A. Publicity and Promotion of Products

1. Insurance and Benefit Product Vendors offer Perennial as well as Plan Year Based Products.
   
   
2. The Promotional Materials including Application Forms for Perennial Products should be made available on the Client's Website.
   
   
3. Upon requests form individual, the CRM staff should be capable of dispatching hard copies by Surface Mail.
   
   
4. Insurance Agents also canvass for Products and their management for a specified Commission amount. The details of Agents are held in the database.
   
   
5. Insurance and Benefit Vendors also promote their Products through brokers for Corporate Clients on a specified brokerage. The details of brokers and Corporate Client Information are to be stored in the database.
   
   
6. For the Year Based Benefit Plans, the Promotional Materials and Application Forms are obtained from Vendors in advance and dispatched prior to the beginning of Plan Year. Corporate Client may employ it's own representative or use the services of Broker or Agent for bulk enrollment. The materials are dispatched either through Bulk Email or by Surface mail as convenient to the Client. For the Individuals and Groups who wish to enroll or continue for the Year Based Benefit plans the promotional materials and application Forms are sent as per their requirement.
   
   
7. Enrollment Management Staff is responsible for collection and dispatch of promotional materials, maintenance of the concerned web page(s), receipt and approval of Applications, maintenance of master data of Plans.

B. Product Evaluation

1. The selection of Products for promotion and management depends on the business yield, the popularity of the Product with benefits, the reliability of Vendors, the business relationship with the Vendors, legal and statutory requirements.
   
   
2. To have an objective analysis of the Products, the Program will be using statistical tools to analyze the data on Plans, Premiums, Claims, Revenue Flows and Revenue earned.
   
   
3. To gauge the relative effectiveness of the Vendors, the lead-time for Claims Adjustment, Rejections, Net Rebate Earned, the total number of beneficiaries will be given by the program
   
   
4. The Enrollment Management will select the appropriate Vendors and Products in the best interest of the business and Clients for promotion.

Insurance and Benefits Management Business Processes:

a) Publicity and Promotion of Products.
b) Product Evaluation.
c) Enrollment of Beneficiaries for the Plans.
d) Receipts and Accounting of Premiums.
e) Processing and Settlement of Claims.
f)  Payments Processing and Settlement of Accounts with Vendors.
g) Payments Processing and Settlement of accounts with Agents/ Brokers.
h) Routine and Exception Reporting for Management Control.
i)  Customer Relations Management with Beneficiaries and Vendors.
j)  Accounting and Audit.
System Administration.

Case Studies:

• Cook Children's Health Care System, U.S.A.
• Claim Management Services Inc., U.S.A.
• Memorial Hermann Health Network Providers., U.S.A.