Amended Attachment A.xlsx

XLSX spreadsheet 95 KB Posted Nov 20, 2025

Attached to: WORKERS' COMPENSATION MANAGEMENT SYSTEM
Solicitation number: 5400020469
Issued by: Lexington County, Lugoff CDP, South Carolina

About this file

Written by GovTribe AI · Nov 20, 2025

This is an Amended Attachment A spreadsheet providing detailed technical and functional requirements for a Workers' Compensation Management System for the State of South Carolina. The document outlines a comprehensive evaluation framework for offerors to demonstrate how their proposed solutions align with the state's core system preferences across four primary modules: Policy Administration, Billing Management, Claims Management, and Technology. The spreadsheet requires offerors to indicate functionality delivery methods (Base Functionality, Configuration, Custom Development, or Not Supported) and complexity levels (High, Medium, or Low) for each preference, with detailed textual responses required to describe conformance. The Policy Administration module encompasses 90 preferences covering insurance product support, underwriting rules, policy transactions (quotes, new business, renewals, endorsements, cancellations, reinstatements), premium audits, rating methodologies, and agency integration. The Billing Management module includes 63 preferences addressing billing and invoicing, payment processing, receivables management, workflow and issue handling, reporting, and system integration capabilities. The Claims Management module comprises 47 preferences covering first report of injury, claim assignment, investigation, evaluation, negotiation, resolution, reserves, payment processing, recovery, medical management, vendor management, document management, security, and workflow tracking.

The Technology module contains 66 preferences organized into mandatory requirements and optional capabilities spanning architecture, database management, interfaces, security, performance and scalability, application configuration and customization, batch processing, system administration, disaster recovery, implementation support, and reporting. Two mandatory requirements (4.1.1 and 4.1.2) specify that all customer-facing interfaces must employ browser-based Web technology compatible with industry-recognized browsers and that the system must capture configurable audit details for database transactions to ensure compliance with ORC 1347.15. Offerors must complete the spreadsheet in Microsoft Excel 2003 or 2007 format without modifications to structure, formatting, or cell protection. The requirements indicate that proposals failing to meet these criteria or omitting required responses across all four module tabs may be eliminated from consideration. The system must support 99.9% high-availability performance with Tier 3 or better clustering, handle peaks of 500 transactions per minute with response times under three seconds, and provide comprehensive encryption, disaster recovery, and integration capabilities across internal and external systems including managed care organizations, payroll providers, and document management platforms.

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Other files

File	Type	Posted
Attachment A.xlsx	XLSX spreadsheet	Nov 20, 2025
Amendment 3.docx	DOCX document	Nov 20, 2025
Amendment 4.docx	DOCX document	Nov 20, 2025
Notice of Award Posting.docx	DOCX document	Nov 20, 2025
Notice of Award Extension.doc	DOC document	Nov 20, 2025
Amendment 1.docx	DOCX document	Nov 20, 2025
Amendment 2.docx	DOCX document	Nov 20, 2025
Solicitation.docx	DOCX document	Nov 20, 2025
Attachment B.xlsx	XLSX spreadsheet	Nov 20, 2025

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Instructions

Instructions:

This spreadsheet provides offerors the opportunity to describe how the attributes and capabilities of their proposed solution align with the Core System functional and technical preferences.

1 This spreadsheet includes four response tabs - (1) Policy, (2) Billing, (3) Claims, and (4) Technology. For proposals to be considered, offerors must complete each section of all four tabs.

2 Each preference has four functionality columns labeled Base Functionality, Configuration, Custom Development, and Not Supported. Offerors must indicate the level of functionality supported by adding an "X" mark in the appropriate column for each preference.

3 Each preference has three configuration / customization complexity columns labeled High, Medium, and Low. Offerors must indicate the level of complexity by adding an "X" mark in the appropriate column for each preference.

4 The response/description area immediately below each preference allows the entry of textual information. Offerors must use this space to describe in detail how their proposed solution conforms with the preference. Precise references to other portions of the submission may be used as necessary. Simply repeating the preference or stating agreement will not be considered a satisfactory response.

5 The first section of the (4) Technology tab contains two mandatory requirements (4.1.1 and 4.1.2). Proposals that do not meet these requirements may be eliminated from further consideration. The offeror must provide a text response in sufficient detail to demonstrate their proposal's compliance.

6 Offerors must submit the completed spreadsheet in Microsoft Excel 2003 or 2007 format. Cells may be expanded to accommodate text responses. However, other formatting changes such as removing or inserting rows or columns, renumbering preferences, hiding or protecting cells, altering colors or fonts, or modifying headings are not permitted and may be grounds to dismiss a proposal.

