Attachment 8.xlsx
XLSX spreadsheet 407 KB Posted
- Attached to
- Claims System Modernization
- Solicitation number
- ITN-14535
- Issued by
- Leon County, Florida
About this file
This is a Business Requirements Matrix document created by the Florida Department of Financial Services, Division of Rehabilitation and Liquidation (DRL), outlining the functional and technical requirements for a modernized Claims System to replace the current Online Liquidation Claims Processing System (OLCP). The matrix specifies comprehensive capabilities across multiple functional areas including general company setup, data entry and transaction processing, reserving, correspondence, claims evaluation, outbound and inbound proof of claim processing, objections handling, uniform data standards (UDS) management, payment and distributions, forms processing, audit history tracking, rules engine functionality, workflows, documentation management, notifications and communications, online portals, reporting, system functionality, and workflow management. Vendors responding to ITN No. 2526-01 must evaluate their solution's capability for each defined business requirement and indicate whether functionality is available "Out of the Box," requires "Configuration," needs "Customization," depends on "3rd Party Integration," or is "Unable to Supply." The document contains over 200 individual requirements organized by business process category, with provision for vendor comments explaining solution capabilities for each requirement.
The requirements matrix serves as the primary evaluation tool for assessing vendor responses against DRL's functional needs for processing approximately 14.8 million policy records across multiple concurrent liquidations. Vendors must address all requirement areas including handling diverse claim types (bond, employee, general creditor, guaranty association, premium return claims), supporting multiple Florida-regulated insurance lines (property and casualty, workers' compensation, health, title, continuing care), maintaining comprehensive audit trails and security controls, enabling workflow automation and approvals, supporting distributed data entry, integrating with external systems via API and EDI, providing electronic document management, generating specialized reports, and delivering a Service Oriented Architecture (SOA) platform capable of operating in multiple deployment environments (DEV, TEST, TRAIN, PROD). The document specifies that the system must operate as a Platform as a Service (SaaS) solution with 24-hour availability (except maintenance windows), support role-based security with single sign-on capabilities using Active Directory or LDAP authentication, and provide configurable business rules engines, workflow management, and comprehensive help systems accessible to trained end-users without vendor assistance for forms customization and report generation.
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Instructions
| How to Use This Workbook | |
| This workbook is designed to capture vendor's solution capabilities for each Core Requirement section. Vendors are to review all tabs and input the solution's capability for each defined business requirement in column E, "Solution Capabilities". The response options are as follows: "Out of the Box", "Configuration", "Customization", "3rd party Integration", and "Unable to Supply". Vendors are encouraged to provide any relevant additional information within the "Comments" column (column F) for the related business requirements. | |
| Definitions | |
| Solution options are defined as follows: |
-Out of the Box: The capability is fully available in the vendor's solution without any additional setup or modification. The functionality works immediately upon deployment with no further configuration or customization.
-Configuration: The capability requires some adjustment of standard parameters, settings, or options with in the solution. No code changes or development work is needed, only configuration through the solution's native administrative interfaces or tools.
-Customization: The capability requires custom development, coding, or significant modification to the solution. This includes creating custom workflows, developing new features, or modifying existing functionality beyond standard configuration options.
-3rd Party Integration: The capability is not natively available within the solution and would require reliance on an external third-party provider or partner to deliver the functionality. This indicates the functionality is not included in the solution but instead depends on another organization's services.
-Unable to Supply: The capability cannot be provided in the solution, either natively, through configuration, customization, or third-party integration. This represents a functional gap in the solution.
&G &"-,Bold"ITN No. 2526-01 Department of Financial Services - Division of Rehabilitation and Liquidation (DRL) Business Requirements Matrix - Business Process
&A &P of &N
Business Process
| Reference Number | Function | Core Requirement | Requirement ID | Solution Capabilities | Comments |
| Gen-8 | General Company Setup | Business Process | Ability for the system to allow authorized users to begin entering company data on or before the first day of liquidation. | ||
| Gen-10 | General Company Setup | Business Process | Ability for the system to capture comprehensive company-related information including: |
- Guaranty Association (GA) details, deductibles, and coverage limits that inform claims evaluation and reserving rules.
- Policy, claims, and claimant data
- Associated parties (lawyers for noticing, general creditors, agents, etc.)
| Gen-11 | General Company Setup | Business Process | Ability for the system to capture the claim filing deadline per company in receivership. |
| Gen-12 | General Company Setup | Business Process | Ability for the system to disallow input/import of duplicate records. |
| Gen-13 | General Company Setup | Business Process | Ability to automatically enable or disable features in the user interface for each company in receivership, depending on whether the data needed for those features is available. |
For example, if claims data is not yet loaded for a company, options to generate Notice of Determinations or process distributions should be grayed out or inactive.
