to create



requests?

more





requests?



Yes
Link
Yes
Link for “Yes”


No
Link
No
Link for “No”









3.1.4.3. Front End Validations
None.
3.1.4.4. Screen Flow
The following are the scenarios the user may come across when operating on the screen














Scenario
Description









Yes
Leads to the Supply Request Screen



No
Leads to the Supply Request Home Page










4. Business Rule Mapping











Activity
Rules







Create Supply Request ID
Should have unique Id for a Supply Request - 10



digits with an increment of 1, Say EX00000001,



EX00000002, EX00000003 and so on.









Benefit Partners
Process Specification
Workgroups
1. Introduction
1.1. Purpose
This functional specification document addresses the part of the sales and marketing system that would facilitate the creation of workgroups.
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









None
None










1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
2.1. Process Description
Workgroups define the broad categorization of a group of agents, internal working personnel of BPI, external working personnel associated with BPI and Mailing groups.
The process shall include creating

    
    
        1) Categories
    
    


Categories define the segment a workgroup can fall under. For eg—Agents, Employees, HR etc.

    
    
        2) Define Parent and assign to a category
    
    


A Parent is the highest in the hierarchy of a work group. Typical examples include Agent Work groups, Internal work groups. A parent is assigned to a category

    
    
        3) Define Main Work group and assign to a Parent
    
    


A work group defines the various groups that come under a parent—Examples include—Agents by ranking etc. A work group can also be a child workgroup. A workgroup is assigned to a Parent

    
    
        4) Define Child workgroup and assign to a main work group
    
    


Child groups is a set of groups under a workgroup and typically examples include—agents in San Diego Area Etc

    
    
        5) Define Mail Members—Create, Modify, View, Delete
    
    


Mail Members are the components of a child work group for a category Mail and are assigned to the child workgroups
The work groups are designed in such a way that members can be swapped in full or in partial or duplicated from one work group to another.
2.2. Process Flow (See FIG. N-4)
3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's














Corresponding 


Screen ID (SID)
Screen Name
HTML File Name







utl.workgroup.category
Category
Category.jsp


utl.workgroup.maingroup
Main Workgroup
MainGroup.jsp


utl.workgroup.childgroup 
Child Workgroup
ChildGroup.jsp


utl.workgroup.mailmember
Mail Members
MailMember.jsp


utl.workgroup.swapmembers
Swap Members
SwapMembers.jsp









3.1.2. User Interface Id: Category
3.1.2.1. Screen Name: Category (BPI_CAS_UTL_SCR—002—001)
3.1.2.2. SID, Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the screen being


“Category”

“Category”
navigated


Name
Text
Name
Text For “Name”


Name Entry
Entry Field
Name Entry
Entry field for entering the name


Field

Field



Description
Text
Description
Text for “Description”


Description
Entry Field
Description
Entry field for entering the description


Entry Field

Entry Field



Add
HTML Button
Add
Button for adding the name/description in to the





HTML table. Changes with label “Modify” when





the row in the table is on edit mode.


Table
HTML table
Table
For displaying all the information added by





pressing the add button, in the form of rows, for





every add operation/Rows retrieved from the





permanent repository


Delete
Button (HTML
Delete
To delete the rows checked



Button)




Check All
Text Link
Check All
To check all the check boxes in the table


Clear All
Text Link
Clear All
To uncheck all the check boxes checked in the





table/does not function when all the





checkboxes in the table are unchecked


Delete
Check box
Delete
To check the items for deletion


Edit
Button (HTML
Edit
To edit the rows entered by “Add”/



Button)

“Modify”/displayed from permanent repository





against the row selected for edition


Save
Button (HTML
Save
Save the information to the repository



Submit button)




Cancel
Button
Cancel
Reset information as described in the scenarios









3.1.2.3. Front End Validations












Element Name
Action/Validation Details
Error Message Text







Name
Mandatory Entry
When the Add HTML Button is


Entry Field
Becomes non editable when on modify mode for
pressed with an empty entry on



data from permanent repository
the name entry field, an Error




Dialog Box pops up with the




message “Please enter the name




before adding to the table” with




“yes” option




On press of Yes Button, The




cursor must be placed on the




name entry field


Add
On Clicking add button or the pressing the enter
When the Add HTML Button is



key field with the cursor position on the Add
pressed with an empty entry on



button, The data gets added to the table.
the name entry field, an Error



Validation checks are done to not allow null value 
Dialog Box pops up with the



on the name entry field.
message “Please enter the name



Must not allow duplicate entries on the name
before adding to the table” with



Must not allow the length of the field entry to go 
“yes” option.



beyond as per the database design for the
On press of Yes Button, The



column
cursor must be placed on the




name entry field




For duplicate entries, Error dialog




box - “Duplicate values not




allowed. Please enter again”


Modify
On Clicking the modify button or pressing the
None



enter key field with the cursor positioned on the




modify button, the data gets added to the table.



Table
Should have column header and each




subsequent row should be identified by alternate




color combinations. i.e. First row should have




color ‘x’ and the next row should have color ‘y’.




The next row should have color ‘x’ again and so




on. The size of any text inside any cell should be




wrapped if the text becomes too long.




The letters must be green in color for the rows




retrieved from the permanent repository and red




for the rows in temporary storage.




All the letters of the row on edit must be in dark




gray.



Delete
Should function with enter key cursor positioned
Error Dialog Box: “Please choose



on the “Delete” button or on mouse click
the row or rows to be deleted.”



Delete button should work on multiple deletes
with “yes” option



based on the check box or boxes selected. If the




user clicks on the delete button without checking




any of the check box should throw error




message.




Success: Deletes the row or rows from the table




(temporary storage)



Check All
On clicking the “Check All” link should check all
Not Applicable



the check boxes in the HTML table.



Clear All
On clicking the “Clear All” link should uncheck all
Not Applicable



the checked check boxes in the HTML table.



Edit
Should function with Enter Key Cursor positioned




on the “Edit” button or on mouse click.




Refer Interface flow on scenarios - “edit data”



Save
Should function with enter key cursor positioned
Not Applicable



on the “Save” button or on mouse click.




On saving the data the data gets saved to the




permanent repository.



Cancel
All the data entered is reset with empty/initial
Not Applicable



values in the data entry fields as the case may be




(Text Field, List etc).




If a row is already modified and added to the




table on the screen and the Cancel button is




pressed, the row remains with the modified




values



Browser
When a user tries to close the window with out
Error Dialog box message: “Do


Window
saving data into the permanent repository, a
you want to save all changes



dialog box pops up
before closing/leaving the




window?” with a “Yes” and “No”




option.




On press of “Yes” leads to saving




of information and “No” leads to




the Category screen with the




original values









3.1.2.4. Screen Flow
The user enters the information on the Category name and description.
The following are the scenarios the user may come across when operating on the screen











Scenario
Description







Add data entered
Adding the data entered (pressing the “Add” Button) leads to adding name



and description to a temporary storage. The data gets loaded into the



permanent repository only after the user saves the information.


Modify data entered
When a row is selected for an edit operation, the row is highlighted and data



elements populated into respective fields and the add button has a label



“modify”. Modifying the data entered (pressing the “Modify” button) leads to



adding the non-editable name information and modified “description” to a



temporary storage. The data gets loaded into the permanent repository only



after the user saves the information.


Edit data
Editing the Data (pressing the “Edit” Button).



The edit operation may be on any of the two scenarios.



 1. (Edit for rows from database) When the user comes to the



  Category screen and the screen is already loaded with data from



  the permanent repository into a table on the screen.



 2. (Edit for rows from the temporary storage) When the user has just



  added the data into a table on the screen and wants to edit the



  data entered before saving



The data in the table on the screen would be shown as green letters for the



data from the database and red letters for the data that is in the temporary



storage (not saved yet).



The table shall have alternate rows colored with different light colors



Under 1, on an edit operation for a row on the table, the row does not get



deleted from the table and the data is transferred to the name (becomes non



editable) and editable description.



Under 2, on an edit operation for a row on the table, the row gets deleted from



the table and the data is transferred to the name and description, which are



editable.



When a row is on edit mode, the letters are in dark gray color in the table.


Delete Checked
The data in the table on the screen contains the data, which is from the


Rows
permanent repository, or the data just added and is in temporary storage.



When the rows are “checked” for the rows that contain the data from the



repository and a “Delete Checked Rows” is performed, inactivation takes



place on saving the information provided there are no subtypes else provides



the user with the necessary error information in an error page. Message “The



following Category has associated parents” - “parent 1 . . . parent n”



When the rows are “checked” for the rows that contain the data from the



temporary storage and a “Delete Checked Rows” is performed, the rows are



deleted from the temporary storage.


Check All
Enables checking of all the checkboxes by checking “check All” Check Box


Check All & Delete
Enables deleting all the rows from the table on the screen enabled by “check


Checked Rows
All”


Check Any Number
Enables deleting the rows from the table on the screen that are only checked.


& Delete Checked



Rows



Check All & Clear
Enables clearing (removing the check) all checked rows done by “Check All”


All



Check Any Number
Enables clearing (removing the check) the rows that are checked.


& Clear All



Clear All when no
The user can only press the button and nothing happens like checking,


rows are checked
removing a check


Save
All the data added or modified and added into/deleted from the rows in the



table are saved into the permanent repository



Once saving is done, return back to the Category screen with all the fresh



updates


Cancel
All the data entered is reset with empty/initial values in the data entry fields as



the case may be (Text Field, List etc).



If a row (which is retrieved from the database) is already modified and added



to the table on the screen and the “Cancel” button is pressed, the row



remains with the modified values.









3.1.3. User Interface Id: Main Work Group
3.1.3.1. Screen Name: Main Work Group (BPI_CAS_UTL_SCR—002—002) (See FIG. N-5)
3.1.3.2. SID, Element Name, Element Type & Purpose













ElementName
Element Type 
Label
Purpose







Main Header
Text
Main Header 
To give the heading for the screen being navigated


“Main

“Main



Workgroup”

Workgroup”



Name
Text
Name
Text For “Name”


Name Entry
Entry Field
Name Entry
Entry field for entering the name


Field

Field



Description
Text
Description 
Text for “Description”


Description
Entry Field
Description 
Entry field for entering the description


Entry Field

Entry Field



Parent
Text
Parent
Text for Parent


Parent Search
Search
Parent
Search window for all active parents




Search



Is it a child work 
Text
Is it a child
Text for “Is it a child workgroup?’


Group

work Group



Is it a child work 
Checkbox
Is it a child
Check Box - Default “No”


Group

work Group



Add
HTML Button
Add
Button for adding the name/description into the





HTML table. Changes with label “Modify” when the





row in the table is on edit mode.


Table
HTML table
Table
For displaying all the information added by





pressing the add button, in the form of rows, for





every add operation/Rows retrieved from the





permanent repository


Delete
Button (HTML
Delete
To delete the rows checked



Button)




Check All
Text Link
Check All
To check all the check boxes in the table


Clear All
Text Link
Clear All
To un check all the check boxes checked in the





table/does not function when all the checkboxes in





the table are unchecked


Delete
Check box
Delete
To check the items for deletion


Edit
Button (HTML
Edit
To edit the rows entered by “Add”/



Button)

“Modify”/displayed from permanent repository





against the row selected for edition


Save
Button (HTML
Save
Save the information to the repository



Submit button)




Cancel
Button
Cancel
Reset information as described in the scenarios









3.1.3.3. Front End Validations












Element Name
Action/Validation Details
Error Message Text







Name
Mandatory Entry
When the Add HTML Button is


Entry Field
Becomes non editable when on modify mode for
pressed with an empty entry on



data from permanent repository
the name entry field, an Error




Dialog Box pops up with the




message “Please enter the name




before adding to the table” with




“yes” option




On press of Yes Button, The




cursor must be placed on the




name entry field


Add
On Clicking add button or the pressing the enter
When the Add HTML Button is



key field with the cursor position on the Add
pressed with an empty entry on



button, The data gets added to the table.
the name entry field, an Error



Validation checks are done to not allow null value
Dialog Box pops up with the



on the name entry field.
message “Please enter the name



Must not allow duplicate entries on the name
before adding to the table” with



Must not allow the length of the field entry to go
“yes” option.



beyond as per the database design for the
On press of Yes Button, The



column
cursor must be placed on the



Must choose a Parent
name entry field




For duplicate entries, Error dialog




box - “Duplicate values not




allowed. Please enter again”




For category, Error dialog Box




“Please choose a Parent” with a




Yes Option


Modify
On Clicking modify button or the pressing the
None



enter key field with the cursor position on the




modify button, The data gets added to the table.



Table
Should have column header and each




subsequent row should be identified by alternate




color combinations. i.e. First row should have




color ‘x’ and the next row should have color ‘y’.




The next row should have color ‘x’ again and so




on. The size of any text inside any cell should be




wrapped if the text becomes too long.




The letters must be green in color for the rows




retrieved from the permanent repository and red




for the rows in temporary storage.




All the letters of the row on edit must be in dark




gray.



Delete
Should function with enter key cursor positioned
Error Dialog Box: “Please choose



on the “Delete” button or on mouse click
the row or rows to be deleted.”



Delete button should work on multiple deletes
with “yes” option



based on the check box or boxes selected. If the




user clicks on the delete button without checking




any of the check box should throw error




message.




Success: Deletes the row or rows from the table




(temporary storage)



Check All
On clicking the “Check All” link should check all
Not Applicable



the check boxes in the HTML table.



Clear All
On clicking the “Clear All” link should uncheck all 
Not Applicable



the checked check boxes in the HTML table.



Edit
Should function with Enter Key Cursor positioned




on the “Edit” button or on mouse click.




Refer Interface flow on scenarios - “edit data”



Save
Should function with enter key cursor positioned
Not Applicable



on the “Save” button or on mouse click.




On saving the data the data gets saved to the




permanent repository.



Cancel
All the data entered is reset with empty/initial
Not Applicable



values in the data entry fields as the case may be




(Text Field, List etc).




If a row is already modified and added to the




table on the screen and the Cancel button is




pressed, the row remains with the modified




values



Browser
When a user tries to close the window with out 
Error Dialog box message: “Do


Window
saving data into the permanent repository, a
you want to save all changes



dialog box pops up
before closing/leaving the




window? ” with a “Yes” and “No”




option.




On press of “Yes” leads to saving




of information and “No” leads to




the Parent screen with the original




values









3.1.3.4. Screen Flow
The user enters the information on the Main work Group name and description and assigns to a parent.
The following are the scenarios the user may come across when operating on the screen











Scenario
Description







Add data entered
Adding the data entered (pressing the “Add ” Button) leads to adding name



description, parent and child group option to a temporary storage. The data



gets loaded into the permanent repository only after the user saves the



information.


Modify data entered
When a row is selected for an edit operation, the row is highlighted and data



elements populated into respective fields and the add button has a label



“modify”. Modifying the data entered (pressing the “Modify ” button) leads to



adding the non-editable name information, modified “description ”/parent to a



temporary storage and child group option. The data gets loaded into the



permanent repository only after the user saves the information. Once the



main subgroup has been defined as a child work group, the editable data will



be shown in the child work group screen


Edit data
Editing the Data (pressing the “Edit ”Button).



The edit operation may be on any of the two scenarios.



 1. (Edit for rows from database) When the user comes to the Main



 workgroups screen and the screen is already loaded with data from



 the permanent repository into a table on the screen.



 2. (Edit for rows from the temporary storage) When the user has just



 added the data into a table on the screen and wants to edit the data



 entered before saving



The data in the table on the screen would be shown as green letters for the



data from the database and red letters for the data that is in the temporary



storage (not saved yet).



The table shall have alternate rows colored with different light colors



Under 1, on an edit operation for a row on the table, the row does not get



deleted from the table and the data is transferred to the name (becomes non



editable) and editable description/Parent



Under 2, on an edit operation for a row on the table, the row gets deleted from



the table and the data is transferred to the name, description/parent (default),



which are editable.



When a row is on edit mode, the letters are in dark gray color in the table.


Search
The search window must generate a list of all active Parents. The user will not



be allowed to make entries into the entry field where the search results are



going to be put in.


Delete Checked
The data in the table on the screen contains the data, which is from the


Rows
permanent repository, or the data just added and is in temporary storage.



When the rows are “checked” for the rows that contain the data from the



repository and a “Delete Checked Rows” is performed, inactivation takes



place on saving the information provided there are no subtypes else provides



the user with the necessary error information in an error page. Message “The



following Main workgroup has associated child workgroups” - “child



workgroup1 . . . child workgroup n”



When the rows are “checked” for the rows that contain the data from the



temporary storage and a “Delete Checked Rows” is performed, the rows are



deleted from the temporary storage.


