CRM Implementation

4.1.5 Restructure of Policy Status Outputs – CRM - Functional

Specs V2.1

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4800 Lyons Technology Parkway, Suite 4 Coconut Creek, Fl 33073 | 877.4.VUESOFT | www.VUEsoftware.com
 Document History

Version Date Author Description

2.0 07/27/2010 Dawn Avila Translation into Functional Specs 2nd time around.

Approvals
Date Name Role

Reviewers
Date Name Role

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 Table of Contents

Document History...................................................................................................................... 2
Approvals.................................................................................................................................. 2
Reviewers................................................................................................................................. 2
Overview............................................................................................................................................... 4
1. Dashboard/Views/Reports.........................................................................................................5
1.1. Policy Dashboard...................................................................................................................... 5
1.2. Phase List View......................................................................................................................... 7
1.3. Status Reason List View............................................................................................................ 8
1.4. My Policy Summary................................................................................................................... 9
1.5. My Pending List View.............................................................................................................. 10
1.6. My Active List View................................................................................................................. 11
1.7. My Policies with Outstanding Requirements List View............................................................12
1.8. Team Phase List View...............................................................Error! Bookmark not defined.
1.9. Team Status Reason List View..................................................Error! Bookmark not defined.
1.10. Team Pending List View.......................................................................................................... 13
1.11. Team Active List View............................................................................................................. 14
1.12. Team Policies with Outstanding Requirements List View........................................................14
1.13. UW Requirements List View on Policy....................................................................................15
1.14. Policy Detail Report................................................................................................................. 16
1.15. Disposition Summary & Detail Report.....................................................................................18
2. Frequency/Scheduling............................................................................................................. 19
3. Output Generation Trigger.......................................................................................................19
4. Security/Access....................................................................................................................... 19
5. Data Glossary.......................................................................................................................... 19
6. Appendices............................................................................................................................. 24
Appendix A: Policy Phase/Agent Action/CRM Policy Status Mapping.....................................24

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 Overview
The current case reporting does not provide clarity to the key points in the lifecycle or where agent
action is required. The data is made available as a whole, but further refinement is required to drive
agents to the tasks which need to be worked.

Status mapping is changing which will allow for a greater granularity of tracking where agent action
is required.

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 1. Dashboard/Views/Reports
1.1. Policy Dashboard
Traceability 3.1.1 60
Requirement Create a dashboard to provide an overview of policies by phase and policy
status reason for a given agent/hierarchy. The summary page should be an
on screen display and will not require printing. It should be located in CRM
under Workplace (on the left navigator) and positioned below Agent Desktop.
The agents should be able to drill down into a particular phase and view a list
of policies currently in that phase. If possible, the agents should also be able
to drill down into a particular policy status reason and view a list of the
policies with that status reason as well.
 Summarized view of policy data containing counts broken out by Policy Phases
and Policy Status Reasons.
 Page should contain drop down select boxes for filter criteria.
 Once filters are selected by the user, the page should automatically refresh.
 Page should contain Agent Action icons for each Policy Status Reason. (See
Appendix A)
 The Policy Phases and Policy Status Reasons should be a link to the applicable
list view, including selected filter criteria.
 Page should contain legend for Agent Action icon.

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 Location  Link located below "Agent Desktop" under Workplace in CRM
Title  Policy Dashboard
Fields/Column  Carrier
Headers
 Policy Phase
 Policy Status Reason
 Totals
Filters  Dropdown selection list:
 Secondary Dropdown - Carrier [Use a Carrier List to select specific
carrier]
 My Policies
 Team Policies
Selection Criteria  Should contain counts of policies by Phase and Policy Status Reason based on

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 filter criteria entered by the user.
Sort  Carrier
 Policy Phase in the following order:
 Application Submitted
 Application Received
 In Underwriting
 UW Decision Complete
 Policy Activation
 Active
 Terminated
 Within each phase, sort by Policy Status Reason.
Grouping / Sub-  Group By:
Totals
 Carrier
 Policy Phase
 Policy Status Reason
 Totals:
 Policy Phase
 Sub-Totals:
 Policy Status Reason
Assumptions  Standard CRM Audits
 We are assuming that there will be dropdown for the carrier and the above
screenshot will show the data for that carrier from where the user can drill down,
if you want to change the carrier, the carrier will be changed from the dropdown
and the screen will refresh to display the data of the selected carrier.
Security Roles 