| Dat-40 | Data Entry & Transaction Processing | Business Process | Ability for transactions in one module to not block, delay, or otherwise interfere with transactions in other modules. |
| Dat-41 | Data Entry & Transaction Processing | Business Process | Ability for system architecture to support distributed data entry by authorized users. |
| Dat-42 | Data Entry & Transaction Processing | Business Process | Ability for system to provide data entry transaction templates (i.e. onboarding, performance evaluations, requisitions, etc.), with custom defined fields as a default. |
| Dat-44 | System Operations and Administration | Business Process | Ability for the external facing system to be available 24 hours a day with exceptions for maintenance and capabilities to lock system as needed. |
| Dat-45 | Data Entry & Transaction Processing | Business Process | Ability for the system to provide record locking functionality which only allow viewing, and query access to system records by users, while a user is making edits to the record. With ability to handle exception cases for locking. |
| Dat-46 | Data Entry & Transaction Processing | Business Process | Ability to configure data entry setting, to include: auto‑fill field‑level information (e.g., department), accommodate up to four decimal places, configure tabbing order on all data‑entry screens, control entry so users complete all required fields, automatically default fields to specific values (e.g., current date), and spell‑check. |
| Res-158 | Reserving | Business Process | Ability to allow authorized users to set, view, and edit reserves for all claim types; establish reserves based on statutory deductibles (including Guaranty Associations); set reserves for policy return‑premium claims; set specific deductible amounts for GA‑covered policyholder claims; associate GA claim reserves with policyholder claims; and carry over company reserves for policy loss claims. |
| Res-161 | Reserving | Business Process | Ability to track reserve changes for all claims throughout the process. |
| Out-181 | Outbound POC Processing/Noticing | Business Process | Ability to classify claims as “Loss claims” and automatically exclude them from Proof‑of‑Claim (POC) notice processing. |
| Cor-202 | Correspondence | Business Process | Ability to create, add, or edit outgoing correspondence - including form letters, letters not based on templates, and letters/forms from a library or user‑generated. |
| Cor-203 | Correspondence | Business Process | Ability to associate outgoing correspondence with multiple claimants. |
| Cor-204 | Correspondence | Business Process | Ability to classify correspondence (incoming types and post‑office return mail), filter by type, and identify & store incoming POC returns, objections, inquiries, emails, and outgoing correspondence types with received dates - including correspondence related to filed objections. |
| Cor-207 | Correspondence | Business Process | Ability to generate referral emails with links to related documentation. |
| Cor-211 | Correspondence | Business Process | Ability to notify authorized users when incoming correspondence is received. |
| Cor-212 | Correspondence | Business Process | Ability to prefill form letters and forms with system data, attach files, embed email information and include links to correspondance images. |
| Cor-216 | Correspondence | Business Process | Ability to send outgoing Proof of Claim (POC) notices, Notice of Determination (NOD), POC exception letters, and other letters/forms in bulk or individually; indicate bulk/individual status; capture sent dates; and maintain customizable templates (NOD and claimant correspondence) with merge fields and audit history. |
| Cor-218 | Correspondence | Business Process | Ability to track certified mail delivery date. |
| Cor-219 | Correspondence | Business Process | Ability to view all incoming and outgoing correspondence for a claim, including captured email bodies and their attachments. |
| For-228 | Forms Processing | Business Process | Ability to provide an integrated forms solution that allows trained users to develop and customize forms within the system without vendor assistance, integrate those forms with all modules, and ensure customized forms remain compatible with future vendor releases. |
| For-229 | Forms Processing | Business Process | Ability to provide an integrated Forms Solution that allows for custom development of various forms within the system that can be integrated with all modules. |
| Cla-255 | Claims Setup Validation | Business Process | Ability to perform standard validations that identify business‑rule violations before company data is moved to production, and allow authorized users to run reports and perform high‑level aggregate validation prior to promotion. |
| Cla-257 | Claims Setup Validation | Business Process | Ability for the system to provide the ability for authorized users to resolve duplicate policy, claim, or claimant information from multiple sources for a single company in receivership. |
| Cla-258 | Claims Setup Validation | Business Process | Ability for the system to allow authorized users to review and approve company data prior to promoting to production. |
| Cla-259 | Claims Evaluation | Business Process | Ability to evaluate claims manually or in bulk with tracking, distinguish between manual and bulk evaluations, perform evaluations without a Proof of Claim (POC), and use bulk templates for common updates. |
| Cla-261 | Claims Evaluation | Business Process | Ability to classify claims as secured when necessary. |
| Cla-262 | Claims Evaluation | Business Process | Ability to generate draft Interim Claims Reports (ICR) with templates for auditing, include claims in multiple ICRs, edit claim information in draft ICRs, perform quality checks before issuing ICRs. |
| Cla-265 | Claims Evaluation | Business Process | Ability to recommend claim amounts and class. |
| Cla-266 | Claims Evaluation | Business Process | Ability to run production Interim Claims Reports (ICR) and Final Claims Reports (FCR) as needed, flag records, and customize ICR reporting based on classes. |
| Obj-293 | Objections | Business Process | Ability to classify responses as objections and further categorize by type (class, amount). |
| UDS-305 | UDS | Business Process | Ability to generate, transmit, and export outbound Uniform Data Standards (UDS) files (A, B, E, F, G) from Receiver to Guaranty Association both automatically on schedule and through an ad hoc user interface for authorized users. This includes UDS-A (policy/claim/claimant data), UDS-B (policy/claim/claimant/return premium), UDS-E (claim/claimant/notes), UDS-F (claim/claimant/notes), and UDS-G (claim/claimant/pre-liquidation payments). |
| UDS-311 | UDS | Business Process | Ability to validate that UDS-C files only include UDS-A reported records. |
| Pay-323 | Payment/Distributions | Business Process | Ability to generate Final Claims Report (FCR) with class, GA, and non-GA sections. |
| Hel-417 | Help System | Business Process | Ability for the system to provide a comprehensive help system that includes: |
- Menu-driven navigation with utility functions
- Field-level and screen-level help throughout the application
- Customization capabilities for trained users.