Check All
Enables checking of all the checkboxes by checking “check All” Check Box


Check All & Delete
Enables deleting all the rows from the table on the screen enabled by “check


Checked Rows
All”


Check Any Number
Enables deleting the rows from the table on the screen that are only checked.


& Delete Checked



Rows



Check All & Clear
Enables clearing (removing the check) all checked rows done by “Check All”


All



Check Any Number
Enables clearing (removing the check) the rows that are checked.


& Clear All



Clear All when no
The user can only press the button and nothing happens like checking,


rows are checked
removing a check


When “ Is it a child 
When the checking is done and the saving of information takes place the


workgroup” is
Main workgroups also becomes a child workgroup


checked



Save
All the data added or modified and added into/deleted from the rows in the



table are saved into the permanent repository. The main groups gets saved



as child workgroup if the check box is selected for “is it a child workgroup?”



Once saving is done, return back to the main workgroup screen with all the



fresh updates


Cancel
All the data entered is reset with empty/initial values in the data entry fields as



the case may be (Text Field, List etc).



If a row (which is retrieved from the database) is already modified and added



to the table on the screen and the “Cancel” button is pressed, the row



remains with the modified values.









3.1.4. User Interface Id: Child Work Group
3.1.4.1. Screen Name: Child Work Group (BPI_CAS_UTL_SCR—002—003) (See FIG. N-6)
3.1.4.2. SID, Element Name, Element Type & Purpose













Element Name
Element Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the screen being


“Child

“Child
navigated


Workgroup”

Workgroup”



Name
Text
Name
Text For “Name”


Name Entry
Entry Field
Name Entry
Entry field for entering the name


Field

Field



Description
Text
Description
Text for “Description”


Description
Entry Field
Description
Entry field for entering the description


Entry Field

Entry Field



Main Work
Text
Main Work
Text for Main Work Group


Group

Group



Main Work
Search
Main Work
Search Window with all active Main Work group


Group Search

Group Search



Add
HTML Button 
Add
Button for adding the name/description into the





HTML table. Changes with label “Modify” when





the row in the table is on edit mode.


Table
HTML table
Table
For displaying all the information added by





pressing the add button, in the form of rows, for





every add operation/Rows retrieved from the





permanent repository


Delete
Button (HTML
Delete
To delete the rows checked



Button)




Check All
Text Link
Check All
To check all the check boxes in the table


Clear All
Text Link
Clear All
To un check all the check boxes checked in the





table/does not function when all the





checkboxes in the table are unchecked


Delete
Check box
Delete
To check the items for deletion


Edit
Button (HTML
Edit
To edit the rows entered by “Add”/



Button)

“Modify”/displayed from permanent repository





against the row selected for editing


Save
Button (HTML
Save
Save the information to the repository



Submit





button)




Cancel
Button
Cancel
Reset information as described in the scenarios









3.1.4.3. Front End Validations












Element Name
Action/Validation Details
Error Message Text







Name
Mandatory Entry
When the Add HTML Button is


Entry Field
Becomes non editable when on modify mode for
pressed with an empty entry on



data from permanent repository
the name entry field, an Error




Dialog Box pops up with the




message “Please enter the name




before adding to the table” with




“yes” option




On press of Yes Button, The




cursor must be placed on the




name entry field


Add
On Clicking add button or the pressing the enter
When the Add HTML Button is



key field with the cursor position on the Add
pressed with an empty entry on



button, The data gets added to the table.
the name entry field, an Error



Validation checks are done to not allow null value
Dialog Box pops up with the



on the name entry field.
message “Please enter the name



Must not allow duplicate entries on the name
before adding to the table” with



Must not allow the length of the field entry to go
“yes” option.



beyond as per the database design for the
On press of Yes Button, The



column
cursor must be placed on the



Must choose a Main work group
name entry field




For duplicate entries, Error dialog




box - “Duplicate values not




allowed. Please enter again”




For category, Error dialog Box




“Please choose a Main Work




Group” with a Yes Option


Modify
On Clicking modify button or the pressing the
None



enter key field with the cursor position on the




modify button, The data gets added to the table.



Table
Should have column header and each




subsequent row should be identified by alternate




color combinations. i.e. First row should have




color ‘x’ and the next row should have color ‘y’.




The next row should have color ‘x’ again and so




on. The size of any text inside any cell should be




wrapped if the text becomes too long.




The letters must be green in color for the rows




retrieved from the permanent repository and red




for the rows in temporary storage.




All the letters of the row on edit must be in dark




gray.



Delete
Should function with enter key cursor positioned
Error Dialog Box: “Please choose



on the “Delete” button or on mouse click
the row or rows to be deleted.”



Delete button should work on multiple deletes
with “yes” option



based on the check box or boxes selected. If the




user clicks on the delete button without checking




any of the check box should throw error




message.




Success: Deletes the row or rows from the table




(temporary storage)



Check All
On clicking the “Check All” link should check all
Not Applicable



the check boxes in the HTML table.



Clear All
On clicking the “Clear All” link should uncheck all 
Not Applicable



the checked check boxes in the HTML table.



Edit
Should function with Enter Key Cursor positioned




on the “Edit” button or on mouse click.




Refer Interface flow on scenarios - “edit data”



Save
Should function with enter key cursor positioned
Not Applicable



on the “Save” button or on mouse click?




On saving the data the data gets saved to the




permanent repository.



Cancel
All the data entered is reset with empty/initial
Not Applicable



values in the data entry fields as the case may be




(Text Field, List etc).




If a row is already modified and added to the




table on the screen and the Cancel button is




pressed, the row remains with the modified




values



Browser
When a user tries to close the window with out
Error Dialog box message: “Do


Window
saving data into the permanent repository, a
you want to save all changes



dialog box pops up
before closing/leaving the




window?” with a “Yes” and “No”




option.




On press of “Yes” leads to saving




of information and “No” leads to




the Parent screen with the original




values









3.1.4.4. Screen Flow
The user enters the information on the Child work Group name and description and assigns to a Main work group.
The following are the scenarios the user may come across when operating on the screen











Scenario
Description







Add data entered
Adding the data entered (pressing the “Add” Button) leads to adding name,



description and Main Workgroup to a temporary storage. The data gets



loaded into the permanent repository only after the user saves the



information.


Modify data entered
When a row is selected for an edit operation, the row is highlighted and data



elements populated into respective fields and the add button has a label



“modify”. Modifying the data entered (pressing the “Modify” button) leads to



adding the non-editable name information, modified “description”, main



workgroup to a temporary storage. The data gets loaded into the permanent



repository only after the user saves the information.


Edit data
Editing the Data (pressing the “Edit” Button).



The edit operation may be on any of the two scenarios.



 1. (Edit for rows from database) When the user comes to the Child



 workgroups screen and the screen is already loaded with data from



 the permanent repository into a table on the screen.



 2. (Edit for rows from the temporary storage) When the user has just



 added the data into a table on the screen and wants to edit the data



 entered before saving



The data in the table on the screen would be shown as green letters for the



data from the database and red letters for the data that is in the temporary



storage (not saved yet).



The table shall have alternate rows colored with different light colors



Under 1, on an edit operation for a row on the table, the row does not get



deleted from the table and the data is transferred to the name (becomes non



editable) and editable description/Main Work group



Under 2, on an edit operation for a row on the table, the row gets deleted from



the table and the data is transferred to the name, description/Main work



group (default), which are editable.



When a row is on edit mode, the letters are in dark gray color in the table.


Search
The search window must generate a list of all active Main Work Groups. The



user will not be allowed to make entries into the entry field where the search



results are going to be put in.


Delete Checked
The data in the table on the screen contains the data, which is from the


Rows
permanent repository, or the data just added and is in temporary storage.



When the rows are “checked” for the rows that contain the data from the



repository and a “Delete Checked Rows” is performed, inactivation takes



place on saving the information provided there are no subtypes else provides



the user with the necessary error information in an error page. Message “The



following Child workgroup has associated members” - “Member1 . . . Member



n” members could be employer groups, Agent/Agency, Mail work groups or



Associates



When the rows are “checked” for the rows that contain the data from the



temporary storage and a “Delete Checked Rows” is performed, the rows are



deleted from the temporary storage.


Check All
Enables checking of all the checkboxes by checking “check All” Check Box


Check All & Delete 
Enables deleting all the rows from the table on the screen enabled by “check


Checked Rows
All”


Check Any Number
Enables deleting the rows from the table on the screen that are only checked.


& Delete Checked



Rows



Check All & Clear 
Enables clearing (removing the check) all checked rows done by “Check All”


All



Check Any Number
Enables clearing (removing the check) the rows that are checked.


& Clear All



Clear All when no
The user can only press the button and nothing happens like checking,


rows are checked
removing a check


Save
All the data added or modified and added into/deleted from the rows in the



table are saved into the permanent repository



Once saving is done, return back to the Child workgroup screen with all the



fresh updates


Cancel
All the data entered is reset with empty/initial values in the data entry fields as



the case may be (Text Field, List etc).



If a row (which is retrieved from the database) is already modified and added



to the table on the screen and the “Cancel” button is pressed, the row



remains with the modified values.









3.1.5. User Interface Id: Mail Members
3.1.5.1. Screen Name: Mail Members (BPI_CAS_UTL_SCR—002—004) (See FIG. N-7)
3.1.5.2. SID, Element Name, Element Type & Purpose













Element Name
Element Type 
Label
Purpose







Main Header
Text
Main Header
To give the heading for the screen being


“Mail Members”

“Mail
navigated




Members”



Mail ID
Text
Mail ID
Text For “Mail ID”


Mail ID Entry
Entry Field
Mail ID Entry
Entry field for entering the Mail ID


Field

Field



Child
Text
Child
Text for “Child Workgroup”


Workgroup

Workgroup



Child
Search
Child
Search window with all active Child Work


Workgroup

Workgroup
Groups under the category Mail


Search

Search



Add
HTML Button
Add
Button for adding the name/description in to the





HTML table. Changes with label “Modify” when





the row in the table is on edit mode.


Table
HTML table
Table
For displaying all the information added by





pressing the add button, in the form of rows, for





every add operation/Rows retrieved from the





permanent repository


Delete
Button (HTML
Delete
To delete the rows checked



Button)




Check All
Text Link
Check All
To check all the check boxes in the table


Clear All
Text Link
Clear All
To un check all the check boxes checked in the





table/does not function when all the





checkboxes in the table are unchecked


Delete
Check box
Delete
To check the items for deletion


Edit
Button (HTML
Edit
To edit the rows entered by “Add”/



Button)

“Modify”/displayed from permanent repository





against the row selected for edition


Save
Button (HTML
Save
Save the information to the repository



Submit





button)




Cancel
Button
Cancel
Reset information as described in the scenarios









3.1.5.3. Front End Validations












Element Name
Action/Validation Details
Error Message Text







Mail ID
Mandatory Entry
When the Add HTML Button is


Entry Field
Must accept a valid mail id format
pressed with an empty entry on




the mail id entry field, an Error




Dialog Box pops up with the




message “Please enter the name




before adding to the table” with




“yes” option




On press of Yes Button, The




cursor must be placed on the




name entry field




When the Add HTML Button is




pressed with an invalid entry on




the mail id entry field, an Error




Dialog Box pops up with the




message “Please enter a valid




Mail ID” with “yes” option




On press of Yes Button, The




cursor must be placed on the




name entry field


Add
On Clicking add button or the pressing the enter
When the Add HTML Button is



key field with the cursor position on the Add
pressed with an empty entry on



button, The data gets added to the table.
the name entry field, an Error



Validation checks are done to not allow null value
Dialog Box pops up with the



on the Mail ID entry field.
message “ Please enter the Mail



Must not allow duplicate entries on the name
ID before adding to the table” with



Must not allow the length of the field entry to go 
“yes” option.



beyond as per the database design for the
On press of Yes Button, The



column
cursor must be placed on the



Must Choose a Child workgroup
name entry field




For duplicate entries, Error dialog




box - “Duplicate values not




allowed. Please enter again”




For child workgroup, Error Dialog




Box “Please choose a Child




workgroup”


Modify
On Clicking modify button or the pressing the
None



enter key field with the cursor position on the




modify button, The data gets added to the table.



Table
Should have column header and each




subsequent row should be identified by alternate




color combinations. i.e. First row should have




color ‘x’ and the next row should have color ‘y’.




The next row should have color ‘x’ again and so




on. The size of any text inside any cell should be




wrapped if the text becomes too long.




The letters must be green in color for the rows




retrieved from the permanent repository and red




for the rows in temporary storage.




All the letters of the row on edit must be in dark




gray.



Delete
Should function with enter key cursor positioned
Error Dialog Box: “Please choose



on the “Delete” button or on mouse click
the row or rows to be deleted.”



Delete button should work on multiple deletes
with “yes” option



based on the check box or boxes selected. If the




user clicks on the delete button without checking




any of the check box should throw error




message.




Success: Deletes the row or rows from the table




(temporary storage)



Check All
On clicking the “Check All” link should check all
Not Applicable



the check boxes in the HTML table.



Clear All
On clicking the “Clear All” link should uncheck all 
Not Applicable



the checked check boxes in the HTML table.



Edit
Should function with Enter Key Cursor positioned




on the “Edit” button or on mouse click.




Refer Interface flow on scenarios - “edit data”



Save
Should function with enter key cursor positioned
Not Applicable



on the “Save” button or on mouse click? 




On saving the data the data gets saved to the




permanent repository.



Cancel
All the data entered is reset with empty/initial
Not Applicable



values in the data entry fields as the case may be




(Text Field, List etc).




If a row is already modified and added to the




table on the screen and the Cancel button is




pressed, the row remains with the modified




values



Browser
When a user tries to close the window with out
Error Dialog box message: “Do


Window
saving data into the permanent repository, a 
you want to save all changes



dialog box pops up 
before closing/leaving the




window?” with a “Yes” and “No”




option.




On press of “Yes” leads to saving




of information and “No” leads to




the Category screen with the




original values









3.1.5.4. Screen Flow
The user enters the information on the Mail ID and Child Workgroup
The following are the scenarios the user may come across when operating on the screen











Scenario
Description







Add data entered
Adding the data entered



(pressing the “Add” Button)



leads to adding mail id and Child



Workgroup to a temporary



storage. The data gets loaded



into the permanent repository



only after the user saves the



information.


Modify data entered
When a row is selected for an



edit operation, the row is



highlighted and data elements



populated into respective fields



and the add button has a label



“modify”. Modifying the data



entered (pressing the “Modify” 



button) leads to adding modified



information to a temporary



storage. The data gets loaded



into the permanent repository



only after the user saves the



information.


Edit data
Editing the Data (pressing the



“Edit” Button).



The edit operation may be on



any of the two scenarios.



1 (Edit for rows from



database) When the



user comes to the Mail



Member screen and the



screen is already loaded



with data from the



permanent repository



into a table on the



screen.



2 (Edit for rows from the



temporary storage)



When the user has just



added the data into a



table on the screen and



wants to edit the data



entered before saving



The data in the table on the



screen would be shown as green



letters for the data from the



database and red letters for the



data that is in the temporary



storage (not saved yet).



The table shall have alternate



rows colored with different light



colors



Under 1, on an edit operation for



a row on the table, the row does



not get deleted from the table



and the data is transferred to the



mail id and Child Workgroup.



Under 2, on an edit operation for



a row on the table, the row gets



deleted from the table and the



data is transferred to the mail id



and child workgroup, which are



editable.



When a row is on edit mode, the



letters are in dark gray color in



the table.


 
The search window must generate a list of all active Child work groups for category Mail. The user will not be allowed to make entries into the entry field where the search results are going to be put in.


Delete Checked Rows
The data in the table on the



screen contains the data, which



is from the permanent repository,



or the data just added and is in



temporary storage.



When the rows are “checked” for



the rows that contain the data



from the repository and a “Delete



Checked Rows” is performed,



inactivation takes place on



saving the information



When the rows are “checked” for



the rows that contain the data



from the temporary storage and



a “Delete Checked Rows” is



performed, the rows are deleted



from the temporary storage.


Check All
Enables checking of all the



checkboxes by checking “check



All” Check Box


Check All & Delete Checked Rows
Enables deleting all the rows



from the table on the screen



enabled by “check All”


Check Any Number & Delete Checked Rows
Enables deleting the rows from



the table on the screen that are



only checked.


Check All & Clear All
Enables clearing (removing the



check) all checked rows done by



“Check All”


Check Any Number & Clear All
Enables clearing (removing the



check) the rows that are



checked.


