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SCHEDULE A – ATTACHMENT 1 – BUSINESS SPECIFICATION WORKSHEET
Instructions for Completing the Business Specifications Worksheet Contractors must respond to each business Specification on how they will meet the requirements in the document provided. Contractor must not alter the document.
The Business Specifications Worksheet contains columns and is defined as follows:
Column A: Business Specification number.
Column B: Business Specification Column C: Contractor must indicate how they will deliver the business Specification and should not just indicate they can do it, or they can meet the requirement. Such responses may be considered deficient.
NOTE:
All configuration changes made during the term of the awarded contract must be forward-compatible with future releases and be fully supported by the awarded Contractor without additional costs.
| Business Specification Number |
| Business Specification |
| Contractor must explain how they will deliver the Business Specification |
Advice Matters: A primary business function used by the OGC and OALRMR. It is a process of Inter-office consultation on matters. The offices consulted are OB, OCU, OIRF, OIE, OILIA, OCF and OCS.
Advice Matter Process flow is initiated either from DIFS office or as a standalone request from OGC/OALRMR.
| 1 |
| The system must provide the ability to submit an Advice matter (Opinion) request from Charter, Applications, Examination, and Investigation. |
| 2 |
| The system must provide the ability to view the outcome of the Advice matter (Opinion) request. |
| 3 |
| The system must provide the ability to request General Advice Matter requests. |
| 4 |
| The system must provide the ability to view the outcome of a General Advice matter (Opinion) request. |
| 5 |
| The system must provide the ability for staff members to create a Matter, with varying levels of Matter data fields. |
| 6 |
| The system must be able to autogenerate Matter numbers sequentially. |
| 7 |
| The system must be able to select a Matter Type (Research, Final Decision, Review and Determination, Class Action, etc.) |
| 8 |
| The system must provide a Matter Tracker with varying levels of detail showing Matters in various statuses. |
| 9 |
| The system must provide the ability to manually specify a Due Date, overriding any automatically calculated Due Date. |
| 10 |
| The system must provide the ability for staff members to see a Matter summary. |
| 11 |
| The system must provide the ability to search by author or Attorney. |
| 12 |
| The system must provide the ability for staff members to assign a Matter Status (Open, Ready for Review, Closed etc.) |
| 13 |
| The system must automatically take actions based on set Matter Statuses. |
| 14 |
| The system must provide the ability for staff members to designate specific users as having Conflict for a given Matter, making the Matter inaccessible by that user. |
| 15 |
| The system must provide the ability to assign a master user for the purpose of assigning a Matter to a specific user or users. |
| 16 |
| The system must provide the ability to define groups for access purposes. |
| 17 |
| The system must allow the staff member to enter comments related to a Matter at any time. |
| 18 |
| The system must provide the ability to automatically and/or manually record Matter actions in an audit log. |
| 19 |
| The system must provide the ability to run a statistics based report on Matter Status, Matter Types, Matter Name, Matter Number and within a user defined date range. |
| 20 |
| The system must provide a running Comment dialogue for Matter collaborators to add a running conversation associated to the Matter. |
| 21 |
| The system must provide the ability for staff members to assign a Rule Set Status (Open, Pending External Ste, Closed, Voided etc.) |
| 22 |
| The system must automatically take actions based on set Rule Set Statuses. |
| 23 |
| The system must allow the staff member to enter comments related to a Rule Set at any time. |
| 24 |
| The system must provide the ability to automatically and/or manually record Rule Set actions in an audit log. |
| 25 |
| The system must provide a running Comment dialogue for Rule Set collaborators to add a running conversation associated to the Rule Set. |
| 26 |
| The system must allow assigning a name for an Advice Matter |
| 27 |
| The system must allow capturing the statutes involved |
| 28 |
| The system must provide a process to search by Statutes in OGC matters/cases |
| 29 |
| The system must provide a process to search by Name of the Advice Matter |
| 30 |
| The system must allow comments / notes to be entered for Advice Matters |
| 31 |
| The system must provide a process to draft an opinion, synopsis etc. based on the comments / notes for an Advice Matter |
| 32 |
| The system must provide a process to draft an opinion, synopsis etc. based on comments/notes from similar Advice Matters in the past |
| 33 |
| The system must allow Other as an outcome for an Advice Matter in addition to Agree/Disagree |
| 34 |
| The system must allow entering an outcome description when the outcome is 'Other' |
| 35 |
| The system must provide a process to create an Advice Matter that is standalone where it was not a referral from another DIFS office |
| 36 |
| The system must format the assigned name for an OGC Matter as Year: Matter Case ID: Referring Office - MTR |
| 37 |
| The system must track the referring office for an OGC Matter / Indicate Other for standalone matters |
| 38 |
| The system must require a brief description for the OGC Matter |
| 39 |
| The system must provide a process for Deputy General Counsel to review New OGC Matters and assign it to OGC staff |
| 40 |