Questions 

1.2. Phase List View

Traceability 3.1.2 8
Requirement The Phase List View should contain a list of policies in a particular phase,
based on the phase selected by the user from the Policy Dashboard.
Location  Via Policy Dashboard in CRM
Title  My Policies by Phase
Fields/Column  App Date
Headers
 Action Required
 Carrier
 Client Name

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  Policy Number
 Policy Status
 Policy Status Reason
 Issue Date
 Effective Date
Filters  None
Selection Criteria  Should contain list of policies based on:
 Phase selected on Policy Dashboard AND
 Filter criteria entered by the user on Policy Dashboard
Sort  Agent Name
 Policy Phase
 Policy Status Reason
Assumptions  Use standard CRM grid/list view.
 Standard CRM Audits ( why is this assumption here?)
 Clicking on the Phase name in the dashboard will let the user to see this View
Security Roles 

Questions 

1.3. Status Reason List View

Traceability 3.1.3 6
Requirement The Status Reason List View should contain a list of policies with a particular
policy status reason, based on the status reason selected by the user from the
Policy Dashboard.

Location  Via Policy Dashboard in CRM

Title  My Policies by Status Reason
Fields/Column  App Date
Headers
 Action Required
 Carrier
 Client Name
 Policy Number
 Policy Status
 Policy Status Reason
 Issue Date
 Effective Date

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 Filters  None
Selection Criteria  Should contain list of policies based on:
 Status Reason selected on Policy Dashboard AND
 Filter criteria entered by the user on Policy Dashboard
Sort  Agent Name
 Policy Phase
 Policy Status Reason
Assumptions  Use standard CRM grid/list view.
 Standard CRM Audits ( why is this assumption here?)


Security Roles 

Questions  Why do we need this sorting critiera itself when it will is already filtered when the
user is in this VIEW

1.4. My Policy Summary

Traceability 3.1.4 8
Requirement This is a group of links on the Agent Desktop. The entries in this section of the
Desktop should be Pending policies, Policies with Outstanding Requirements
and Active policies.

Links to list views:

1. My Pending Policies
2. My Active Policies
3. My Policies with Outstanding Requirements
4. Team Pending Policies
5. Team Active Policies
6. Team Policies with Outstanding Requirements

Add ability to see drop down containing all policy views.

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 Location  On "Agent Desktop" page in CRM (exists today)
Title 

Fields/Column 
Headers
Filters 

Selection Criteria 

Sort 

Assumptions 

Security Roles 

Questions 

1.5. My Pending List View

Traceability 3.1.5 0
Requirement This view should contain a list of pending policies for a particular agent.

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 Location  Via My Policy Summary in CRM
Title  My Policies - Pending
Fields/Column  App Date
Headers
 Action Required
 Carrier
 Client Name
 Policy Number
 Policy Status
 Policy Status Reason
 Issue Date
 Effective Date
Filters  None
Selection Criteria  Should contain a list of policies where:
 Policy Status = Pending AND
 User is the owner of the policy
Sort  Agent Name
 Policy Phase
 Policy Status Reason
Assumptions  Use standard CRM grid/list view.
 Standard CRM Audits
Security Roles 

Questions 

1.6. My Active List View

Traceability 3.1.6 0
Requirement This view should contain a list of active policies for a particular agent.
Location  Via My Policy Summary in CRM
Title  My Policies - Active
Fields/Column  App Date
Headers
 Action Required
 Carrier
 Client Name
 Policy Number

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  Policy Status
 Policy Status Reason
 Issue Date
 Effective Date
Filters  None
Selection Criteria  Should contain a list of policies where:
 Policy Status = Active AND
 User is the owner of the policy
Sort  Agent Name
 Policy Phase
 Policy Status Reason
Assumptions  Use standard CRM grid/list view.
 Standard CRM Audits
Security Roles 

Questions 

1.7. My Policies with Outstanding Requirements List View

Traceability 3.1.7 6
Requirement This view should contain a list of pending policies with outstanding UW
requirements for a particular agent.