Clear All when no rows are checked
The user can only press the



button and nothing happens like



checking, removing a check


Save
All the data added or modified



and added into/deleted from the



rows in the table are saved into



the permanent repository



Once saving is done, return back



to the Mail Member screen with



all the fresh updates


Cancel
All the data entered is reset with



empty/initial values in the data



entry fields as the case may be



(Text Field, List etc).



If a row (which is retrieved from



the database) is already modified



and added to the table on the



screen and the “Cancel” button is



pressed, the row remains with



the modified values.









3.1.6. User Interface Id: Swap Members
3.1.6.1. Screen Name: Swap Members (BPI_CAS_UTL_SCR—002—005)
3.1.6.2. SID, Element Name, Element Type & Purpose













Element



Element Name
Type
Purpose







Main Header
Text
To give the heading for the screen


“Swap Members”

being navigated


Choose Source
Text
Text For “Choose Source Child 


Child Work Group

Workgroup”


Choose Source
Search
Search window showing a list of all 


Child Work Group

child work groups


Choose
Text
Text for “Child Workgroup”


Destination 




Work Group




Choose
List
Search window showing a list of all 


Destination Child

active child work groups


Work Group




Do you want to
Text
Text for “ Do you want to do a full


do a full or

or partial or duplicate swap?”


partial or 




duplicate swap?




Partial/Full
Radio
Default - Partial



Buttons



Table
HTML
For displaying all the information of 



table
rows retrieved from the permanent 




repository


Swap
Button
To swap the rows checked



(HTML




Button)



Check All
Text Link
To check all the check boxes in the table


Clear All
Text Link
To un check all the check boxes checked




in the table/does not function when all the




checkboxes in the table are unchecked









3.1.6.3. Front End Validations












Element




Name
Action/Validation Details
Error Message Text







Submit
The source and destination
Error Dialog “Source and 



child work group must not
Destination Child Groups 



be the same
cannot be the same” with a 



The source and destination
Yes Option



groups must belong to the
Error Dialog “Source and 



same Main Workgroup
Destination Child Groups 



The Child work groups must
must belong to the same 



belong to the same category
Main Workgroup” with 




yes option




Error Dialog “Child 




workgroups must belong




to the same category”


Swap
As mentioned in scenario
As mentioned in scenario









3.1.6.4. Screen Flow
The user chooses the source and destination child workgroups and decided whether the swap is for full or partial members of the workgroup.
The following are the scenarios the user may come across when operating on the screen











Scenario
Description







Submit
Press the submit button after choosing the valid values from 



the source and destination child groups and whether the 



swap is in full or partial.



Full swap leads to swapping of all the members of the source 



to the destination.



Partial swap leads to the screen showing the list of all mem-



bers of the source in alphabetical order and enables the user 



to check members who are to be swapped to the destination



child group



Duplicate swap leads to the screen showing the list of all 



members of the source in alphabetical order and enables 



the user to check members who are to be swapped to the 



destination child group and would also remain in the source 



child group (Duplicate)



Inserts information of the swap into the database and



navigates to the confirmation screen


Yes/No
Yes leads to the swap members screen and No leads to the 



work Group Home Page









4. Business Rule Mapping











Activity
Rules







Create Category
Should have unique Id for a category -- 



10 digits with an increment of 1, Say



CT00000001, CT00000002, CT00000003



and so on.


Create Main Workgroup
Should have unique Id 10 digit for a main



workgroup with an increment of 1, Say



1000, 1001, 1002 and so on.


Create Child Workgroup
Should have unique Id 4 digit for a 



child workgroup with an increment of 1, 



Say 1000, 1001, 1002 and so on.


Create Mail Members
Should have unique Id 4 digit for a 



mail member with an increment of 1, 



Say 1000, 1001, 1002 and so on.


Create swap
Should have unique Id 4 digit for 



a parent with an increment of 1, 



Say 1000, 1001, 1002 and so on.









Benefit Partners Inc
Process Specification
Supply Request
Internal
1. Introduction
1.1. Purpose
This functional specification document addresses the part of the Core Administration System that would facilitate the sending of Supply Requests or any handbooks to employer groups or the members of a group.
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









None
None










1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
2.1. Process Description
A Supply Request—Internal contains a list of all stationeries ordered from individual associates for their daily use, which shall be facilitated and fulfilled by a specific department of a person.
2.2. Process Flow (See FIG. N-8)
3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's












Screen ID (SID)
Screen Name
Corresponding HTML File Name







utl.supplyrequest.internal
Supply Request Internal
InternalSupplyRequest.jsp


utl.supplyrequestview.internal
Supply Request Internal View
IntemalSupplyRequestView.jsp


utl.supplyrequestresult.internal
Supply Request Internal
IntemalSupplyRequestResult.jsp


utl.supplyconfirm.internal
Supply Request Internal
InternalSupplyRequestMailConfirm.jsp



Confirmation









3.1.2. User Interface Id: Supply Request—Internal
3.1.2.1. Screen Name: Supply Request—Internal (BPI_CAS_UTL_SCR—003—001) (See FIG. N-9)
3.1.2.2. SID, Element Name, Element Type & Purpose













Element
Element




Name
Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the 


“Internal 

“Internal
screen being navigated


Supply

Supply



Request”

Request”



Text items as
Text
Text items as
To provide information as shown 


shown in the

shown in the
in the screen along with Qty Text 


screen

screen
and in Boxes as shown in the 





screen snapshot


Qty Entry 
Entry 
Qty Entry
Entry field for Quantity for all 


Field
Field
Field
items


Special
Text
Special
Text for “Special Instructions”


Instructions 

Instructions



Text

Text



Special
Text 
Special
Text Area For Special Instructions


Instructions 
Area
Instructions



Text Area

Text Area



Confirm
Check 
Confirm
Check Box for “Confirm 


Fulfillment 
Box
Fulfillment 
Fulfillment by Email”


by Email

by Email



Save
Button 
Save
Save the information to the 



(HTML

repository



Submit





button)




Cancel
Button
Cancel
Reset information as described 





in the scenarios









3.1.2.3. Front End Validations












Element




Name
Action/Validation Details
Error Message Text







Save
Should function with enter key cursor
Mandatory Entries:



positioned on the “Save” button or on
6) Choose anyone 



mouse click.
item with Qty



On saving the data the data gets saved 
Error dialog Box - 



to the permanent repository. And send 
“Choose Any one 



an email to the fulfillment staff along 
item with Quantity”



with a confirmation page to the user
with Yes option



Mandatory Entry




1) Choose any one item with Qty



Cancel
All the data entered is reset with null 
Not Applicable



values in the data entry fields as the 




case may be (Text Field, List etc).









3.1.2.4. Screen Flow
The following are the scenarios the user may come across when operating on the screen











Scenario
Description







Save
Pressing the save button leads to saving the data 



in the repository, sending an email to fulfillment 



Specialist and confirmation to the user who has



checked the confirmation by email check box



Email Content - Subject: Internal Supply Request



Dear Staff,



Please forward the following to the address mention below



Items - Qty



Special Instructions



Thanks



<ID of the person who has made the request>


Cancel
All the data entered is reset with empty in the data entry 



fields as the case may be (Text Field, List etc).









3.1.3. User Interface Id: Internal Supply Request Confirmation
3.1.3.1. Screen Name: Internal Supply Request Confirmation
(BPI_CAS_UTL_SCR—003—002)
3.1.3.2. SID, Element Name, Element Type & Purpose













Element
Element




Name
Type
Label
Purpose







Main Header
Text
Main Header
To give the heading for the 


“Supply 

“Supply
screen being navigated


Request -

Request -



Internal

Internal



Confirmation”

Confirmation”



Message
Text
Message
Text For “The Supply 





Request has been forwarded 





to the fulfillment specialist”


Message
Text
Message
Text For “The Reference 





confirmation number is”


Dynamic Text
Text
Dynamic Text 
Dynamic Value Text for 





“<Supply Request ID>”


Do you want to 
Text
Do you want
Text for “Do you want to 


create more

to create
create more requests?”


requests?

more





requests?



Yes
Link
Yes
Link for “Yes”


No
Link
No 
Link for “No”









3.1.3.3. Front End Validations
None.
3.1.3.4. Screen Flow
The following are the scenarios the user may come across when operating on the screen














Scenario
Description









Yes
Leads to the Supply Request - Internal Screen



No
Leads to the Supply Request - Internal Home Page










3.1.4. User Interface Id: Supply Request Fulfillment Confirmation
3.1.4.1. Screen Name: Supply Request Fulfillment Confirmation
(BPI_CAS_UTL_SCR—003—003) (See FIG. N-10)
3.1.4.2. SID, Element Name, Element Type & Purpose













Element
Element




Name
Type
Label
Purpose







Main Header
Text
Main Header 
To give the heading for the 


“Internal 

“Internal
screen being navigated


Supply

Supply



Request-

Request-



Fulfillment

Fulfillment



Confirmation”

Confirmation”



Message
Text
Message
Text For “The following are the





pending Supply Requests. On 





fulfilling the request, check the 





row and press save to confirm”


Check All
Link
Check All
Checks all the check Boxes


Clear All
Link
Clear All
Clears All or any Checked 





Boxes


Save
HTML 
Save
Save Button



Button 




Cancel
HTML 
Cancel
Cancel Button



Button









3.1.4.3. Front End Validations












Element




Name
Action/Validation Details
Error Message Text







Save
Must choose at least 
Error Dialog Box - “Please Check



one check Box
at least one row” with yes option









3.1.4.4. Screen Flow
The following are the scenarios the user may come across when operating on the screen











Scenario
Description







On Entering
Provides a list of all pending requests


the screen



Check All
Checks all the check Boxes


Clear All
Clears all the Check Boxes/Or any checked boxes


Save
Saves all the updates made and send email to the



personnel who made the request where the confirma-



tion on fulfillment by Email check Box is checked.



The user Email details are picked up from the security



framework



Email:



Subject: Internal Supply Request Fulfillment”



Dear “Name”



We have fulfilled your request <Supply Request id>



on “date of saving the fulfillment request”



Thanks



Internal SuppliesFulfillment Staff


Cancel
Resets the screen with original values before a save









4. Business Rule Mapping











Activity
Rules







Create Internal
Should have unique Id for a Supply Request -- 10


Supply Request ID
digits with an increment of 1, Say IN00000001,



IN00000002, IN00000003 and so on.









Benefit Partners Inc
Process Specification
Associates
1. Introduction
1.1. Purpose
This functional specification document addresses the part of the sales and marketing system that would deal with creation of master records for internal and external associates.
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









None
None










1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
2.1. Process Description & Flow
The Internal associates are the associates who are employed by BPI and work with BPI. External associates are the associates who are associated with the Business and may not be employed by BPI.
The associates masters are created and assigned to a child work groups
The user has the option to create, modify, delete and view within the same screen.
3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's














Corresponding


Screen ID (SID)
Screen Name
HTML File Name







sales.associate.create
Associates
CreateAssociate.jsp









3.1.2. User Interface Id: Associates
3.1.2.1. Screen Name: Associates (BPI_CAS_UTL_SCR—004—001) (See FIG. N-11)
3.1.2.2. SID, Element Name, Element Type & Purpose













Element
Element
Label
Purpose


Name
Type







Main 
Text
Main 
To give the heading for the


Header

Header
screen being navigated


“Internal

“Internal



Associate”

Associate”



Sub Header
Text
Sub Header
To give the heading for the


“General

“General
section being navigated


Information”

Information”



Association
Text
Association 
To show Association type


Type

Type



Internal
Radio
Internal
To show Association type


External
Radio
External
To show Association type


Salutation
Text
Salutation
Used in sub section General





Information


Salutation
List
Salutation
List for Salutation - Mr., Mrs.,





Miss


First Name
Text
First Name
Used in sub section General





Information


First Name
Entry Field
First Name
Entry field for first name.


MI
Text
MI
Used in sub section General





Information


MI
Entry Field
MI
Entry Field for MI. Used in sub





section General Information


Last Name
Text
Last Name
Used in sub section General





Information


Last Name
Entry Field
Last Name
Entry Field for Last Name. 





Used in sub section General 





Information


Suffix
Text
Suffix
Used in sub section General





Information


Suffix
List
Suffix
List showing Sr, Jr. Used in sub 





section General Information


Address
Text
Address
Used in sub section General





Information


Address
Entry Field
Address
Entry Field for Address, Used





in sub section General 





Information


Apt No
Text
Apt No
Used in sub section General





Information


Apt No
Entry Field
Apt No
Entry Field for Suite/Apt no.





Used in sub section General





Information


City
Text
City
Used in sub section General





Information


City
Entry Field
City
Entry Filed for City. Used in





sub section General Information


Zip
Text
Zip
Used in sub section General





Information


Zip
Entry Field
Zip
Entry Field for Zip. Used in sub





section General Information


State
Text
State
Used in sub section General





Information


State
List
State
List of all states in USA. Used 





in sub section General





Information


Sub Header
Text
Sub Header
To give heading for the 


“Contact

“Contact
subsection


Details”

Details”



Phone
Text
Phone
Text for Phone


Phone
Entry Field
Phone
Entry Field for Phone


Fax
Text
Fax
Text for Fax


Fax
Entry Field
Fax
Entry Field for Fax


Email
Text
Email
Text for EMail


Email Entry
Entry Field
Email Entry
Entry Field for EMail


Field

Field



Sub Header
Text
Sub Header
To give heading for the 


“Associated

“Associated
subsection


Workgroups”

Workgroups”



Associated
Text
Associated
Text for Associated 


Workgroup

Workgroup
workgroups


Associated
Search
Associated
Search for Associated child 


work groups 

work groups
work groups for category


(non editable)

(non editable)
Internal Associates


with search

with search



Sub Header
Text
Sub Header
To give heading for the 


“Other

“Other
subsection


Information”

Information”



License 
Text
License
Text for “License Number”


Number

Number



License
Entry Field
License
Entry Field for: License 


Number

Number
Number”


Add
HTML
Add
Button for adding the name/



Button

description in to the HTML





table. Changes with label





“Modify” when the row in





the table is on edit mode.


Table
HTML
Table
For displaying all the informa-



table

tion added by pressing the add





button, in the form of rows, 





for every add operation/Rows





retrieved from the permanent 





repository


Delete
Button
Delete
To delete the rows checked



(HTML





Button)




Check All
Text Link
Check All
To check all the check boxes 





in the table


Clear All
Text Link
Clear All
To uncheck all the check boxes





checked in the table/does not





function when all the check-





boxes in the table are un-





checked


Delete
Check box
Delete
To check the items for deletion


Edit
Button
Edit
To edit the rows entered by 



(HTML

“Add”/“Modify”/displayed from 



Button)

permanent repository against 





the row selected for edition


Save
Button
Save
Save the information to the



(HTML

repository



Submit





button)




Cancel
Button
Cancel
Reset information as described





in the scenarios









3.1.2.3. Front End Validations












Element




Name
Action/Validation Details
Error Message Text







First
Mandatory Entry
When the Add HTML Button 


Name
Accepts Alpha numeric
is pressed with an empty entry 



characters
on the name entry field, an 




Error Dialog Box pops up with 




the message “First Name is 




required” name before adding 




to the table”


License
Alpha Numeric
When the Add HTML Button


Number

is pressed with a non numeric 




entry on the License Number, 




an Error Dialog Box pops up 




with the message “License 




Number - Accepts Alpha 




numeric values only”


Add
On Clicking add button or 
When the Add HTML Button



the pressing the enter key 
is pressed without choosing 



field with the cursor position
the child work group, an Error 



on the Add button, The data
Dialog Box pops up with the 



gets added to the table. Val-
message “Assigned Workgroup 



idation checks are done to not
is required”



allow null value on the First




name entry field. Must not




allow the length of the field




entry to go beyond as per 




the database design for the 




column 




Must choose a workgroup



Modify
On Clicking modify button
Same as Add



or the pressing the enter key




field with the cursor position




on the modify button, The




data gets added to the table.



Table
Should have column header




and each subsequent row




should be identified by alter-




nate color combinations. 




i.e. First row should have 




color ‘x’ and the next row 




should have color ‘y’. The 




next row should have color 




‘x’ again and so on. The size




of any text inside any cell




should be wrapped if the text




becomes too long. The letters




must be green in color for the 




rows retrieved from the perm-




anent repository and red for 




the rows in temporary storage.




All the letters of the row on 




edit must be in dark gray.



Delete
Should function with enter 
Error Dialog Box: “Select



key cursor positioned on the 
a record(s) to delete.” with



“Delete” button or on mouse
“yes” option



click Delete button should 




work on multiple deletes 




based on the check box or




boxes selected. If the user




clicks on the delete button 




without checking any of the 




check box should throw error 




message.




