Benefits administration system and methods of use and doing business

• US 20060064313A1
• Filed: 12/06/2004
• Published: 03/23/2006
• Est. Priority Date: 12/05/2003
• Status: Active Grant

• Current Assignee: John Steinbarth, Patricia A. Steinbarth
• Original Assignee: John Steinbarth, Patricia A. Steinbarth
• Inventors: Steinbarth, Patricia A., Steinbarth, John
• Granted Patent: US 8,078,481 B2
• Time in Patent Office: Days
• US Class Current: 705/322
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 10/1057 Benefits or employee welfare, e.g. insurance, holiday or retirement packages
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

An automated benefit administration system and methods of use and doing business. The full system includes a wide range of features including application of business rules to enrollment, eligibility, and maintenance data input, making of business decisions based on the specific data entered, and issuing of notices based on business rule discrepancies including notices to third parties when deemed appropriate. The full system also is secure while providing remote access, including through the Internet, limits access based on user hierarchy, allows user customization of various features including communications vehicles (e-mail, letter correspondence, or facsimile) and of the format of certain communications, provides automatic enrollment in Cobra without re-entry of beneficiary data, accomplishes various types of financial reconciliation, accommodates differing organizational structures and groupings of entities, provides business rule over-ride capability for certain users, and provides robust information about carriers and their services.

Claims

1. An automated benefits administration system of the type used to administer benefits of members of employed personnel subject to business rules for such benefits, the benefits administration comprising:

A. an automated business rules application automatically applying at least all legally-required rules to enrollment, eligibility, and group maintenance data input and making business rule decisions based on said data input; and

B. an automatic action application issuing notice to one or more users for all business rule discrepancies based on said data input.

2. The automated benefits administration system of claim 1 also comprising:

(C) a business rules database having business rules accessible to the automated business rules application, whereby the automated business rules application may apply business rules from said business rules database.

3. The automated benefits administration system of claim 1 also comprising:

(C) a business rule over-ride through which users may over-ride a business rule applied by the automated business rules application based on user authority level.

4. The automated benefits administration system of claim 2 also comprising:

(D) a business rule over-ride too through which users may over-ride a plurality of business rules applied by the automated business rules application based on user authority level.

5. A benefits administration method of operating an automated benefits administration computing system of the type for administering benefits of employed personnel subject to business rules for said benefits, the benefits administration method comprising:

A. automatically applying at least all legally-required rules to enrollment, eligibility, and group maintenance data input into the automated benefits administration computing system and making business rule decisions based on said data input; and

B. automatically issuing notices to one or more users for all business rule discrepancies based on said data input.

6. The benefits administration method of claim 5 further comprising, during said automatic application step (A), automatically accessing a business rules database having business rules including said legally-required rules.

7. The automated benefits administration system of claim 5 further comprising, in step (A), providing a business rule over-ride as selected by a user have a predetermined authority level.

8. The automated benefits administration system of claim 6 further comprising, in step (A), providing a business rule over-ride as selected by a user have a predetermined authority level.

9. An automated benefits administration system of the type used to administer benefits of members of employed personnel subject to business rules for such benefits, the benefits administration comprising:

A. an automated business rules application automatically applying at least all legally-required rules and desired additional rules to enrollment, eligibility, and group maintenance data input and making business rule decisions based on said data input;

B. an automatic action application issuing notice to one or more users for all business rule discrepancies based on said data input, the automatic action application including the ability to issue notice to third parties by disparate communications vehicles.

10. The automated benefits administration system of claim 9 also comprising:

(C) a business rules database having business rules accessible to the automated business rules application and wherein said business rules include a plurality of business rules among said legally-required and additional rules, whereby the automated business rules application may apply business rules from said business rules database.

11. The automated benefits administration system of claim 9 also comprising:

(C) a business rule over-ride through which users may over-ride a plurality of business rules applied by the automated business rules application based on user authority level.

12. The automated benefits administration system of claim 10 also comprising:

(D) a business rule over-ride too through which users may over-ride a business rule applied by the automated business rules application based on user authority level.

13. A benefits administration method of operating an automated benefits administration computing system of the type for administering benefits of employed personnel subject to business rules for said benefits, the benefits administration method comprising:

A. automatically applying at least all legally-required rules and additional business rules to enrollment, eligibility, and group maintenance data input into the automated benefits administration computing system and making business rule decisions based on said data input;

B. automatically issuing notices to one or more users for all business rule discrepancies based on said data input, including automatic issuance of one or more attention notice to a remote managing party upon entry of certain unsatisfactory data during local data input; and

C. providing at least remote enrollment access over the Internet to said automated benefits administration computing system.