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Apothegm Software Perspective Rating System

Apothegm’s Perspective Rating System™ is our flagship health plan pricing suite. Use our Retrospective Renewal Management Tool™ experience pricing model to develop multiple strategies by health plan or business line. Drive new business with the Prospective New Sales Pricing Tool™. Measure, analyze and manage the entire process with our Introspective Reporting and Analysis Tool™. Learn more about all the applications in Perspective below…

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Apothegm Software Perspective Rating System

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  1. Primary Deliverables… • Model Rating Strategies • Experience Rating • Manual Rating • Compare Enterprise Level Results • Actual vs. Expected

  2. Features Monitor Rating Strategy and impacts to the distribution of Rate Increases and Loss Ratio by: • Health Plan • Business Segment • Group • Plan

  3. Features Test the implications of rating variables across multiple years and apply different methodologies by user defined Group Size…

  4. Features Manage variations in plans from group to group with Claims Normalization and Adjustment process…

  5. Features Examine and balance Pooling Charges and Pooling Credits… Total Claims Dollar To Dollar Pooling Credit and Charges Large Claims Excess Claims Trend Indexing

  6. Features • Apply Trends by: • Year • Plan • Medical and Rx

  7. Rating Process • 10 Stage Actuarial Rating Engine • Rating data is processed modularly in 10 steps. This provides for: • Simplification of rating method; greatly reducing the time and effort needed to update or change components within the rating process. • Greater flexibility in adapting to new business needs. • Easy auditing of rating data. • Rapid recalculation of rates after manipulation of rating variables.

  8. Rating process Data extraction flow Rating Process Rating Process Stages

  9. Rating Process Controls Set ranges for group Pooling Class… Set Pooling Point by Class… Set Pooling Method by Class…

  10. Rating Process Controls Manage size classification, Plans, and Trend…

  11. Rating Process Controls Adjust credibility… Set the experience period and contract duration…

  12. Rating Process Controls Create customizable Large Claim Reports…

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