LOMA 290
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LOMA 290
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LOMA 290
Chapter 1 Organization and Operations
Key Stakeholders
Customers
Employee
Producers
Owners
Suppliers
Creditors
Reinsurers
Regulators
Rating Agencies
Other stakeholders
Balancing Stakeholder Interests.
Levels of management
Board of Directors
Senior-Level Managers
Lower_Level Managers
Management Functions
Planning
Organizing
Directing
Controlling
Organizing Insurance Operations
Value Chain
Inputs
Marketing/Sales
New Business Administration
Underwriting
Customer Service
Claim Administration
Profit
Ways Insurers Organize Work Activities
Organization By function
Organization by Product
Organization by Territory
Organization by Distribution System
Organization by Customer
Profit Centers/ Strategic Business Units
Committees
Holding Company Systems
Downstream and Upstream Holding Companies
Corporate Governance
SOX
Ethics and Ethical Conduct
A code of Conduct
An Ethics Office
Education
Training
Insider Training
Privacy and Confidentiality
Membership in Association
Types of Controlls
Steering Controls
Concurrent Controls
Feedback Controls
Establishing Performance standard
Measuring Performance
Budget
Audits
Exception Reports
Chapter 3 Legal and Compliance
Organizations
General Counsel
Chief Compliance Officer
Responsibilities of the legal department
Responsibilities to the board
methods begin operations in foreign countries
Incorporating
Opening a branch office
Joint Venture
Responsibilities to Internal Functions
Responsibilities to External Parties
Law Firm
Alternative dispute resolution(ADR) method
Mediation
Arbitration
Policyowners / Beneficiaries
Employees/Former Employees
Industry Regulatory Groups
Responsibilities of the Compliance department
Prevention
Education and Training
Monitoring
Internal Audit
External Audit
Market Conduct Examinations in USA
NAIC
Chapter 4 Human Resource Management
Human Resource Planning
Projecting staffing Needs
Planning for international Operations
Home country staffing
Host country staffing
Third-country national
Outsourcing
Estimating the Labor Supply
Internal Labor Supply
Succession planning
External Labor Supply
Recruitment
Internal Recruitment
External Recruitment
Employee Selection
Employment Application
Screening Interviews
Pre-Employment Test
Validity
Reliability
Tests
Aptitude test
performance test
behavioral tendencies test
Employment Interview
Background checks/Drug Test
Applicant Hired
Training and Development
on-the-job traning
Classroom training
Self-study training
Performance Evaluation
Establishing Performance Goal
Monitoring and Reviewing Employee Performance
Performance Tools
Performance Evaluation Program
Compensation and Employee Benefits
Compliance
Separate
Separation
Layoff
discharge
Chapter 5 Information and Technology
Responsibilityes
Organization
Chief Information Officer
Chief Technology Officer
Information Management
Databases
Database Management Systems
Document Management Systems
Workflow Management Systems
Business Process Technology
Transaction Processing Systems
Business Intelligence
Outsourcing IT Operations
SaaS Software as a service
Cloud computing
Telecommunication
Network
Intranet
Email
Instant Messaging
firewall
Extranet
VPN
Encryption
Intrusion Detection software
Internet
Computer Telephony Integration
Customer Service Application
automatic call distributor
screen pop
Interactive voice response system
Customer relationship management
Other Telecommunications Technologies
Teleconferencing
Videoconferencing
smart phone
fax machine
IT Security and Disaster Recovery
Chapter 6 Financial Management
Chief Financial Officer
Accounting and Financial Reporting
Controller
Treasury Operations
Treasurer
activities
Cash management
Bank Relations and account administration
Bank Reconciliation
Short-term credit activities
Cash forecasting
Liquidity management
Investment Operations
investment policies
investment objectives
investment strategies
portfolio
Asset/Liability management
Audit and Internal Control
Chief auditor
interdepartmental responsibilities
Responsibilities of Financial Management
Setting financial strategy
aggressive financial strategy
