Brand versus Generic Claims Summary Report

What does this report show?

This report breaks down pharmacy claims by brand versus generic drugs. It summarizes the number of unique claimants, number of occurrences, number of members, total dispensing fee submitted, total dispensing fee paid, total deductible, total COB amount, total amount submitted, total amount eligible, total amount paid for each category of brand/generic drugs (e.g. Single Source Brand drugs, Multisource Brand drugs, and generic drugs).

How can I use it?

This report can be used to determine the utilization rate between Single Source Brand Drugs, generic drugs, and Multisource Brand drugs. It provides insight as to whether the current generic substitution program is working or whether a more aggressive generic substitution program should be introduced to encourage higher utilization of generic drugs.

Claims by Age Range Report

What does this report show?

This report groups claims by age band and summarizes the number of claimants, number of occurrences, amount paid per occurrence, and amount paid broken down by benefit categories and sex.

How can I use it?

This report can be used to gain insights into claiming patterns within defined age bands and sex for benefits selected.

Claims by Dollar Range Report

What does this report show?

This report groups claimants into dollar ranges, based on amount paid within the reporting period. The information provided includes the number of claimants, number of occurrences, amount paid per occurrence, and amount paid broken down by dollar range.

How can I use it?

This report can be used to gain insights into the amount being claimed within a plan and how many claimants are claiming within a specific dollar band.

Claims by Submission Type Report

Submitted Claims by Submission Type Report

What does this report show?

This report shows the submission volume based on the benefit category, associated sub-categories for services (where applicable), number of claims submitted, number of members, percentage of total submits, and percentage of total benchmark based on the submission method.

How can I use it?

This report can be used to gain insights into the volume of submitted claims and the number of claimants against Manulife's block of business by paper, Dental EFT and Pay Direct, Online Claims Submissions, and Provider eClaims Submissions.

Paid Claims by Submission Type Report

What does this report show?

This report shows the paid claims volume based on benefit category, associated sub-categories for services (where applicable), number of claims submitted, amount paid, percentage of total submits and percentage of total benchmark based on the submission method.

How can I use it?

This report can be used to gain insights into the number of occurrences and amount paid against Manulife's block of business by paper, Dental EFT and Pay Direct, Online Claims Submissions, and Provider eClaims Submissions.

Note

Use the Claims by Source filter to generate the reports above. Choose between:

• Submitted
• Paid

Claims Service Detail Report

Claim Service Detail by Month Report

What does this report show?

This report groups claims by benefit category, benefit description, and province and amount paid broken down by each reporting month.

How can I use it?

This report can be used to gain insights into claiming patterns for each benefit categories and provinces on a monthly basis.

Claim Service Detail by Relationship Report

What does this report show?

This report groups claims by benefit category, benefit description, province, number of unique claimants, occurrences, amount submitted, amount eligible, and amount paid broken down by employee, spouse, and dependant.

How can I use it?

This report can be used to gain insights into claiming patterns for each benefit categories and provinces based on the employee, spouse, and dependant split.

Note

Use the Claims by Service Detail filter to generate the reports above. Choose between:

• Month
• Relationship

Most Common Indication Report

Most Common Indication Report (with 25 Claimant Privacy and Confidentiality Filter)

What does this report show?

This report ranks pharmacy claims by the most common indication. The data is summarized by number of unique claimants, number of occurrences, total dispensing fee submitted, total dispensing fee paid, total deductible, total COB amount, total amount submitted, total amount eligible, total amount paid, contract rank, and Manulife rank. This report also includes benchmarking against Manulife's block of business. Results can be ranked by both total amount paid and by number of claims.

This report will only produce results when the grouping has 25 or more claimants within the selected reporting period.

How can I use it?

This report can be used to understand the most common indications within the drug plan and how the plan compares against Manulife's block of business.

Most Common Indication Report (with 15 Claimant Privacy and Confidentiality Filter)

What does this report show?

This report ranks the most common indication by plan's paid rank, amount paid, percentage of total amount paid, number of occurrences, percentage of total number of occurrences, and occurrence rank. Results can be ranked by both total amount paid and by number of claims.

This report will only produce results when the grouping has 15 or more claimants within the selected reporting period.

How can I use it?

This report can be used to understand the most common indications within a plan.

Note

Use the Privacy and Confidentiality Claimant Filter to generate the reports above. Choose between:

• 15
• 25

Pooled Claims Report

Pooled Claims by Certificate Report

What does this report show?

