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Centralizing Claims Disbursements for the Insurance Industry with

PeopleSoft PayablesMadeline Osit

Beacon Application Services

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Agenda• Issues and the Pre-PeopleSoft Landscape• Key Considerations• Technology• Case Studies

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Issues facing the insurance industry

• Use of legacy technology [often mainframe based] for policy, claims, investment and financial processing

• Older applications have a difficult time meeting today’s financial, operational, administrative and reporting demands from customers, regulators and financial professionals

At a time when….

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Issues facing the insurance industry

• There are rising pressures to improve operational efficiency and extend competitive reach

and• Deregulation presents opportunities to capture

new marketshare

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Bottom line

Financial systems can be viewed as the foundation of the <insurance> organization – the operational systems (underwriting and claims) sit on top and feed information downstream to support financial transactions and reporting. Conversely, financial systems support and enable the lifecycle of all corporate activities and operations as well as provide all necessary statutory and management reporting and analysis

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• Specialized legacy applications handle operational needs (underwriting, policy administration, investment management, claims etc.)

• Core financial and operational systems employ disparate and often incompatible technologies

• Core financial systems are not tightly integrated• Multiple repositories of critical reference data (accounts,

customers, vendors etc.)• Inconsistent data standards and validations often applied late in

the processing cycle• Little flexibility for growth – acquisitions or changes in business

model cannot readily be reflected in systems• Access to source transaction data [drill down] is limited or non-

existent• Applications using advanced technology are not present in high

volume or acute pain areas

• Numerous manual reconciliations of data transfers

• Lack of consistent compliance

• Processes expand closing cycles

• Lack of timely financial information

• Increasing demands on finance & cash management

• Delays in implementing organizational and other changes

Resulting in:Pre-PeopleSoft Financials Landscape

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Considerations for Claims Processing through AP

• Daily integration with core operational systems is critical to these implementations

• Fully functional document printing engine is required to support a wide range of check format and content requirements

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Considerations for Claims Processing through AP

• Types of payments needed– Claims Payment Requests– Recovery Requests– GL adjustment transactions– Payment cancellations

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Considerations for Claims Processing through AP

• Understanding how claims, policy, and premium accounting and payment detail and requirements increases complexity of AP implementation

• Where you are in the lifecycle of implementing AP [net new implementation or claims payment add-on]

• Availability of project team members from the Claims area for requirements definition

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Considerations for Claims Processing through AP

• For simultaneous claims system replacements, there should be close coordination with the claims implementation team and rollout strategy

• Understand how claims system design and functionality has impact to the complexity of the Payables implementation

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Considerations for Claims Processing through AP

• Level of Detail– Multiple insurance applications and types of

data (policy, claims, brokers, etc.)– Numerous insurance subsystems– Complex and varied state regulatory

reporting requirements

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Other Key Considerations

• High payment transaction volume with immediate disbursement as the performance standard

• Use of Single Payment Vouchers for non 1099 reportable claims payments

• Older operational systems without proven integration processes for applications like PeopleSoft

• Daily batch interfaces required within a defined batch window after the system completes its internal, nightly processes

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Other Key Considerations

• Understanding your personal integration challenge– Is a robust check production system in place

[Bottomline, Xpression]– What is the integrating systems [ClaimsCenter,

Mainframe based, or home-grown]– Comfort level with technology choice

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Technology

Identify the best integration tools and solutions, taking into account the state of the claims systems themselves (disparate or integrated, status of new solution in process, etc.):• Integration Broker• Application Messaging• Web Services/XML• Application Engine• SQR• Schedulers for “lights-out” processing

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Technology

How generic and/or extendible do you want your solution to be?• Schedulers for “lights-out” processing• The number and disparity of payment requests• The ability to map accounting entries and inter-unit

processing from systems with different accounting structures

• Importing Escheated transactions• Messaging for immediate action

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Technology

The PeopleTools technical platform provides the ability to establish a fully

integrated solution, rather than point to point data movement

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Case Studies

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Questions?Madeline OsitChief Operating OfficerBeacon Application Services Corporationmosit@beaconservices.com508.663.4407

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APRIL 7-11, 2014Sands Expo and Convention CenterLas Vegas, Nevada

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