| Int-418 | Integration and Interfacing | Business Process | The system must enforce user security permissions on all data imports, restricting what each user can import based on their access rights (e.g., allowing some users to import claims data but not financial records). |
| Aud-424 | Audit History | Business Process | Ability for the system to provide authorized users the ability to perform various internal audits (name and address changes, work quality, receiver reserves, and amount recommended claimant) in compliance with relevant procedures and policies (e.g., R6-13(4), R6-02, R8-05). |
| Aud-431 | Audit History | Business Process | Ability for the system to provide the ability for authorized users with appropriate authority levels to approve a change to a name or address within the system. |
| Aud-432 | Audit History | Business Process | Ability to allow searching within the activity history. |
| Aud-433 | Audit History | Business Process | Ability to establish management's read-only access. |
| Aud-434 | Audit History | Business Process | Ability to identify additional audit claims. |
| Aud-435 | Audit History | Business Process | Ability to post Interim Claims Report (ICR), Final Claims Report (FCR), Claims Distribution Report (DR), and Designated Liability (DL) to Estate Management. |
| Aud-436 | Audit History | Business Process | Ability to provide authorized users access to change history. |
| Rul-467 | Rules Engine | Business Process | Ability for the system to utilize a configurable business rules engine for processing all data updates (bulk and individual), ensuring consistent application of data integrity rules, validation, and workflow across all operations. |
| Wor-536 | Workflows | Business Process | Ability to create business process-defined workflows for various claim processing tasks. |
| Wor-537 | Workflows | Business Process | Ability to flag bulk claims for manual evaluation. |
| Wor-538 | Workflows | Business Process | Ability to flag claims with associated judgments, enabling staff to validate whether judgment amounts are correctly applied to claim values. |
| Wor-539 | Workflows | Business Process | Ability to manually or automatically assign inbound POC work tasks. (Ability to toggle on and off) |
| Wor-541 | Workflows | Business Process | Ability to route exceptions during initial reserve setup. |
&G &"-,Bold"&12&K000000ITN No. 2526-01
Business Requirements Matrix - Business Process
&A Page &P of &N
Documentation Management
| Reference Number | Function | Core Requirement | Requirement ID | Solution Capabilities | Comments |
| Bul-58 | Bulk Data Load/Update | Documentation Management | Ability for authorized users to create, edit, and update records in bulk via a user interface; execute pre‑defined process‑based or ad‑hoc bulk updates; schedule or run those jobs outside production for performance; define selection criteria; select and verify updates with required approvals; view summary results; and capture full audit details (user, method, authority level). | ||
| Doc-68 | Documentation | Documentation Management | Ability to provide "as‑built" documentation as part of implementation, provide on‑line tutorials, provide contextual searchable online documentation for all software modules sufficient to explain internal structure and operating procedures, and provide release notes for each version in a user‑friendly format that highlights changes affecting end‑users versus IT. | ||
| Est-72 | Estate/ Company Detail | Documentation Management | Ability to manage multiple account types per company; generate notices, invoices, and other documents; record transactions, disputes, judgments, and related information; and provide a user interface to view, add, or edit account records and full transaction history. | ||
| Dat-115 | Data Management | Documentation Management | Ability to store all data in a database that supports standard ODBC connections, so DRL can easily build custom reports, share data with other tools, and automate postings (e.g., dashboards, exports to accounting). | ||
| Dat-116 | Data Management | Documentation Management | Ability for system to interact with the relational database and offer robust querying and online analysis tools that do not require programming knowledge, allowing users to pick and choose fields, link tables, and establish criteria. | ||
| Dat-117 | Data Management | Documentation Management | Ability for database to support querying and reporting across multiple servers without requiring manual data merging by authorized users (e.g., allowing a single query or report to pull claims data from one server and payment data from another automatically). | ||
| Dat-118 | Data Management | Documentation Management | Ability for the system to have cut/copy/paste functionality. | ||
| Dat-119 | Data Management | Documentation Management | Ability to access tables from other systems using both SQL and non-SQL data sources. | ||
| Dat-120 | Data Management | Documentation Management | Ability to log all on-line input and provide the ability to recover the data files to the point of the last transaction in the event of a programming or system failure. This process should minimize user involvement. | ||
| Dat-121 | Data Management | Documentation Management | Ability to setup rules/filters for data entry (e.g. for Michigan, put in MI not mi). | ||
| Dat-122 | Data Management | Documentation Management | Ability to support referential integrity through the ability to create database integrity constraints that match the business rules enforced by the system through the modules code. | ||
| UDS-319 | UDS | Documentation Management | Ability to bidirectionally process UDS-I files (policy/claim/claimant/images) and UDS-M files (secondary payer information) between Receiver and Guaranty Association on scheduled or ad hoc bases. | ||
| UDS-320 | UDS | Documentation Management | Ability to process inbound UDS files (C, D) from Guaranty Association to Receiver through the CPS user interface on both scheduled and ad hoc bases. This includes importing UDS-C files (policy/claim/claimant/transactions), generating appropriate work items based on UDS-C submissions according to business rules, and processing UDS-D files containing financial reporting information. | ||
| Out-567 | Outbound POC Processing/Noticing | Documentation Management | Ability for the system to reconcile the total number of Proof of Claim notices against selection criteria, sample Proof of Claim forms (PDF) for all claimant types, and track approvals prior to sending bulk Proof of Claim notices. | ||
| Doc-595 | Documentation | Documentation Management | Ability for the system to automatically save generated reports in document management system (DMS). |
&G &"-,Bold"&12ITN No. 2526-01
Business Requirements Matrix - Documentation Management
&A Page &P of &N
Notification and Communication
| Reference Number | Function | Core Requirement | Requirement ID | Solution Capabilities | Comments |
