“System And Methods For Code Analysis And Data Storage With Cryptography” in Patent Application Approval Process (USPTO 20230108454): Patent Application

2023 APR 26 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- A patent application by the inventors Albright, Abigail (Boston, MA, US); Gidwaney, Veer (Hoboken, NJ, US); Turcotte, Amanda (Montclair, NJ, US); Zarrillo, Michael (Charlotte, NC, US), filed on June 29, 2022, was made available online on April 6, 2023, according to news reporting originating from Washington, D.C., by NewsRx correspondents.

This patent application has not been assigned to a company or institution.

The following quote was obtained by the news editors from the background information supplied by the inventors: “The primary purpose of a supplemental health plan is to reduce unexpected out-of-pocket medical costs. This is a critical need today as the cost of employer-sponsored health coverage and associated out of pocket cost-sharing has become increasingly burdensome for employees. The average employee pays $5,588 in premiums for family health coverage that comes with an average deductible of $3,655. Yet, a recent study found that 60% of Americans would struggle to pay a $1,000 unexpected expense (Source: Bankrate Financial Security Index January 2020). Conventional methods of providing supplemental health insurance and submitting, adjudicating and processing claims were designed decades ago and have not evolved to address today’s challenges.

“In addition, the narrow scope of conventional supplemental coverage leads directly to low utilization rates. Misalignment of benefits with the employee’s actual financial responsibility leaves many people financially exposed, and complex rules and claims requirements cause employees to miss opportunities to obtain the benefits they need to help ease the financial burden of a medical event. Poor strategic ties to overall health plan objectives have caused today’s most common supplemental health insurance options to demonstrate poor product/market fit. Furthermore, conventional methods of obtaining and evaluating claim information is a burden on network and computer resources, and often does not include secure networks or cryptography techniques during collection. Therefore, there is a need for an intelligent insurance design, pricing, automated administration, and claim submission system to overcome the limitations of conventional systems to provide comprehensive coverage which better fits current and future market needs.”

In addition to the background information obtained for this patent application, NewsRx journalists also obtained the inventors’ summary information for this patent application: “Some embodiments provide an appointment application and an associated appointment application webform flow. In some embodiments, an appointment webform is automatically generated by the system per agency. Some embodiments of the system automatically generate a version for individual producers. This appointment webform flow may supplement or replace current processes used to manage appointments according to some embodiments. In some embodiments, the system is configured to check for a valid appointment record at the time of contract issue regardless of process. In some embodiments, DocuSign® or similar secure document transfer services are used for partner and agency contracting.

“Regarding partner ongoing administration, the system enables partners to have access to a partner portal module according to some embodiments. In some embodiments, a partner portal graphical user interface (GUI) is configured to enable partners to request quotes, communicate with an underwriting module (i.e., to provide feedback, share documents, request a re-quote), view quotes, access employer details, access policy details for in force policies and contract documents, get help, manage their own users, and manage their team. In some embodiments, a book of business and/or (Brella) book management system can be accessed from the partner portal GUI. In some embodiments, the system is configured to enable access to performance dashboards (for enrollment, premium calculations, etc.) through the partner portal GUI. In some embodiments, the partner portal module is integrated into one or more modules and/or systems described herein (e.g., the core admin system, the secure processing platform/policy admin system). In some embodiments, the system is configured to enable all of the functionality that can be triggered through the partner portal module (e.g., a quote request) to be accessed from another platform, product, or process.

“Some embodiments enable functionality to be turned on and off as needed due to a modular design of one or more portions of the system. As just one non-limiting example, the system is configured to provide a cobranded version of the partner portal module for partners. In some embodiments, the cobranded version that has custom branding and custom get-help messaging according to some embodiments. In some embodiments, the system is configured to enable a user to input one or more items through the partner portal GUI, receive the data from the partner portal module, and send data back to the user. One non-limiting example, according to some embodiments, is the user going to a partner portal GUI or partner portal module for book of business reporting across the full product suite, but single signing into a cobranded portal for quote requests.