1. Policy

	1	Policy Administration Preferences
			Functionality Delivered Through (indicate with 'X')				Configuration / Customization Complexity (indicate with 'X')	Critical (or) Desired
		Preference Description	Base Functionality	Configuration	Custom Development	Not
Supported	High	Medium	Low	Priority
	1.1	Insurance Product Support
	1.1.1	Ability to support the underwriting and administration of workers' compensation insurance products, policies, rates and forms in all U.S. states						C
		Response/Description:
	1.1.2	Ability to support multiple coverages and rating plan options						C
		Response/Description:
	1.1.3	Ability to support class codes and associated rates						C
		Response/Description:
	1.1.4	Ability to support all US state policy forms and endorsements						C
		Response/Description:
	1.1.5	Ability to provide part 1 and part 2 coverage						C
		Response/Description:
	1.2	States, Rates, Rules & Forms
	1.2.1	Ability to provide support for rating tiers						C
		Response/Description:
	1.2.2	Ability to support rating for all states						D
		Response/Description:
	1.2.3	Ability to support the definition and application of underwriting rules at the account level						C
		Response/Description:
	1.2.4	Ability to support the definition and application of underwriting rules at the policy level						C
		Response/Description:
	1.2.5	Ability to support the definition and application of underwriting rules at the product level						C
		Response/Description:
	1.2.6	Ability to support the definition and application of underwriting rules at the coverage level						C
		Response/Description:
	1.2.7	Ability to support SAF standard and company specific policy forms						C
		Response/Description:
	1.3	Transactions: General Preferences
	1.3.1	Ability to support quote transactions with unlimited iterations						C
		Response/Description:
	1.3.2	Ability to support new business transactions						C
		Response/Description:
	1.3.3	Ability to support coverage renewal transactions						C
		Response/Description:
	1.3.4	Ability to support non-renewal						C
		Response/Description:
	1.3.5	Ability to support standard endorsement transactions						C
		Response/Description:
	1.3.6	Ability to support out of sequence endorsement transactions						C
		Response/Description:
	1.3.7	Ability to support endorsements applied after the policy term has expired						C
		Response/Description:
	1.3.8	Ability to support policy cancellation transactions						C
		Response/Description:
	1.3.9	Ability to support flat cancellation transactions						C
		Response/Description:
	1.3.10	Ability to support pro-rata cancellation transactions						C
		Response/Description:
	1.3.11	Ability to support short rate transactions						D
		Response/Description:
	1.3.12	Ability to support reinstatement transactions						C
		Response/Description:
	1.3.13	Ability to support rescission transactions						C
		Response/Description:
	1.3.14	Ability to support rewrite transactions						C
		Response/Description:
	1.3.15	Ability to support policy inquiry transactions						C
		Response/Description:
	1.3.16	Ability to support premium audit transactions						C
		Response/Description:
	1.3.17	Ability to support the application of underwriting rules on a per transaction basis						C
		Response/Description:
	1.3.18	Capability to define, manage and execute workflows specific to a transaction						C
		Response/Description:
	1.3.19	Capability to define underwriting roles and rights specific to a transaction						C
		Response/Description:
	1.3.20	Capability to generate system messages in response to data at time of entry (edit or help)						C
		Response/Description:
	1.3.21	Ability to easily integrate with internal and external web sites on an ad hoc basis in real-time						C
		Response/Description:
	1.3.22	Capability to save user context and entered data from a partially completed transaction and allow the user to return and continue from the same point at a later time						C
		Response/Description:
	1.3.23	Ability to support the use of system-wide underwriting edits for all transactions						C
		Response/Description:
	1.3.24	Ability to support the definition of customized page flow sequences to correspond with different writing companies						D
		Response/Description:
	1.3.25	Capability to associate all transaction types with external and internal producers to track production						C
		Response/Description:
	1.4	Quote
	1.4.1	Ability to support the rating of a quote with only minimum required data						C
		Response/Description:
	1.4.2	Ability to allow quotes for annual, semi-annual, and non-standard term policies						C
		Response/Description:
	1.4.3	Ability to provide for the creation and retention of multiple versions (iterations) of quotes						C
		Response/Description:
	1.4.4	Ability to allow a quote (or iteration of a quote) to be selected and transferred into a new business application						C
		Response/Description:
	1.4.5	Ability to associate a quote with external and internal producers to track production						C
		Response/Description:
	1.4.6	Ability to allow side-by-side comparison of different quote iterations						C
		Response/Description:
	1.4.7	Ability to allow quotes to be easily modified and re-rated						C
		Response/Description:
	1.4.8	Ability to support user override of the quote rate date						C
		Response/Description:
	1.4.9	Ability to allow prior and future effective dates to be supported as permitted by company guidelines						C
		Response/Description:
	1.4.10	Ability to automatically generate unique quote numbers						C
		Response/Description:
	1.4.11	Ability to allow the quote display format to be modified for online review by internal and external users						C
		Response/Description:
	1.4.12	Ability to support the automatic purge of quotes after a predefined period of time						D
		Response/Description:
	1.4.13	Ability to support the automatic archive of quotes after a predefined period of time						D
		Response/Description:
	1.4.14	Ability to allow a quote to be manually or automatically marked as "dead" and subject to archive						C
		Response/Description:
	1.4.15	Ability to allow the entry and retention of notes to capture competitor information on lost quotes						D
		Response/Description:
	1.4.16	Capability to produce statistics on quote activity						C
		Response/Description:
	1.4.17	Ability to provide configurability for quote display formats including the division of coverages over multiple pages						C
		Response/Description:
	1.4.18	Ability to allow assumptions and modifications to be applied to quotes and labeled premium estimates						C
		Response/Description:
	1.4.19	Ability to allow text input on the proposal document to indicate it is an estimate, how long the quote is valid, and underlying assumptions used in generating the quote						C
		Response/Description:
	1.4.20	Ability to support the production of quotes using various document formats (such as Microsoft Word and Adobe Acrobat) and distribute it using electronic methods						C
		Response/Description:
	1.5	New Business Application
	1.5.1	Ability to support the automated processing of new business submissions using predefined underwriting rules with the following outcomes:

• Declined at the point of eligibility

• Fully completed approved applications with no referrals

• Fully completed approved applications with referrals requiring underwriting review