| The system must allow for maintaining OGC staff attorneys and a staff member under each staff attorney |
| 41 |
| The system must allow a staff attorney to be assigned for an OGC Matter |
| 42 |
| The system must automatically assign the default staff members to an OGC Matter when the staff attorney is assigned |
| 43 |
| The system must allow to override the assigned staff members or add additional staff members to the OGC Matter. |
| 44 |
| The system must record staff assigned and staff assignments beginning dates |
| 45 |
| The system must allow to indicate a Primary Staff Member for an OGC Matter |
| 46 |
| The system must allow Attachments, Comments and Actions for an OGC Matter |
| 47 |
| The system must provide a process to add and track statutes for an OGC Matter with certain details and attachments |
| 48 |
| The system must allow to add Respondents to an OGC Matter and maintain specific details for each respondent |
| 49 |
| The system must allow to record Violations/Statutes for each Respondent |
| 50 |
| The system must provide a process for the OGC staff to request additional information from the referring office for an OGC Matter |
| 51 |
| The system must provide a process to create an Enforcement case from an OGC Matter |
| 52 |
| The system must link the Enforcement case to the OGC Matter when an Enforcement case is created for an OGC Matter |
| 53 |
| The system must provide a process to reopen an OGC Matter |
| 54 |
| The system must provide a process to convert/import the OGC Matters from the spreadsheet provided |
| 55 |
| The system must allow OIRF to refer issues (Matter) for legal research (from SERFF Filing findings, sometimes from company associates) for legal research attorney. |
| 56 |
| The system must provide the ability to request for Matter (opinion) to the OGC Office for a License/Charter or Business processes, including but not limited to Licensing, Financial analysis, Examination, Report of actions, Audits, Credit Rostering, Other applicable laws, General Mortgage, Statute, Contracts, Additional power request, Complaint, CMR Events, and Orders |
| 57 |
| The system must provide the ability to add a memo to a Matter (opinion) request. |
| 58 |
| The system must provide the ability to view Matter (opinion) outcome, Statute list, and final decision. |
| 59 |
| The system must provide a process for offices to request General Matter (opinion) requests to the OGC office. |
| 60 |
| The system must provide the ability to include memo, and attachments to a General Matter (opinion) request. |
| 61 |
| The system must provide a process for an Office to include other offices in the General Matter (opinion) request. |
| 62 |
| The system must provide the ability to view General Matter (opinion) outcome, Statute list, and final decision to the offices included in the request. |
Agency Audit: Performed solely by the OILIA department, Agency Audits are audits of entities for compliance with laws/regulations. The OILIA audit team performs compliance audits on licensed insurance agencies and Premium Finance Companies (PFCs). Due to the large number of agency licenses, audits are conducted on agencies selected based on the internal criteria. All licensed PFCs are subject to routine audits every three to five years. An Agency Audit is very much like Examinations performed by other DIFS offices.
| 1 |
| The system must have a method to send emails |
| 2 |
| The system must have templates used for emails and documents, including NOCS (Notice to Show Compliance) and SA (Settlement Agreement) |
| 3 |
| The system must keep a list for Michigan risk polices for surplus lines |
| 4 |
| The system must audit trail of all actions |
| 5 |
| The system must have a process to reconcile some data automatically |
| 6 |
| The system must allow the user to add comments |
| 7 |
| The system must add comments systematically depending on certain actions |
| 8 |
| The system must require this review be completed prior to starting the Late Filing Process |
| 9 |
| The system must allow for multiple statuses to be used from a pre-determined list |
| 10 |
| The system must allow for completed cases to be reopened |
| 11 |
| The system must assign statuses automatically based on actions performed |
| 12 |
| The system must provide a check list of items be completed prior to completing specific actions |
Company Mergers: Process to combine multiple entities into a single entity.
| 1 |
| The system must allow for a method to merge insurance company appointments from non-surviving entity to surviving entity |
| 2 |
| The system must have the ability to move appointments to the surviving insurer |
| 3 |
| The systems must have the ability to do a mass termination of all remaining active appointments from the non-surviving entity without moving any to the surviving insurer |
| 4 |
| The system must add active appointments from the non-surviving entity to the surviving entity, where all applicable rules are met |
| 5 |
| The system must send notices to both the surviving entity and non-surviving entity summarizing appointment processing |
| 6 |
| The system must have a systematic merger process for appointments that is initiated once OIE merger process is completed. |
| 7 |
| The system must provide a process to systematically copy all appointments, or not copy all appointments, from non-surviving entity to surviving entity once the merger is approved (based on effective date) |
| 8 |
| The system must keep a history of insurance companies merger transactions, both surviving and non-surviving entities |
Complaints: A primary business function used by the OCS. It is the process of Intake and processing of filing a grievance or criticism against a regulated individual or entity or filing an appeal of a health care claims denial.