 Expand Activity Description column.

 Wrap the text in the Activity Description column. (This is needed so that all
comments for the UW Notes are visible.)
Location  Via My Policy Summary in CRM
Title  My Policies with Outstanding UW Requirements
Fields/Column  Policy Number
Headers
 App Date
 Carrier
 Client Name
 Activity Type
 UW Requirements ( Activity Code)
 Requested Date
 Requirement Status (Activity Status)
 Description / Comment

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  Policy Status
 Policy Status Reason
Filters  None
Selection Criteria  Should contain a list of outstanding requirements for policies where:
 Policy Status = Pending AND
 UW Requirements Activity Status Category = Outstanding AND
 User is the owner of the policy
Sort  Policy Status Date in ascending order.
 Policy number
Assumptions  Use standard CRM grid/list view.
 Standard CRM Audits
 Assuming that all other fields that are mentioned above is part of the Policy entity
and will be pushed from VUE to CRM
Security Roles 

Questions 

1.8. Team Pending List View

Traceability 3.1.8 0
Requirement This view should contain a list of all pending policies for the user and their
downline hierarchy.
Location  Via My Policy Summary in CRM
Title  Team Policies - Pending
Fields/Column  Agent Name
Headers
 App Date
 Action Required
 Carrier
 Client Name
 Policy Number
 Policy Status
 Policy Status Reason
 Issue Date
 Effective Date
Filters  None
Selection Criteria  Should contain a list of policies where:

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  Policy Status = Pending AND
 Policy owner is in user's hierarchy
Sort  Agent Name
 Policy Phase
 Policy Status Reason
Assumptions  Use standard CRM grid/list view.
 Standard CRM Audits


Security Roles  The user's security in CRM should determine whether the user is eligible to see
other agents' policies or only their own.
Questions 

1.9. Team Active List View

Traceability 3.1.9 0
Requirement This view should contain a list of all active policies for the user and their
downline hierarchy.
Location  Via My Policy Summary in CRM
Title  Team Policies - Active
Fields/Column  Agent Name
Headers
 App Date
 Action Required
 Carrier
 Client Name
 Policy Number
 Policy Status
 Policy Status Reason
 Issue Date
 Effective Date
Filters  None
Selection Criteria  Should contain a list of policies where:
 Policy Status = Active AND
 Policy owner is in user's hierarchy
Sort  Agent Name
 Policy Phase
 Policy Status Reason

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 Assumptions  Use standard CRM grid/list view.
 Standard CRM Audits
 Assuming that all other fields that are mentioned above is part of the Policy entity
and will be pushed from VUE to CRM
Security Roles  The user's security in CRM should determine whether the user is eligible to see
other agents' policies or only their own.
Questions 

1.10. Team Policies with Outstanding Requirements List View

Traceability 3.1.10 4
Requirement This view should contain a list of all pending policies with outstanding UW
requirements for the user and their downline hierarchy.

 Expand Activity Description column.

 Wrap the text in the Activity Description column. (This is needed so that all
comments for the UW Notes are visible.)
Location  Via My Policy Summary in CRM
Title  Team Policies with Outstanding UW Requirements
Fields/Column  Agent Name
Headers
 Policy Number
 App Date
 Carrier
 Client Name
 Activity type
 UW Requirements (Activity Code)
 Requested Date
 Requirement Status (Activity Status)
 Description / Comment
 Policy Status
 Policy Status Reason
Filters  None
Selection Criteria  Should contain a list of outstanding requirements for policies where:
 Policy Status = Pending AND
 UW Requirements Activity Status Category = Outstanding AND
 Policy owner is in user's hierarchy
Sort  Policy Status Date in ascending order.