conservative financial strategy
Managing Risk
Risk Management
Diversification
Enterprise Risk Management
Managing solvency and profitability
managing capital
Capital = Assets - Liabilities
managing cash flows
cash inflow
cash outflow
providing financial information to stakeholder
Financial Statements
Income Statement
Revenues
Expenses
Net Income
balance sheet
Surplus
Assets = Liabilities + Capital and surplus
The Annual Report
Financial Compliance
Current Ratio
Current assets / current liabilities
Capital and surplus ratio
capital and surplus / total liabilities
Tools to Monitor Solvency
Annual Statement
Financial Condition Examination
External Audits
Financial Reporting Requirement
segregation of duties
Accounting
Users of Accounting Information
Accounting Systems
Financial accounting
Accounting Standards
Recognition
Valuation
GAAP
going-concern concept
Statutory accounting practices
Accounting conservatism
IFRS
Financial Reporting
Income statemnet
Cash flow statement
Statement of owner's equity
Admitted asset
Partially admitted asset
Nonadmitted asset
Management accounting
Budgeting
master budget
discrepancy
favorable variance
unfavorable variance
Cost Accounting
Cash Management
lockbox
liquidity management
Auditing
Chapter 8 Investment Management
Investment Policy
Investment Risk
Risk and Return
Principal
Required Rate of Return
Required rate of return = risk-free rate of return + risk premium
strategy
buy-and-hold strategy
active management strategy
Evaluating an Investment
Buying and Selling Securities
security
debt security
equity security
New Issues of Securities
Previously Issued Securities
securities exchange
over-the-counter market
Investment Portfolios
The General Account
Fixed-income investment
Separate Account
subaccounts
mutual fund
Types of Investments
bonds
Bond Risk and Return
Term to maturity
Default Risk
Bond ratings
Call provision
Convertibility
Types of bonds
Corporate bond
Government bond
mortgages
amortization
stocks
real estate
policy loan
Chapter 9 Marketing
The Marketing Plan
Elements
Executive summary
Situation Analysis
Marketing objectives
Marketing strategies
Tactical/action programs
Budgets
Evaluation and control methodolody
Communicating the marketing plan
The Marketing Mix
Product
Price
Competition
Customer's puchasing power
Regulatory requirements
Other Marketing mix variables
Promotion
Personal selling
Sales promotion
Advertising
Institutional Advertising
Product Advertising
Publicity
Distribution
Third-party-institution
Direct response
Positioning
Basic insurance marketing activities
Identifying Markets
Segmenting Markets
Single-variable segmentation
Mutivariable segmentation
Target Marketing
Selecting Target Markets
By life cycle stage
By Income
By Buying behavior
By TYpe of Group
Target Marketing Strategies
Undifferentiated marketiong
Concentrated marketing
Differentiated marketing
Marketing Information
Internal Databases
Website Traffic Analysis
Competitive and Market Intelligence
Market Research
Marketing Enviroment
Marketing Controls
Chapter 10 Product Development
Product Development Process
Product Planning
Idea Generation
Screening
Concept testing
focus group
Comprehensive Business Analysis
Market Analysis
Product Design Objectives
A feasibility study
A marketing plan
Marketing Projections
Technical Design
Financial design
Ensure that company can cover future benefits and expense
create a package of benefits that will appeal both to producers and customers
provide an adequate return to the company's owners
Create Application forms and sales contract
Sets the product's administrative guidelines adn underwriting standards
Develops a schedule and budget for the product's implementation
Product Implementation
Regulatory Approval
Promotion and Training Material
Administrative and Systems activities
Day 1 functionality
Day 2 functionality
Performance Monitoring and Review
Review of the Product Development Process
Chapter 11 Product Distribution
Personal Selling Distribution System
Agent
Agent Type
Career Agents
Multiple-line agents
Home service agents
not always considered employees of an insurer
Benefits
First-year commission
renewal commission
Quoter
personal-producing general agent(PPGA)