There are two separate flows depending on how the issues are reported
1. Complaint Process Flow
2. Referral Process Flow
Complaints are referred to OB, OCU, OIRF, OIE, OILIA, OCF, OGC and OALRMR
| 1 |
| The system must provide the ability to receive and process Complaint referrals from other offices. |
| 2 |
| The system must provide a process to view Complaint outcomes for Entities within the office. |
| 3 |
| The system must be able to receive and record Cases from patients via manual entry (paper mail, email, fax). |
| 4 |
| The system must provide the ability for a staff member to create a Case of varying types, such as Medical, Contractual and Expedited. |
| 5 |
| The system must automatically, when creating a Case, take into account the Case type, such as Medical and Contractual, and expand or limit functionalities pre-defined for those Case types. |
| 6 |
| The system must automatically generate a Case number. |
| 7 |
| The system must provide the ability for a staff member to select a Product Type when creating a Case. |
| 8 |
| The system must automatically, when creating a Case, take into account the Product Type, and expand or limit functionalities pre-defined for those Product types. |
| 9 |
| The system must allow any Case creation value to change and update the Case configuration automatically. |
| 10 |
| The system must provide the ability for a staff member to select a Case Reason. |
| 11 |
| The system must provide the ability for a staff member to select various Case statuses. |
| 12 |
| The system must provide the ability for the Case status to be automatically updated based on user actions. |
| 13 |
| The system must automatically trigger updates and actions on a case based on changes in Case status. |
| 14 |
| The system must provide the ability to configure a Plan / Plan Type cross reference. |
| 15 |
| The system must visually provide a Plan / Plan Type cross reference for staff members. |
| 16 |
| The system must automatically check for duplicate Case when creating a Case, and flag that Case for staff review. |
| 17 |
| The system must allow for the manual linking of duplicate Cases to an existing Case by staff. |
| 18 |
| The system must automatically use a round robin process to assign cases to staff members. |
| 19 |
| The system must notify the staff member of a new case assignment by e-mail and entry into a Case Tracker log. |
| 20 |
| The system must maintain a Case Tracker log detailing such items as case assignments and their due dates. |
| 21 |
| The Case Tracker log must provide the ability for a user to change staff member case assignment. |
| 22 |
| The Case Tracker log must allow for sorting and filtering, such as on Case Status, Staff Member, Due Date, Issue and Service. |
| 23 |
| The Case Tracker log must flag Cases on certain conditions such as past the Due Date and upcoming Due Date. |
| 24 |
| The system must provide the ability to configure due dates for steps in the appeals process. Due dates are based on business rules. |
| 25 |
| The system must be able to automatically calculate due dates for any given step in the appeals process, taking into account, state holidays, calendar days and business days. |
| 26 |
| The system must provide the ability to automatically and manually record case actions in an audit log, such as initial case entry, case staff assignment, letter sending, etc. |
| 27 |
| The system must provide visual reference of where a Case is in the appeals process. |
| 28 |
| The system must provide the ability to search for a Case(s) |
| 29 |
| The system must enable the business user the ability to view a Case, and all documents associated with the Case for the purposes of accepting or rejecting the appeal. |
| 30 |
| The system must allow the user to enter comments related to the Case at any time. |
| 31 |
| The system must allow users to manually exclude a case from being included in statistics. |
| 32 |
| The system must provide the ability for staff members to assign a letter via template to a Case. |
| 33 |
| The system must allow staff members to assign reviewers or mark for review a case and initiate a review process (ex. Peer review, Manager review, Director review, Attorney review.) |
| 34 |
| The system must automatically notify a staff member of a pending review for the Case assign to them. |
| 35 |
| The system must automatically assign a staff member via a round robin process when the Peer review status is selected. |
| 36 |
| The system must allow staff members to maintain a configurable list of Independent Review Organizations (IRO) for the purpose of selecting an IRO for independent reviews. |
| 37 |
| The system must automatically assign an IRO via a round robin process when a Case is accepted into Medical Review. |
| 38 |
| The system must provide a worklist from which staff members will see outstanding actions to be done on a Case. |
| 39 |
| The system must populate a worklist with outstanding actions to be done by a staff member based on Case value selections. (ex. Letters with due dates to be sent) |
| 40 |
| The system must provide the ability to select pre-configured text to add to a letter. |
| 41 |
| The system must provide the ability to open multiple letters for reference when crafting a letter to be sent. |
| 42 |
| The system must provide a function to generate and e-mail a Proof of Service document, including the IRO and the Order. |
| 43 |
| The system must provide the staff member the ability to record that a Circuit Court appeals case has been opened on a Case. |
| 44 |
| The system must auto populate letters based on letter templates with appropriately tagged data. |
| 45 |
| The system must auto populate the Insurance company name associated to an entered NAIC #, when creating a Case |
| 46 |
| The system must provide the ability to re-open a previously closed Case |
| 47 |
| The system must provide the ability to flag Cases that may be duplicate Cases, for possible further staff member review, based on pre-defined requirements. (ex. A cross reference between NAIC, Provider, Procedure Code). |
| 48 |
| The system must provide the ability to configure an interest rate type and interest rate for that type. |
| 49 |
| The system must be able to calculate interest for a given value and associate that interest to the Case. (ie, for Proof of Payment) |
| 50 |
| The system must optionally auto populate the Insurance company name associated to an entered partial name, full name of the insurance company, NAIC #, when interacting with a Case |
| 51 |
| The system must provide the ability for a staff member to specify numerous details when creating a Case (ie, Case Type, Product Type, NAIC #, demographic information etc.) |
| 52 |
| The system must automatically, when creating a Case, take into account the Product Type, and expand or limit functionalities pre-defined for those Product types. (ex. HMO, Commercial, Medicaid etc.) |