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  Policy number
Assumptions  Use standard CRM grid/list view.
 Standard CRM Audits
Security Roles  The data visible to the user should mimic the existing user's security in CRM.
Questions 

1.11. UW Requirements List View on Policy

Traceability 3.1.11 8
Requirement This view should contain a list of all pending policies with outstanding UW
requirements for the user and their downline hierarchy. The data visible to the
user should mimic the existing user's security in CRM.

 Make the Outstanding Requirements stand out from the others.

(Suggestion: Either bold or change font color for requirements where the
Activity Status Category = Outstanding or add an Icon such as “!”)
 Expand Activity Description column.
 Wrap the text in the Activity Description column. (This is needed so that all
comments for the UW Notes are visible.)
Location  Via Policy Summary in CRM
Title  UW Requirements on Policy
Fields/Column  Activity code
Headers
 Activity Status
 Activity Type
 Requested Date
 Date Received
 Description / Comment
Filters  Use a drop down list to select UW Requirements Status Category
Selection Criteria  Should contain a list of all UW Requirements (regardless of status) for a
particular policy.
 Policy owner is in user's hierarchy
Sort  UW Requirements Activity Status Category, with Outstanding listed first.
 Created On in descending order.
Assumptions  Use standard CRM grid/list view.
 Standard CRM Auditsu
 Although the title of the requirement shows as “List VIEW”, but in actual it will be
a separate tab in the Policy Screen where all the underwriter requirements will be
shown as per the requirement above.

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  4.1.3 should already be in model
Security Roles 

Questions 

1.12. Policy Detail Report

Traceability 3.2.1 TBD
Requirement The Policy Detail report will provide an overview of the entire pending case
including outstanding and completed UW Requirements, as well as UW Notes.
It should be an aggregate view of all case activity in an easily read and
printable report, allowing the user to view/print multiple policies at once. This
should be a print function within CRM and function similar to the Lead Card
functionality.

Printable report containing aggregate view of all policy activity that currently
exists on the Policy entity in CRM, including UW requirements and UW Notes.

DETAIL PENDING POLICY REPORT

as of Friday, May 21, 2010

ABC Insurance Company

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 Location  Via any policy list view in CRM
Title 

Fields/Column 
Headers
Filters  Dropdown selection list:
 Carrier [Use a Carrier List to select specific carrier]
Selection Criteria  Should contain all policies where:
 Policy Status = Pending AND
 Filter criteria entered by the user
Sort 

Assumptions  The report will be pulled from VUE Directly and shown in CRM as per the above
requirement ( there is a possibility that if at an stage where the policy in VVUE is
not in synch with CRM) then the data that is available in VUE will be displayed in
the report.
Security Roles 

Questions  What kind of grouping is required?

 What kind of sorting is required?
 What does client data means?

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  What do we need to show under the Underwriting Message section?

1.13. Disposition Summary & Detail Report

Traceability 3.2.2
Requirement The purpose of the decisions summary report will be to provide the agent
visibility to cases which are Active>issued, Pending>Approved, or terminated
within a given window. This will enable the agent to either isolate the cases
where further action is required to support activation or declination activities or
gain insight into recently activated cases ready for comp.

Summarized view of policies that have been "dispositioned" within a particular

timeframe.

Location May be report in RC or Advanced Find in CRM.

 Creation of a CRM view may be sufficient. Needs further research/discussion.
Title 

Fields/Column 
Headers
Filters  Dropdown selection list:
 Secondary Dropdown - Carrier [Use a Carrier List to select specific
carrier]
 My Policies
 Team Policies
 Policy Status
 Date Range
Selection Criteria  Should contain policies where:
 Policy Status Date is within date range selected by the user
Sort 

Assumptions 

Security Roles 

Questions 

2. Frequency/Scheduling
The output will be generated upon arrival to the appropriate screen in CRM. No scheduling will be
required. The data will be populated based on the existing VUE IP to CRM daily load schedule.

3. Output Generation Trigger

Upon arrival on screen that houses output, the output should populate.

