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Scenario - Plan Member Pre-authorized Debit (PAD) process for Canucks Insurance

Canucks Insurance Company

(CIC) offers a wide range of insurance products and services including group benefits, life insurance, health insurance, annuities, credit insurance, property and casualty insurance, and pension plan services. The company prides itself for providing a complete range of personal insurance products with quality service. It is a credible name in market for over 110 years and positively reviewed and rated well by top rating agencies. It is listed by Forbes Magazine in its "100 Most Trustworthy Companies" in Canada. Its robust and diverse product portfolio as well as good customer service and high service offering ensured long term success of CIC. It can bank upon its credibility to acquire new customers. It has been successful with more product offering and services and trying to attract clients who are looking to switch their existing Insurance Carrier. 

CICs Group Benefits team supports the Plan Member Pre-authorized Debit (PAD) product for their clients. This product provides plan members the option of paying for their benefits via direct withdrawal from their personal bank account when the member goes on leave for various reasons. ARGON is CIC's proprietary application software for setting up and update group benefits (GB) policy for claim processing and it is the source of member data for PAD amounts. Clients notify CIC via Client File when a member goes on leave. A Group Benefit Administrator (GBA) updates the ARGON system with PAD identifier and effective date. GBA removes plan member from regular payroll file as they no longer an active employee of the client. GBA sends banking form to plan member on leave for them to complete the form and send CIC a void Cheque. On a monthly basis, SQL extracts are run for all members designated as being on PAD against ARGON database. Members are selected based on custom, client specific criteria. The data is added to the 'Member Billing DB'. Member Billing DB is an Excel template where ARGON PAD data is input and the Finance file is output. Adjustments are calculated and changes in amounts (including members moving in and out of PAD) are identified by comparing last month's DB to current. Changes are reviewed individually for effective dates and adjustments are calculated. Adjustments Log contains all historical adjustment records for Rejects/ Not Sufficient Funds(NSFs)/Terminations/Retroactive Adjustments/Refunds. A PAD File is created and sent to Finance. Finance submits the file to Bank. The results of the Bank feed are relayed back via email to Group Benefits by Cash Management. If there are NSFs, GBA mail out appropriate letters and PAD form for updates. If a member reached NSF limit, GBA follows client specific termination procedure and mail out letters. The amount submitted to Bank is relayed via the Inquiry Mgmt DB from Group Benefits to Clients in order to credit the Client. The client is credited via Batch Deposits for the total amount collected from members via PAD. This is reflected in their billing statement. Client payments are tracked through Client Database. The process ends at this point.

Deliverable(s): Swimlane Diagram .

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