| 53 |
| The system must provide the ability to flag Cases that may be duplicate Cases, for possible further staff member review, based on pre-defined requirements. (ex. A cross reference between NAIC, Provider, Procedure Code, Plan, or Complainant names, etc.) |
| 54 |
| The system must provide the ability to re-open a previously closed Case |
| 55 |
| The system must provide the staff member the ability to record that a Circuit Court appeal case has been opened on a Case. |
| 56 |
| The system must provide the ability to perform powerful searches for Case(s) using previously entered Case Data. |
| 57 |
| The system must allow any Case creation value to change and update the Case configuration automatically. |
| 58 |
| The system must include a "Summary" page that pulls specific fields (with most current information) for a quick overview of the case. |
| 59 |
| The system must have the ability to close a case due to Provider Withdraw, Insurer Settlement, Consolidation, and Non-Acceptance (also Order issued- Upheld or Reversed). |
| 60 |
| The system must provide a worklist from which staff members must see outstanding actions to be done on a Case. |
| 61 |
| The system must populate a worklist with outstanding actions to be done by a staff member based on Case value selections. (ex. Letters with due dates to be sent) |
| 62 |
| The system must automatically use a round robin process to assign cases to staff members. |
| 63 |
| The system must allow for section-specific access should be able to review or work a case regardless of assignment |
| 64 |
| The system must maintain a Case Tracker log detailing such items as case assignments and their due dates, and associated actions taken on the case. |
| 65 |
| The Case Tracker log must provide the ability for a user to change staff member case assignment. |
| 66 |
| The Case Tracker log must allow for sorting and filtering, such as on Case Status, Staff Member, Due Date, Issue and Service. |
| 67 |
| The Case Tracker log must flag Cases on certain conditions such as past the Due Date and upcoming Due Date. |
| 68 |
| The system must be able to automatically calculate due dates for any given step in the appeals process, taking into account, state holidays, calendar days and business days. |
| 69 |
| The system must provide the ability for a staff member to modify a MS Word letter on a Case, such as markup a letter with comments. |
| 70 |
| The system must allow staff members to assign reviewers or mark for review a case and initiate a review process (ex. Peer review, Manager review, Director review, Attorney review.) |
| 71 |
| The system must allow staff members to initiate a review process by selecting a review status (ex. Peer review, Manager review, Director review, Attorney review.) |
| 72 |
| The system must automatically assign a staff member via a round robin process when the Peer review status is selected. |
| 73 |
| The system must automatically assign an IRO via a round robin process when a Case is assigned by staff for an independent review. |
| 74 |
| The system must provide the ability to configure an interest rate type and interest rate for that type. |
| 75 |
| The system must be able to calculate interest for a given value and associate that interest to the Case. (ie, for Proof of Payment of interest) |
| 76 |
| The system must have the ability to specify an Out of Network Complaint within an existing Case, with its varying details, in order to report on at a later date. |
| 77 |
| The system must allow OCF staff to view all information within complaint that relates to non-depository consumer finance entities and individuals. |
| 78 |
| The system must provide for a Review functionality of Complaint Investigations, involving multiple OCF staff members and enforce the review process, not allowing the Investigation to be completed without Review. |
| 79 |
| The system must allow for a distinct classification of complaints and complaint investigations as these are separate events that must be tracked accordingly. |
| 80 |
| The system must provide a Reasons field for a Complaint that can be used to document multiple Reason, including modification of existing Reasons. |
| 81 |
| The system must automatically populate the "complaint received date" when a complaint folder is associated with an investigation. |
| 82 |
| The system must require that a Supervisor be assigned for additional review for Complaint Referral Investigations. |
| 83 |
| The system must allow OCS staff members to systematically assign a Complaint to a different DIFS office, with a comment, giving them access to the Complaint and all attached documents, and automatically notify the assigned to DIFS office of the assignment. |
| 84 |
| The system must provide the ability for a staff member to change Complaint Types. |
| 85 |
| The system must automatically route Complaints based on Complaint Type and automatically notify the assigned to DIFS office of the assignment. (ex. This facilitates the ability for staff members to re-assign an incorrectly assigned Web Complaint.) |
| 86 |
| The system must visually note that there are Comments on a Complaint. (ie showing the number of Comments on the Comment button at the Folder level.) |
| 87 |
| The system must provide the ability to auto populate certain specified fields when other certain related specified fields are manually entered. (ie Auto populate License Number when the Licensee is selected.) |
| 88 |
| The system must provide the ability to auto populate, and limit selections based on other previous selections (ie Limit letter templates based on Product Type.) |
| 89 |
| The system must more thoroughly automatically record actions to the Action log. (ie, currently not all Actions are being automatically recorded, such as when documents are generated causing staff members to make manual entries.) |
| 90 |
| The system must provide the ability for staff members to identify what Companies have no e-mail address in order to print letters. |
| 91 |
| The system must provide the ability for staff members to generate a letter to Companies notifying them of the need to establish an e-mail address in the system. |
| 92 |
| The system must provide the ability for staff members to generate a Complaint Reconciliation letter for all companies that have received Complaints in a given date range and mail or e-mail that letter. |
| 93 |
| The system must provide a link in the Complaint Reconciliation e-mailed letter for Companies to select and be taken to a Complaint Reconciliation Response system. |
| 94 |
| The system must provide for the ability for Licensees to respond to each line item on the Complaint Reconciliation report (ie. "Not my complaint", "Wrong Coverage Type" etc.) |
| 95 |
| The system must automatically notify staff members via e-mail a list of Complaint Reconciliation responses. |
| 96 |