• Submitted applications with a hold requiring underwriting review before an policy can be issued			C
		Response/Description:
	1.5.2	Ability to support e-signatures		C
		Response/Description:
	1.5.3	Ability to allow for the definition of default values for every field		C
		Response/Description:
	1.5.4	Ability to permit default field values to be changed dynamically as new information is discovered during the application process		C
		Response/Description:
	1.5.5	Ability to allow required/optional characteristics be defined for every field		C
		Response/Description:
	1.5.6	Ability to allow data validation rules to be defined on a per field basis		C
		Response/Description:
	1.5.7	Capability to flag applications and create referrals based on individual field values, comparison of multiple field values or a combination of both		C
		Response/Description:
	1.5.8	Ability to allow referrals to be segmented (such as holds and unbound business submissions by Underwriting by risk characteristics)		C
		Response/Description:
	1.5.9	Ability to support the application of underwriting edits throughout the new business process		C
		Response/Description:
	1.5.10	Ability to support the tracking of risks referred to assigned risk / residual market plans		D
		Response/Description:
	1.5.11	Ability to provide pages/modules to support clearance and registration		C
		Response/Description:
	1.5.12	Ability to provide pages/modules to support prequalification / eligibility		C
		Response/Description:
	1.5.13	Ability to provide pages/modules to support information gathering		C
		Response/Description:
	1.5.14	Ability to provide pages/modules to support risk assessment		C
		Response/Description:
	1.5.15	Ability to provide pages/modules to support capture of NCCI classification codes		C
		Response/Description:
	1.5.16	Ability to provide pages/modules to support capture of payroll data		C
		Response/Description:
	1.5.17	Ability to provide pages/modules to support capture of general information (reference ACORD 130)		C
		Response/Description:
	1.5.18	Ability to provide pages/modules to support capture of employer operations / practices		C
		Response/Description:
	1.5.19	Ability to provide pages/modules to support capture of workforce quality and experience		C
		Response/Description:
	1.5.20	Ability to provide pages/modules to support capture of loss experience		C
		Response/Description:
	1.5.21	Ability to provide pages/modules to support capture of rate / price		C
		Response/Description:
	1.5.22	Ability to provide pages/modules to support coverage issue		C
		Response/Description:
	1.5.23	Ability to provide pages/modules to support policy production		C
		Response/Description:
	1.5.24	Ability to provide pages/modules to support declined submissions		C
		Response/Description:
	1.6	Renewal
	1.6.1	Ability to support automated policy renewals		C
		Response/Description:
	1.6.2	Ability to support pre-renewal processing		C
		Response/Description:
	1.6.3	Ability to support renewal risk assessment processing		C
		Response/Description:
	1.6.4	Ability to support conditional renewal processing		D
		Response/Description:
	1.6.5	Ability to support non-renewal processing		C
		Response/Description:
	1.6.6	Ability to allow the entry of predefined automated renewal rules by producer codes		C
		Response/Description:
	1.6.7	Ability to allow the entry of predefined automated renewal rules by state		C
		Response/Description:
	1.6.8	Ability to allow the entry of predefined automated renewal rules by product		C
		Response/Description:
	1.6.9	Ability to allow the entry of predefined automated renewal rules by policy		C
		Response/Description:
	1.6.10	Capability to rate, price and develop a renewal quote, and issue a renewal		C
		Response/Description:
	1.6.11	Capability to generate a renewal quote proposal		C
		Response/Description:
	1.6.12	Ability to allow renewal issuance to trigger a document production		C
		Response/Description:
	1.6.13	Ability to support carrier-defined rules for renewal policy number assignment. It should be possible to replicate the expiring policy number and/or assign a new policy number based on established company rules		C
		Response/Description:
	1.7	Endorsements
	1.7.1	Ability to support all types of endorsements including premium and non-premium generating		C
		Response/Description:
	1.7.2	Ability to support the application of underwriting rules for endorsements		C
		Response/Description:
	1.7.3	Capability to pro-rate endorsement transactions		C
		Response/Description:
	1.7.4	Ability to allow endorsement issuance processing to trigger document production		C
		Response/Description:
	1.8	Cancellations
	1.8.1	Ability to support company underwriting cancellations		C
		Response/Description:
	1.8.2	Ability to support non-payment cancellations		C
		Response/Description:
	1.8.3	Ability to support non-sufficient funds cancellations		C
		Response/Description:
	1.8.4	Ability to support under-payments cancellations		C
		Response/Description:
	1.8.5	Ability to support insured request cancellations		C
		Response/Description:
	1.8.6	Ability to support integration with cancellation effective dating resources		C
		Response/Description:
	1.8.7	Ability to perform flat rate cancellation calculations		C
		Response/Description:
	1.8.8	Ability to perform short rate cancellation calculations		D
		Response/Description:
	1.8.9	Ability to perform pro-rata cancellation calculations		C
		Response/Description:
	1.8.10	Capability to trigger the generation of a document confirming cancellation		C
		Response/Description:
	1.9	Reinstatements