4. Security/Access

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 The following users should have access to the dashboards/views/reports/, based on existing
CRM/Resource Center security:
Note: "Wrote" (as being used below) refers to the agent tied to the policy in VUE and the Owner of
the policy in CRM.
# User CRM User Role Access
1. Agent  Insphere Agent  Ability to see policies he/she wrote (set
as default)
2. Sales Assistant  Insphere  Ability to see policies he/she wrote (set
Administrative as default)
Assistant  Ability to see policies written by
 Insphere New hierarchy
Business Specialist
3. Sales Leader  Insphere Sales  Ability to see policies he/she wrote (set
Manager as default)
 Ability to see policies written by
hierarchy
4. Agency Manager  Insphere Agency  Ability to see policies he/she wrote (set
Manager as default)
 Ability to see policies written by
hierarchy
5. Zone Manager  Insphere Zone  Ability to see policies he/she wrote (set
Manager as default)
 Ability to see policies written by
hierarchy
Intouch Team  Insphere National  Ability to see all policies.
Sales Support
Insphere  Insphere Corporate  Ability to see all policies.
Corporate User User

5. Data Glossary
The following table contains a list of data elements, definitions and business rules required to
populate one or more of the new reports requested in section 3.

Note: Not all of the data elements listed below are available. The requirement for 3.2.1 Policy
Detail Report is to include the data that is currently available for a policy.

Data Term Definition Field Name Field Name Rules

in VUE in CRM
Activity Source Activity Activity
Source Source
Admin Fee Admin Fee
Admin Fee
Base
Agent The first and last names of First Name, Agent
the agent tied to an Last Name
application/policy.
Agent Action Based on the Policy Does not Does not Derived field in VUE based on
Status Reason, identifies exist exist Policy Status Reason. Data is
the type of action required then passed to CRM.

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 Data Term Definition Field Name Field Name Rules
in VUE in CRM
for a policy in an effort to Available options are:
assist the agent with  Definite Action Required
managing his business.  Possible Action Required

Agent Management structure for

Hierarchy the agent tied to an
application/policy.

The hierarchy consists of

the following levels:
 Zone
 Agency Manager
 Sales Leader
 Agent
Agent ID Unique number assigned Agent Code
to an agent for
identification purposes.
Annual Annual Annual
Premium Premium Premium
Application The date the application Application Application
Date was signed by the Date Date
applicant.
Application Application Application
Number Number Number
Carrier (Insurance Carrier) - Carrier Name Carrier
Organization that
develops and offers
Insurance related
products.
Carrier Status Identifies the current
Reason "state" of an
application/policy as
provided by the Carrier.
Case Manager Case
Manager -
Being added
in 4.2.1
project.
Client The name of the person(s) Customer ID Insured
who applied for Insurance
Coverage.
County
Created On
Currency
Effective Date The date the Effective Date Effective Date
application/policy
becomes active and
effective, as provided by
the Carrier.
Exchange Rate
Face Amount Face Amount
Insured Type Customer Insured Type
Type

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 Data Term Definition Field Name Field Name Rules
in VUE in CRM
Issue Date Issued Date Issued Date
Line of Category of products LOB Line of
Business (LOB) based on market segment. Business

Values consist of:

 Health
 Life
 Disability
 LTC
Modal Premium
Modified By Modified By
Name
Originating
Application
Originating Originating
Opportunity Opportunity
Payment Mode Payment Payment
Mode Mode
Policy
Expiration Date
Policy Number Unique account number Policy Policy
assigned to an Number Number
application/policy.
(This number is provided
to VUE via a Carrier policy
file.)
Policy Phases Steps an application/policy Does not Does not Derived field in VUE, based on
goes through in the policy exist exist Policy Status Reason. Data is
lifecycle process. Specific then passed to CRM.
application/policy statuses
make up each phase. See Appendix A - Policy Phase /
There are currently 7 Agent Action / CRM Policy
phases identified. Status Mapping
Policy State This is the state in which State State
the applicant lived when
they applied for Coverage
and/or currently lives as
provided by the Carrier. (2
digit state code)
Policy Status Identifies the current Status Policy Status
"state" of an
application/policy.
Policy Status The date in which the Status Date Status Date
Date current policy status was
loaded in VUE for an
application/policy.
Policy Status Further identifies the Status Status
Reason current "state" of an Reason Reason
application/policy.
Policy Status Status Status
Reason Date Reason Date Reason Date
Premium Premium
Amount Quoted Amount

