Tropics Policy Administration System

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2 Tropics Policy Administration System Whether you desire a browser-based, or a Windows-based interface, Tropics provides robust functionality under either platform for your business. Tropics Breeze is a browser-based product and is built on the Microsoft.NET Framework. Tropics Ocean is a client/server product and offers a traditional Windows interface for internal users, as well as browser-based self-service web portals for agents and policyholders over the Internet. Delivering business efficiency and exceptional customer service through advanced technology has been and remains a key focus of Tropics Software Technologies in creating its Policy Administration system. Based on modern technologies, this system includes all business cycle phases; from application processing to policy issuance, audits, cancellations, reinstatements, commissions, renewals, management reports, statutory reports, and all other aspects of policy management. The Tropics Policy system uniquely employs a robust rules engine to process client-specific underwriting rules for new business and renewals. Many aspects of the risk, including class codes, industry, loss ratio, location, years-in-business, etc., can be evaluated and scored by the rules engine. Core modules offer solutions for the fundamental business processes while additional modules further expand business efficiency. A solution is prepared for a client by incorporating selected modules and setting hundreds of configuration values to tailor the system to the client s needs. Summary of Tropics Policy System Modules Multi-State Rating Engine Tropics Rating module provides one central rating engine which can be defined, configured, modified, and edited by both clients and Tropics staff. The system facilitates rating policies across different states, rate tiers, and rating algorithms. Application Processing and Quoting The Policy Administration system uses a framework of workflow, and document automation, and centralized contact management to provide the utmost productivity to an organization. This system provides for entering an application or receiving it through the agency self-service web portal. The application system supports multistate and multi-location entries and can produce multiple quotes per application based on different workers compensation plans (guaranteed cost, deductible, retro plans, etc.). Enrolling and issuing policies based on a valid quote can be accomplished by a single click of a button or scheduled for after-hours production. Insured Management In order to achieve ultimate usability, the Tropics Insured Management tiered hierarchy architecture allows various divisions, segregations, and associations for billing, multi-state policies, and financial purposes. The insured can be divided into multiple exposure units for gathering specific exposure and to generate rating. Each exposure unit can further be broken down into physical locations or workplaces.

3 Policy Issuance/Endorsement Processing Tropics automation speeds up the policy issuance process with built-in logic assignments to pre-populate policy and endorsement forms, auto-generate, and print forms in batch or individually. The system provides options to install forms for multiple states and to automate multi-state policy issuance. Through full integration with other modules, with each endorsement transaction, premium is adjusted (where applicable), appropriate forms are created, and billing records are adjusted automatically. The full history of policy forms and endorsements is kept in the system for review and reprinting. Policy Management The Tropics Policy Management module provides the necessary flexibility for rating, billing, and payments to be issued and tracked from the master policy level or the subsidiary levels. Policy Management is rules-based, meaning rating plans and rating schemas are initially defined and used to govern the creation of each policy. This allows multi-state, multi-location policies to be administered with credits/debits and other factors allocated appropriately for each unit. The policy system also supports accompanying coverages such as USL&H, Maritime, Waiver of Subrogation, and aircraft seats. Taxes and other state surcharges are also supported by this system. The policy system stores and keeps track of estimated, reported, and audited payroll. System functionality allows clients to configure payroll rating options, inflation factors, and renewal methods. Cancellation / Reinstatement Management This module identifies and processes policies that are delinquent in payment or have failed to fulfill other obligations such as sending in periodically reported payroll. All policies, which require cancellation for any reason, are selected as cancellation candidates. A robust user interface provides management, inquiry/review, and processing tools to the users to perform several different related functions and finalize the process of cancellation or reinstatement. All necessary notices are generated based on the state rules. Agency Commission, 1099 Processing, Check Reconciliation The Agency Commission module enables processing of unlimited commission types including flat or tiered commissions, split commissions, and payment exceptions such as bonuses, incentives, or overrides. Payments can be issued at the branch or agent level. For convenience, the system can also execute ACH/EFT payments (requires customization with client s bank). To complete the commission cycle, the system is capable of processing and printing 1099s through integration with 1099 Convey Desktop Edition. Positive Pay Processing is an optional feature of payment processing. It facilitates creating an electronic file of issued checks for the bank to prevent fraud and ensure the accuracy of cleared checks. Check Reconciliation is another optional feature. It allows receiving an electronic transmission of cleared checks from the bank and reconciliation of the cleared checks to the Tropics check register.