	1.9.1	Ability to interface with the billing module to support automated reinstatements when payments are received and minimum payment thresholds are met (for reinstatement on non-pay cancellations)		C
		Response/Description:
	1.9.2	Capability to notify the billing module to resume billing activities when Underwriting decides to reinstate a policy (for company underwriting cancellations or for possible voids of insured request cancels)		C
		Response/Description:
	1.9.3	Ability to allow for reinstatements with no lapse in coverage		C
		Response/Description:
	1.9.4	Ability to allow for reinstatements with a lapse in coverage		C
		Response/Description:
	1.9.5	Ability to allow for prorates for reinstatement		C
		Response/Description:
	1.9.6	Ability to allow a reinstatement transaction to trigger document production		C
		Response/Description:
	1.10	Rescinds
	1.10.1	Ability to allow recissions to policies that have passed the initial flat cancel period, as defined by state rules		C
		Response/Description:
	1.10.2	Capability to capture text describing rescission reasoning		C
		Response/Description:
	1.11	Rewrites
	1.11.1	Capability to correct a policy issued in error		C
		Response/Description:
	1.11.2	Ability to support changes to rating tier, company, pay plan, etc., effective on inception date and re-issue the policy		C
		Response/Description:
	1.11.3	Ability to support a policy rewrite without re-keying current data		C
		Response/Description:
	1.11.4	Ability to support modification of policy data when performing a rewrite		C
		Response/Description:
	1.11.5	Ability to allow the current policy to be canceled and the rewrite initiated in one transaction		D
		Response/Description:
	1.11.6	Ability to allow the use of the same policy number for a rewrite transaction		C
		Response/Description:
	1.11.7	Capability to rewrite a policy using a different policy number (different company, state dependent rules – primary insured)		C
		Response/Description:
	1.11.8	Capability to send updated instructions to the billing module		C
		Response/Description:
	1.12	Policy Inquiry
	1.12.1	Ability to support on-line policy inquiry by authorized related customers/parties with proper security		C
		Response/Description:
	1.12.2	Capability to interactively query policy data based upon customer name or number		C
		Response/Description:
	1.12.3	Capability to interactively query policy data based upon policy number		C
		Response/Description:
	1.12.4	Capability to interactively query policy data based upon producer code or number		C
		Response/Description:
	1.12.5	Capability to interactively query policy data based upon address		C
		Response/Description:
	1.12.6	Capability to interactively query policy data based upon submission or quote number		C
		Response/Description:
	1.12.7	Capability to interactively query policy data based upon customer account number		C
		Response/Description:
	1.12.8	Capability to search policy data using wildcards		C
		Response/Description:
	1.12.9	Capability to query policy data using phonetic searching		C
		Response/Description:
	1.12.10	Capability to view policy details as of specific point in time (as of date)		C
		Response/Description:
	1.12.11	Capability to display processed transactions (regardless of whether they have gone into effect) with respect to the as of date		C
		Response/Description:
	1.12.12	Capability to view all transaction history associated with a policy in summary and detail views at both the account and policy levels		C
		Response/Description:
	1.13	Premium Audit
	1.13.1	Ability to support interim audit transactions		D
		Response/Description:
	1.13.2	Ability to support final audit transactions		C
		Response/Description:
	1.13.3	Ability to support revised interim audit transactions		D
		Response/Description:
	1.13.4	Ability to support revised final audit transactions		C
		Response/Description:
	1.13.5	Ability to support waived audit transactions		C
		Response/Description:
	1.13.6	Ability to support cancellation audit transactions (pursue or waive)		C
		Response/Description:
	1.13.7	Ability to support premium adjustments due to an audit		C
		Response/Description:
	1.13.8	Ability to track the ordering of premium audits and the results of those audits		C
		Response/Description:
	1.13.9	Capability to prevent endorsements or rewrites after a final audit		C
		Response/Description:
	1.14	Rating
	1.14.1	Ability to support experience rating		C
		Response/Description:
	1.14.2	Ability to support scheduled rating		C
		Response/Description:
	1.14.3	Ability to support individual retrospective rating		C
		Response/Description:
	1.14.4	Ability to support group retrospective rating		C
		Response/Description:
	1.14.5	Ability to allow for easy rate maintenance		C
		Response/Description:
	1.14.6	Capability to produce a detailed rating worksheet showing the rating elements used in premium calculation		C
		Response/Description:
	1.15	Agency Integration
	1.15.1	Capability to integrate with agency management systems		C
		Response/Description:
	1.15.2	Ability to support agent authentication and validation		C
		Response/Description:
	1.15.3	Capability to validate producer licensing		D
		Response/Description:
	1.15.4	Capability to check for producer licensing effective and expiration dates		D
		Response/Description:
	1.15.5	Ability to support agency transfer of policies		C
		Response/Description:
	1.15.6	Capability to create activities for producing agents		C
		Response/Description:
	1.15.7	Capability to capture commission rates and transaction types by producers		C
		Response/Description:
	1.15.8	Capability to keep policy number associations for premium / commission purposes and integration to the billing module		C
		Response/Description:

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2. Billing

	2	Billing Management Preferences
			Functionality Delivered Through (indicate with 'X')				Configuration / Customization Complexity (indicate with 'X')		Critical (or) Desired
		Preference Description (Modified)	Base Functionality	Configuration	Custom Development	Not
Supported	High	Medium	Low	Priority
	2.1	Billing and Invoicing
	2.1.1	Ability to support an address that is used exclusively for billing purposes							D
		Response/Description:
	2.1.2	Ability to allow for notification on selected billing issues. Describe the billing scenarios and format of notification your system is capable of producing							C
		Response/Description:
	2.1.3	Capability to calculate paid, written premium							C
		Response/Description:
	2.1.4	Capability to store and display commission information							D
		Response/Description:
	2.1.5	Ability to provide flexibility with regard to billing frequency (i.e. daily, weekly, monthly, etc.). Document any constraints that could limit billing frequency alternatives							C
		Response/Description:
	2.1.6	Capability to bill debit endorsements based upon triggers such as the dollar amount of the charge, the due date of unbilled installments, and the policy expiration date							C
		Response/Description:
	2.1.7	Capability to spread credit endorsements over all unpaid installments. Describe the system's capability to constrain such a spread if the due date of the installment pre-dates the effective date of the endorsement							C
		Response/Description:
	2.1.8	Capability to generate billing messages based upon policy or account billing status							C
		Response/Description:
	2.1.9	Ability to support multiple payment methods. Document supported payment alternatives							C
		Response/Description:
	2.1.10	Ability to support all accounting transactions necessary for invoicing, claims transactions, and policy transactions							C
		Response/Description:
	2.1.11	Capability to require deposit requirements with a new business application							C
		Response/Description:
	2.1.12	Flexibility to schedule billing events							C
		Response/Description:
	2.1.13	Capability to trigger events within the policy administration module. For example, if a cancellation is pending on a policy, the policy module should not renew the policy.							C
		Response/Description:
	2.1.14	Capability to create new accounts. Describe the process through which an account is setup							C
		Response/Description:
	2.1.15	Capability to permit multiple policies to be billed to a single account							D
		Response/Description:
	2.1.16	Ability to allow policies to added or removed from an account at any point in the billing cycle							D
		Response/Description:
	2.1.17	Ability to handle the propagation of policy level changes (i.e. address, payment plan, etc.) when an account is updated							C
		Response/Description:
	2.1.18	Ability to provide installment payment options for accounts that are affected by billing on a daily, weekly and monthly basis. Describe all such options.							C
		Response/Description:
	2.1.19	Ability to support the rules that govern cash allocation when a payment received is different than the amount billed							C
		Response/Description:
	2.1.20	Capability to refer an account to a billing analyst (or appropriate staff) for review and to determine appropriate action. Such referrals may be based upon configurable criteria							C
		Response/Description:
	2.1.21	Ability to provide a methodology for determining when to bill an account. Describe this methodology in detail							C
		Response/Description:
	2.1.22	Ability to handle various reporting cycles (annual, semi-annual, quarterly, bi-weekly, etc.)							C
		Response/Description:
	2.1.23	Ability to provide the capability to create and maintain payment plans							C
		Response/Description:
	2.1.24	Ability to accommodate payment plan structures that incorporate uneven installment amounts and irregular installment intervals							C
		Response/Description:
	2.1.25	Capability to include or remove payment plan discounts based on specific payment plan rules							C
		Response/Description:
	2.2	Payment Processing
	2.2.1	Capability to calculate a short rate and pro-rated cancellation when needed							C
		Response/Description:
	2.2.2	Ability to provide secure storage and maintenance for bank and account information associated with EFT payment methods							C
		Response/Description:
	2.2.3	Ability to support payment plans where installments will be paid via recurring EFT transactions							C
		Response/Description:
	2.2.4	Capability to identify and track source codes for payments							C
		Response/Description:
	2.2.5	Ability to support credit card payments, ACH, EFT and lockbox transactions from agents and/or third party vendors							C
		Response/Description:
	2.2.6	Capability to establish suggested down payment amounts during the new business application processing based on the payment plan							D
		Response/Description:
	2.2.7	Capability to allocate cash with application to the new policy and previously cancelled policies							C
		Response/Description:
	2.2.8	Capability to apply any outstanding debit or credit amounts to the premium due at policy renewal							C
		Response/Description:
	2.2.9	Capability to automatically apply a specific flat fee							C
		Response/Description:
	2.2.10	Capability to add and reverse late fees when a cancellation notice is generated							C
		Response/Description:
	2.2.11	Ability to support adding and reversing of reinstatement and/or return fees							C
		Response/Description:
	2.2.12	Capability to generate/request refunds for overpayment of premium, credit endorsements, or cancellation							C
		Response/Description:
	2.2.13	Ability to support the issuance/suppression of refunds with an approval process							C
		Response/Description:
	2.2.14	Capability to remove service charges if premium installments are paid ahead of time or when a policy cancels before the installment is due							D
		Response/Description:
	2.2.15	Capability to calculate service charges. Describe the general process and the degree to which it can be configured							D
		Response/Description:
	2.3	Receivables Management
	2.3.1	Capability to allocate one payment to all of the policies associated with an account to keep equity current and/or to apply the payment to one policy							C
		Response/Description:
	2.3.2	Capability to process multiple cash batches within a single day							C
		Response/Description:
	2.3.3	Ability to allow the transfer of cash to the same policy or account for current and prior years							C
		Response/Description:
	2.3.4	Ability to allow the transfer of cash to different policy numbers and accounts							C
		Response/Description:
	2.3.5	Ability to provide configurable reconciliation edits (i.e., to ensure that billing transactions and payment transactions on the policy remain in balance)							C
		Response/Description:
	2.3.6	Capability to manually or automatically trigger the issuance of past due notifications, WCC cancellation forms, and policyholder cancellation letters.							C
		Response/Description:
	2.3.7	Capability to notify the appropriate party when non-pays are issued or rescinded							C
		Response/Description:
	2.3.8	Capability to notify certificate holders when a non-pay is issued							C
		Response/Description:
	2.3.9	Capability to generate proof of mailing when non-pay notices are mailed							C
		Response/Description:
	2.3.10	Capability to perform transactional account reconciliation (i.e., the ability to enforce via edits that when a user transfers credit from one policy to another, both transactions are in balance)							C