| The system must automatically create tasks for staff members to follow-up on Complaint Reconciliation response for a Licensee. |
| 97 |
| The system must provide staff members the ability to confirm that the Complaint Reconciliation process is complete in an overall manner, versus in a company specific manner. |
| 98 |
| The system must provide the ability for staff members to define criteria for which a mass e-mailing can be executed upon. (ie. Update Complaint Contact, Complaint Reconciliation, etc.) |
| 99 |
| The system must provide the ability to mass e-mail without preventing users from using their PC during the mass e-mailing process. |
| 100 |
| The system must provide a method for staff members to define, save and maintain Survey Questionnaires. |
| 101 |
| The system must provide a method for staff members to singularly and mass e-mail survey questionnaires. |
| 102 |
| The system must provide a method for staff members to print for mailing of survey questionnaires. |
| 103 |
| The system must provide a method for staff members to manually enter survey results received by letter into the system. |
| 104 |
| The system must provide a method for staff members to scan and save letter surveys into the system. |
| 105 |
| The system must provide the ability for authorized staff members to perform searches for invalid data/selections for Complaint and Referral records. (ie. Complaints with an invalid Reason Code, invalid industry, invalid Respondent Type Code.) |
| 106 |
| The system must provide the ability for authorized staff members to execute Complaint and Referral changes based on returned invalid date/selection searches on 1 or many records at a time. |
| 107 |
| The system must provide the ability to automatically and manually record Complaint actions in an audit log, such as initial Complaint entry, Complaint changes, Complaint staff member assignments, letter sending, survey sending etc. |
| 108 |
| The system must visually display the Complaint Summary page into a better user experience (ie, separate out functionality onto 3 tabs). |
| 109 |
| The system must update the Process Status properly when a related action is taken. (ie, Wrong Respondent instead of Closed.) |
| 110 |
| The system must maintain a list of Legislative members for selection throughout the system to ensure we are adding the correct Legislator. |
| 111 |
| The system must provide for the ability to enter an anonymous record. |
| 112 |
| The system must allow assigned staff members to return a Complaint assignment, which automatically notifies the assigning manager of the returned Complaint. |
| 113 |
| The system must allow for the specification of Municipality when filing a Complaint (ie Fire Insurance Withholding) |
| 114 |
| The system must provide OIRF access to OCS folders to review the Insurance complaints status. |
| 115 |
| The system must provide the ability to enter Rapid Response flow for complaints. |
| 116 |
| The system must provide the ability to enter the Essential Insurance Act (EIA) compliant process. |
| 117 |
| The system must provide the ability to enter Paper complaints process (Receive/intake complaints - scan to system, Management reviews/assigns web complaint to staff, Staff receive complaint(s) assigned by manager, Staff process complaint (open file), Staff document actions on complaint, Staff produce and send letters and/or emails to complainant or licensee, and Staff closes complaint file.) |
| 118 |
| The system must provide the ability to process the following Complaint Actions, (Failure to Respond, Recording comments/ phone calls, etc., Adding/Deleting actions, Populating due dates (business days) - ability to auto populate, Populating received dates, Attaching correspondence to a complaint file) |
| 119 |
| The system must provide the ability to Enter Complaint Data (paper/web) (Industry, Employment type, reasons, dispositions, violations, role, outcome, general classifications, etc. Assigned date/Received date/Opened date, Adding a respondent, Adding the complainant, Adding an involved party, Valid Complaint/Send to NAIC data, Exclude from Statistics, Alerts for improper data entry and/or updating data when entry changed) |
Compliance: Intake and processing of consumer and industry concerns against regulated entities.
| 1 |
| The system must require a process for the user to select which agencies will require surplus lines compliance review |
| 2 |
| The system allows for an email process to the agency requesting samples of documentation, using a templated email |
| 3 |
| The system must have a process to send a warning letter via an email, using a templated email |
| 4 |
| The system must require a process for the filer to file amendments |
| 5 |
| The system must allow for policy details to be imported from a spreadsheet (xlsx or csv) |
| 6 |
| The system must have data points, payments, and premiums reported by line of business during the review process |
Education Maintenance: A primary business function used by OILIA. It is the ongoing review, evaluation, and updating of educational curricula and teaching materials for licensees and insurance education providers. There are two separate process flows within this business function:
1. Pre-Licensing Education (pre-requisite for licensure): This process is initiated by the Provider when they upload courses via the Education Rostering process.
2. Continuing Education (requirements to keep license active and in good standing): This process can be initiated by the Provider for corrections to courses, by OILIA importing the courses, or by the system notifying users of an open review period.
| 1 |
| The system must provide a list of pre-licensing error messages |
| 2 |
| The system must pre-populate the birthdate field when a no match of SSN record is added |
| 3 |
| The system must allow status to be changed |
| 4 |
| The system must only display errors that are pending |
| 5 |
| The system must allow user to reprocess the error job |
| 6 |
| The system must provide a link to the application details |
| 7 |
| The system must provide ability to send letters to licensee for notifications |
| 8 |
| The system must provide a status of letters sent |
| 9 |
| The system must a provide success notifications of letter sent |
| 10 |
| The system must provide exam error messages |
| 11 |
| The system must only allow changing of certain fields within the error report |
| 12 |
| The system must display fields specific related to exams |
| 13 |
| The system must allow for searching of pending applications for chosen record |
| 14 |
| The system must provide a link to the application details |
| 15 |
| The system must allow user to reprocess the error job again |
| 16 |
| The system must automatically change the CE review period for the licensee when a DOB year is changed from an even year to an odd year |
| 17 |
| The system must automatically change the CE review period for the licensee when a DOB year is changed from an odd year to an even year |