4 Audit processing The Tropics Audit system is used to automate the audit processing cycle. Audits of any kind (final, cancellation, etc.) are requested and managed through this system. Audits may be assigned to internal or external auditors and tracked through this module. Audit entry allows the user to easily complete payroll entry and concentrate on finalizing reviews, entering revisions, and completing verifications of payroll, coverage, and classification codes. To simplify audits further, adjustments to billing and audit and refund invoices are generated automatically. As an option, an XML export facility allows audit orders to be loaded to a third party audit system for completion in the field. The completed audits may be received and imported into Tropics through an XML import file. Loss Control The Tropics Loss Control module assists in effectively managing safety and loss control activities. The system provides a vehicle to schedule, plan, and track loss control related tasks. Loss Control Events, as well as the accompanying document templates, can be defined by clients based on their business needs. Safety visits and seminars are among the most widely used types of events. Once events are assigned to a loss control representative, he/she can view and manage the events remotely. The representative can schedule appointments, make visits, and finalize the event by completing the necessary forms and letters. Renewal Processing and Renewal Quotes Tropics Renewal module expedites the renewal process by providing a framework under which policies can be flagged for automatic renewal or underwriter review. The Renewal system provides the ability to automatically increase payroll by a default or specific percentage, and can automatically assign or roll over credits based on client-specific logic. Using the rules engine, policies requiring underwriting review can be segregated to determine renewal eligibility and requirements. To facilitate the analysis, an Underwriting Analysis Screen (UAS) displaying a premium and loss history summary is created and notes (produced during analysis) are maintained. Any quotes or changes made to the policy are stored for reference in determining future actions on the policy. Notification System The Notification system is an optional mass background ing system that creates and send s based on pre-defined templates. s may be issued to external and internal recipients based on defined rules, without user intervention. This system is used in automating many of the required notifications such as Bill is Ready to Pay, Payment Reminder, Past Due Notice, Self Audit Reminder, Termination Notification, Payment Reminder, Self-Billing Reminder, and many other types of notifications.

5 Agency Information Management Tropics Agency Information Management system maintains all data and actions associated with agency, branch, agent (broker), and CSR. The three-tiered hierarchy supports streamlined data entry and gives complete flexibility when structuring commission payments. Reports, Custom Reports, Ad-hoc Information With robust online inquiry, availability of information on-demand, and the capability of copying certain data grids into MS Excel for further manipulation, Tropics has dramatically reduced the need for reports which are used for processing purposes in most other systems. However, Tropics provides a number of financial, management, and exception reports which can be printed or viewed online. As an option, Tropics adds a significant level of capability in reporting, analysis and trending, as well as access to ad-hoc information through OLAP cubes, delivered with the Tropics Business Intelligence product. Using Crystal Reports and Tropics integration tools, Tropics affords users access to any data element stored in the system to create additional reports and to integrate them back into the Tropics menu. We chose Tropics because we want to be on the cutting edge technologically within our industry. None of our competitors had anything comparable to this software. Also, we were adding staff at a rapid pace and saw this software as a means to become more efficient with fewer people. -Gregory L. Buie, Executive Director, KESA Claims Inquiry Tropics Claims Inquiry module helps users quickly access summary claims information for a policy. This enables users to retrieve pertinent claims data for evaluating a policyholder s loss history. The claim summary information, which is usually created nightly, is also used for several reports including loss runs. The information is also used in processing deductible and paid loss retro billing. Notes through Centralized Notebook System Tropics provides a robust centralized notebook across all systems which allows definition of note types by entities (claim, policy, insured, etc.). Additionally, notes may be associated with documents and work items, enabling the client to manage communication related to an entity from a single interface. Other Options and Features Policy & Unit Statistical Reporting (WCPOLS, WCSTAT) Small Deductible Processing & Billing (Requires the Billing System) Large Deductible Processing & Billing (Requires the Billing System) Dividend Plan Processing Incurred & Paid Loss Retro Plan Processing Experience Mod Promulgation Consent to Rate Support