| Out-182 | Outbound POC Processing/Noticing | Notification and Communication | Ability for users to select or deselect claims for bulk Proof of Claim (POC) processing, generate POC notices in bulk based on claim status and date criteria. | ||
| Out-185 | Outbound POC Processing/Noticing | Notification and Communication | Ability to record historical data for Proof of Claim (POC) notices (including claimant types), capture POC notice generation and sending dates, and send POC notices via physical or electronic media, including ad‑hoc notices. | ||
| Out-187 | Outbound POC Processing/Noticing | Notification and Communication | Ability to validate and update claimant names and addresses. | ||
| Mas-449 | Master Claim | Notification and Communication | Ability to notify if non-existing claimant submitted. | ||
| Sec-488 | Security and Auditing | Notification and Communication | Ability to support encryption of data communications between client and server, deliver security in a layered format (data, database, application, network, physical). | ||
| Wor-542 | Workflows | Notification and Communication | Ability to capture communication between adjusters and approving authorities. | ||
| Pay-549 | Payment/Distributions | Notification and Communication | Ability to support ACH / EFT payment processing, including prenote testing, OFAC screening, and cleared-payment confirmation; still support checks when required. | ||
| Wor-593 | Workflows | Notification and Communication | Ability for system to notify external users about status/deadlines/schedules. |
&G &"-,Bold"&12ITN No. 2526-01
Business Requirements Matrix - Notification and Communication
&A Page &P of &N
Online Portal
| Reference Number | Function | Core Requirement | Requirement ID | Solution Capabilities | Comments |
| Por-197 | Portal - Public Claimant | Online Portal | Ability for the public claimant site to manage the submission process with a consistent workflow for all electronic submissions, ensuring proper Receiver review and assignment, and seamless transition of approved submissions into the claims processing system. | ||
| Por-198 | Portal - Public Claimant | Online Portal | Ability for external users to submit Proof of Claim (POC) and change of name/address request data using forms prepopulated with claimant information in specified fields. | ||
| Por-199 | Portal - Public Claimant | Online Portal | Ability for the portal to provide an intuitive, simple-to-use interface that supports mobile submissions (including QR code functionality), desktop access, and attachment uploads for all claimant interactions. | ||
| Por-200 | Portal - Public Claimant | Online Portal | Ability for the portal to implement comprehensive security measures including user authentication with unique identifiers (e.g., RCN, temporary username and password,etc.), fraud prevention mechanisms, and industry-standard encryption for all data during collection and transmission. | ||
| Cla-271 | Claimant Self-Service | Online Portal | The system must allow claimants to log into the online portal and securely enter their payment details (e.g., bank account info for ACH or mailing address for checks) so payments can be processed. | ||
| Cla-272 | Claimant Self-Service | Online Portal | Ability to let claimants submit claim forms and supporting documentation via the portal, including tax documents (e.g., W‑9) and additional files uploaded after submission, with validation and staff notification. | ||
| Cla-275 | Claimant Self-Service | Online Portal | Ability for a claimant to perform "what-if" analysis based on the amount of the potential distribution. | ||
| Cla-276 | Claimant Self-Service | Online Portal | Ability for a claimant to receive necessary tax information through an online portal (e.g., 1099). | ||
| Cla-278 | Claimant Self-Service | Online Portal | Ability to let claimants view claim status and payment information through the portal. | ||
| Cla-279 | Claimant Self-Service | Online Portal | Ability for the system to provide ability to perform an online claimant registration, including interactive assistance to guide vendors through the process, with ability for vendors to request updates to their records. | ||
| Onl-336 | Online Vendor Customer Support Portal | Online Portal | Ability to provide a portal solution that allows users to query on specific items that they have submitted. | ||
| Onl-337 | Online Vendor Customer Support Portal | Online Portal | Ability to provide a portal solution that allows users to submit enhancement requests and system bugs on-line that allows for tracking of progress on individual items. | ||
| Onl-338 | Online Vendor Customer Support Portal | Online Portal | Ability to provide a portal solution to access various online information regarding the vendor's solution including: |
- Knowledge base of user documentation
- Release Notes
- Other Documentation.
| Ven-339 | Vendor Self-Service | Online Portal | Ability for a vendor to receive necessary tax information through a secured online portal (e.g., 1099). |
| Mis-447 | Misc Data | Online Portal | Ability for the system to capture claimant demographic information (e.g. name and address for agent, company employee, vendor, general creditor, company attorney, etc.). |
| Use-510 | User Interface | Online Portal | Ability for system to display all dollar amounts formatted with dollar signs and commas. |
| Use-511 | User Interface | Online Portal | Ability for system to ensure a consistent use of command keys and screen layouts across the application. |
| Use-512 | User Interface | Online Portal | Ability for system to ensure that all features and functions within the application will be available and operate identically regardless of the web-based interface used (e.g., Edge, Firefox, Google Chrome, etc). |
| Use-515 | User Interface | Online Portal | Ability to allow any screen to be modified to use the customized terminology. |
| Use-516 | User Interface | Online Portal | Ability to ensure that the software applications provide functionality for or are compatible with third party industry standard (Lunar, Supernova, Zoom Text, Magic) screen magnification products to enlarge the print on the computer screen and configure print size, contrast and color selection for blind users. Please note third party product compatibility in Comment field. |
| Use-517 | User Interface | Online Portal | Ability to have access to the system outside of our network (e.g., home computer). If the system is available as a SaaS, extend the ability to have access to the system via mobile/tablet devices. |
| Use-518 | User Interface | Online Portal | Ability for authorized users to modify pull down menus and pick lists without vendor support. |
| Cla-548 | Claimant Self-Service | Online Portal | Ability to provide role-based portals for Agents, GA and Policyholders to view claim / policy status, download loss-runs, and submit documents. |
&G &"-,Bold"&12ITN No. 2526-01
Business Requirements Matrix - Online Portal