| 18 |
| The system must automatically update the CE courses to the correct review period when DOB year changes from odd year to even year |
| 19 |
| The system must automatically update the CE courses to the correct review period when DOB year changes from even year to odd year |
| 20 |
| The system must have a process to adjust CE requirements that were provided in the wrong period |
| 21 |
| The system must have a process to reinstate credits from an inactive review period |
| 22 |
| The system must allow to change the review period date |
| 23 |
| The system must provide for reasons to change the review period |
| 24 |
| The system must allow for comments to be added when statuses are changed |
| 25 |
| The system must have a process to re-evaluate once a review period has been adjusted |
| 26 |
| The system must have a process to not allow individuals to apply to wrong review period, especially if suspended |
| 27 |
| The system must automatically have a review process for CE requirements, by line of authority |
| 28 |
| The system must have a process to notify individuals that their review period has ended, by line of authority |
| 29 |
| The system must have a process to allow for corrections to made to errors submitted by the provider |
| 30 |
| The system must have a process to move credits from one course to another course |
| 31 |
| The system must have a process to correct courses |
| 32 |
| The system must have a process to correct individuals |
| 33 |
| The system must have a process to waive CE requirements |
| 34 |
| The system must have a way to automatically reactive a suspended licenses once CE credits have been completed |
| 35 |
| The system must have a way to recognize when the applicant has re-applied as part of the application process |
| 36 |
| The system must allow for separate tasks within the same record (warnings, suspensions, terminations all in one place) |
| 37 |
| The system must have a process load eligible records and provide a list of individuals for review |
| 38 |
| The system must automatically send warning notifications to individuals via email, with attached letter, on a timing cadence, controlled by a configurable business rule |
| 39 |
| The system must review records for data errors |
| 40 |
| The system must keep a history of all actions taken for a record, with dates |
| 41 |
| The system must add comments as needed |
| 42 |
| The system must have a process to identify bad emails so the emails can be systematically removed with comment |
| 43 |
| The system must automatically mark an individual's license was suspended on a timing cadence, controlled by a configurable business rule, if no active qualifications |
| 44 |
| The system must automatically send suspension letters to individuals on a timing cadence, controlled by a configurable business rule |
| 45 |
| The system must send notifications to the appointer and sponsor of the individual when suspensions or terminations occur; to be printed locally or to the print center |
| 46 |
| The system must allow for extensions to be added on an individual to waive warnings, suspensions, and/or terminations |
| 47 |
| The system must automatically mark the license as suspended when the individual meets the suspension requirements |
| 48 |
| The system must automatically update the CE review date and all corresponding data points, per business rules |
| 49 |
| The system must perform the termination process on individuals on a timing cadence, controlled by a configurable business rule |
| 50 |
| The system must create a termination notification and save it as attachment (this is mailed) |
| 51 |
| The system must require one active course for a provider to be active, if not their CE providership is terminated |
| 52 |
| The system must send a notification when a provider is terminated |
| 53 |
| The system must require one active course for a provider to be active, if not their CE providership is terminated |
| 54 |
| The system must send a notification when a provider is terminated |
| 55 |
| The system must send a notice to analyst when there is a surrender of the providership via the Portal |
| 56 |
| The system must terminate all courses for a provider when the provider is terminated |
| 57 |
| The system must have a process for the analyst to terminate the provider |
| 58 |
| The system must have a process to not terminate the provider, with a reason code |
| 59 |
| The system must have a process requiring the vendor manager to send to vendor intake team for approval |
| 60 |
| The system must not require all checklist items to be completed during the vendor intake process |
| 61 |
| The system must have some fields be required for a provider |
| 62 |
| The system must change the application status to "expired" after it has been pending for 180 days. |
| 63 |
| The system must create and send an email of the provider verification code upon request from an online dashboard |
Education Rostering: A primary business function used by OILIA. It is the process of managing classes and participants for Pre-Licensing Education (pre-requisite for licensure), and Continuing Education (requirements to keep license active and in good standing). The rostering process flow is the same for both and is initiated by the Provider via the DIFS Portal. Upon request, OGC will conduct a review process
| 1 |
| The system must allow a Provider to upload an Education Roster via an online Portal. |
| 2 |
| The system must automatically create new Education Provider records when an Education Roster is uploaded. |
| 3 |
| The system must have a workflow review process to refer to different roles within the Education Rostering team. |
| 4 |
| The system must be able to refer to OGC during the workflow review process, and for OGC to send back to OILIA. |
| 5 |
| The system must automatically notify users of a referral. |
| 6 |
| The system must allow for status changes, and update status automatically upon referrals to other users. |
| 7 |
| The system must be able to generate letters and documents from editable templates. |
| 8 |
| The system must be able to send an email, with attachments. |
| 9 |
| The system must keep an audit trail log of all activities |
| 10 |
| The system must be able to save attachments. |
| 11 |
| The system must have search capabilities. |
| 12 |
| The system must send a notification to Analyst for any pending payment problems. |
Enforcements: While Enforcements are performed solely by the OGC department, most DIFS offices can refer an issue to OGC for an Enforcement action. Enforcements are actions taken as a result of Examinations/Investigations/Fraud to return an entity to compliance. Enforcements are initiated by a referring office. Additionally, appeals to an Enforcement can take place where OGC takes part in the case review process and has input on a final decision.