		Response/Description:
	2.3.11	Ability to support collection processing. Describe the available collection processes, facilities, and interfaces							C
		Response/Description:
	2.4	Workflow/Issue Handling
	2.4.1	Capability to grant individual and group permissions for amending payment plans mid-term and at renewal							C
		Response/Description:
	2.4.2	Capability to grant individual and group permissions for suspending all billing activity on a policy or an account							C
		Response/Description:
	2.4.3	Capability to grant individual and group permissions for processing of cash transactions							C
		Response/Description:
	2.4.4	Capability to grant individual and group permissions for processing of billing transactions							C
		Response/Description:
	2.4.5	Ability to provide configurable search criteria (i.e. is the criteria user defined or system defined)							C
		Response/Description:
	2.4.6	Capability within workflow to prompt a user to attach and categorize documents							C
		Response/Description:
	2.4.7	Ability to allow policyholders to access billing inquires, electronic bill presentment, premium/collection payments and updates to basic billing information via a public Web site							C
		Response/Description:
	2.4.8	Capability to process returned items (e.g., NSF checks)							C
		Response/Description:
	2.4.9	Capability to define an installment shortage tolerance (i.e., underpayment of an installment)							C
		Response/Description:
	2.4.10	Capability to define a threshold for writing off credit or debit balances							C
		Response/Description:
	2.4.11	Capability to reconcile billing data with other systems (i.e., month end processing, policy administration, etc.)							C
		Response/Description:
	2.4.12	Capability to display and print a complete history of installments due, paid, billed, unbilled, premium transactions, and payments received for a policy or an account							C
		Response/Description:
	2.4.13	Capability to create and maintain business rule versions and effective dates							C
		Response/Description:
	2.4.14	Ability to support workflow decisions based on invoice status							C
		Response/Description:
	2.4.15	Ability to support monitoring of work load balancing, performance metrics, etc.							C
		Response/Description:
	2.4.16	Capability to adjust workload across teams and users
								C
		Response/Description:
	2.4.17	Capability to allow a team to share work across its members
								C
		Response/Description:
	2.4.18	Ability to provide each supervisor with a view of assigned tasks for their team							C
		Response/Description:
	2.4.19	Capability to track the history of workflow activity for a policy transaction							C
		Response/Description:
	2.4.20	Capability to capture notes including the associated dates and creator							C
		Response/Description:
	2.4.21	Capability to restrict access/deletion/revision of notes based upon role							C
		Response/Description:
	2.4.22	Ability to support the tracking of disputes of premiums and fees, billing or payment instructions							C
		Response/Description:
	2.5	Reporting
	2.5.1	Capability to produce daily, weekly, monthly and yearly reports of all cash transactions							C
		Response/Description:
	2.5.2	Capability to produce daily, weekly, monthly and yearly balancing reports							C
		Response/Description:
	2.5.3	Capability to produce daily, weekly, monthly and yearly financial reports							C
		Response/Description:
	2.5.4	Capability to produce daily, weekly, monthly and yearly reports presenting detail for all transaction types							C
		Response/Description:
	2.5.5	Capability to produce daily, weekly, monthly and yearly premium volume reports							C
		Response/Description:
	2.5.6	Capability to produce daily, weekly, monthly and yearly reports presenting additional configurable performance metrics							C
		Response/Description:
	2.5.7	Capability to send reports to external subscribers in a full range of standard file formats (excel, pdf, word)							C
		Response/Description:
	2.5.8	Ability to provide "out of the box" reporting capabilities. Detail all fixed or configurable built-in reports and any included report writer or query tools.							C
		Response/Description:
	2.5.9	Ability to provide a configurable template-based correspondence generation facility which has the capability to pre-fill variable fields from the billing database (as defined in the requirements)							C
		Response/Description:
	2.6	Other Processes, Integration
	2.6.1	Ability to provide SAF business users with the capability to easily create and configure system functionality with regard to workflows, billing plans, accounts, etc.							C
		Response/Description:
	2.6.2	Ability to detect, collect, and log application errors							C
		Response/Description:
	2.6.3	Capability to handle batches consisting of multiple transactions							C
		Response/Description:
	2.6.4	Ability to generate and save an audit trail for all transactions and notes							C
		Response/Description:
	2.6.5	Capability to maintain, display, and report line item detail							C
		Response/Description:
	2.6.6	Capability to edit and track changes to correspondence templates							D
		Response/Description:
	2.6.7	Capability to preview the results of pending correspondence template changes							D
		Response/Description:
	2.6.8	Capability to roll back committed correspondence template changes in the event of problems							C
		Response/Description:
	2.6.9	Capability to associate a document with a user, policy, account, etc.							C
		Response/Description:
	2.6.10	Capability to index documents and associate a date with a document							C
		Response/Description:
	2.6.11	Capability to view associated documents as a group							D
		Response/Description:
	2.6.12	Capability to archive and purge documents per privacy and retention regulations							C
		Response/Description:
	2.6.13	Capability to restrict which documents a user may view							C
		Response/Description:
	2.6.14	Capability to store completed documentation, electronic correspondence (such as e-mail) seamlessly to an external document management system							C
		Response/Description:
	2.6.15	Ability to support electronic signatures							D
		Response/Description:
	2.6.16	Capability to alter the user interface to create user friendly billing screens							C
		Response/Description:
	2.6.17	Capability to customize edit messages. Describe the system’s standard edit messages and the extent to which they can be modified to ensure they are descriptive and user friendly							C
		Response/Description:
	2.6.18	Ability to allow online edits (mandatory fields, formatting restrictions) that prevent user or system error							C
		Response/Description:
	2.6.19	Capability to control update functionality (i.e., amend due date, amend amount due, change transaction type) on pages based upon the user's role/security/authorizations							C
		Response/Description:
	2.6.20	Ability to provide a diary feature							C
		Response/Description:
	2.6.21	Ability to integrate with financial/general ledger systems							C
		Response/Description:
	2.6.22	Ability to integrate with check issuance applications							C
		Response/Description:
	2.6.23	Ability to integrate with customer relationship management (CRM) and interactive voice response (IVR) solutions such as Aspect and i3							C
		Response/Description:
	2.6.24	Ability to provide for electronic transactions with financial institutions (EFT, EBT, Reloadable Debit Card)							C
		Response/Description:

3. Claims

	3	Claims Management Preferences
			Functionality Delivered Through (indicate with 'X')				Configuration / Customization Complexity (indicate with 'X')	Critical (or) Desired
		Preference Description	Base Functionality	Configuration	Custom Development	Not
Supported	High	Medium	Low	Priority
	3.1	First Report of Injury
	3.1.1	Ability to support multiple means of reporting new injury claims. List available claim reporting alternatives						C
		Response/Description:
	3.1.2	Ability to support user-defined fields within the first report of injury (FROI) process. Explain where and how additional data can be captured						C
		Response/Description:
	3.1.3	Ability to recognize the uniqueness of each claim and claimant						C
		Response/Description:
	3.1.4	Ability to support data interfaces with reporting agencies for cross-matching purposes						C
		Response/Description:
	3.1.5	Ability to provide notifications of claimants who are eligible for Medicare						C
		Response/Description:
	3.1.6	Capability for certain types of claims to initiate requests for information/reports from third parties						C
		Response/Description:
	3.1.7	Ability to recognize different types of claims. Explain how reporting requirements are identified for each type and how exceptions are handled						C
		Response/Description:
	3.2	Assignment
	3.2.1	Capability to configure business rules that support auto adjudication of a claim (straight through processing)						D
		Response/Description:
	3.2.2	Capability to identify and utilize each claim handler's specialization during the assignment process						C
		Response/Description:
	3.2.3	Capability to assess the level of claim complexity and utilize this data during the assignment process						D
		Response/Description:
	3.2.4	Capability to automatically assign and reassign claims across claim handlers based upon configurable criteria including all applicable considerations, inputs and limitations to the process						C
		Response/Description:
	3.2.5	Capability to simultaneously assign claim tasks to several resources on separate teams. Explain the criteria that can be used to identify appropriate resource(s)						C
		Response/Description:
	3.2.6	Capability to update assignment rules						C
		Response/Description:
	3.3	Investigation
	3.3.1	Capability to generate and present investigation work plans, steps and tasks						C
		Response/Description:
	3.3.2	Ability to provide flexible and configurable claim investigation rules and tools						C
		Response/Description:
	3.3.3	Ability to capture and retain claim handler identification, categorization, edits and updates beyond FROI level						C
		Response/Description:
	3.3.4	Capability to identify catastrophic and large loss claims						C
		Response/Description:
	3.3.5	Capability to trigger action plans/alerts upon identification of a catastrophic or large loss claim						C
		Response/Description:
	3.4	Evaluate
	3.4.1	Ability to provide evaluation and forecasting tools. Describe which tools are provided, how such tools are presented, how the results are documented and how they are reported to appropriate levels of authority						C
		Response/Description:
	3.4.2	Ability to support ICD-10 injury classifications and also support the conversion of claims from ICD-9. Explain what conversion capabilities are provided and how they are implemented						C
		Medical Management
	3.4.3	Ability to provide flexibility in the design, configuration and implementation of claim evaluation rules and tools						C
		Response/Description:
	3.4.4	Capability of being configured to perform different claim review processes based on the type of loss. At what level of granularity can this customization be assigned (to a single claim or to a group of claims)?						C
		Response/Description:
	3.5	Negotiate
	3.5.1	Ability to support multiple types of settlements. List the types supported and any available checks and balances to ensure timely and properly approved settlements						C
		Response/Description:
	3.5.2	Ability to provide a designated space to organize the justification and explanation of proposed settlements to include award calculation - specifically for the allocation to parts of body per the statute - and additional associated terms. This window must govern maximum settlement allowable on the claim.						C
		Response/Description:
	3.6	Resolve
	3.6.1	Ability to support a formal litigation management program with avoidance processes and procedures						C
		Response/Description:
	3.6.2	Capability to settle individual claim features independently						C
		Response/Description:
	3.6.3	Capability to modify or establish claims status at the claim and/or body part level						C
		Response/Description:
	3.6.4	Capability to select claims appropriate for mediation, hearing or trial						C
		Response/Description:
	3.6.5	Capability to identify and track appealed claims and orders, depositions, mediations, hearings, and other legal events						C
		Response/Description:
	3.6.6	Ability to provide calendaring and docketing systems for legal deadlines at all court levels						C
		Response/Description:
	3.6.7	Capability to budget and track legal fees for outside counsel by specific legal entity						C
		Response/Description:
	3.6.8	Capability to assign multiple legal parties and/or employers to one claim						C
		Response/Description:
	3.7	Reserve
	3.7.1	Capability to automatically set, monitor and flag reserves as certain claim conditions arise and payment thresholds are met. How is manual reserve setting supported?						C
		Response/Description:
	3.7.2	Ability to support role-based reserve hierarchies for settling and approving reserves, along with the capability to trigger and send notifications as needed to the next appropriate approver per the hierarchy.						C
		Response/Description:
	3.8	Payment Processing
	3.8.1	Capability to establish and maintain authority hierarchies within the claim system to reflect permission levels, payment authorizations and approvals, and the need for compliance governance						C
		Response/Description:
	3.8.2	Ability to provide a place where multiple periods of lost time can be defined and delineated by specific start and end dates						C
		Response/Description:
	3.8.3	Capability to assess the appropriateness of payments and to identify threshold breaches						C
		Response/Description:
	3.8.4	Ability to support bulk, repetitive and scheduled payments including payments across multiple claims						C