&A Page &P of &N
Reporting
| Reference Number | Function | Core Requirement | Requirement ID | Solution Capabilities | Comments |
| IT-104 | IT | Reporting | Ability to provide data/referential‑integrity validation reporting for the staging environment - including identification of duplicate/orphan records, missing primary/foreign keys, and other record‑level business‑rule violations - at the time data is loaded. | ||
| Res-162 | Reserving | Reporting | Ability to run reports to identify claims exceeding threshold amounts. | ||
| Rep-168 | Reporting | Reporting | Ability to implement security and control measures for reports, including authorization levels for report generation, compliance with supplemental specifications, and automatic routing of reports to appropriate users via workflow. | ||
| Rep-169 | Reporting | Reporting | Ability to provide flexible report output options with appropriate formatting, including: selection of output types; export to PDF, Excel, and CSV formats; automatic adjustment to printer requirements; direct output without cumbersome print queues; proper data field formatting (commas, decimals, currency symbols, justification); electronic output capabilities for external organizations; sequential page numbering; date information (current and 'as of' dates); and data exchange with Excel and Access. | ||
| Rep-175 | Reporting | Reporting | Ability to generate specialized report types, including: reports with partial class information; reports based on objection statuses; financial statements with merged word documents and work paper notes; checks with signatures and MICR coding; bulk loss run reports; and reports containing all necessary demographic information. | ||
| Rep-176 | Reporting | Reporting | Ability to provide comprehensive ad-hoc reporting capabilities through integration with SSRS reporting tool, allowing users to create, edit, save, and query without SQL knowledge. The system should include consistent file organization structure across modules, integration with all application modules, flexible formatting, mailing list and label generation, and the ability to save custom report configurations for future use. | ||
| Rep-178 | Reporting | Reporting | Ability to provide flexible search and query capabilities across the system, including wildcard/keyword functionality, partial/similar match options (e.g., soundex), real-time data display for selected reports, searching by any data entry field, and specialized searches such as identifying inactive accounts with no transaction history within user-defined time periods. | ||
| Rep-179 | Reporting | Reporting | Ability to perform cross-entity analysis, including: setting parameters for claim and multi-class reporting; selecting specific departments/cost centers for inclusion/exclusion in reports; summarizing data across departments/companies for defined activities/projects; and supporting comprehensive cross-department/company and cross-fund account analysis. | ||
| Rep-354 | Reporting and Printing | Reporting | Ability for the system to communicate with the accounting system to generate comprehensive financial reports including: trial balances with fund rollups; non-normal balance reports; preliminary financial statements; historical general ledger reporting across fiscal/calendar years; and complete financial statements with supporting documentation. Reports should be available for any date range (including overlapping fiscal years) and across accounting periods, with appropriate access for departments/companies to view their financial activity and options to list all detailed accounts combined into each line for verification of accounting accuracy. | ||
| Rep-358 | Reporting and Printing | Reporting | Ability for the system to have an easily accessible and end user-friendly data dictionary. | ||
| Rep-371 | Reporting and Printing | Reporting | Ability to organize and sort report data flexibly, including obtaining and producing reports in different sort sequences (e.g., by cost center) and retrieving information from multiple tables/files to create comprehensive reports. | ||
| Rep-387 | Reporting and Printing | Reporting | Ability to configure and manage reports, including naming reports, scheduling automatic generation, running multiple reports simultaneously, specifying generation criteria, making and tracking alterations for audit purposes, and organizing reports in customizable menues for easy access and printing. | ||
| Rep-389 | Reporting and Printing | Reporting | Ability to perform calculations within reports and queries, including averages (e.g., average claim amount, processing time), percentages (e.g., claims by class, payments by claimant type), and user-specified subtotal breaks and totaling fields to support comprehensive analysis and compliance reporting. | ||
| Aud-437 | Audit History | Reporting | Ability for automated generation of random sample data reports. | ||
| Aud-439 | Audit History | Reporting | Ability to generate reports listing claims with changes. | ||
| Aud-441 | Audit History | Reporting | Ability to set confidence level for random sample report. | ||
| Aud-442 | Audit History | Reporting | Ability to sort random sample data reports by class and amount. | ||
| Aud-443 | Audit History | Reporting | Ability to generate a random sample listing of claims for audit purposes. |
&G &"-,Bold"&12ITN No. 2526-01
Business Requirements Matrix - Reporting
&A Page &P of &N
System Functionality
| Reference Number | Function | Core Requirement | Requirement ID | Solution Capabilities | Comments |
| Com-5 | Company Closure | System Functionality | Ability for the system to allow view-only access to claims processing data after a company is closed. | ||
| Com-6 | Company Closure | System Functionality | Ability for the system to provide authorized users the ability to reopen a closed company estate. | ||
| Com-7 | Company Closure | System Functionality | Ability for authorized users to indicate that a company estate is closed recording the date and time. | ||
| Pol-14 | Policy Data | System Functionality | Ability to enable manual entry of policy data, associate each policy with one or more claims, capture key policy details (dates, reasons, coverage limits), record policy‑related codes, agent information, multiple insured parties, and store the policyholder’s mailing address. | ||
| Pol-16 | Policy Data | System Functionality | Ability to manage, view, and index all images and documents related to a policy record. | ||
| Sys-20 | System Installation | System Functionality | Ability to provide a configuration management solution to allow for easy management of moving data and programs between the various environments. | ||
| Sys-21 | System Installation | System Functionality | Ability to provide capabilities for system to be deployed with an "agentless client" (i.e. no software on the desktop). | ||