Success: Deletes the row or 




rows from the table (temporary




storage)



Check
On clicking the “Check All”
Not Applicable


All
link should check all the check




boxes in the HTML table.



Clear
On clicking the “Clear All” link 
Not Applicable


All
should uncheck all the checked




check boxes in the HTML table.



Edit
Should function with Enter Key




Cursor positioned on the “Edit” 




button or on mouse click. Refer




Interface flow on scenarios -




“edit data”



Save
Should function with enter key
Not Applicable



cursor positioned on the “Save” 




button or on mouse click 




On saving the data the data 




gets saved to the permanent 




repository



Cancel
All the data entered is reset with
Not Applicable



empty/initial values in the data




entry fields as the case may be




(Text Field, List etc). If a row




is already modified and added 




to the table on the screen and 




the Cancel button is pressed, the




row remains with the modified 




values










3.1.2.4. Screen Flow











Scenario
Description







Click
On click of Internal/External Association type. 


Internal/External
Available Internal/External associated work-


workgroup Radio
group in the system will be listed in the respec-


button
tive list box.


Add Selected
Assigning the Internal/External workgroup.


Internal/External



Workgroup



Remove Selected
Remove the assigned Internal/External workgroup.


Internal/External



Workgroup



Add data entered
Adding the data entered (pressing the “Add”



Button) leads to adding name (first name +



Last Name) and child work group to a tempo-



rary storage. The data gets loaded into the 



permanent repository only after the user 



saves the information.


Modify data entered
When a row is selected for an edit operation,



the row is highlighted and data elements pop-



ulated into respective fields and the add button



has a label “modify”. Modifying the data entered



(pressing the “Modify” button) leads to adding



the information to a temporary storage. The data 



gets loaded into the permanent repository only 



after the user saves the information.


Search
The search window must generate a list of all 



active child groups for Category Internal Asso-



ciates. The user will not be allowed to make 



entries into the entry field where the search 



results are going to be put in.


Edit data
Editing the Data (pressing the “Edit” Button).



The edit operation may be on any of the two 



scenarios.



1. (Edit for rows from database) When the user



comes to the Internal Associates screen and the



screen is already loaded with data from the per-



manent repository into a table on the screen.



2. (Edit for rows from the temporary storage)



When the user has just added the data into a 



table on the screen and wants to edit the data 



entered before saving



The data in the table on the screen would be 



shown as green letters for the data from the 



database and red letters for the data that is in



the temporary storage (not saved yet). The table



shall have alternate rows colored with different 



light colors



Under 1, on an edit operation for a row on the



table, the row does not get deleted from the 



table and the data is transferred to the placeholders.



Under 2, on an edit operation for a row on the 



table, the row gets deleted from the table and the 



data is transferred to the placeholders, which are 



editable. When a row is on edit mode, the letters 



are in dark gray color in the table.


Delete Checked
The data in the table on the screen contains the


Rows
data, which is from the permanent repository, 



or the data just added and is in temporary storage.



When the rows are “checked” for the rows that



contain the data from the repository and a “Delete



Checked Rows” is performed, inactivation takes 



place on saving the information When the rows 



are “checked” for the rows that contain the data



from the temporary storage and a “Delete 



Checked Rows” is performed, the rows are 



deleted from the temporary storage.


Check All
Enables checking of all the checkboxes by check-



ing “check All” Check Box


Check All & Delete
Enables deleting all the rows from the table on


Checked Rows
the screen enabled by “check All”


Check Any Number
Enables deleting the rows from the table on the


& Delete Checked
screen that are only checked.


Rows



Check All & Clear
Enables clearing (removing the check) all 


All
checked rows done by “Check All”


Check Any Number
Enables clearing (removing the check) the rows 


& Clear All
that are checked.


Clear All when no
The user can only press the button and nothing 


rows are checked
happens like checking, removing a check


Save
All the data added or modified and added into/



deleted from the rows in the table are saved 



into the permanent repository Once saving is 



done, return back to the Internal Associates 



screen with all the fresh updates


Cancel
All the data entered is reset with empty/initial



values in the data entry fields as the case may



be (Text Field, List etc). If a row (which is re-



trieved from the database) is already modified



and added to the table on the screen and the 



“Cancel” button is pressed, the row remains 



with the modified values.









4. Business Rule Mapping











Activity
Rules







Create Associate ID
Should have unique Id for an Associates -- 10 digits



with an increment of 1, Say 0000000001,



0000000002, 0000000003 and so on.









Benefit Partners Inc
Process Specification
Call Tracking
1. Introduction
1.1. Purpose
The purpose of this document is to describe the process of Call Tracking. This document identifies how the user interacts with the system, the data to be captured, the business logic to be implemented, and the output of the process.
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









None
None










1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
2.1. Back Ground
Call tracking is used to basically track the calls that are made or received with specific business intentions. The call can be inbound or outbound based on the nature of calls.
2.2. Process Description
The objective of the Call Tracking process is to:

    
    
        1) Provide for a user interface for calls categorized as inbound or outbound.
        2) The inbound or outbound calls would make up the “To Do List” based on follow up required to be performed by the work group associated with the call in question.
    
    


2.3. Process Flow
Process for Call Tracking

    
    
        1) Call would be identified as inbound or outbound.
        2) The user requests the Call Tracking screen (somehow—either menu or something else) and then the Call Tracking appears as a child window. In this case the user can still view the information brought up for use in the inquiry while completing the Call Log. In this case the user would have to specify the type of referenced entity, either Group or Agent, then enter the ID of the referenced entity, the caller name, the nature of call, any remarks, and finally whether follow-up is required.
        3) All calls received, having specific inquiries or intentions by the caller, would be documented only at the Group level or Agent level. For instance, if the group calls in reference to a specific employee, then when logging the call, the user will indicate the Group ID, the caller name, the nature of call and indicate in the remarks section of the call log, the specific Employee name/ID.
        4) All calls made would have the nature of calls that specifies the nature or reasons for the call received or made. If “referenced entity” is “Group” then nature of call list is displayed for “Group”—If referenced entity is “Agent” then nature of call list is displayed for “Agent”.
        5) Date and time stamp for the calls received or made would be automatically stamped by the system.
        6) If any call needs follow up it would be flagged for follow up and would be visible in the “To Do List” sorted by Date and Workgroup.
        7) All completed follow up would have completed status to mark.
    
    


3. User Interface
3.1. User Interface Screens
3.1.1. Screen ID's














Corresponding


Screen ID (SID)
Screen Name
HTML File Name







utl.calltracking.create
Call Tracking
CallTracking.jsp


utl.calltracking.todolist
To Do List
ToDoList.jsp









3.1.2. User Interface Id: Call Tracking
3.1.2.1. Screen Name: Call Tracking (BPI_CAS_UTL_SCR—005—001) (See FIG. N-12)
3.1.2.2. SID, Element Name, Element Type & Purpose












Element Name
Element Type
Purpose







Call Type
Drop down list
Select the type of call


RE:
Text
To provide text


Group
Radio Button
To select either Group or Agent




for what the call was regarding.


Caller name
Entry Field
Enter the caller name This will 




allow a search capability in order 




to link the inbound call to the 




correct agent or group


Nature of Call
Text
To provide text


Group




Nature of Call 
Drop down list
Select the nature of call based


Group

on the caller type


Nature of Call 
Text
To provide text


Agent




Nature of Call
Drop down list
Select the nature of call based


Agent

on the caller type


Other
Entry Field
Enter if other Should only appear 




if “other” is selected from drop




down menu.


Follow Up
Check Box
To check if follow up required


Required




Follow Up Date
Text
To provide text


Follow Up Date
Entry Field
To specify date for follow-up. 




Default should be next day. Date




will have an option of a calendar




or entering the date in the format




MM/DD/YYYY


Date and Time
Date Text
To specify the date


Stamp




Comments
Text Box
Text area to enter comments


Save
HTML Button
To save the data captured


Cancel
HTML Reset Button
To reset to the status as was on 




loading the page.









3.1.2.3. Front End Validations












Element




Name
Action/Validation Details
Message







Call type
Should list the call types of
“Call Type - is required”



In bound nad Out bound. The




first option should be - Choose




One -. Subsequent call types




should listed in alphabetical 




order.



Caller name
Entry field for entering the 
“Caller Name - Is required.”



caller name
“Caller Name - Accepts




alphabetic characters only”


Nature of 
Nature of call depends on the
“Nature of Call - Is 


Call
“referenced entity”. Each
required.”



“referenced entity” has a dif-




ferent list for choosing Nature 




of Call. Hence the list should 




get populated based on the 




“referenced entity”. Categories 




for Nature of Call are included




in the drop down menu list.



Other
If the nature of call is other.
“Others - is required.”



Entry field to write other.



Follow Up
Check box to be un checked by
None


Required
default. Checked if required for




follow up.



Follow Up 
To specify date for follow-up,
“Follow-up Date - Is 


Date
should default to next working
required”



day following.
“Follow-up Date - Accepts




date from 1900 to 2200 in 




the format of 




MM/DD/YYYY”


Comments
Text area to write comments
“Comments - Accepts all 




Alphanumeric and special 




Characters except double 




quotes.”


Save
On click should save the data
“The Field Name is blank. 



captured above into the 
Please enter a valid value.”



repository



Cancel
Reset to the state as was on 
None



loading the page on click.









3.1.2.4. Screen Flow
None.
3.1.3. User Interface Id: Call Tracking To Do List
3.1.3.1. Screen Name: Call Tracking To Do List (BPI_CAS_UTL_SCR—005—002) (See FIG. N-13)
3.1.3.2. SID, Element Name, Element Type & Purpose













Element
Element




Name
Type
Label
Purpose







Call type
Text
Call type
To provide text


Call Type
Radio
Call Type
To Select a rate type





(Whether Inbound or Out





bound)


Follow-up
Text
Follow-up
To provide text


Date

Date



Follow-up
Entry Field/
Follow-up
To pick the date for the to


Date
Calendar
Date
do list


Called Date
text
Called Date
To provide text.


Called Date
text
Called Date
To pick the date for the to do





list.


Search
Button
Search
To show the To do List 





based on the called date


Table
HTML Table
Table
Table to provide the inbound





or outbound calls information.


Task
Check Box
Task
To check if task completed


Completed

Completed



Save
HTML Submit
Save
To save the data



button




Cancel
HTML reset
Cancel
To reset



button









3.1.3.3. Front End Validations












Element Name
Action/Validation Details
Message







Follow-up Date
Choose follow-update radio button.
“Follow-up Date - Is required.”



And Select the date to show the to do
“Follow-up Date - Accepts date from 1900



list.
to 2200 in the format of MM/DD/YYYY”


Called Date
Choose Called Date radio button and
“Called Date - Is required.”



select the date to show the to do list.
“Called Date - Accepts date from 1900 to




2200 in the format of MM/DD/YYYY”


Search
On Click should show the To Do
none



List based on the date selected



Table
Table to display the data. The table
None



should only contain that data or




called that need to be followed up.




(i.e. Check box Checked for the




Follow up required in previous




screen




BPI_CAS_SCR_UTL_05_001



Task Completed
Default unchecked. If Checked and
None



saved should not allow for Un




checking again.



Save
On click should save the data
None



captured above into the repository



Cancel
Reset to the state as was on loading
None



the page on click.









3.1.3.4. Screen Flow
None.
4. Business Rule Mapping















Activity
Rules









Benefit Partners Inc
Process Specification
BPI_CAS_FSD_SECURITY—01
1.1 Introduction
This purpose of this document is to identify the processes associated with the security mechanism for core administrative system
1.2 Business Use Case Specification Reference













Business Use Specification ID
Business Use Case Name








NONE
NONE









1.3 Process Identification
1.3.1 Process Description & Flow
This process describes the security framework requirements. The security framework consists of creating database for security system as well as administrator login into the system. The system also allows the administrator to create users, module, groups, and application, assign user roles and ACL etc. The system also takes care of user login into the core administrative system. The system should generate the ACL for each user when user logs in into the system. The access to any resource in the core administrative system will be decided by this ACL which will be stored in the User Profile object, stored into the session.
The security system for Intranet application built for shall broadly contain following categories.

    
    
        1. Definition of Realms
        2. Definition of Modules
        3. Definition of Applications
        4. Definition of Resources
        5. Definition of groups (groups can ideally be a department which has a number of users)
        6. Definition of User
        7. Definition of User Roles
        8. Definition ACL/Permissions
        9. Resources, which can be assigned to the groups.
        10. User, User Role and Groups mapping
        11. Overriding the group access rights.
    
    


Realms
A realm is a database of users, groups, modules, application resources and access control lists. A user must be defined in a realm in order to access any resources belonging to that realm.
Modules
The modules provide the high level classification for the applications. The module is a group of applications. The following modules have been identified in the initial stage as a part of core administrative system viz. Carrier Maintenance, Enrollment, Sales and Marketing and Finance.
Applications
A module consists of many applications. An application represents the business use case or set of related use cases. A module consists of many applications. For e.g. Carrier Maintenance module consists of following applications viz. Zip Master, Carrier Master, and M Plan etc. Each application can be further classified into the pages.
Resources
An application can be further classified into the Resources. An application can have one or more resources.
Resources are the valuable items accessible from the Web server/Web Application server:
Web Applications: Java Servlet or JSP
The resources can be protected by using a single access control (ACL). The ACL specifies which users or groups are allowed to access or modify the resource.
For each resource to protect, you'll specify:


    
    
        An access control list (ACL)—a list defining who can use the resource
    
    


Groups
A group is a collection of users. A user can belong to multiple groups. The groups can be created based on the department where all the uses are going to perform the similar kind of operation.
Groups are sets of users. Groups provide an efficient way to manage large numbers of users because an administrator can specify permissions for an entire group at one time. The resources pages can be allocated to group instead of assigning to individual user.
The user gets the default access rights as a part of group. The user can override the group access rights.
A person can be defined as both an individual user and as a member of a group. When an individual user also belongs to a group, the individual access permissions override any group access permissions.
For e.g. a set of data entry operators can have be classified into one group. The rights can be assigned to this group as all basically going to do the data entry operation.
USER ROLES
In any system, there are many roles, which a particular entity plays. For e.g. in any industry role played by the manager differs from the subordinate.
The roles need to be classified into the security system. A user can play multiple roles in the system. A manager can play the role as data entry as well as authorizing body.
A data entry operation may not have provision to enter some critical data, which manager does enter if manager is logging into the system as manager role. The managers can login into the system as data entry operator as well.
If manager is logging in as data entry operation he may not have the privileges as he was having in manager role. In such a case he will be treated as data entry operator.
The security system needs to take above situations.
The user roles can be

    
    
        SUPER USER
        SENIOR MANAGEMENT
        MANAGER
        DATA ENTRY PERSONNEL
        PART TIME EMPLOYEE
    
    


The user roles need to be configured into the system. The user roles can be added for the future modifications. The CAS (Core Administration System) system need to be pre configured for the basic pre defined roles which will not be editable.
Users
A user is an identity that can be authenticated by the system. A user can represent a person who is working in any of the departments in Benefit Partners Inc.

    
    
        A user can belong to multiple groups.
        A user can play multiple roles
    
    


Access Rights/Permissions
Permissions represent the privileges required for accessing resources. An administrator protects resources by establishing access control lists to grant permissions to users and groups.
Individual user permissions take precedence over group permissions. Individual user permission overrides the more restrictive group permission. (Even if the group permission is less restrictive than the user permission, the user permission overrides the group permission and vice versa).
List of Programs
1. Security Login

    
    
        Allows the administrator to login into the security system.
    
    


2. Module Master

    
    
        Allows administrator to do following operations
        Create Module
        Modify Module
        Delete Modules
    
    


3. Application Master
Allows administrator to do following operations

    
    
        Create Application
        Modify Application
        Delete Application
    
    


4. Resources
Allows administrator to do following operations

    
    
        Create Resources
        Modify Resources
        Delete Resources
    
    


5. Group Master
Allows administrator to do following operations

    
    
        Create Group
        Modify Group
        Delete Group
    
    


6. User Master
Allows administrator to do following operations

    
    
        Create User
        Modify User
        Delete User
    
    


7. User Role
Allows administrator to do following operations

    
    
        Create Role
        Modify Role
        Delete Role
    
    


8. User Access Rights
9. User, User Role and Groups Mapping
10. Group Access Rights
Allows administrator to do following operations.
Assign Rights for a User. This program allows the administrator to override the access rights for a user.
11. User Login
When the system user logs in into the core administration system the separate ACL will be generated for each user. The ACL will be stored in the User Profile object, which will be stored in the user session. When user request for a particular page controller will check with the security system whether user is having access to the particular page.
The user password needs to be validated as follows

    
    
        The password need to be minimum 6 characters long and max 10 characters
        The password needs to be combination of alphabets and special characters and numbers (for e.g. Amit1$3, sriRam9#445 etc).
        The password is valid for 15 days, which is configurable. The system should prompt user to change the password three days (which is configurable) prior to expiry date of the password.
        If user changes the password then his password is valid for 15 days (which is configurable) from the date of change.
        In the same way administrator can configure the minimum limit for password age, which signifies that user cannot change the password for this period from the date of prior change.
        The minimum limit for the password age, which is configured value, cannot be greater than or equal to configured maximum limit of the password age.
        First time user must change his password before entering into the system.
    