		Response/Description:
	3.8.5	Capability to issue warnings when potential duplicate payments are made that are not scheduled and/or repetitive payments						C
		Response/Description:
	3.8.6	Capability to offset periodic payments or awards by specified amounts (i.e., child support, etc.) and be able to house the information for the offsetting factor						C
		Response/Description:
	3.8.7	Capability to enable payments via various payment options in multi-currency such as checks, electronic funds transfer (EFT) or electronic benefits transfer (EBT) debit cards						C
		Response/Description:
	3.8.8	Capability to void or stop electronic payments. Which roles have the authority to execute these actions?						C
		Response/Description:
	3.9	Recover
	3.9.1	Ability to provide embedded recovery features within the base configuration						C
		Response/Description:
	3.9.2	Capability to automatically identify claims with subrogation or fraud potential including electronic notification of the appropriate employees/departments						C
		Response/Description:
	3.9.3	Capability to apply an overpayment recovery to different funds when SAF receives the money via checks, EFT, or deducts it from future compensation payments (predetermined percentage based upon compensation type). Explain how this functionality is supported						C
		Response/Description:
	3.9.4	Capability to track reinsurance claims and recoveries						C
		Response/Description:
	3.9.5	Capability to recover from multiple outside (third) parties on the same claim and provide a method of offsetting those various recoveries against a lien, if needed						C
		Response/Description:
	3.9.6	Capability to record and track UEF collections						C
		Response/Description:
	3.10	Medical Management
	3.10.1	Capability to manage and process medical bills. Describe whether these capabilities are based upon integration with a third party solution or are an inherent solution capability						C
		Response/Description:
	3.10.2	Capability to route selected medical bills to third parties when needed						D
		Response/Description:
	3.10.3	Capability to embed pre-set business rules including the auto-adjudication of certain medical bills with notification when established threshold(s) are breached						D
		Response/Description:
	3.10.4	Ability to support pre-configured interfaces out of the box. Describe in detail interfaces with financial reporting systems						C
		Response/Description:
	3.10.5	Capability to house and cross check medical and pharmaceutical bills using unique identifiers generated by the system. Explain how such data is presented to the claim handler						C
		Response/Description:
	3.11	Vendor Management
	3.11.1	Capability to select, evaluate and present (e.g., geographically by relevant specialty) preferred third-party vendors						C
		Response/Description:
	3.11.2	Capability to manage, measure and review preferred vendors. List the objective and subjective factors supported for monitoring consistency and performance.						C
		Response/Description:
	3.12	Reporting
	3.12.1	Ability to provide data aggregation and analytical capabilities. Document how statistics are calculated, presented and reported						C
		Response/Description:
	3.12.2	Ability to support the generation of financial summaries and transactional data presentations						C
		Response/Description:
	3.12.3	Ability to provide systematic audit capabilities that support employee competency and compliance with practice guidelines						C
		Response/Description:
	3.12.4	Capability to establish, measure and report customer service standards and satisfaction metrics						D
		Response/Description:
	3.13	Document & Data Management
	3.13.1	Ability to support document template data auto-fill capabilities and automated distribution. Describe whether these capabilities are based upon integration with a third-party solution or are an inherent solution capability						C
		Response/Description:
	3.13.2	Ability to support document workflow through the use of a rules engine. Describe whether rules engine is incorporated in the solution or enabled through integration						C
		Response/Description:
	3.13.3	Ability to support document indexing capabilities including the capability to index, sort, and package documents						C
		Response/Description:
	3.13.4	Capability to attach documents and correspondence to an individual claim						C
		Response/Description:
	3.13.5	Capability to attach a document / correspondence to an e-mail with appropriate subject and title information						C
		Response/Description:
	3.13.6	Ability to support smart navigation of received documents including page-jump capabilities						C
		Response/Description:
	3.14	System Security & Claim History
	3.14.1	Ability to support role-based security						C
		Response/Description:
	3.14.2	Ability to provide a security structure that allows a user to fulfill multiple roles						C
		Response/Description:
	3.14.3	Capability to track and display user history, including details surrounding activities and events						C
		Response/Description:
	3.15	Workflow Management
	3.15.1	Ability to provide each claims handler with a consolidated view of daily tasks						C
		Response/Description:
	3.15.2	Capability to establish and track against timelines and thresholds which, when exceeded, trigger notifications. Describe the notification modes available						C
		Response/Description:
	3.15.3	Ability to allow managers/supervisors to view productivity metrics for their team or area (individually or as a group) on a real or near-real time basis						C
		Response/Description:
	3.15.4	Capability to create, manage, display, categorize, and sort file and diary notes. Document the specific capabilities offered						C
		Response/Description:

4. Technology

	4	Technology Preferences
			Functionality Delivered Through (indicate with 'X')				Configuration / Customization Complexity (indicate with 'X')	Critical (or) Desired
		Preference Description	Base Functionality	Configuration	Custom Development	Not
Supported	High	Medium	Low	Priority
	4.1	Mandatory Requirements
	4.1.1	All customer facing user interface components must employ a browser-based Web interface fully compatible with industry recognized common browsers (i.e., Internet Explorer, Firefox).
		Response/Description:

This is the start of the file's text. The full file is on GovTribe.

File details come from the government source that posted it. Updated Nov 20, 2025.