| Sys-22 | System Installation | System Functionality | Ability to retain user preferences when installing new releases of the vendor's software. | ||
| Sys-23 | System Installation | System Functionality | Ability to support the following environments during system implementation including: DEV, TEST, TRAIN, PROD at no additional licensing cost. | ||
| Ima-25 | Imaging | System Functionality | Ability to auto‑index new images and outgoing correspondence and manually index documents/images received outside bulk‑load processes. | ||
| Ima-27 | Imaging | System Functionality | Ability to capture objection‑related images and documents, including court‑order images for final objection determination, filed objection images and supporting documents, and objection referral emails. | ||
| Ima-30 | Imaging | System Functionality | Ability to capture correspondence images and returns, including inbound physical and electronic correspondence images, outgoing notices or correspondence images, identification of incoming correspondence with returned NOD, and scanning and associating returned envelopes. | ||
| Ima-34 | Imaging | System Functionality | Ability to classify image by type. | ||
| Ima-35 | Imaging | System Functionality | Ability to image physical or electronic documents individually and import images from the company in bulk or individually. | ||
| Ima-39 | Imaging | System Functionality | Ability to send policy-related images to the Guaranty Association. | ||
| Err-54 | Error Processing | System Functionality | Ability to log error messages for future review and reporting, ensure messages are meaningful to users (not technical jargon), and allow administrators or designated end‑users to view the error log to support users. | ||
| Err-56 | Error Processing | System Functionality | Ability to perform error checking to verify the quality of the information being entered and that system balances are maintained. | ||
| Err-57 | Error Processing | System Functionality | Ability to support for Simple Network Management Protocol (SNMP) traps for error collection. | ||
| Est-73 | Estate/ Company Detail | System Functionality | Ability to allow users to record (log) details about correspondence they send outside the system (e.g., letters sent by mail, custom emails), and later view this information in the related claim or account history. | ||
| Est-75 | Estate/ Company Detail | System Functionality | Ability for the user to record multiple notes at the account level. Notes functionality is applicable to accounts of all recovery types. The Division is interested in exploring whether notes can be recorded in or linked to another level. | ||
| Est-76 | Estate/ Company Detail | System Functionality | Ability to record or manage the following in relation to each account: |
-Payor (name and demographics)
- Receivables
- Adjustments
- Settlements/Settlement Amount
- Write-offs
- Total Monthly Payment
- Payment Due Date
- Principle, interest, tax, and fee amounts due and amounts paid where applicable
- Specific amount billed date
- Specific amount paid date
- Nature of payment
- Running Balance
| Est-77 | Estate/ Company Detail | System Functionality | Ability to associate multiple contacts with each account. |
| Est-80 | Estate/ Company Detail | System Functionality | Ability to construct ad‑hoc record searches via the user interface, selecting fields and criteria and choosing which fields appear in the results. |
| Est-82 | Estate/ Company Detail | System Functionality | Ability to designate an address as a bad address even if not superseded by another address. |
| Est-83 | Estate/ Company Detail | System Functionality | Ability to designate one contact on each policy as the primary contact. |
| Est-85 | Estate/ Company Detail | System Functionality | Ability to generate and log account correspondence from Division customized templates with dynamic data merge, select accounts by criteria, and log/view system-generated correspondence with type and date. |
| Est-92 | Estate/ Company Detail | System Functionality | Ability to record settlement agreements, including the settlement amount and other supporting data. |
| Est-94 | Estate/ Company Detail | System Functionality | Ability to store demographic information for each contact, including but not limited to address and email. |
| Est-95 | Estate/ Company Detail | System Functionality | Ability to store historical address records for each contact, with the ability to indicate why an address record was superseded (e.g., bad address, etc.). |
| IT-105 | IT | System Functionality | Ability for the system to provide a flexible staging template data schema to accommodate the mapping of numerous company database schemas and file types. |
| IT-106 | IT | System Functionality | Ability for the system to provide a staging environment for company data. |
| IT-107 | IT | System Functionality | Ability to manage data promotion workflow: provide a standard process to load data from staging to test (manually initiated by IT), identify all records within each subset at row level, indicate when a subset is ready for promotion, load subsets incrementally as they become ready, and automate promotion from test to production (all at once or in phases) after proper approval/authorization. |
| IT-110 | IT | System Functionality | Ability for the system to provide the ability for application security to be applied to the test environment to prevent data manipulation if company data will be promoted directly from test to production. |
| IT-111 | IT | System Functionality | Ability for the system to provide the ability for authorized IT staff to map and manipulate company data, as needed. |
| Cla-123 | Claimant Data | System Functionality | Ability to capture claimant demographic information, capture additional loss payee demographic information, capture SSN or FEIN (displayed only to authorized users), and record applicable claimant representatives and their mailing addresses. |
| Cla-126 | Claimant Data | System Functionality | Ability to create custom claimant class priority schemes for each company in receivership. |
| Cla-127 | Claimant Data | System Functionality | Ability to enable authorized users to assign a claimant type. |
| Cla-128 | Claimant Data | System Functionality | Ability to indicate available funds for specific priority classes. |
| Cla-129 | Claimant Data | System Functionality | Ability to maintain a complete history of claimant mailing address updates and manage a single designated mailing address for each claimant, recording the claimant mailing address and designating it from captured data. |
| Cla-133 | Claimant Data | System Functionality | Ability to track secured claim claimants. |
| Nam-134 | Name / Address | System Functionality | Ability for the system to integrate with a third-party address verification and bulk mailing application. |
| Nam-135 | Name / Address | System Functionality | Ability to let authorized users search for a better address within an address‑research tool using demographic information (primarily for returned‑mail processing). |