“Some embodiments provide employer sales functionality including quoting through underwriting module and proposal generation. In some embodiments, the quote request is initiated through the partner portal GUI. In some embodiments, the system is configured to enable a partner to request quotes for new or existing employers. In some embodiments, quote information requested by the system includes one or more employer level details (e.g., Standard Industrial Classification (“SIC”), state, census, etc.) and quote level dates, (e.g., effective date, commission, etc.), as non-limiting examples according to some embodiments. In some embodiments, the quote information then goes through the rating engine and the underwriting review process, which is performed by the automated underwriting module according to some embodiments. Based on that quote being approved in the policy admin system, in some embodiments, the proposal is automatically generated, made available within the partner portal, and a customizable notification is emailed to the partner. In some embodiments, the system is configured to enable the quote to be reviewed and/or approved by a team member before the proposal is auto generated.

“In some embodiments, the system is configured generate a secure graphical user interface to enable one or more portions of the proposal to be modified by an employer and/or partner to evaluate different strategies and/or product offerings (e.g., Choice or Select, Riders or not, employer contribution scenarios, etc.) which would require re-quotes in conventional systems. In some embodiments, the system is configured to provide a modeling tool (e.g., a premium calculator tool) to aid in determining an optimum proposal modification. In some embodiments, the system is configured to generate a custom tokenized Uniform Resource Locator (“URL”) per quote. In some embodiments, the URL displays static sales and marketing content (e.g., at the top) but allows a partner and/or employer to modify inputs with regards to one or more plan offerings, benefit amounts, different employer contribution scenarios, and including or excluding riders. In some embodiments, the application is connected to the quoting and rating engine. As a non-limiting example, in some embodiments, employer contribution impacts rates, and if an employer contributes to the employee premium, a rate adjustment may be applied. If the user enters an employer contribution on the proposal user interface (“UI”), the rating engine is accessed again by the system (e.g., a secure processing platform) and automatically adjusts those rates, according to some embodiments. In some embodiments, the updated rates are shown on the proposal in real time.

“In some embodiments, the system includes a proposal acceptance (application) module. In some embodiments, the proposal acceptance module is configured to automatically trigger the next piece of the contracting flow: the employer welcome and case install workflow. In some embodiments, based on the contact information provided on proposal acceptance, the system creates that employer portal and that employer portal user account and automatically sends the employer a welcome email to implement the next step of the flow.

“In some embodiments, the system includes automatic implementation of one or more rules described herein. In some embodiments, for underwriting module execution, the system is configured to include limits of certain attributes and/or forced contract terms based on state regulatory requirements. In some embodiments, non-limiting examples of one or more rules include maximum benefit waiting period, maximum rate guarantee, minimum number of age bands, and/or minimum benefit amounts. In some embodiments, the automatic implementation of one or more rules is configured to impact employer implementation flows. In some embodiments, non-limiting examples of employer implementation flows include available choices and/or configuration limits based on state requirements. In some embodiments, the system is configured to reflect regulatory “forced” (required) contract term configurations in displayed shopping and/or education experiences. As a non-limiting example, Florida’s child eligibility requirements, which are different from other states, are automatically implemented by the system in one or more sections described herein according to some embodiments.

“Some embodiments provide fully automated employer implementation by one or more modules. In some embodiments, the employer reviews the information populated by the partner on the proposal acceptance flow. In some embodiments, the group application is automatically generated with the appropriate state specific form, plan offering and employer contribution scenarios and prepopulated with all those employer details. In some embodiments, it’s then presented via an integrated secure electronic signature system (e.g., DocuSign®) through the employer portal for signature. In some embodiments, the document can be resent, or the signer can be reassigned if there needs to be a different designated signer as well.

“In some embodiments, based on the completion of the group application signature, the system then updates the contract record and the policy administration system and all of the policy documents (e.g., policy and the employer version of the certificate) are automatically generated and made available simultaneously. In some embodiments, the system then moves on to open enrollment setup. In some embodiments, the open enrollment setup and remainder of the implementation is all done through an implementation form provided by an implementation module. In some embodiments, the implementation form is a web-based implementation form that is customized for each employer by the system automatically. In some embodiments, the implementation web form includes a combination of enrollment method and plan offering.