    


Scenario

    
    
        If the user password is “123456” the for first time login user goes and change the password to “Mali5%9”. The user is created on date Jan. 4, 2002. User logs in on Jan. 5, 2002 and password expiry date for the user changes to Jan. 19, 2002 (15 calendar days) if the configured time limit is 15 days. The user needs to prompt to change password on Jan. 17, 2002 (3 calendar days prior to the expiry date). If user changes the password within stipulated time then extend the password expiry date. by 15 calendar days. (New Date=Sys Date+15). All changes in the date is effective from 0000 AM
        The above validation is not applicable at the time of user creation as administrator can keep the password 123456 for all.
        The new password in the change password is to be validated for above conditions. The old password need not be validated for above conditions. As user can have 123456 as first time as his password.
        The old password needs to be maintained in the history. The new password must not be equal to last five passwords. This number of history of passwords (here its 5) should be configurable. (A configurable password history where the administrator can enter value that would represent how many passwords it would remember until the user can use the same password again)
        The ability to enable or disable Account lockout with a configuration value for the number of user log in attempts at which point a lockout would occur. A way timer for when to reset the count of attempts before lock would be helpful. Also if it possible to make a lockout duration value that would be configurable would also be helpful.
        User Name cannot be a part of password.
    
    


Configurable Items












Sr




No
Item Name
Value







1
Length Of Password (Minimum 
Integer (Ranging From 1-n)



Value)
Need to be set by the




administrator


2
Length Of Password (Maximum 
Integer (Ranging From 1-n)



Value)
Need to be set by the




administrator




Maximum need to be greater




than minimum value


3
Expiry of the password from the
Integer (Number of days)



date of validity (Maximum Range)
Ranging from 1-n




Need to be set by the




administrator


4
Expiry of the password from the
Integer (Number of days)



date of validity (Minimum Range)
Ranging from 1-n




Need to be set by the




administrator


5
Password Repeat allowed value
Integer (Number of days)



This indicates that new passwords 
Ranging from 1-n



can not be same as last n passwords
Need to be set by the




administrator


6
Invalid Passwords allowed before
Integer (Number of days)



locking the account
Ranging from 1-n



If user enters the password incorrect
Need to be set by the



for n times then his account will be
administrator



locked automatically.



7
Lock Time
Time for which account to be




locked if it is locked because




of successive invalid




passwords entry.


8
Password change prompt date
This value signifies that user




need to be intimated by 3




days prior about password




change (Value here set as 3)









1.3. Security Framework
Process Flow Diagram (See FIG. P-1)
1.3.1.1. Script for Setup
Run the basic admin script, which will create the basic administrative user for security login and minimal data into the database.
1.3.1.2. Security Login
Security Login

    
    
        Refer Process Flow Diagram FIG. 2. The flow of the process is as described below.
    
    


System allows user to login into the system. The basic user id and password validation will be done for the administrator for the security system.
On successful login administrator can create modules, groups, applications, user etc.
FIG. 2 Process Flow Diagram (See FIG. P-2)
1.3.1.3. Module Master
Refer Process Flow Diagram FIG. 3. The flow of the process is as described below.
Create Modules

    
    
        a) On selecting create modules option. The user needs to enter the module name and description.
        b) The user enters the details and clicks save.
        c) Upon save the data will be stored in the database.
    
    


Modify Modules

    
    
        a) When user selects modify modules option. He will be shown all the modules in the combo box.
        b) The user selects the module name and clicks select.
        c) The user will be shown the details about the selected module. The user can modify the module details and click save. The data will be updated into database.
    
    


Delete Modules

    
    
        a) When user selects the Delete option, the user will be shown all the modules where in user can select one or more access control list and click delete.
        b) The selected modules will be deleted from the database.
    
    


FIG. 3: Process Flow Diagram (See FIG. P-3)
1.3.1.4. Application Master
Refer Process Flow Diagram FIG. 4. The flow of the process is as described below.
Create Application

    
    
        a) On selecting create application option. The user needs to enter the application details like application name, module name and description.
        b) The user enters the data and clicks save.
        c) Upon save the data will be stored in the database.
    
    


Modify Application

    
    
        a) When user selects modify applications option. He will be shown all the applications in the selection box. The user selects one application and clicks select.
        b) The user will be shown the details about the selected application. The user can modify the application details and click save.
        c) The data will be updated into database.
    
    


Delete Application

    
    
        a) When user selects the Delete option, the user will be shown all the applications where in user can select one or more applications and click delete.
        b) The selected applications will be deleted from the database.
    
    


FIG. 4: Process Flow Diagram (See FIG. P-4)
1.3.1.5. Resource Master
Refer Process Flow Diagram. The flow of the process is as described below.
Create Resource

    
    
        a) On selecting create resource option. The user needs to enter the resource details like resource name, application name and description.
        b) The user enters the data and clicks save.
        c) Upon save the data will be stored in the database.
    
    


Modify Resource

    
    
        a) When user selects modify resource option. He will be shown all the resources in the selection box. The user selects one resource and clicks select.
        b) The user will be shown the details about the selected resource. The user can modify the resource details and click save.
        c) The data will be updated into database.
    
    


Delete Resource

    
    
        a) When user selects the Delete option, the user will be shown all the resource where in user can select one or more resources and click delete.
        b) The selected resources will be deleted from the database.
    
    


FIG. 5: Process Flow Diagram (See FIG. P-5)
1.3.1.6. Group Master
Refer Process Flow Diagram FIG. 6. The flow of the process is as described below.
Create Group

    
    
        a) On selecting create group option. The user needs to enter the group details like group name and description.
        b) The user enters the data and clicks save.
        c) Upon save the data will be stored in the database.
    
    


Modify Group

    
    
        a) When user selects modify group's option. He will be shown all the groups in the selection box. The user selects one group and clicks select.
        b) The user will be shown the details about the selected group. The user can modify the group details and click save
        c) The data will be updated into database.
    
    


Delete Group

    
    
        a) When user selects the Delete option, the user will be shown all the groups where in user can select one or more groups and click delete
        b) The selected groups will be deleted from the database.
    
    


FIG. 6: Process Flow Diagram (See FIG. P-6)
1.3.1.7. User Creation
Refer Process Flow Diagram FIG. 7. The flow of the process is as described below.
Create User

    
    
        a) On selecting create user option. The user needs to enter the details like user name, description, address details etc.
        b) The user enters the data and clicks save.
        c) Upon save the data will be stored in the database.
    
    


Modify User

    
    
        a) When user selects modify user option. He will be shown all the user details in the selection box. The user selects one-user and clicks select.
        b) The user will be shown the details about the selected user. The user can modify the user details and click save
        c) The data will be updated into database.
    
    


Delete User

    
    
        a) When user selects the Delete option, the user will be shown all the users where in user can select one or more users and click delete
        b) The selected users will be deleted from the database.
    
    


FIG. 7: Process Flow Diagram (See FIG. P-7)
1.3.1.8. User Role Creation
Refer Process Flow Diagram FIG. 7a. The flow of the process is as described below.
Create User Role

    
    
        a) On selecting create user role option. The user needs to enter the details like user role name, description
        b) The user enters the data and clicks save.
        c) Upon save the data will be stored in the database.
    
    


Modify User Role

    
    
        a) When user selects modify user role option. He will be shown all the user role details in the selection box. The user selects one-user role and clicks select.
        b) The user will be shown the details about the selected user role. The user can modify the user details and click save
        c) The data will be updated into database.
    
    


Delete User Role

    
    
        a) When user selects the Delete option, the user role will be shown all the users roles where in user can select one or more users role and click delete
        b) The selected user roles will be deleted from the database.
    
    


FIG. 7a: Process Flow Diagram (See FIG. P-8)
1.3.1.9. User, User Role and Group Mapping
Refer Process Flow Diagram FIG. 8. The flow of the process is as described below.
Assign Rights

    
    
        a) On selecting the User, User Role and Group Mapping option. The user will be shown the all the users and user roles in the selection box. The user can select the combination of user and user role.
        b) On selection user will be shown the all the groups with already assigned groups as checked.
        c) The user adds or removes the group assignment and clicks save.
        d) Upon save the data will be stored in the database
    
    


FIG. 8: Process Flow Diagram (See FIG. P-9)
1.3.1.10. Group Access Rights
Refer Process Flow Diagram. The flow of the process is as described below.
Assign Rights

    
    
        a) On selecting the group access rights. The user will be shown the all the groups in the selection box. The user can select any group and click select.
        b) When user selects the particular group, the user will be shown the all the resources and with the access rights selection box corresponding to each module.
        c) User can assign one or more resources to the group and click save.
        d) Upon save the data will be stored in the database.
    
    


FIG. 9: Process Flow Diagram (See FIG. P-10)
1.3.1.11. User Access Rights
Refer Process Flow Diagram. The flow of the process is as described below.
As stated earlier, user can override the access specified to the group.
Assign User Rights

    
    
        a) On selecting the user access rights. The user will be shown the all the users in the selection box. The user can select any one user and click select.
        b) When user selects the particular user, the user will be shown the all the access rights for his group for corresponding resource.
        c) The user can add or remove the resources.
        d) Upon save the data will be stored in the database.
    
    


1.3.1.12. Configure Items
Refer Process Flow Diagram. The flow of the process is as described below. This allows administrator to configure various items like password length, expiry etc.
FIG. 10: Process Flow Diagram (See FIG. P-11)
FIG. 10A: Process Flow Diagram (See FIG. P-12)
1.4 User Interface
1.4.1 User Interface ID: SECURITY_SCREEN—001 (See FIG. P-13)
User Interface ID: SECURITY_SCREEN—002 (See FIG. P-14)
1.4.1.1 User Interface Screen Snap Shot—Screen Name: Security Login
1.4.1.2 Field Name, Element Type & Purpose
Table for Screen SECURITY_LOGIN_SCREEN—001












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


Security Login

being navigated


Sub Header
Text
Text for the Login Name


Login Name




Login Name
Entry Field
Text for the entry field


Sub Header
Text
Text for the password


password




Password
Entry Field
Text for the password


Save
Button (HTML
To Save the data this button 



Button)
need to be clicked


Cancel
Button (HTML
To cancel current operation.



Button)



Select the Role
Text
Text for the Role


Role
Selection Box
Selection box applicable for user 




login only.









Table for Screen SECURITY_LOGIN_SCREEN—002












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen


Security Login

being navigated


Sub Header Login
Text
Text for the Login Name


Name




Login Name
Entry Field
Text for the entry field


Sub Header old
Text
Text for the old password


password




old Password
Entry Field
Text for the old password


Sub Header new
Text
Text for the new password


password




new Password
Entry Field
Text for the new re enter password


Sub Header re
Text
Text for the re enter password


enter password




re enter Password
Entry Field
Text for the re enter password


Select
Button (HTML
To select the current selected module



Button)
to modify.


Cancel
Button (HTML
To cancel current operation.



Button)









1.4.1.3 Front End Validation
Validation Details
This section provides the front end screen validations along with the associated message—Success/Error Message text














Element




#
Name
Action/Validation Details
Message







1.
Login Name 
Accepts all the alphabets
Mandatory Max Length: 15



(Entry Field)
and numeric characters.
“Please Enter Login Name”


2.
Password
Accepts all the alphabets 
Mandatory Max Length: 15




and numeric characters.
Min Length: 6





“Please Enter the





password”


3.
User Role
Selection Box validation
Default: Choose One





“Mandatory”





“Please choose one of the





options specified”









1.4.2 User Interface ID: SECURITY_SCREEN—003 (See FIG. P-15)
User Interface ID: SECURITY_SCREEN—004 (See FIG. P-16)
User Interface ID: SECURITY_SCREEN—005 (See FIG. P-17)
1.4.2.1 User Interface Screen Snap Shot—Screen Name: Module Master
1.4.2.2 Field Name, Element Type & Purpose
Table for Screen SECURITY_SCREEN—003












Element
Name Element
Type Purpose







Main Heading
Text
To give the heading for the screen


Create Module

being navigated


Sub Header
Text
Text for the Module Id


Module Id




Module Id
Entry Field
Text for the entry field


Sub Header
Text
Text for the Module Name


Module Name




Module Name
Entry Field
Text for the entry field


Sub Header
Text
Text for the Module Name


Module




Description




Module
Entry Field
Text for the entry field


Description




Save
Button (HTML
To Save the data this button need 



Button)
to be clicked


Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—004












Element Name
Element Type
Purpose







Search
Gif File
Used to search the module









Table for Screen SECURITY_SCREEN—004












Element Name
Element Type 
Purpose







Main Heading
Text
To give the heading for the screen


Modify Module

being navigated


Sub Header
Text
Text for the Module Id


Module Id




Module Id
Entry Field
Text for the entry field


Sub Header
Text
Text for the Module Name


Module Name




Module Name
Entry Field
Text for the entry field


Sub Header
Text
Text for the Module Name


Module




Description




Module
Entry Field
Text for the entry field


Description




Update
Button (HTML
To Save the data this button need to



Button)
be clicked


Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—005













Element 



Element Name
Type
Purpose







Main Heading
Text
To give the heading for the screen being 


Delete Modules

navigated


Sub Heading
Text
To give the sub heading for the screen 


Select the

being navigated


modules




Module Names
Check Box
Check boxes for module names to be 


Sales, finance

deleted.


Check Box
Check All
On clicking the “Check All” link should 




check all the check boxes in the HTML 




table.


Check Box
Clear All
On clicking the “Clear All” link should 




uncheck all the checked check boxes in the




HTML table.


Delete
Delete
To Delete the data this button need to be




clicked









1.4.2.3 Front End Validation
Validation Details
This section provides the front end screen validations along with the associated message—Success/Error Message text













#
Element Name
Action/Validation Details
Message







1
Module Name
Accepts all the alphabets 
Max length: 50



(Entry Field)
and numeric characters.
Mandatory





BPI_CAS_FSD_COMMON


2
Module Id 
Accepts all the 
Max length: 10



(Entry Field)
alphabets and numeric 
Mandatory




characters.
BPI_CAS_FSD_COMMON


3
Comments
Accepts all the alphabets
Max length: 250



(Entry Field)
and numeric characters.
BPI_CAS_FSD_COMMON









1.4.3 User Interface ID: SECURITY_SCREEN—006 (See FIG. P-18)
User Interface ID: SECURITY_SCREEN—007 (See FIG. P-19)
User Interface ID: SECURITY_SCREEN—008 (See FIG. P-20)
1.4.3.1
User Interface Screen Snap Shot—Screen Name: Group Master
1.4.3.2 Field Name, Element Type & Purpose
Table for Screen SECURITY_SCREEN—006












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen


Create Group

being navigated


Sub Header
Text
Text for the Group Id


Group Id




Group Id
Entry Field
Text for the entry field


Sub Header
Text
Text for the Group Name


Group Name




Group Name
Entry Field
Text for the entry field


Sub Header
Text
Text for the Group Name


Group




Description




Group
Entry Field
Text for the entry field


Description




Save
Button (HTML
To Save the data this button need 



Button)
to be clicked


Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—007














Element Name
Element Type
Purpose








Search
Image
To provide search









Table for Screen SECURITY_SCREEN—007












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


Modify Group

being navigated


Sub Header
Text
Text for the Group Id


Group Id




Group Id
Entry Field
Text for the entry field


Sub Header
Text
Text for the Group Name


Group Name




Group Name
Entry Field
Text for the entry field


Sub Header
Text
Text for the Group Name


Group




Description




Group
Entry Field
Text for the entry field


Description




Update
Button (HTML
To Save the data this button need 



Button)
to be clicked


Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—008












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen being navigated


Delete Group




Sub Heading
Text
To give the sub heading for the screen being navigated


Select the Groups




Group Names
Check Box
Check boxes for group names to be deleted.


Sales, finance




Check Box
Check All
On clicking the “Check All” link should check all the check




boxes in the HTML table.