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 Data Term Definition Field Name Field Name Rules
in VUE in CRM
Quoted
Product The type of Insurance Product Code Product
Coverage. Products roll
up into specific Lines of
Business.
Product Name Product Product
Name Name
Requested By "Necessary
& Necessary Before" is
Before (MN Life being added
only) under INS-
2121 & INS-
2165. CR's
are not
assigned to a
release.
"Requested
By" is not
currently
available in
CRM.
Requested Requested Requested
Date Date Date
Requirement Currently, the following Activity Status Activity *See UW Requirements Activity
Status statuses may be provided Status Status Category
from the various carriers:
 Approved
 Cancelled
 Closed
 Declined
 Received
 Waived
 Active
 Null
 Outstanding
 Pending
 Sent to Client
 Submitted
Split Agent Agent
Code
Split Split Split %
Percentage Percentage
Status Detail This field should be hidden and
all associated workflows
removed.
Submitted Date Submitted Submitted
Date Date
Target Amount Target
Amount
UW Req Details Concatenated The following columns should be
Requirement columns: concatenated in VUE and CRM
Description Activity as one is applicable for UW
Description Requirements and the other for

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 Data Term Definition Field Name Field Name Rules
in VUE in CRM
and UW Notes, but both provide the
Comments same information:
 Activity Description
 Comments
UW Req Code Activity
Requirement Code?
Name
UW Does not Does not Derived field in VUE based on
Requirements exist exist UW Requirements Activity
Activity Status Status, which is then passed to
Category CRM. The statuses are grouped
into the following 3 categories:
 ALL - Contains all UW
Requirements, regardless
of status.
 Closed - Contains UW
Requirements in the
following statuses:
o Approved
o Cancelled
o Closed
o Declined
o Received
o Waived
 Outstanding - Contains
UW Requirements in the
following statuses:
o Active
o Null
o Outstanding
o Pending
o Sent to Client
o Submitted
*Note: The business includes
ALL UW Notes in the
"Outstanding" bucket as they do
not have a status.

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 6. Appendices
Appendix A: Policy Phase/Agent Action/CRM Policy Status Mapping
Policy Status Policy Status Reason Policy Phase Agent Action Identifier CRM Policy Statuses
ACTIVE Re-instated Active Monitor Cases
ACTIVE Replacement Conversion Active Monitor Cases
ACTIVE Suspended Active Monitor Cases
ACTIVE InForce Active Monitor Cases
ACTIVE Issued, Not InForce Policy Activation Possible Action Required
PENDING App Received By Carrier Application Received Possible Action Required
PENDING Issued, Not InForce Policy Activation Possible Action Required
PENDING Underwriting Decision Complete UW Decision Complete Monitor Cases
PENDING Approved, Issue/Activation Pending UW Decision Complete Possible Action Required
PENDING In Underwriting In Underwriting Possible Action Required
PENDING Teleapp In Process Application Submitted Possible Action Required
PENDING Not an App or App Started Application Received Monitor Cases
PENDING Teleapp Interview Complete Application Received Monitor Cases
PENDING Incomplete App Application Submitted Definite Action Required
PENDING Submitted to Carrier Application Submitted Monitor Cases
PENDING Delivery Receipt Outstanding In Underwriting Definite Action Required
PENDING App Received Application Received Possible Action Required
TERMINATE
D Withdrawn Terminated No Action Required
TERMINATE
D Term After Issue Terminated No Action Required
TERMINATE
D Deceased Terminated No Action Required
TERMINATE
D Cancelled by Customer Terminated No Action Required
TERMINATE
D Decline Terminated No Action Required
TERMINATE
D Closed (Incomplete) Terminated No Action Required
TERMINATE
D Expired Terminated No Action Required
TERMINATE Replaced Terminated No Action Required

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 D
TERMINATE
D Duplicate App Need to exclude policies in this status. N/A

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