“In some embodiments, the system includes different versions based on prior selections. Some non-limiting versions include one for third party benefits administration vendors, one for the enrollment platform (also referred to as Brella Enroll herein), and one for situations in which the employer is fully funding the product for their employees. In some embodiments, a provided version or configuration is then automatically generated based on the contract attributes in the policy admin system (or secure processing platform, as another non-limiting example). In some embodiments, different versions of education/recommendation are automatically provided, based on the completion of the web form. In some embodiments, changes can be made before an invoice is finalized regardless of whether Brella Enroll is employed or not.”

There is additional summary information. Please visit full patent to read further.”

The claims supplied by the inventors are:

“1. A system for secure transfer of electronic documents comprising: one or more computers comprising one or more processors and one or more non-transitory computer readable media, the one or more non-transitory computer readable media having instructions stored thereon that when executed cause the one or more computers to: generate, by the one or more processors, a secure processing platform; generate, by the one or more processors, a claims module; initiate, by the one or more processors, a secure data connection between the processing platform and the claims module; send, by the one or more processors, one or more documents from the claims module to the secure processing platform; analyze, by the one or more processors, the one or more documents for one or more ICD codes; and associate, by the one or more processors, the one or more ICD codes with one or more conditions.

“2. The system of claim 1, wherein compensation associated with the one or more conditions are sent via a data encrypted network.

“3. The system of claim 1, the one or more non-transitory computer readable media having instructions stored thereon that when executed cause the one or more computers to: generate, by the one or more processors, a digital marketplace module; and send, by the one or more processors, compensation associated with the one or more conditions from the digital marketplace module.

“4. The system of claim 1, wherein the one or more ICD codes are ICD-10 codes.

“5. The system of claim 1, wherein the claims module is configured to use a combination of one or more ICD codes and one or more benefit categories to determine the compensation without human intervention.

“6. The system of claim 5, the claims module is configured to determine if more than one benefit category is covered by analysis of one or more eligible documents.

“7. The system of claim 1, the one or more non-transitory computer readable media having instructions stored thereon that when executed cause the one or more computers to: generate, by the one or more processors, a member portal module; and generate, by the one or more processors, an employer portal module; wherein the secure processing platform is configured to accept one or more member inputs and one or more employer inputs from the member portal module and the employer portal module, respectively.

“8. The system of claim 1, the one or more non-transitory computer readable media having instructions stored thereon that when executed cause the one or more computers to: generate, by the one or more processors, a recommendation engine; and send, by the one or more processors, the one or more member inputs and the one or more employer inputs from the secure processing platform to the recommendation engine.

“9. The system of claim 8, wherein the recommendation engine is configured to apply a factor to each of the one or more member inputs and each of the one or more employer inputs.

“10. The system of claim 9, wherein the recommendation engine is configured to sum each factor.

“11. The system of claim 1, the one or more non-transitory computer readable media having instructions stored thereon that when executed cause the one or more computers to: generate, by the one or more processors, a graphical user interface; and display, on the graphical user interface, a partner portal; wherein the partner portal is configured to enable a user to input a quote request.

“12. The system of claim 11, the one or more non-transitory computer readable media having instructions stored thereon that when executed cause the one or more computers to: generate, by the one or more processors, an underwriting module; and send, by the one or more processors, the quote request to the underwriting module; wherein the underwriting module is configured estimate risk; and wherein if the risk is below a predetermined threshold, the underwriting module is configured to automatically provide a quote proportional to the risk.”

URL and more information on this patent application, see: Albright, Abigail; Gidwaney, Veer; Turcotte, Amanda; Zarrillo, Michael. System And Methods For Code Analysis And Data Storage With Cryptography. U.S. Patent Application Number 20230108454, filed June 29, 2022 and posted April 6, 2023. Patent URL (for desktop use only): https://ppubs.uspto.gov/pubwebapp/external.html?q=(20230108454)&db=US-PGPUB&type=ids

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