1. paid premiums (medical / rx / riders)
2. adjusted paid premiums (medical / rx / riders)
3. total paid premiums (medical / rx / riders)
4. total number of member months
5. total number of shared risk member months
6. shared risk members bop
7. shared risk members eop

• Medical claims information including:

1. average number of subscribers, all products
2. average number of members, all products
3. average number of members, selected products
4. product members eop
5. paid premiums (medical / rx / riders)
6. adjusted paid premiums (medical / rx / riders)
7. total paid premiums (medical / rx / riders)
8. total number of member months
9. total number of shared risk member months
10. shared risk members bop
11. shared risk members eop
12. adjusted paid medical claims
13. beginning ibnr
14. ending ibnr
15. total incurred non-capitated medical claims
16. trended incurred non-capitated medical claims before medical management
17. change in shared risk ibnr
18. excess claims

• Medical / rx capitation including:

1. incurred medical capitation
2. incurred rx capitation
3. incurred medical / rx capitation
4. underwriting capitation adjustment factor
5. adjusted incurred medical / rx capitation
6. capitation adjustment factor
7. adjustment to capitation
8. total adjusted medical / rx capitation
9. shared risk settlement charge
10. trended capitation before medical management

• Drug claims information including:

1. paid rx claims
2. adjusted rx claims
3. ibnr pmpm bop
4. beginning ibn
5. ibnr pmpm eop
6. ending ibnr
7. change in rx ibnr
8. ppg incentive factor
9. ppg incentive charge
10. incurred rx claims
11. trending rx claims before medical management

• Medical management information including:

1. charges on medical claims
2. charges on medical capitation
3. charges on medical / rx claims
4. projected medical / rx / rider(s) costs
5. incurred medical / rx costs
6. projected medical / rx costs

• Medical / rx retention information including:

1. medical retention
2. medical profit
3. rx retention
4. rx profit

• Adjustments available:

1. experience rate %
2. experience credibility %
3. blended renewal %
4. total floor experience premium needed
5. floor experience rate %
6. blended floor renewal %
7. underwriting renewal %
8. additional broker commission factor %

• Powerful manual rating with the ability to generate needed floor rate using:



• Current information:

1. current premium
2. current manual premium pmpm

• Medical data information:

1. medical book cost pmpm
2. current age / sex factor
3. sic factor
4. current micro-market factor
5. current cobra factor
6. medical trend factor
7. medical retention pmpm
8. medical sg&a %
9. medical profit
10. needed medical pmpm

• Rx data information including:

1. rx book cost pmpm
2. current age / sex factor
3. sic factor
4. current cobra factor
5. rx trend factor
6. rx sg&a %
7. needed rx pmpm

• Riders data including:

1. rider a, b, c, etc.
2. book cost pmpm

• Optional customization and integration available

Sales on Demand

• Simple and user friendly contact manager



• Track:

1. broker and agent contact information, groups and activities
2. group contact information and proposal history
3. sales activities

• Display and analyze relationships between groups, brokers and sales



• Initiate RFP requests by entering:

1. proposal information
2. group questionnaire
3. medical conditions
4. competitor rates

• Easily modifiable to client specifications
• Optional customization and integration available

Click below to download product specifications.
Renewal Automation Suite