| Nam-136 | Name / Address | System Functionality | Ability to update an invalid name and/or address with a better name and/or address and uniformly capture mailing‑address changes throughout all business processes. |
| Cla-138 | Claims Data | System Functionality | Ability to track claim status, capture the initial company status at receivership, allow status changes with defaults for new/policy claims, and maintain full status history. |
| Cla-139 | Claims Data | System Functionality | Ability for the system to capture data related to Policy related loss claims, Policy related return premium claims, and Non-policy related claims. |
| Cla-140 | Claims Data | System Functionality | Ability to allow linking a single policy claim to multiple claims. |
| Cla-141 | Claims Data | System Functionality | Ability to generate sequential automated claim numbers on submission (with email confirmation), assign unique receiver claim numbers, and edit or store multiple company claim numbers per claim. |
| Cla-142 | Claims Data | System Functionality | Ability to automatically associate checks with claims and allow claim reopening. |
| Cla-143 | Claims data | System Functionality | Ability to capture multiple objection filing deadlines for each claim. |
| Cla-144 | Claims data | System Functionality | Ability to capture payment and reserve information for claims. |
| Cla-146 | Claims Data | System Functionality | Ability to enable authorized users to manually enter and manage claims. |
| Cla-149 | Claims Data | System Functionality | Ability to import, view, and update claim notes from company systems, including deem‑filed updates with custom notes. |
| Cla-151 | Claims Data | System Functionality | Ability to manage mailing addresses, representatives, and named insureds for claims. |
| Cla-152 | Claims Data | System Functionality | Ability to manage subrogation codes and loss‑date fields, flag claims for subrogation based on data parameters, and flag claims tied to policies with large deductibles (including deductible amount). |
| Cla-153 | Claims Data | System Functionality | Ability to search and filter claims data and generate custom reports based on selected fields. |
| Cla-155 | Claims Data | System Functionality | Ability to record invoice numbers for non-policy claims. |
| Cla-156 | Claims Data | System Functionality | Ability to record UDS coverage codes and GA (General Agent) information for policy-related claims. |
| Rep-180 | Reporting | System Functionality | Ability to provide interactive dashboards and data visualization tools, including: user-configurable management dashboards showing key performance statistics; real-time reporting on claims processing (counts, types, statuses, estate breakdowns); management reports to track claim statuses; dashboard tiles for outstanding payments pending banking information; and intuitive drill-down/up/around navigation with minimal keystrokes to access detailed source transactions. |
| Out-189 | Outbound POC Processing/Noticing | System Functionality | Ability to customize Proof of Claim (POC) notice templates and merge fields. |
| Cor-221 | Correspondence | System Functionality | Ability to capture outgoing correspondence date, generating user, and images. |
| Cor-223 | Correspondence | System Functionality | Ability to collate multiple correspondence items into a single package for sending, printing, or saving. |
| Cor-225 | Correspondence | System Functionality | Ability to deliver outbound correspondence by mail or email. |
| Cor-226 | Correspondence | System Functionality | Ability to display correspondence chronologically by default and display incoming or outgoing correspondence separately or together, by type. |
| Inb-230 | Inbound POC Processing | System Functionality | Ability to auto‑index returned Proof of Claim (POC) forms with claims, capture USPS return dates for POCs (undeliverable and better address), and reissue POC notices when addresses are updated. |
| Inb-232 | Inbound POC Processing | System Functionality | Ability to handle W-9 form requirements and receipt. |
| Inb-233 | Inbound POC Processing | System Functionality | Ability to identify Proof of Claim (POC) exceptions (signature, form, or documentation issues) in bulk or individually, manage “Exception” status for incomplete POCs with notes and predefined exception types, and flag incomplete claims to generate automated reminder emails to claimants. |
| Inb-235 | Inbound POC Processing | System Functionality | The system must monitor and record the complete turnaround time for each Proof of Claim (POC) process (from creation to final status) to support performance metrics and reporting. It must also allow toggling between automatic (round robin) and manual assignment of POC work items to staff. |
| Inb-236 | Inbound POC Processing | System Functionality | Ability to provide a view of Proof of Claim (POC) disposition and history for each claim, record POC notice and response history, track POC received and filed dates, and set claim status as “Filed Claim” when the POC is complete and received. |
| Not-243 | Notes | System Functionality | Ability for the system to not allow users to edit or delete notes once they are entered and saved. |
| Not-244 | Notes | System Functionality | Ability to allow a selection and printing/export of single or multiple notes. |
| Not-252 | Notes | System Functionality | Ability to prevent editing or deletion of saved notes. |
| Not-254 | Notes | System Functionality | Ability for the system to provide a unified interface for accessing all notes (policy, claim, and claimant) with chronological display by default, robust filtering capabilities (by type, source, date, user, company), keyword search functionality, and a common area for correspondence and notes management. |
| NOD-281 | NOD Processing | System Functionality | Ability to manage Notice of Determination (NOD) objections, including capturing filing deadlines and processing period waivers with the ability to suppress NODs accordingly. |
| NOD-282 | NOD Processing | System Functionality | Ability to create and capture claims notes. |
| NOD-283 | NOD Processing | System Functionality | Ability to generate ad hoc Notice of Determinations (NOD) and view before printing. |
| NOD-285 | NOD Processing | System Functionality | Ability to include reason codes in Notice of Determination (NOD) templates based on class. |
| NOD-286 | NOD Processing | System Functionality | Ability to indicate undeliverable Notice of Determinations (NOD) to prevent check mailing. |
| NOD-288 | NOD Processing | System Functionality | Ability to issue multiple Notice of Determinations (NOD) to a single claimant. |
| NOD-289 | NOD Processing | System Functionality | Ability to initiate and track history of bulk Notice of Determination (NOD) mailings, including reissuing NODs for better addresses while maintaining deadlines. |
| NOD-290 | NOD Processing | System Functionality | Ability to view check distribution details. |