Check Box
Clear All
On clicking the “Clear All” link should uncheck all the checked




check boxes in the HTML table.


Delete
Delete
To Delete the data this button need to be clicked









1.4.3.3 Front End Validation
Validation Details
This section provides the front end screen validations along with the associated message—Success/Error Message text













#
Element Name
Action/Validation Details
Message







1
Group Name
Accepts all the alphabets 
Max length: 50



(Entry Field)
and numeric characters.
Mandatory





BPI_CAS_FSD_COMMON


2
Group Id (Entry
Accepts all the alphabets 
Max length: 10



Field)
and numeric characters.
Mandatory





BPI_CAS_FSD_COMMON


3
Comments/
Accepts all the alphabets 
Max length: 255



Description
and numeric characters.
BPI_CAS_FSD_COMMON









1.4.4 User Interface ID: SECURITY_SCREEN—009 (See FIG. P-21)
User Interface ID: SECURITY_SCREEN—010 (See FIG. P-22)
User Interface ID: SECURITY_SCREEN—011 (See FIG. P-23)
1.4.4.1 User Interface Screen Snap Shot—Screen Name: Application Master
1.4.4.2 Field Name, Element Type & Purpose
Table for Screen SECURITY_SCREEN—009












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


Create

being navigated


Application




Sub Header
Text
Text for the Application Id


Application Id




Application Id
Entry Field
Text for the entry field


Sub Header
Text
Text for the Application Name


Application Name




Application Name
Entry Field
Text for the entry field


Sub Header
Text
Text for the Application Name


Application




Description




Application
Entry Field
Text for the entry field


Description




Sub Header
Text
Text for the Module Name


Module Name




Selection Box
Selection Box
Module Name


Save
Button (HTML
To Save the data this button need 



Button)
to be clicked


Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—010












Element Name
Element Type
Purpose







Search
Gif
To search the application









Table for Screen SECURITY_SCREEN—010












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


Modify

being navigated


Application




Sub Header
Text
Text for the Application Id


Application Id




Application Id
Entry Field
Text for the entry field


Sub Header
Text
Text for the Application Name


Application Name




Application Name
Entry Field
Text for the entry field


Sub Header
Text
Text for the Application Name


Application




Description




Application
Entry Field
Text for the entry field


Description




Update
Button (HTML
To Save the data this button need 



Button)
to be clicked


Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—011












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen being navigated


Delete




Application




Sub Heading
Text
To give the sub heading for the screen being navigated


Select the




Application




Application
Check Box
Check boxes for applications names to be deleted.


Names




Sales, Select box




for Application




Check Box
Check All
On clicking the “Check All” link should check all the check




boxes in the HTML table.


Check Box
Clear All
On clicking the “Clear All” link should uncheck all the checked




check boxes in the HTML table.


Delete
Delete
To Delete the data this button need to be clicked









1.4.4.3 Front End Validation
Validation Details
This section provides the front end screen validations along with the associated message—Success/Error Message text













#
Element Name
Action/Validation Details
Message







1
Application Name
Accepts all the alphabets and numeric
Max length: 50



(Entry Field)
characters.
Mandatory





BPI_CAS_FSD_COMMON


2
Application Id
Accepts all the alphabets and numeric
Max length: 10



(Entry Field)
characters.
Mandatory





BPI_CAS_FSD_COMMON


3
Comments/
Accepts all the alphabets and numeric
Max length: 255



Description
characters.



4
Module Name
Selection Box validation
Default: Choose One





BPI_CAS_FSD_COMMON









1.4.5 User Interface ID: SECURITY_SCREEN—012 (See FIG. P-24)
User Interface ID: SECURITY_SCREEN—013 (See FIG. P-25)
User Interface ID: SECURITY_SCREEN—0014 (See FIG. P-26)
1.4.5.1 User Interface Screen Snap Shot—Screen Name: Resource Master
1.4.5.2 Field Name, Element Type & Purpose
Table for Screen SECURITY_SCREEN—012












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


Create Resource

being navigated


Sub Header
Text
Text for Resource Id


Resource ID




Resource ID
Entry Field
Text for the entry field


Sub Header
Text
Text for Resource Name


Resource Name




Resource Name
Entry Field
Text for the entry field


Sub Header
Text
Text for screen url


Screen URL




Screen URL
Entry Field
Text for the entry field


Resource
Text
Text for the Resource Description


Description




Resource
Entry Field
Text for the entry field


Description




Save
Button (HTML
To Save the data this button need 



Button)
to be clicked


Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—012 & Screen SECURITY_SCREEN—013












Element Name
Element Type
Purpose







Search
Gif
To search the resource and application









Table for Screen SECURITY_SCREEN—013












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


Create Resource

being navigated


Sub Header
Text
Text for Resource Id


Resource ID




Resource ID
Entry Field
Text for the entry field


Sub Header
Text
Text for Resource Name


Resource Name




Resource Name
Entry Field
Text for the entry field


Sub Header
Text
Text for screen url


Screen URL




Screen URL
Entry Field
Text for the entry field


Resource
Text
Text for the Resource Description


Description




Resource
Entry Field
Text for the entry field


Description




Save
Button (HTML
To Save the data this button need 



Button)
to be clicked


Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—14












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen being 


Delete Resources

navigated


Sub Heading
Text
To give the sub heading for the screen 


Select the

being navigated


Resources




Resources
Check Box
Check boxes for Resources to be deleted.


Check Box
Check All
On clicking the “Check All” link should 




check all the check boxes in the HTML 




table.


Check Box
Clear All
On clicking the “Clear All” link should 




uncheck all the checked check boxes 




in the HTML table.


Delete
Delete
To Delete the data this button need to 




be clicked









1.4.5.3 Front End Validation
Validation Details
This section provides the front end screen validations along with the associated message—Success/Error Message text













#
Element Name
Action/Validation Details
Message







1
Resource Name
Accepts all the alphabets and numeric
Max length: 50



(Entry Field)
characters.
Mandatory





BPI CAS_FSD_COMMON


2
Resource Id (Entry
Accepts all the alphabets and numeric
Max length: 10



Field)
characters.
Mandatory





BPI CAS_FSD_COMMON


3
Screen URL (Entry
Accepts all the alphabets and numeric
Max length: 255



Field)
characters.
Mandatory





BPI_CAS FSD_COMMON


4
Comments/
Accepts all the alphabets and numeric Max length: 255




Description
characters.



5
Application Name
Selection Box validation
Default: Choose One





“Mandatory”





BPI_CAS_FSD_COMMON









1.4.6 User Interface ID: SECURITY_SCREEN—015 (See FIG. P-27)
Interface ID: SECURITY_SCREEN—016 (See FIG. P-28)
User Interface ID: SECURITY_SCREEN—017 (See FIG. P-29)
1.4.6.1 User Interface Screen Snap Shot—Screen Name: User Master
1.4.6.2 Field Name, Element Type & Purpose
Table for Screen SECURITY_SCREEN—015












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


Create User

being navigated


Sub Header User
Text
Text for the User Id


Id




User Id
Entry Field
Text for the entry field


Sub Header
Text
Text for the Display Name


Display Name




Display Name
Entry Field
Text for the entry field


Sub Header
Text
Text for the Name


Name




Sub Header First
Text
Text for the First Name


Name




First Name
Entry Field
Text for the entry field


Sub Header MI
Text
Text for Middle Initial


Middle Initial
Entry Field
Text for the entry field


Sub Header Last
Text
Text for last name


Name




Last Name
Entry Field
Text for the entry field


Sub Header
Text
Text for the password


password




Password
Entry Field
Text for the entry field


Sub Header
Text
Text for the Phone


Phone




Phone
Entry Field
Text for the entry field


Sub Header Fax
Text
Text for the fax


Fax
Entry Field
Text for the entry field


Sub Header Extn
Text
Text for the ext


Extn
Entry Field
Text for the entry field


Sub Header email
Text
Text for the email


Email
Entry Field
Text for the entry field


Sub Header Lock
Text
Text for the lock


Lock
Check Box
Check box for lock field


Save
Button (HTML
To Save the data this button need 



Button)
to be clicked


Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—016















Element Name
Element Type
Purpose









Search
Gif
To search the user










Table for Screen SECURITY_SCREEN—016












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


Modify User

being navigated


Sub Header User
Text
Text for the User Name


Name




Sub Header User
Text
Text for the User Id


Id




User Id
Entry Field
Text for the entry field


Sub Header
Text
Text for the Display Name


Display Name




Display Name
Entry Field
Text for the entry field


Sub Header
Text
Text for the Name


Name




Sub Header First
Text
Text for the First Name


Name




First Name
Entry Field
Text for the entry field


Sub Header MI
Text
Text for MI


MI
Entry Field
Text for the entry field


Sub Header Last
Text
Text for last name


Name




Last Name
Entry Field
Text for the entry field


Sub Header
Text
Text for the password


password




Password
Entry Field
Text for the entry field


Sub Header
Text
Text for the Phone


Phone




Phone
Entry Field
Text for the entry field


Sub Header Fax
Text
Text for the fax


Fax
Entry Field
Text for the entry field


Sub Header Ext
Text
Text for the Ext


Ext
Entry Field
Text for the entry field


Sub Header email
Text
Text for the email


Email
Entry Field
Text for the entry field


Lock
Check Box
Check box for the lock field


Update
Button (HTML
To Save the data this button 



Button)
need to be clicked


Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—017












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


Delete User

being navigated


Sub Heading
Text
To give the sub heading for the screen 


Select the User

being navigated


User Names
Check Box
Check boxes for User names to be deleted.


Sales, Select box




for Application




Check Box
Check All
On clicking the “Check All” link should 




check all the check boxes in the HTML 




table.


Check Box
Clear All
On clicking the “Clear All” link should 




uncheck all the checked check boxes 




in the HTML table.


Delete
Delete
To Delete the data this button need to 




be clicked









1.4.6.3 Front End Validation
Validation Details
This section provides the front end screen validations along with the associated message—Success/Error Message text














Element




#
Name
Action/Validation Details
Message


















1
Display 
BPI_CAS_FSD_COMMON
Mandatory Max Length: 30



Name

BPI_CAS_FSD_COMMON



(Entry 





Field)




2
First 
BPI_CAS_FSD_COMMON
Mandatory Max Length: 25



Name

BPI_CAS_FSD_COMMON



(Entry 





Field)




3
MI 
BPI_CAS_FSD_COMMON
Mandatory Max Length: 1



(Entry 

BPI_CAS_FSD_COMMON



Field)




4
Last 
BPI_CAS_FSD_COMMON
Mandatory Max Length: 35



Name

BPI_CAS_FSD_COMMON



(Entry 





Field)




5
Pass-
BPI_CAS_FSD_COMMON
Mandatory Max Length: 15



word

Min Length: 6



(Entry 

BPI_CAS_FSD_COMMON



Field)




6
Phone
BPI_CAS_FSD_COMMON
Max Length: 10





BPI_CAS_FSD_COMMON


7
Fax
BPI_CAS_FSD_COMMON
Max Length: 10





BPI_CAS_FSD_COMMON


8
Extn
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


9
Email
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


10
Lock 
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON



Status









1.4.7 User Interface ID: SECURITY_SCREEN—0018 (See FIG. P-30)
User Interface ID: SECURITY_SCREEN—019 (See FIG. P-31)
User Interface ID: SECURITY_SCREEN—020 (See FIG. P-32)
1.4.7.1 User Interface Screen Snap Shot—Screen Name: User Role Master
1.4.7.2 Field Name, Element Type & Purpose
Table for Screen SECURITY_SCREEN—018












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


Create User Role

being navigated


Sub Header User
Text
Text for the User Role Id


Role Id




User Role Id
Entry Field
Text for the entry field


Sub Header User
Text
Text for the User Role Name


Role Name




User Role Name
Entry Field
Text for the entry field


Sub Header User
Text
Text for the User Role Name


Role Description




User Role
Entry Field
Text for the entry field


Description




Save
Button (HTML
To Save the data this button need 



Button)
to be clicked


Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—019












Element Name
Element Type
Purpose







Search
Gif
To search the user role









Table for Screen SECURITY_SCREEN—019












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


Modify User Role

being navigated


Sub Header User
Text
Text for the User Role Id


Role Id




User Role Id
Entry Field
Text for the entry field


Sub Header User
Text
Text for the User Role Name


Role Name




User Role Name
Entry Field
Text for the entry field


Sub Header User
Text
Text for the User Role Name


Role Description




User Role
Entry Field
Text for the entry field


Description




Update
Button (HTML
To Save the data this button need 



Button)
to be clicked


Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—020












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


Delete User Role

being navigated


Sub Heading
Text
To give the sub heading for the screen 


Select the User

being navigated


Role




User Role Names
Check Box
Check boxes for User Role names 


Sales, finance

to be deleted.


Check Box
Check All
On clicking the “Check All” link should 




check all the check boxes in the 




HTML table.


Check Box
Clear All
On clicking the “Clear All” link should 




uncheck all the checked check boxes 




in the HTML table.


Delete
Delete
To Delete the data this button need 




to be clicked









1.4.7.3 Front End Validation
Validation Details
This section provides the front end screen validations along with the associated message—Success/Error Message text














Element




#
Name
Action/Validation Details
Message







1
User 
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON



Role 





Name





(Entry 





Field)




2
User 
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON



Role 





Id





(Entry 





Field)




3
Comments/
BPI_CAS_FSD_COMMON
Max length: 255



Description











1.4.8 User Interface ID: SECURITY_SCREEN—021 (See FIG. P-33)
1.4.8.1 User Interface Screen Snap Shot—Screen Name: Group Access Rights
1.4.8.2 Field Name, Element Type & Purpose
Table for Screen SECURITY_SCREEN—021












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


Group Access

being navigated


Rights




Sub Header
Text
Text for the Group Name


Select Group




Group Name
Selection Box
Selection box for the Group Name


Sub Header
Text
Text for the Application Name


Select Application




Application Name
Selection Box
Selection box for the Application Name


Select
Button (HTML
To select the current selected Group 



Button)
to assign rights and modules.


Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—021












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


Group Access

being navigated


Rights




Sub Header
Text
Text for the Resource Name


Resource Name




Resource Name
Check Boxes
Check boxes


Sub Header
Text
Text for Access Rights


Access Rights




Combo Box
Combo Box
Combo box for selection of access rights.


Save
Button (HTML
To Save the data this button need 



Button)
to be clicked


Cancel
Button (HTML
To cancel current operation.



Button)









1.4.8.3 Front End Validation
Validation Details
This section provides the front end screen validations along with the associated message—Success/Error Message text














Element 




#
Name
Action/Validation Details
Message







1
Group Name
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON


2
Application 
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON



Name




3
Resource Id
BPI_CAS_FSD_COMMON
BPI_CAS_FSD_COMMON









1.4.9 User Interface ID: SECURITY_SCREEN—022 (See FIG. P-34)
User Interface ID: SECURITY_SCREEN—023 (See FIG. P-35)
1.4.9.1 User Interface Screen Snap Shot—Screen Name: User, Role and Group Mapping
1.4.9.2 Field Name, Element Type & Purpose
Table for Screen SECURITY_SCREEN—022












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


User Search

being navigated


Sub Header
Text
Text for the User Id


Select User Id




User Id
Text Box
Text Field for the User Id


Sub Header
Text
Text for the User Name


Select User




Name




User Name
Text Box
Text Field for the User Name


Search
Button (HTML
To search the current selected User id



Button)



Cancel
Button (HTML
To cancel current operation.



Button)









Table Screen SECURITY_SCREEN—022












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


User Search

being navigated


Sub Header
Text
Text for the User Id


Select User Id




User Id
Text Field
Text Field for the User Id


Sub Header
Text
Text for the User Name


Select User




Name




User Name
Text Field
Text Field for the User Name


Search
Button (HTML
To search the current selected User id



Button)



Cancel
Button (HTML
To cancel current operation.



Button)



Sub Heading
Text
To give the heading for the search 


User Search

screen


Results




Sub Header User
Label
Text for the User Id


Id




Sub Header User
Label
Text for the User Name


Name




Data Row from
User Id
User id from database. To be displayed


database

in table


Data Row from
User Name
User name from database. To be 


database

displayed in table


Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—023












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


User Role

being navigated


Mapping




Sub Header
Text
Text for the User Id


Select User Id




User Id
Text Label
Text Label for the User Id


Sub Header
Text
Text for the User Name


Select User




Name




User Name
Text Label
Text Label for the User Name


Sub Header
Text
Text for the User Role


Select User Role




Selection box
Selection Box
Selection Box for User Role


Select
Button (HTML
To select the current selected User id



Button)



Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen FIG. 33: Screen SECURITY_SCREEN—023












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


User Role

being navigated


Mapping




Sub Header
Text
Text for the User Id


Select User Id




User Id
Text Label
Text Label for the User Id


Sub Header
Text
Text for the User Name


Select User




Name




User Name
Text Label
Text Label for the User Name


Sub Header User
Text
Text for the User Role


Role




Text Label
Text Label
Selection Box for User Role


Sub Header
Text
Text for the Groups


Select the groups




Check Box
Check Box
Check Box for groups. User can select 




one or more groups.