6 Billing and Accounts Receivable Tropics Billing and Accounts Receivable module offers ultimate flexibility and functionality in billing and collecting premium. The system supports all types of transactions and allows each exposure unit to be billed separately or to be combined into one entity and tracked accordingly. This kind of flexibility is very unique to Tropics allowing a master policy to be billed in smaller portions (i.e. for each location or groups of locations). Conversely, a policy across multiple states with separate exposure units in each state may be billed to one central location. Financial transactions can be done individually or by an automated, scheduled batch process. Billing and payment plans can be defined, edited, changed, or modified at any time to allow necessary adjustments with proper authorization access. Tropics A/R supports standard financial operations such as entering and posting payments, allocating payments to invoices and line items (premium, tax, deductible, etc.), voiding /reversing transactions, attaching notes, and printing billing statements. Tight integration with the policy system provides additional efficiencies by facilitating execution of automatic billing schedule creation and billing adjustments when a policy is created, endorsed, or audited. Refund Check Processing is also offered as an option in the A/R system. Through this option, users are able to create application and policy refund checks based on application status or credit billing statements/credit invoices. Feature Highlights Provides real-time billing and payment information to the self-service web portals Supports self-service web portal payments via ACH and other types of payments Automates self-reported billing based on periodic payroll including online entry and payment Allows receipt of payment for application and renewals before the policy is created Provides precise financial transaction tracking through specific transaction codes Rolls the A/R transactions into an easy-to-read credit card style billing statement Automates cash receipts through lockbox file processing Integrates with the commission system for commission payment based on premium receipts Provides a precise aging of accounts receivable Collection Module This optional module provides a comprehensive set of tools for managing all aspects of delinquent and cancelled accounts. Tropics automates A/R reconciliation and allows users to create and maintain non-standard payment arrangements, track and assign collection processes to outside agencies (with outside agency fee allowance), and maintain a database of any collection contacts. Through integration with the document management system, dunning notices and other correspondence can be generated based on user-defined settings. Detailed activity logs summarize production of past due notices, payment reminders, and manual or automated diary entries.

7 Business Intelligence Tropics Business Intelligence product empowers clients to transform their data into meaningful and actionable information. Information is the most powerful resource to an insurance organization. However, a mountain of data without the proper aggregation and tools to analyze and identify trends remains to be just a mountain of data The system sifts through hundreds of policy, claim, and financial data tables on a daily basis to aggregate and summarize them into meaningful information stored in a data mart. From this information, hundreds of reports, charts, and dashboards are created for use by different levels of management. The system also creates OLAP Cubes with a large number of measures and dimensions for drag-and-drop, ad-hoc information analysis. Tropics Software Technologies has used its years of experience in understanding its clients data analysis requirements to create meaningful OLAP measures. This includes figures such as earned premium, written premium, incurred losses, paid losses, etc. This information can be further sliced and diced by many OLAP dimensions such as industry, class code, agency, policy year, calendar year, etc. in real-time. The BI Product includes drill-down functionality, which allows users to view a report, and then subsequently click on hyperlinks within the report to dive further into the details of the analysis in a dynamic fashion. The rich set of tools within Tropics BI allows users to perform advanced data analysis, as well as create attractive dashboards and scorecards utilizing a cube browser. The Tropics BI solution leverages well-known tools such as Microsoft Excel and provides additional functionality through the Microsoft SQL Server suite of products: SQL Server, Analytics, and Reporting. Business Intelligence Reports The base Tropics Business Intelligence solution provides more than 125 standard reports in both chart and traditional report formats in various different subject areas, such as Underwriting, Claims, and Loss Control. These reports may be accessed online, on an as needed basis, or can be scheduled for delivery via . With the Business Intelligence product s integrated tools, all reports may be easily customized and clients may add new reports or charts as needed.