overriding commission
Broker
Agent Channel Support
Recruiting
pre-contract training
Licensing
Sales Support
Business development support
Marketing support
Enhanced service support
Advanced underwriting
Technology support
Monitoring Market Conduct
Methods of Personal Selling
Salaried Sales Representatives
Financial Advisors
Third-Party-Institution Distribution System
Broker-Dealers
Banks and other Depository Institutions
bancassurance
Insurance Companies
nonproprietary product
Direct Response Distribution System
Distribution Decision
Costs
Control
Expertise
Customers' Characteristics
Product Characteristics
External Marketing Enviroment
Chapter 12 Underwriting
New Business Processing
Processing Life Insurance Applications
Electronic insurance applications
exception-based underwriting
Goal: straight through processing(STP)
Processing Annuity New Business
Identify customer needs
Generate annuity illustrations
Submit application
Check for suitability
Generate pending contract
Organization of new business and Underwriting operations
Jet unit
Purpose of Underwriting
Organization and Concepts
Chief underwriter/medical underwriting director
Anti-selection
Persistency
Underwriting philosophy and guidelines
The Underwriting Process
Process
子主题
Field Underwriting and Teleunderwriting
field underwriting manual
Evidence of insurability
table of underwriting requirements
Agent's Statement
sources of medical underwriting
nonmedical supplement
paramedical report
medical report
MIB Group Inc.
Attending physician's statement(APS)
specialized medical questionnaire
Medical tests
Pharmaceutical databases
The underwriting Decision
numerical rating system
Applying the Premium Rate
table rating method
flat extra premium method
Control Mechanisms forUnderwriting Operations
Authority Levels
Other Underwriting Controls
Audit Log
Company Interrelationshipsand Underwriting
Group Underwriting
The Group Underwriting Process
ff
Risk Factors for Group Life Insurance
Regulatory Requirements
Chapter 13 Claim and AnnuityBenefit Administration
Chief claim officer
Claim Philosophy and Claim Practices
Claim Philosophy
Claim Practices
Life Insurance Claim Process
Diagram
Determining if Benefits are payable
Was the policy in Force?
Was the Deceased the Insured?
Is the Policy Contestable?
Did the Loss Occur?
Was the Loss Covered?
Approve or Deny Claim?
Calculating the Amount Payable
Addition and subtractions
Adjusting for misstatement of Age or Sex
Paying the Proceeds
Policy Settlement Options
Interest
Fixed-period
Fixed-amount
Life income
retained asset account
Identifying the Proper Payee
Claims on Reinsured Policies
Claim Investigation
investigative consumer report
Claim Fraud
Fraud Prevention
Quality Control in Claim Processing
comply with laws adn regulations
adhere to the insurer's claim philosophy and practices
Model Unfair Claims Settlement Practices act
International Laws
Annuity Administration
Annuity Death Benefit Administration
Authenticating and documenting the claim
Determining the amount of the death benefit
Paying the death benefit
Addressing applicable tax issue
Annuity payout Administration
Chapter 14 Customer Service
Typical Customer Service Job Positions
Customer service representative
Customer Service Department Relationship
Effective Customer Service
Technology
Customer Relationship management
Customer Service Process
Fulfilling Customer Requests
Common nonfinancial Transaction
Address and name changes
Policy ownership changes
Beneficiary changes
Premium payment chages
Insurer producer changes
Life insurance coverage changes
Common Financial Transactions
Investment fund allocations
Life insurance policy surrenders
annuity surrender
partial surrender
Dividend payment
Replacement
Reinstatement
Handling Customer Complaint
complaint management system
Customer Service Processes for Group Products
Establishing Records and Processing Enrollment
Group administration
Terminating Group Coverage
Control Mechanisms for Customer Service
moment of truth
qualitative performance measurement
customer satisfaction survey
monitoring
Empathy
mystery shoppers
quantitative performance measurement
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