Select
Button (HTML
To select the current selected User id



Button)



Cancel
Button (HTML
To cancel current operation.



Button)









1.4.10 User Interface ID: SECURITY_SCREEN—024 (See FIG. P-36)
User Interface ID: SECURITY_SCREEN—025 (See FIG. P-37)
1.4.10.1 User Interface Screen Snap Shot—Screen Name: Group Access Rights
1.4.10.2 Field Name, Element Type & Purpose
Table for Screen SECURITY_SCREEN—024












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the screen 


User Search

being navigated


Sub Header
Text
Text for the User Id


Select User Id




User Id
Text Box
Text Field for the User Id


Sub Header
Text
Text for the User Name


Select User




Name




User Name
Text Box
Text Field for the User Name


Search
Button (HTML
To search the current selected User id



Button)



Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—024












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the 


User Search

screen being navigated


Sub Header
Text
Text for the User Id


Select User Id




User Id
Text Field
Text Field for the User Id


Sub Header
Text
Text for the User Name


Select User




Name




User Name
Text Field
Text Field for the User Name


Search
Button (HTML
To search the current 



Button)
selected User id


Cancel
Button (HTML
To cancel current operation.



Button)



Sub Heading
Text
To give the heading for 


User Search

the search screen


Results




Sub Header User
Label
Text for the User Id


Id




Sub Header User
Label
Text for the User Name


Name




Data Row from
User Id
User id from database. 


database

To be displayed in table


Data Row from
User Name
User name from database. 


database

To be displayed in table


Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—025












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the 


User Access

screen being navigated


Rights




Sub Header User
Text
Text for the User Name


Name




User Name
Text
Text for the User Name


Sub Header User
Text
Text for the User Id


ID




User Id
Text
Text for the User Id


Sub Header
Text
Text for the Module Name


Module Name




Selection Box
Selection Box
Selection Box for Module name


Sub Header Role
Text
Text for the Role Name


Name




Selection Box
Selection Box
Selection Box for Role name


Select
Button (HTML
To select the current selected 



Button)
User assign rights for all the r




application.


Cancel
Button (HTML
To cancel current operation.



Button)









Table for Screen SECURITY_SCREEN—025















Element Name
Element Type
Purpose









Main Heading
Text
To give the heading for 



User Access

the screen being navigated



Rights





Sub Header
Text
Text for the Resource Name



Resource Name





Resource name
Text
Text for the Resource Name



Sub Header
Text
Text for Access Rights



Access Rights





Combo Box
Combo Box
Combo box for selection of 





access rights.



Save
Button (HTML
To Save the data this button 




Button)
need to be clicked



Cancel
Button (HTML
To cancel current operation.




Button)










1.4.10.3 Front End Validation
Validation Details
This section provides the front end screen validations along with the associated message—Success/Error Message text













#
Element Name
Action/Validation Details
Message







1
User Role
BPI_CAS_FSD_COMMON
“Please choose the 





User Role”


2
Module Name
BPI_CAS_FSD_COMMON
“Please choose the 





Module name”


3
Access Rights
BPI_CAS_FSD_COMMON
“Please choose the





Resource name”









1.4.11 User Interface ID: SECURITY_SCREEN—026 (See FIG. P-38)
1.4.11.1 User Interface Screen Snap Shot—Screen Name: Configurable Items
1.4.11.2 Field Name, Element Type & Purpose
Table for Screen SECURITY_SCREEN—026












Element Name
Element Type
Purpose







Main Heading
Text
To give the heading for the 


Configure Items

screen being navigated


Sub Header
Text
Text for the Password Length


Password Length




Password Length
Text Box
Text Field for the Password Length


Sub Header
Text
Text for the Password Length 


Password Length

(Minimum)


(Minimum)




Password Length
Text Box
Text Field for the Password Length 


(Minimum)

(Minimum)


Sub Header
Text
Text for the Expiry of password


Expiry of




password (Max)




Expiry of
Text Box
Text Field for the Expiry of password


password




Sub Header
Text
Text for the Expiry of password


Expiry of




password (Min)




Expiry of
Text Box
Text Field for the Prompt Date Period


password




Sub Header
Text
Text for the Prompt Date Period


Prompt Date




Period




Prompt Date
Text Box
Text Field for the Expiry of password 


Period

Prompt Date Period


Sub Header
Text
Text for the Password Repeat Count


Password Repeat




Count




Password Repeat
Text Box
Text Field for the Password 


Count

Repeat Count


Sub Header
Text
Text for the Invalid Passwords 


Invalid

Count


Passwords Count




Invalid
Text Box
Text Field for the Invalid Passwords 


Passwords Count

Count


Sub Header Lock
Text
Text for the Lock Time


Time




Lock Time
Text Box
Text Field for the Lock Time


Search
Button (HTML
To search the current selected User id



Button)



Cancel
Button (HTML
To cancel current operation.



Button)









1.4.11.3 Front End Validation
Validation Details
This section provides the front end screen validations along with the associated message—Success/Error Message text















Action/Validation 



#
Element Name
Details
Message







1
Password Length
Numeric (Integer)
Integer Length max 2



(Maximum &

For eg Min Value 6



Minimum)

Max Value 10


2
Expiry of password
Numeric (Integer)
Integer Length max 2



(Min)

For eg Min Value 1





Max Value 99


3
Expiry of password
Numeric (Integer)
Integer Length max 2



(Max)

For eg Min Value 0





Max Value 99





Should be greater than





Expiry of password (Min)


4
Password Repeat
Numeric (Integer)
Integer Length max 2



Count

For eg Min Value 1





Max Value 10


5
Invalid Passwords
Numeric (Integer)
Integer Length max 2



Count

For eg Min Value 1





Max Value 10


6
Lock Time
Numeric (Integer)
Integer Length max 2



(Minutes)

For eg Min Value 10





Max Value 36000


7
Password Length
Numeric (Integer)
Integer Length max 2



(Minimum)

For eg Min Value 6





Max Value 10





Less than maximum length





of password


8
Prompt Date
Numeric (Integer)
Less than maximum limit



Period for

for expiration date



expiration

For eg Min Value 1





Max Value 10









1.4.12 User Login
When the system user logs in into the core administration system the separate ACL will be generated for each user. The ACL will be stored in the User Profile object, which will be stored in the user session. When user request for a particular page controller will check with the security system whether user is having access to the particular page.
When any user requests a particular page in the core administrative system, the controller will ask the security system about the security rights for the application. If user is having rights he will be allowed to perform the current operation.
For e.g. If user request for create carrier master. The carrier master is registered into the system with system with id as 0001. The controller will check the access rights for the carrier master. If the rights for carrier master is write then user will have access to create carrier master as the user rights are higher than requested one. If user is having access rights as read for carrier master then he would not be able to access because it is having lower rights than requested one.
Password Validation
Password validation to be done as per the requirements specified before. The following items need to be configured as per requirements.
1.5 Business Rules














Activity
Rules









Delete Rule
For Deleting referential integrity need to be




considered.




A group can be deleted if no user is referring to the




group




Same applies to other hierarchy




Module




Application




Resource










1.6 Help Menu
Help to be provided for all the screens. Help should contain following details.
Basic Functionality Description
Description about the screen fields.
1.7 Process-Data Structure
This section describes the likely data structure that would contain the data for/by executing the process
BPI_MODULES












Data Element Name
Data Element Type
Constraints







MODULE_ID
Varchar (10)
PK Not Null


MODULE_NAME
Varchar (50)
Not Null


DESCRIPTION
Varchar (255)



CREATED_BY
Varchar (25)



CREATED_DATE
Timestamp



MODIFIED_BY
Varchar (25)



LAST_MODIFIED_DATE
Timestamp



STATUS
NUMBER
1-Active




0-Inactive









BPI_GROUPS












Data Element Name
Data Element Type
Constraints







GROUP_ID
Varchar (10)
PK Not Null


DESCRIPTION
Varchar (255)
Not Null


GROUP_NAME
Varchar (50)



CREATED_BY
Varchar (25)



CREATED_DATE
Timestamp



MODIFIED_BY
Varchar (25)



LAST_MODIFIED_DATE
Timestamp



STATUS
NUMBER
1-Active




0-Inactive









BPI_APPLICATIONS












Data Element Name
Data Element Type
Constraints







APPLICATION_ID
Varchar (10)
PK Not Null


APPLICATION_NAME
Varchar (50)
Not Null


DESCRIPTION
Varchar (255)



MODULE_ID
Varchar (10)
FK Refers




BPI_MODULES


CREATED_BY
Varchar (25)



CREATED_DATE
Timestamp



MODIFIED_BY
Varchar (25)



LAST_MODIFIED_DATE
Timestamp



STATUS
NUMBER
1-Active




0-Inactive









BPI_RESOURCES












Data Element Name
Data Element Type
Constraints







RESOURCE_ID
Varchar (10)
PK Not Null


RESOURCE_NAME
Varchar (50)
Not Null


DESCRIPTION
Varchar (255)



APPLICATION_ID
Varchar (10)
FK Refers




BPI_APPLICATIONS


CREATED_BY
Varchar (25)



CREATED_DATE
Timestamp



MODIFIED_BY
Varchar (25)



LAST_MODIFIED_DATE
Timestamp



STATUS
NUMBER
1 Active




0-Inactive









BPI_ACL












Data Element Name
Data Element Type 
Constraints







ACL_ID
Varchar (10)
PK Not null


ACL_NAME
Varchar (50)
Not null


CREATED_BY
Varchar (25)



CREATED_DATE
Timestamp



MODIFIED_BY
Varchar (25)



LAST_MODIFIED_DATE
Timestamp



STATUS
NUMBER
1 Active




0-Inactive









BPI_ROLES












Data Element Name
Data Element Type 
Constraints







ROLE_ID
Varchar (10)
PK Not null


ROLE_NAME
Varchar (50)
Not null


CREATED_BY
Varchar (25)



CREATED_DATE
Timestamp



MODIFIED_BY
Varchar (25)



LAST_MODIFIED_DATE
Timestamp



STATUS
NUMBER
1 Active




0-Inactive









BPI_USERS












Data Element Name
Data Element Type
Constraints







USER_ID
Varchar (10)
PK Not null


PASSWORD
Varchar (30)
Not null


ADDRESS 1
Varchar (30)



ADDRESS 2
Varchar (30)



CITY
Varchar (25)



STATE
Varchar (25)



ZIP
Varchar (25)



COUNTRY
Varchar (25)



PHONE 1
Varchar (25)



PHONE 2
Varchar (25)



PHONE 3
Varchar (25)



CREATED_BY
Varchar (25)



CREATED_DATE
Timestamp



MODIFIED_BY
Varchar (25)



LAST_MODIFIED_DATE
Timestamp



STATUS
Number
1 Active




0 Inactive


PASSWORD_EXPIRY_DATE 
Timestamp



LOCK_STATUS
Number









BPI_GROUP_ACCESS













Data Element



Data Element Name
Type
Constraints







GROUP_ID
Varchar (10)
Not null Refers 




BPI_GROUPS


RESOURCE_ID
Varchar (105)
Not null Refers




BPI_RESOURCES


APPLICATION_ID
Varchar (10)
Not null Refers




BPI_APPLICATIONS


ACL_ID
Varchar (10)
Not null Refers 




BPI_ACL


CREATED_BY
Varchar (25)



CREATED_DATE
Timestamp



MODIFIED_BY
Varchar (25)



LAST_MODIFIED_DATE
Timestamp



STATUS
Number
1 Active




0 Inactive









BPI_USER_ROLES












Data Element Name 
Data Element Type
Constraints







USER_ID
Varchar (10)
Not Null Refers




BPI_USERS


ROLE_ID
Varchar (10)
Not Null Refers




BPI_ROLES


GROUP_ID
Varchar (10)
Not Null Refers




BPI_USGROUPS


CREATED_BY
Varchar(25)



CREATED_DATE
Timestamp



MODIFIED_BY
Varchar(25)



LAST_MODIFIED_DATE
Timestamp



Status
Number
1 Active




0 Inactive









BPI_USER_ACCESS












Data Element Name
Data Element Type
Constraints







RESOURCE_ID
Varchar (10)
Not Null Refers 




BPI_RESOURCE


USER_ID
Varchar (25)
Not Null Refers 




BPI_USERS


ACL_ID
Varchar (10)
Not Null Refers 




BPI_ACL


ROLE_ID
Varchar (10)



CREATED_BY
Varchar (25)



CREATED_DATE
Timestamp



MODIFIED_BY
Varchar (25)



LAST_MODIFIED_DATE
Timestamp



Status
Number
1 Active




0 Inactive









BPI_USER_PASSWORD_HISTORY












Data Element Name 
Data Element Type
Constraints







USER_ID
Varchar (10)
Not Null Refers




BPI_USERS


PASSWORD
Varchar (10)
Not Null


CREATED_BY
Varchar (25)



CREATED_DATE
Timestamp



MODIFIED_BY
Varchar (25)



LAST_MODIFIED_DATE
Timestamp



Status
Number
1 Active




0 Inactive









1.8 Back End Validations
This subsection provides the field element name and corresponding back end validation if applicable.
Back end validations are those validations where the validations have got to be necessarily done using the database.
As a general rule backend validations should be done for all the validation checks that are being carrier on the front end.
1.9 Non-Functional Requirements
This subsection corresponds to the requirements that do not relate to the user function. It provides information on the system requirements—Ideally identifies the present problems in the existing system from a non-functional perspective and avoiding the same in the new system











Non Functional 



Requirement
Details







Performance
Performance criteria should be established based



on the data size and the page size.


System Exception 
All system exceptions should be handled grace



fully throwing a error page with relevant exception



information and action to be taken for resolving the



exception









1.10 Access Control List
This section describes the classification of users who can access the process under definition















User ID
Job Description
Functionality
Access Level









Benefit Partners Inc
Process Specification
Common Functional Features
1. Introduction
1.1. Purpose
The purpose of this document is to describe the common functional features available across all the modules. This document is identified as Common Functional Features. This document identifies how the user interacts with the system, the data to be captured, the business logic to be implemented, and the output of the process for the common functional features.
1.2. Business Use Case Specification Reference














Business Use Specification ID
Business Use Case Name









BPI_SCOPE
Scope Document



BPI_SCOPE_ADD
Addendum to scope










1.3. Definitions, Acronyms & Abbreviations
















Term
Explanation










2. Process Identification
2.1. Background
Common functional feature is to identify the common functionality across all the modules that have the same usage. This would help in standardization and reuse of the components.
2.2. Process Description
The objective of the Common Functional Features process is to:

    
    
        1) Identify the Common functional features across all the modules:
    
    


2.3. Process Flow
Not applicable
3. User Interface
3.1. User Interface Screens
3.1.1. Not Applicable
3.1.2. Not Applicable
3.1.3. Element Name, Element Type & Purpose












Element Name
Element Type
Purpose







First name
Entry Field
Enter the First name


Last name
Entry Field
Enter the last name


Middle name (MI)
Entry Field
Enter the middle Name


Suffix
Drop Down List
List the Suffix


Salutation
Drop Down List
List the Salutation


Title
Entry Field
Enter the Job Title


Address
Entry Field
Enter the first detail 




about the address


Suite/Apt. #
Entry Field
Enter the suite/Apartment 




PO BOX number


City
Entry Field
Enter the name of the city


State
Drop Down List
List all the States in UAS


ZIP
Entry Field
Enter the ZIP Code


Phone #
Enter Field
Enter the Phone number


Fax #
Entry Field
Enter the FAX number


Phone Extension
Entry Field
Enter extension number


FAX Extension
Entry Field
Enter extension number


Email Address
Entry Field
Enter the email address


Credit Card Number
Enter the Credit 
Entry Credit Card number



Card Number



Credit Card Type
Drop Down List
List the type of Credit Card


(Date) Current Date
Calendar/ 
Entry field to type 


(System Date)
Entry Field
the date or Calendar 




to pick the date


(Date) Past Date (1900 
Calendar/
Entry field to 


to system date)
Entry Field
type the date or




Calendar to pick the date


(Date) Future Date
Calendar/ 
Entry field to type the date or 


(System date to 100
Entry Field
Calendar to pick the date


Yr. hence)




(Date) Default 1st of
Calendar/ 
Entry field to 


Following Month (eg.
Entry Field
type the date or


System date is Dec. 2, 2001

Calendar to pick the date


should default to




Jan. 1, 2002)




(Date) Default 1st of
Calendar/ 
Entry field to 


the current Month (e.g.
Entry Field
type the date or


System date is Dec. 2, 2001

Calendar to pick the date


should default to




Dec. 1, 2001)




(Date) Default End of
Calendar/ 
Entry field to 


current Month (eg.
Entry Field
type the date or


System date is Dec. 2, 2001

Calendar to pick the date


should default to




Dec. 31, 2001)




(Date) Credit Card
Drop Down List
List all the Months in a year


Date (should only




accept future date.)