8 Document Management & Imaging Through the Tropics Document Management system, all documents and forms needed for policy, claims or other systems are automatically created, saved, and electronically tied to their associated entity. Tropics Software Technologies has devised easy-to-use techniques for creating dynamic document and form templates by inserting database fields, formulas, and interactive data items into a document. Popular document formats such as Microsoft Word, Adobe PDF, and Microsoft Excel are supported. Tropics rules engine provides automatic generation of statutory and other required forms and letters. Every document is permanently stored with the associated policy, claim, agency, etc., and can be retrieved on demand. Through the Tropics Imaging system, incoming documents can be scanned and stored in the Tropics Document Management systems. Scanning of documents, image queue management, image review and annotations, etc., are all built-in features of the Tropics Imaging module. Document/Form Printing/ ing Documents or forms in the Tropics Document Management system can also be printed, reprinted, or ed on demand. The integrated facility allows multiple documents to be selected for attachment to an . Tropics also provides a background facility named Notification system, to allow the issuing of individual or group s in the background. Rules Engine, Workflow, and Work Management System The Tropics Rules Engine, Workflow, and Work Management system is a comprehensive rule processing, work assignment, and work management system. It has deep integration with Tropics services and business objects to accommodate additional automation beyond the rich set of standard built-in processing functions. Client-specific underwriting rules, renewal rules, claims processing rules, task assignments, and more can be automated through this robust facility. The workflow rules automate assignment, forwarding, and escalation of work items. Tropics workflow can be triggered by events such as receipt of a new business application, a new report of injury, or closing of a claim. In addition to assigning and tracking work tasks, the system can automatically execute tasks such as zeroing out remaining reserves of a claim when the claim is closed, or creating a form when an event necessitates it. The rules engine can also examine the system activities for lack of progress or failure to complete scheduled activities to highlight and alert users and management for aberrations.

9 Self-Service Web Portals Self-service web portals extend Tropics functionality and benefits beyond internal users to the agencies and policyholders by leveraging the Internet. Insurance agency and policyholder users can access information and interact with the insurance company via the Internet through a web browser. Tropics self-service web portals are real-time online web sites. The portals are highly configurable and leverage the business rules and workflow configuration set forth by the insurance company to provide a sophisticated, yet easy to use, web system. Policy, Billing, Claims Inquiry and Reports Portal The Policy, Billing, and Claim Inquiry system is designed to provide agencies as well as policyholders users immediate access to the most current policy and claims information. The scope of information is automatically determined and narrowed by the type of user. For instance, an agency can review their entire book of business while a policyholder can only view his/her policies. In addition to several inquiry screens, insurance companies using this system can design and deploy reports to be accessed and executed in real-time via a web browser by the end users. Information may also be downloaded to the agency or policyholder s desktop on-demand. Certain actions such as the creation of certificate of insurance by policyholders or agents, and the request for endorsement by agents, may be processed through the inquiry portals. Policyholders can pay bills or process self-billing (reported payroll) on the portal as described below. Feature Highlights (Agency, Producer, Policyholder) Provides unique log in ID s for agency, producer, or policyholder with secured password Ability for agency or policyholder administrators to manage their own users Giving access to your Agents and Ability to limit scope of use and permissions by user Policyholders via the type or role Internet empowers Provides a list of active policies for agency and producer with drill-down capability for more detailed information them while reducing (policyholder will have access to their own policies) your overhead to Displays information about insured, locations, policy, service the accounts. claims, payroll, rating, financials, commissions (agency portal only), etc. Provides and highlights critical information such as pending cancellations to the agent Produces and delivers custom reports to the agency, producer, or policyholders on-demand Provides data export to the agency/policyholder s desktop in Excel based on customizable queries. Includes search for insured, policy, and claims Provides access to documents, from the Tropics document management system, which are sanctioned to be accessed on the portals Allows creation, printing, and management of certificate of insurance Produces s to insurance company recipients customizable to each specific web page Tracks number of log-ins by agency to determine user activity level