| Obj-295 | Objections | System Functionality | Ability to track objection statuses and history, with capability to automate status updated for claims in bulk. |
| Obj-298 | Objections | System Functionality | Ability to handle exceptions for late objections. |
| Obj-299 | Objections | System Functionality | Ability to handle withdrawn objections with or without changes. |
| Obj-300 | Objections | System Functionality | Ability to identify resolved objections and reasons. |
| Obj-301 | Objections | System Functionality | Ability to capture and manage objection-related dates, including response received dates and filed objection dates. |
| Obj-302 | Objections | System Functionality | Ability to record referral to legal section. |
| Obj-303 | Objections | System Functionality | Ability to track hearing dates and scheduled dates. |
| Pay-327 | Payment/Distributions | System Functionality | Ability to capture comprehensive payment information including check details (number, amount, date, payee) and accounting data to support financial inquiries. |
| Pay-330 | Payment/Distributions | System Functionality | Ability to create, identify, and record all distribution records (DR) and distribution lists (DL), including interest distributions, with support for class-specific interest payments (Classes 1-9 paid interest as part of Class 10 as funds are available). |
| Pay-332 | Payment/Distributions | System Functionality | Ability to secure info post-evaluation, with unlock option. |
| Pay-333 | Payment/Distributions | System Functionality | Ability to track unclaimed property referrals. |
| Pay-334 | Payment/Distributions | System Functionality | Ability for the system to integrate and communicate with the Accounting system for the following: |
- Flag undeliverable and returned checks
- Request check reissue
- Record changes to returned check information
- Void outstanding checks.
| Arc-394 | Archive | System Functionality | Ability for the system to allow authorized users to archive and restore all data related to companies in receivership in accordance with Florida Statutes records retention laws. |
| Arc-396 | Archive | System Functionality | Ability for the system to allow authorized users to define and execute rules for archiving and purging system records and images. |
| Arc-398 | Archive | System Functionality | Ability for the system to provide an archive environment for historical data with configurable archiving schedules for all data elements. |
| Adm-400 | Admin | System Functionality | Ability for the system to allow authorized users to add and edit catastrophe codes and claim types. |
| Int-421 | Integration and Interfacing | System Functionality | Ability for the system to manage document integration including: |
- Attaching multiple documents/images (links stored in FileNet) to transactions that flow throughout the transaction lifecycle.
- Linking to EDMS (Navigator Imaging System) for stored correspondence and related documents in FileNet.
Int-423 Integration and Interfacing System Functionality Ability for the system to support comprehensive data exchange capabilities including:
- Import/export of data to/from common interchange formats (ASCII, XML, etc.)
- Manual bulk imports/exports in Microsoft Excel and/or CSV formats with data validation rules enforcement
- Real-time data exchange with other applications via API, EDI, or similar technologies
- Utilities to assist in data conversion.
| Aud-444 | Audit History | System Functionality | Ability to automatically generate notes for changes in reserve amounts, name/address, class/priority, Amount Recommended Claimant, claim status, and dates, with user and date information. |
| Aud-445 | Audit History | System Functionality | Ability to capture and log changes to name and/or address, initiated manually, by third-party components, or in bulk, including details, date, and responsible user/system. |
| Aud-446 | Audit History | System Functionality | Ability to capture and store estate-level events, like court dates or company status changes. |
| Mas-454 | Master Claim | System Functionality | Ability to process master claims using standard procedures, capture recommended amounts with reason codes for both individual and master claimants, and aggregate recommended amounts for master claim entities. |
| Mas-455 | Master Claim | System Functionality | Ability for the system to manage master claim entities, including importing entity data and establishing associations with individual claimants. |
| Mas-456 | Master Claim | System Functionality | Ability to send consolidated Notice of Determination (NOD) to master claim entity. |
| Mas-457 | Master Claim | System Functionality | Ability to manage Guaranty Association (GA) Transaction Categories, including validation, mapping, associating with individual claimants, and calculating total incurred amounts. |
| Use-458 | User Role Config | System Functionality | Ability to manage users and roles, including activating/deactivating users, assigning multiple roles to a user, assigning roles and authority to users, and defining user roles with limited access. |
| Use-460 | User Role Config | System Functionality | Ability to assign "read only" role to non-Claims users. |
| Use-463 | User Role Config | System Functionality | Ability to assign roles by company or field level access. |
| Use-466 | User Role Config | System Functionality | Ability to set dollar limits for authority levels for approvals. |
| Sys-470 | System Operations and Administration | System Functionality | Ability for the system to include appropriate administrative and programming toolsets to configure, modify, and customize the software applications, as well as supply various utilities to facilitate file maintenance, data manipulation, and backup/recovery (e.g., sorts, file generators, and file-to-file copying utilities)." |
| Sys-471 | System Operations and Administration | System Functionality | Ability for the software vendor(s) to provide remote diagnosis and maintenance of the application software, ongoing software maintenance, and new software releases periodically to meet all State and Federal requirements at no additional charge. |
| Sys-474 | System Operations and Administration | System Functionality | Ability to remain logged into multiple instances of the application (e.g., Dev and Production) for extended periods of time. |
| Sys-477 | System Search | System Functionality | The system must let users open and view the full details of individual records directly from a list of search results. |
| Sys-479 | System Search | System Functionality | Ability to maintain populated search criteria upon return. |
| Sys-482 | System Search | System Functionality | Ability to search using multiple criteria simultaneously (e.g., RCN, company policy number, name, date). |
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File details come from the government source that posted it. Updated .