Month




Date) Credit Card
Drop Down List
List the year 25 years ahead


Date (should only




accept future date.)




Year




Social Security
Entry Field
Enter the Social Security 


Number

number


TAX Identification 
Entry Field
Enter the Tax Identification 


Number

Number


Mode of
Drop Down List
List Various modes of 


Communication

communication


Browser Back Button
Button
Validate the back button


Browser Forward
Button
Validate the forward button


Button




Refresh Button
Button
Validate Refresh button


Address Bars
Tool Bars
Hide Address bar


Link Bar
Tool Bars
Hide Link bar


Standard Button
Tool bars
Hide standard bars


Window Close
Browser Window
Validate Close


Window Minimize
Browser Window
Validate minimize









3.1.4. Screen Validations
Note: Validation provided here are the default validations. However if the module functionality has specified different validations for these element described then that would override the default validations provided here.












Element Name
Action/Validation Details
Message







First name
Entry Field with 40 Character long.




Can accept only Alpha characters.




Arnold



Last name
Entry Field with 40 Character long




Can accept only Alpha characters.




Schwarzenegger



Middle name (MI)
Entry Field with 1 Character long




Can accept only Alpha characters.




M, A etc.



Suffix
List should include Jr., Sr., I., II.,




III., IV., and V.



Salutation
List should include Mr., Mrs., Ms.



Title
Entry Field with 20 Character long




Can accept Alpha and numeric




character and blank space between




character (Example Administrator 1)



Address
Entry Field with 40 Character long




3013 Douglas Boulevard,




Can accept free form entry with any




character.



Suite/Apt. #
Entry Field with 20 Character long




Example 200 or 1 D etc.




Can accept free form entry with any




character.



City
Entry Field with 20 Character long




Alpha only and Blank between




words allowed




Roseville, San Jose, San Diego



State
List all the States in USA in




abbreviated form as CA, IL, OH, NY




etc.



ZIP
Should allow maximum and




minimum of 5 Numbers only. Whole




Number Field.



Phone #
Entry Field with 10 Character long




Should allow maximum and




minimum of 10 Numbers only.




Whole Number Field.




3 for Area code, 7 for the number.



Fax #
Entry Field with 10 Character long




Should allow maximum and




minimum of 10 Numbers only.




Whole Number Field.




3 for Area code, 7 for the number.



Phone Extension
Entry Field with 5 Character long




Should allow maximum of 5 and




minimum of 1. Blanks fields are




acceptable.




Whole Number Field.



FAX Extension
Entry Field with 5 Character long




Should allow maximum of 5 and




minimum of 1. Blanks fields are




acceptable.




Whole Number Field.



Email Address
Entry Field with 40 Character long




Allow entering more than 40




character.




Validate for a Valid Email Address.



Credit Card
Entry Field with 20 Character long



Number
Minimum and maximum value




should be 16. Allow only Whole




Number. Numeric Field




For Amex allow 20 as min and max




value.



Credit Card Type
List Credit Card type as




Visa, Master, Discovery, Amex etc



(Date) Current
Entry Field or Calendar with default



Date (System Date)
system date in the Entry Field and




calendar.



(Date) Past Date
Entry Field or Calendar with default



(1900 to system
system date - 1 in the Entry Field



date)
and calendar. Do not allow for




Current date and future date



(Date) Future Date
Entry Field or Calendar with default



(System date to
system date in the Entry Field and



100 Yr. hence)
calendar. Do not allow for past date



(Date) Default 1st
Entry Field or Calendar with default



of Following
first of the following month date in



Month (eg. System
the Entry Field and calendar.



date is Dec. 2, 2001




should default to




Jan. 1, 2002)




(Date) Default 1st
Entry Field or Calendar with default



of the current
first of the current month date in the



Month (e.g. System
Entry Field and calendar.



date is Dec. 2, 2001




should default to




Dec. 1, 2001)




(Date) Default End
Entry Field or Calendar with default



of current Month
end of the current month date in the



(eg. System date is 
Entry Field and calendar.



Dec. 2, 2001 should




default to




Dec. 31, 2001)




(Date) Credit Card
List to show all the months in a year



Date (should only




accept future date.)




Month




Date) Credit Card
List the years from current year to



Date (should only
100 years forward hence.



accept future date.) 
Validate The Credit Card month and



Year
year together. Should not have past




month as credit card entry.



Social Security
Entry Field with 9 Character long



Number
Should allow maximum of 9 and




minimum of 9.




Whole Number Field.



TAX Identification
Entry Field with 9 Character long



Number
Should allow maximum of 9 and




minimum of 9.




Whole Number Field.



Mode of
List various modes of



Communication
Communication like Fax, Phone,




Email, USPS



Browser Back
Disable the browser back button and



Button
hide the back button



Browser Forward
Disable the browser forward button



Button
and hide the forward button



Refresh Button
Disable the browser refresh button




and hide the refresh button



Address Bars
Disable the address bar so that user




cannot type the URL to navigate to




the respective screen



Link Bar
Disable the link bar



Standard Button
Disable the browser standard button



Window Close
Catch windows close event with




Java script and show the message.



Window Minimize
Allow to minimize the window









3.1.5. Interface Flow
N/A
3.1.6. Help Menu

















Element Name
Purpose
Valid Values










4. Business Rule Mapping
Not Applicable














Activity
Rules










1.










5. Data Structures
Not Applicable
















Data Element Name
Data Element Type










5.1. Back End Validations
Not Applicable
















Field Element Name
Back End Validation










6. Non-Functional Requirements
Not Applicable
















Non Functional Requirement
Details










7. Access Control List
Not Applicable















User ID
Job Description
Functionality
Access Level

## Claims

1. An automated benefits administration system of the type used to administer benefits subject to business rules for such benefits, the benefits being organized as multiple benefit plans offered from multiple carriers, the benefits administration system comprising:
a processor;
memory; and
storage storing plural applications that include:
(A) an automated business rules application including software instructions for automatically applying multiple business rules to data input for enrollment data, eligibility data, and group maintenance data, and further including software instructions for making business rule decisions based on said data input, wherein the multiple business rules include:
one or more enrollment rules, each of the one or more enrollment rules pertaining to enrollment in one of the multiple benefit plans from one of the multiple carriers, each of the multiple benefit plans including at least one health care benefit;
one or more eligibility rules, each of the one or more eligibility rules pertaining to eligibility for at least one health care benefit available as part of one of the multiple benefit plans from one of the multiple carriers; and
one or more group maintenance rules, each of the one or more group maintenance rules pertaining to enrollment or eligibility activities for a group of one or more members; and

(B) an automatic action application including software instructions for issuing notices for business rule discrepancies based on said data input;

wherein the storage also stores an accounting module that includes software instructions for:
receiving a change notification that indicates a change in enrollment for a group for which an invoice has been generated, the invoice indicating an invoice amount;
receiving a payment notification that indicates a payment amount from the group for which the invoice has been generated;
determining that the payment amount differs from the invoice amount; and
automatically accounting for the change in enrollment for the group for which the invoice has been generated by adjusting an amount due to reconcile the payment amount and the invoice amount.

2. The automated benefits administration system of claim 1 wherein the storage also stores: (C) a business rules database having the multiple business rules and making the multiple business rules accessible to the automated business rules application, whereby the automated business rules application may apply the multiple business rules from said business rules database.

3. The automated benefits administration system of claim 1 wherein the storage also stores: (C) a business rule override tool through which a user may override one or more of the multiple business rules applied by the automated business rules application based on user authority level, wherein the business rule override tool includes software instructions for:
identifying an exception to one of the multiple business rules;
determining type of the exception;
identifying an authority level of the user; and
determining whether or not to override the exception based upon the authority level of the user and the type of the exception.

4. The automated benefits administration system of claim 2 wherein the storage also stores: (D) a business rule override tool through which a user may override one or more of the multiple business rules applied by the automated business rules application based on user authority level, wherein the business rule override tool includes software instructions for:
identifying an exception to one of the multiple business rules;
determining type of the exception;
identifying an authority level of the user; and
determining whether or not to override the exception based upon the authority level of the user and the type of the exception.

5. The automated benefits administration system of claim 3 wherein the determining the type of the exception comprises classifying the exception as one of multiple types of exceptions in the system, the multiple types of exceptions including:
a first exception type that indicates missing enrollment data;
a second exception type that indicates inconsistent enrollment data;
a third exception type that indicates failure of one of the one or more eligibility rules; and
a fourth exception type that indicates failure of one of the one or more group maintenance rules.

6. The automated benefits administration system of claim 3 wherein the determining the authority level comprises setting the authority level as one of multiple types of authority levels in the system, the multiple types of authority levels including:
a first authority level that indicates absence of authority to override exceptions to the multiple business rules;
a second authority level that indicates authority to override exceptions that relate to missing enrollment data but not to eligibility; and
a third authority level that indicates authority to override any exceptions to the multiple business rules.

7. The automated benefits administration system of claim 1 wherein the change in enrollment for the group for which the invoice has been generated is a termination of a member of the group for which the invoice has been generated, and wherein the adjustment comprises decreasing the amount due based upon the termination.

8. The automated benefits administration system of claim 1 wherein the automated business rules application further includes software instructions for:
from a first user having a first authority level, accepting the enrollment data and the eligibility data for a given application;
checking the enrollment data and the eligibility data for the application against the one or more enrollment rules and the one or more eligibility rules, respectively, to identify one or more exceptions;
presenting at least one of the one or more exceptions to a second user for review, the second user having a second authority level higher than the first authority level;
accepting user input from the second user indicating whether to override the at least one of the one or more exceptions;
if any of the one or more exceptions remains, for at least one remaining exception:
presenting the remaining exception to a third user having a third authority level higher than the second authority level; and
accepting user input from the third user indicating whether to override the remaining exception; and

if none of the one or more exceptions remains, finalizing the application.

9. The automated benefits administration system of claim 8 wherein the first authority level is data entry authority level, the second authority level is supervisor authority level, and the third authority level is manager authority level.

10. The automated benefits administration system of claim 1 wherein the plural applications and the accounting module of the automated benefits administration system are distributed across a computer network.

11. A benefits administration method of operating an automated benefits administration computing system of the type for administering benefits subject to business rules for said benefits, the automated benefits administration computing system including a processor, memory and storage, the benefits being organized as multiple benefit plans offered from multiple carriers, the benefits administration method comprising:
(A) with the automated benefits administration computing system, automatically applying multiple business rules to data input for enrollment data, eligibility data, and group maintenance data, and making business rule decisions based on said data input, wherein the multiple business rules include:
one or more enrollment rules, each of the one or more enrollment rules pertaining to enrollment in one of the multiple benefit plans from one of the multiple carriers, each of the multiple benefit plans including at least one health care benefit;
one or more eligibility rules, each of the one or more eligibility rules pertaining to eligibility for at least one health care benefit available as part of one of the multiple benefit plans from one of the multiple carriers; and
one or more group maintenance rules, each of the one or more group maintenance rules pertaining to enrollment or eligibility activities for a group of one or more members; and

(B) with the automated benefits administration computing system, automatically issuing notices for business rule discrepancies based on said data input;
(C) with the automated benefits administration computing system, if one of the multiple business rules is not satisfied when applied to said data input, providing a business rule override of the non-satisfied business rule as selected by a user have a predetermined authority level: and
(D) with the automated benefits administration computing system, automatically accounting for a change in enrollment for a group for which an invoice has been generated, the invoice indicating an invoice amount, including:
receiving a change notification that indicates the change in enrollment for the group for which the invoice has been generated;
receiving a payment notification that indicates a payment amount from the group for which the invoice has been generated;
determining that the payment amount differs from the invoice amount; and
automatically accounting for the change in enrollment for the group for which the invoice has been generated by adjusting an amount due to reconcile the payment amount and the invoice amount.

12. The benefits administration method of claim 11 further comprising, during said automatic application step (A), automatically accessing a business rules database having the multiple business rules.

13. The benefits administration method of claim 11 wherein the providing the business rule override includes:
identifying an exception to one of the multiple business rules;
determining type of the exception;
identifying the predetermined authority level of the user; and
deciding to override the exception based upon the predetermined authority level of the user and the type of the exception.

14. A benefits administration method of operating an automated benefits administration computing system of the type for administering benefits subject to business rules for said benefits, the automated benefits administration computing system including a processor, memory and storage, the benefits being organized as multiple benefit plans offered from multiple carriers, the benefits administration method comprising:
(A) with the automated benefits administration computing system, automatically applying multiple business rules, including at least all legally-required rules and additional business rules, to data input for enrollment data, eligibility data, and group maintenance data, and making business rule decisions based on said data input, wherein the multiple business rules include:
one or more enrollment rules, each of the one or more enrollment rules pertaining to enrollment in one of the multiple benefit plans from one of the multiple carriers, each of the multiple benefit plans including at least one health care benefit;
one or more eligibility rules, each of the one or more eligibility rules pertaining to eligibility for at least one health care benefit available as part of one of the multiple benefit plans from one of the multiple carriers; and
one or more group maintenance rules, each of the one or more group maintenance rules pertaining to enrollment or eligibility activities for a group of one or more members;

(B) with the automated benefits administration computing system, automatically issuing notices for business rule discrepancies based on said data input, including automatic issuance of one or more attention notices to a remote managing party upon entry of certain unsatisfactory data during local data input;
(C) with the automated benefits administration computing system, providing at least remote enrollment access over the Internet to said automated benefits administration computing system: and
(D) with the automated benefits administration computing system, automatically accounting for a change in enrollment for a group for which an invoice has been generated, the invoice indicating an invoice amount, including:
receiving a change notification that indicates the change in enrollment for the group for which the invoice has been generated;
receiving a payment notification that indicates a payment amount from the group for which the invoice has been generated;
determining that the payment amount differs from the invoice amount; and
automatically accounting for the change in enrollment for the group for which the invoice has been generated by adjusting an amount due to reconcile the payment amount and the invoice amount.

15. The benefits administration method of claim 14 wherein the providing remote enrollment access over the Internet includes:
accepting the enrollment data and the eligibility data for a given application;
checking the enrollment data for the given application against the one or more enrollment rules;
checking the eligibility data for the given application against the one or more eligibility rules;
upon satisfaction of the one or more enrollment rules and the one or more eligibility rules, routing a completed version of the given application to a reviewer for approval; and
upon receipt of approval from the reviewer, finalizing enrollment for the given application.

16. An automated benefits administration system of the type used to administer benefits subject to business rules for such benefits, the benefits being organized as multiple benefit plans offered from multiple carriers, the benefits administration system comprising:
a processor; and
storage storing an accounting module that includes computer-executable instructions for causing the processor to perform a method comprising:
receiving a change notification that indicates a change in enrollment for a group for which an invoice has been generated, the invoice indicating an invoice amount;
receiving a payment notification that indicates a payment amount from the group for which the invoice has been generated;
determining that the payment amount differs from the invoice amount; and
automatically accounting for the change in enrollment for the group for which the invoice has been generated by adjusting an amount due to reconcile the payment amount and the invoice amount;

the group for which the invoice has been generated having been administered using plural applications comprising:
(A) an automated business rules application including software instructions for automatically applying multiple business rules to data input for enrollment data, eligibility data, and group maintenance data, and further including software instructions for making business rule decisions based on said data input, wherein the multiple business rules include:
one or more enrollment rules, each of the one or more enrollment rules pertaining to enrollment in one of the multiple benefit plans from one of the multiple carriers, each of the multiple benefit plans including at least one health care benefit;
one or more eligibility rules, each of the one or more eligibility rules pertaining to eligibility for at least one health care benefit available as part of one of the multiple benefit plans from one of the multiple carriers; and
one or more group maintenance rules, each of the one or more group maintenance rules pertaining to enrollment or eligibility activities for the group; and

(B) an automatic action application including software instructions for issuing notices for business rule discrepancies based on said data input.