10 Application Processing & Quoting Portal This powerful web-based system allows entry and processing of workers compensation applications by agents or employers. Through close integration with the Tropics back-end system, the data is verified and edited in real-time. The system provides dynamic look-up and extensive help to assist the end-user in entering an application completely. Through the Tropics rules engine, client-defined underwriting rules can be processed as the application is being entered to produce an online quote and enable the agents to immediately bind, if desirable by the client. The unique risk scoring mechanism in the Tropics rule engine can evaluate and score many factors, including class codes, industry code, historical losses, and many other characteristics of a risk to create a scoring report. The scoring results can be used in automatic acceptance or to enhance the evaluation process by an underwriter. The Tropics BeamUP option adds another great convenience to application processing for Tropics clients. Through this facility, an ACORD application may be transmitted to the Tropics agency web portal electronically in real time, removing the burden of double-entry of an application. Once uploaded to the portal, the application can be placed through the same set of rules as explained above, while saving valuable time for an agent. Feature Highlights Provides online application entry, processing, and quoting to the insurance agencies Optionally, provides electronic upload of ACORD form data from the agency desktop through the Tropics BeamUP product Validates data in real-time and provides extensive help and look-up for data entry Allows entry of a complete workers compensation application including locations, experience modification, payroll, loss history, officer/owners with inclusion or exclusion, and other pertinent data Checks for duplicate applications by name, phone, and FEIN Allows attachment of documents (loss runs, additional forms, etc.) Makes online forms available based on the application s contents (i.e. trucking form is generated if trucking class code appears on the application) Generates quotes based on client-defined underwriting rules. Clients may use Tropics unique risk scoring mechanism Options to send the risk to a Tropics predictive analytics partner for predictive scoring Works directly with the Tropics back-end rating plans and rates tables Issues real-time to the associated underwriter upon request for binding or other requests Allows online collaboration between the agent/csr and the underwriter while the application is being completed by the agent Maintains text message style conversations between agent (or CSR) and underwriter Places an incomplete application in pending status for completion at a later time Includes an underwriting questionnaire page with the flexibility to add carrier-specific questions. Provides dynamic questions based on the application content and answers to underwriting questions Agent/CSR may have several pending applications which are available for additional work when the user logs on. The user can also view the details of the submitted application and the current status Generates customized binders

11 First Report of Injury Portal Through this module, employers enter a First Report of Injury directly which notifies the insurance company by . Similar to other modules, it uses the Tropics back-end system to verify and help the user in data entry. The notice is retained in a pending area until reviewed and accepted by designated claims staff to be promoted to the claims system. Feature Highlights Allows the client to set up and select claims data fields which are collected through this browser interface Provides detailed help text for each data field Enables ability to make certain fields mandatory with others being optional Displays employer class codes and prompts user for selection of the class code of the injured employee Displays and prompts users for selection of location and department Allows accessing, editing, and/or completing a pending report Designated claims staff can see incoming reports in a special report management screen within seconds. From there staff members can review and accept, reject, or contact employer for more information All information from the online report is copied to the claims system automatically Policyholder Reported Payroll, Final Audit Portal As an additional option, the policyholder portal provides self-service facilities for entering payroll for both self-billing and final audit by the policyholder. In both cases, the system displays the policy class codes on the screen for convenient entry of the associated payroll and number of employees. Feature Highlights Entry of periodic payroll (monthly, quarterly, etc.) with immediate calculation of premium of the period and facility to pay immediately through the online payment feature. The system can also be configured to allow a user to print the rating worksheet and mail it with a payment. Entry of final audit payroll with availability of immediate calculation and reconciliation of premium. Also, ability to pay immediately through the online payment feature, if additional premium is owed. The system can also be configured not to post the final audit until it is reviewed by the carrier s staff. Online Payment Portal This portal displays a summary of billing statements and amounts owed to the authorized user. The user may proceed to pay the full and partial amount by adding or using an existing bank account on file. The online payments are batched and processed through ACH at pre-defined intervals by the client. The user may add one or more bank accounts and authorize the carrier to withdraw money from the accounts electronically. The online payment system can be used for both the bills created and posted to the portal by the carrier or the bills generated in real-time when reported payroll or final audits are entered. For those clients who desire to accept credit cards, Tropics will customize the credit card payment processing through the third-party processor or other credit card processing facility of the client s choice.

12 Tropics Software Technologies Phone: Toll Free: Tropics Corporate Headquarters 7349 Merchant Court Sarasota, Florida 34240