WHAT’S NEW IN THIS RELEASE
| Feature | SL |
| Member Queue - Active Only Toggle | |
| Member Records Enhancement - Added Trip Spec Dates | |
| Claim Ingestion Enhancement - Support of Agg Terms | |
| Policy Enhancements - Support of Spec & Agg Terms | |
| Introduction of a New Aggregate Workspace |
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Member Queue - Active Only Toggle
Reduce the friction of weeding thru inactive member records in the Specific Workspace. A new toggle filter has been introduced to the Member Queue to hide Member Records that are no longer associated with Active Policies.
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Member Records Enhancement - Added Trip Spec Dates
Gain insights into when Spec & Agg Spec Deductible milestones were tripped. Answer questions like:
- What members recently tripped 90% or 100% of Spec?
- When did a member's policy trip 90% or 100% of Agg spec?
- What members and/or policies recently dropped back below their Spec and/or Agg Spec?
To support these type of questions the member records now store and display dates for which to search, build on-demand filters and establish saved filters for ongoing use.
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Hidden columns added to:
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New fields include:
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Filter Example:
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Claim Ingestion Enhancement - Support of Agg Terms
Smart-LinQ has augmented it's Stop Loss administration to support Agg Only policies as well as Spec and Agg bundled policies where the terms are different; e.g. Spec 12/12, Agg 18/15. To accomplish this, Smart-LinQ had to be enhanced to assign claims on both the Spec & Agg terms independently.
Claim Ingestion Flag
Upon import, the system will identify the claim as Spec Eligible, Agg Eligible or some combination of the two. It's possible that a claim is:
- Only Spec Eligible
- Only Agg Eligible
- Both Spec and Agg Eligible
This flag cannot be modified by end users as it simply helps with hide & display logic used within the UI.
- For a claim to display under a Member in the Specific Workspace the claim must have a [Spec Eligible Flag] = TRUE
- For a claim to display under a Policy in the Aggregate Workspace the claim must have an [Agg Eligible Flag] = TRUE
Multiple Policy Scenario
It's possible that upon ingestion that a claim will be deemed eligible for more than one policy.
| Scenario | Claim Eligibility Scenario | Smart-LinQ Ingestion Rule |
| 1 |
For the same Group, assume a claim's incurred & paid dates match:
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| 2 |
For the same Group, assume a claim's incurred dates match:
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***This is the same logic if it were a Spec Eligible Claim |
| 3 |
For the same Group, assume that a previously unpaid Agg claim assigned to the 2024 Policy has been updated with a date that matches the Agg Terms in 2023 Policy
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***This is the same logic if it were a Spec Eligible Claim |
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Policy Enhancements - Support of Spec & Agg Terms
The Policy Details screen has been enhanced to employ tighter controls and utility around the "Includes Specific" and "Includes Aggregate" toggles.
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Copy Policy
The Copy Policy modal has been enhanced to copy both Specific and Aggregate terms. A user can simply leverage the terms from the existing policy or edit as desired before selecting "Copy".
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Introduction of a New Aggregate Workspace
Smart-LinQ is taking it's first step towards administration of both Specific and Aggregate Stop Loss and in doing so it is providing new "in-product" visibility and control over Aggregate Claims.
New Breakout of Workspaces
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Specific Workspace
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Aggregate Workspace
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Aggregate Workspace
This first iteration of the Aggregate Workspace provides users with the ability to:
- Search and display Policies from a Policy Queue
- View where a Policy sits against its Aggregate Attachment
- Search and view Agg Eligible claims
- Move claims in and out of an Agg Filing***; if "Excluded from Agg Filing" the claim will be removed from any Aggregate Reporting and accumulations.
***Note on Agg Filings Logic
All Agg Eligible claims will be placed in a single Agg Filing upon ingestion. This filing will remain in "Accumulating" perpetually as a means to summarize claim amounts against the Agg Attachment.
Agg Filing Manager & Agg Claims Tabs
The Agg Filing Manager displays a single filing with claims visually nested. Leverage the expand and collapse feature to display / hide the claims per card. Agg Claims is a separate tab that provides users with a full table view of all Agg Eligible Claims.
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Filter Claims Excluded from Filings
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Specific Workspace -> Display Card
The Display Card Header in the Specific Workspace has been refined to meet the new user experience standards across all products.
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Old Display |
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New Display
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Group & Policy Details Modals
The viewing experienced has been refined for easier consumption of details in a popup modal. A direct link to the details page is also available for easier navigation.
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Old Display |
New Display |
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