| 1 |
| The system must provide the ability to initiate an Enforcement case from the Investigation and Examination workflow. |
| 2 |
| The system must have the ability to add Involved Parties |
| 3 |
| The system must have the ability to add respondents to the enforcement case independent of the original complaint |
| 4 |
| The system must have the ability to remove the respondents from the enforcement cases independent of the original complaint |
| 5 |
| The system must provide a process to record Actions, Legal Actions, Violations, Penalties/Dispositions for each respondent |
| 6 |
| The system must provide a process add a violation to a respondent and copy it to all the respondents |
| 7 |
| The system must provide a process to edit the violations for each respondent |
| 8 |
| The system must provide a process to add a violation with the complainant’s name independent of the original complaint. |
| 9 |
| The system must allow the due date of a legal action to be overridden |
| 10 |
| The system must provide a process to grant extensions to the legal actions taken |
| 11 |
| The system must provide a process to notify the OGC staff when any of the responses are overdue |
| 12 |
| The system must provide a process to send reminder notifications pertaining to a legal action to one or more OGC staff members |
| 13 |
| The system must provide a process to search for Enforcement cases referred by different offices |
| 14 |
| The system must provide a process for Additional Final Outcome for an Enforcement Case, including the flexibility to specify Other and enter a Description for Other. |
| 15 |
| The system must provide a process to reopen enforcement cases |
| 16 |
| The system must provide a process to create an Enforcement case by request from another DIFS Office and bring over the respondent information from the referring process. |
| 17 |
| The system must provide a process to link the referring process to the Enforcement case |
| 18 |
| The system must provide a process for Deputy General Counsel to review New Enforcement cases and assign it to OGC staff |
| 19 |
| The system must allow to maintain OGC staff attorneys and a staff member under each staff attorney |
| 20 |
| The system must allow a staff attorney to be assigned for an enforcement case |
| 21 |
| The system must automatically assign the default staff members to an enforcement case when the staff attorney is assigned |
| 22 |
| The system must allow to override the assigned staff members or add additional staff members to the enforcement case. |
| 23 |
| The system must record staff assigned and staff assignments beginning dates |
| 24 |
| The system must allow to indicate a Primary Staff Member for an Enforcement case |
| 25 |
| The system must track the Enforcement case level details such as Subject, Begin Date, Status, Type etc. |
| 26 |
| The system must provide a process for the assigned staff member to request additional information from the referring office |
| 27 |
| The system must provide a process to track multiple MOAHR hearing details from the Enforcement case window in addition to being able to maintain it in the related Contested case |
| 28 |
| The system must include, but not limited to, the following templates: |
| 31 |
| Order Referring Petition for Hearing |
| 32 |
| Agency Response to Applicant's Appeal of License Denia |
| 33 |
| Certificate of Service |
| 34 |
| Final Notice of License Denial |
| 37 |
| The system must allow to track a MOAHR (Michigan Office of Administrative Hearings and Rules) Hearing |
| 38 |
| The system must allow tracking of Due dates, status, and other data for various activities related to a MOAHR hearing |
| 39 |
| The system must provide a process to send Weekly reminders to OGC staff on upcoming tasks for MOAHR Hearings |
| 40 |
| The system must provide a process to notify the OGC staff when any action for a MOAHR Hearing activity is due |
| 41 |
| The system must track the staff assignment / staff attorney assigned to the MOAHR hearing |
| 42 |
| The system must provide a process to track multiple MOAHR Hearings for an Enforcement case |
| 43 |
| The system must provide a process to create an OGC case of Type Other apart from Regular EC, Matters, or DRLP |
| 44 |
| The system must allow OIRF to see the current status of the enforcement referral (Matter). |
Examinations: Currently performed only by OB, OCU, OIE and OCF. The periodic review of entities to ensure they are compliant to laws/regulations with an emphasis on Safety & Soundness. Generally, Examinations are triggered by running reports that list entities needed for an Exam based on business rules different for each office. Can also be initiated by the Director of the office manually. Examinations produce a Report of Examination with a summary of the findings and potential actions from having performed the Examination.
Examination Creation
| 1 |
| The system must be able to enable users to create Examinations with various details. |
| 2 |
| The system must automatically generate an Examination number. |
| 3 |
| The system must provide the ability for a staff member to create an Examination of varying types. |
| 4 |
| The system must automatically, when creating an Examination, take into account the Examination type and expand or limit functionalities pre-defined for those Examination types. |
| 5 |
| The system must allow any Examination creation value to change and update the Examination configuration automatically. |
| 6 |
| The system must provide the ability for a staff member to select various Examination statuses and/or modify them as needed. |
| 7 |
| The system must provide the ability for the Examination status to be automatically updated based on user actions. |
| 8 |
| The system must automatically trigger updates and actions on an Examination based on changes in Examination status. |
| 9 |
| The system must provide the ability to flag Examinations that may be duplicate Examinations, for possible further staff member review, based on business rules. |
| 10 |
| The system must allow for the manual linking of duplicate / companion Examinations to an existing Examination by staff. |
| 11 |
| The system must provide for the ability for staff members to merge Examinations. |
| 12 |
| The system must provide the ability to re-open a previously closed Examination |
| 13 |
| The system must enable the staff member the ability to view an Examination and all documents associated with the Examination. |
| 14 |
| The system must allow the staff member to enter comments related to the Examination at any time. |
| 15 |
| The system must provide a configurable retention schedule for all Examinations and documents associated to an Examination. |
| 16 |
| The system must provide the ability to perform powerful searches for Examination(s) using previously entered Examination Data. |
| 17 |
| The system must allow any Examination creation value to change and update the Examination configuration automatically. |
| 18 |
| The system must include a "Summary" page that pulls specific fields (with most current information) for a quick overview of the Examination. |
| 19 |
| The system must have the ability to refer Examinations to other areas of DIFS (ex. Compliance, OCS). |
| 20 |
| The system must provide the ability for authorized staff members to configure selection values, with active and inactive statuses based on date values, used in Examination creation. |
| 21 |
| The system must allow for the Cancellation of an Examination. |
| 22 |
| The system must allow for the Deletion of an Examination. |
| 23 |
| The system must be able to automatically calculate due dates for any given step in the Examinations/Examinations/Visitations process, taking into account, state holidays, calendar days and business days. |
Examination Attachments
| 1 |
| The system must provide the ability to scan, save and label paper documents and associate them to an Examination. |
| 2 |
| The system must provide the ability to save and label electronic attachments and associate them to an Examination (ex. E-mails and e-mail attachments.) |
| 3 |
| The system must provide the ability for a staff member to search for all documents associated to an Examination. |
| 4 |
| The system must provide the ability to easily bundle all documents associated to an Examination for the purposes of complying with document requests. |
| 5 |
| The system must provide the ability for staff members to designate a document type for all documents attached to a Examination. |
| 6 |
| The system must provide the ability for staff members to perform key word and phrase searches of content within specified documents and/or document types across all Examinations or specified Examinations. (ie, search functionality within documents of a specified type). |
Assigning Staff to an Examination
| 1 |
| The system must maintain a configurable list of staff members for the purpose of Examination assignment. |
| 2 |
| The system must automatically use a round robin process to assign Examinations to staff members. |
| 3 |
| The system must allow for manual assignment of Examinations to staff members. |
| 4 |
| The system must allow for the changing of staff member assignment to an Examination. |
| 5 |
| The system must notify the staff member of a new Examination assignment by e-mail and entry into a Examination Tracker log. |
| 6 |
| The system must for provide for access management at various levels. |
| 7 |
| The system must allow for section-specific access should be able to review or work a Examination regardless of assignment |
| 8 |
| The system must allow for authorized staff members to access and modify Examinations and Examinations of other OCF staff members. (ie log a response received from a company or individual.) |
Examination Tracker
| 1 |
| The system must maintain a Examination Tracker log detailing such items as Examination assignments and their due dates, and associated actions taken on the Examination. |
| 2 |
| The Examination Tracker log must provide the ability for a user to change staff member Examination assignment. |
| 3 |
| The Examination Tracker log must allow for sorting and filtering, such as on Examination Status, Staff Member, Due Date, Issue and Service. |
| 4 |
| The Examination Tracker log must flag Examinations on certain conditions such as past the Due Date and upcoming Due Date. |
Examination Tasks
| 1 |
| The system must allow for the completion of Tasks to require a document to be attached to the Task, based on business rules. |
| 2 |
| The system must display the due dates for all tasks assigned to staff members. |
| 3 |
| The system must route tasks to the next level staff approver based on business rules for Examinations and Examinations. (ie. a Examination with a Closure Type of "Warning letter" must route to the Section Director for review an approval.) |
Due Dates
| 1 |
| The system must provide the ability to configure due dates based on business rules for steps in the appeals process. Due dates are based on business rules. |
| 2 |
| The system must be able to automatically calculate due dates for any given step in the appeals process, taking into account, state holidays, calendar days and business days. |
Audit Log
| 1 |
| The system must provide the ability to automatically and manually record Examination actions in an audit log, such as initial Examination entry, Examination staff assignment, letter sending, etc. |
Statistics
| 1 |
| The system must be able to capture configurable statistics business rules. |
| 2 |
| The system must be able to calculate and record various statistics based on configurable statistics business rules for staff reports and management/performance reports. |
| 3 |
| The system must allow users to manually exclude a Examination from being included in statistics. |
Templates and Letters
| 1 |
| The system must provide the ability for staff members to create and maintain letter templates in Microsoft Word. |
| 2 |
| The system must provide the ability for staff members to assign a letter via template to a Examination. |
| 3 |
| The system must provide the ability to select pre-configured text to add to a letter. |
| 4 |
| The system must provide the ability to open multiple letters for reference when crafting a letter to be sent. |
| 5 |
| The system must provide a function to generate and e-mail documents. |
| 6 |
| The system must auto-populate letters based on letter templates with appropriately tagged data. |
| 7 |
| The system must provide the ability to convert the MS word document to a PDF document. |
| 8 |
| The system must provide the ability to staff members to delete documents. |
| 9 |
| The system must have the ability for staff to download documents. |
| 10 |
| The system must be automatically and accurately populate required fields of information when generating letters from letter templates (ie. This includes accurate license/registration numbers with the leading FL or SR, names, addresses, exam ids, dates, etc.) |
Review Process
| 1 |
| The system must provide the ability for a staff member to modify a MS Word letter on a Examination, such as markup a letter with comments. |
| 2 |
| The system must allow staff members to assign reviewers or mark for review a Examination and initiate a review process (ex. Peer review, Manager review, Director review, Attorney review.) |
| 3 |
| The system must automatically notify a staff member of a pending review for the Examination assign to them. |
| 4 |
| The system must allow staff members to initiate a review process by selecting a review status (ex. Peer review, Manager review, Director review, Attorney review, etc.) |
| 5 |
| The system must allow staff members to maintain a configurable list of staff members for the purpose of a Peer review process. |
| 6 |
| The system must automatically assign a staff member via a round robin process when the Peer review status is selected. |
Budgeting
| 1 |
| The system must allow the office to enter, track and monitor hours spent by each staff member on individual exams and pre-defined tasks. |
| 2 |
| The system must allow staff to enter a budget for each exam allocated to pre-defined tasks. |
| 3 |
| The system must allow staff to enter actual hours spent with a cross-check the hours add to 80 hours per pay period. |
| 4 |
| The system must report on budgeted and actual time spent on each exam and pre-defined task. |
General Examination Functionality
| 1 |
| The system must provide the ability to track Penalties and Fines associated to a Licensee. |
This is the start of the file's text. The full file is on GovTribe.