This report provides two tabs; the first tab displays family number, relationship, amount reimbursed, and pooled amount for the population who has pooled claims within the reporting period. This report should only be used for groups where pooling is setup based on certificates.

The second tab provides a detailed view of the claims experience for the population who has pooled claims within the reporting period. The report includes contract, division, class, family number, relationship, service date, issue and reversal date, benefit category, benefit description, Manulife DrugWatch indicator, province, paid, and pooled amount.

How can I use it?

This report can be used to determine the number of certificates who reached their pooling limit and the type of claims they have filed within a reporting period.

Pooled Claims by Relationship Report

What does this report show?

This report provides two tabs; the first tab displays family number, relationship, amount reimbursed, and pooled amount for the population who has pooled claims within the reporting period.

The second tab provides a detailed view of the claims experience for the population who has pooled claims within the reporting period. The report includes policy, division, class, family number, relationship, service date, issue and reversal date, benefit category, benefit description, Manulife DrugWatch indicator, province, amount reimbursed, and pooled amount.

This report should only be used for groups where pooling is setup based on certificate and relationship.

How can I use it?

This report can be used to determine the number of certificates who had reached their pooling limit and the type of claims they have filed within a reporting period.

Note

Use the Pool Claims By filter to generate the reports above. Choose between:

• Certificate
• Relationship

Recurrent Claims Report

What does this report show?

This report displays benefit category, benefit description, number of unique members, number of unique claimants, total amount submitted, total amount eligible, and total amount paid for the recurrent claimers who have reached the selected threshold. A recurrent claimer is identified as having claimed the same benefit in two consecutive 12-month periods. The recurrent claimer is also displayed in percentage to the entire population.

How can I use it?

This report can be used to identify detailed information about the recurrent claimants over the reporting period within the selected threshold.

Specialty Drug Claims Summary Report

What does this report show?

This report compares utilization of high cost specialty drugs with traditional, non-specialty medications. The data is summarized by maintenance flag, number of unique claimants, number of members, number of occurrences, amount submitted, amount eligible, and amount paid.

How can I use it?

This report can be used to gain insights into the group's utilization of specialty drugs versus traditional, non-specialty medications.

Top Drug Ranking Report by Active Ingredient

Top Drug Ranking Report by Active Ingredient (with 25 Claimant Privacy and Confidentiality Filter)

What does this report show?

This report ranks the top active ingredients claimed under the plan, by either total amount paid or by number of claims. The active ingredient includes all strengths of the drug, any brand/generic equivalents, as well as biosimilars. Additional information is provided around most common indication, number of unique claimants, number of occurrences, total dispensing fee submitted, total dispensing fee paid, total deductible, total COB amount, total amount submitted, total amount eligible, total amount paid, contract rank, and Manulife rank. This report also includes benchmarking against Manulife's block of business.

This report will only produce results when the grouping has 25 or more claimants within the selected reporting period.

How can I use it?

This report can be used to understand the top active ingredients claimed under the plan and how the plan compares against Manulife's block of business.

Top Drug Ranking Report by Active Ingredient (with 15 Claimant Privacy and Confidentiality Filter)

What does this report show?

This report ranks the top active ingredients claimed under the plan by either total amount paid or by number of claims. The active ingredient includes all strengths of the drug, any brand/generic equivalents, as well as biosimilars. The report also provides information on the total amount paid, percentage of total amount paid, number of occurrences, and percentage of total number of occurrences for each active ingredient.

This report will only produce results when the grouping has 15 or more claimants within the selected reporting period.

How can I use it?

This report can be used to understand the top active ingredients claimed under the plan.

Note

Use the Privacy and Confidentiality Claimant Filter to generate the reports above. Choose between:

• 15
• 25

Top Drug Ranking Report by DIN

Top Drug Ranking Report by DIN (with 25 Claimant Privacy and Confidentiality Filter)

What does this report show?

This report ranks the top DINs claimed under the plan by either total amount paid or number of claims. A unique DIN is issued for every strength of a drug, as well as a brand, generic, and biosimilar. Additional information for each DIN claimed is provided, including most therapeutic class, common indication, number of unique claimants, number of occurrences, total dispensing fee submitted, total dispensing fee paid, total deductible, total COB amount, total amount submitted, total amount eligible, total amount paid, contract rank, and Manulife rank. This report also includes benchmarking against Manulife's block of business.

This report will only produce results when the grouping has 25 or more claimants within the selected reporting period.

How can I use it?

This report can be used to understand the top DINs claimed under the plan.

Top Drug Ranking Report by DIN (with 15 Claimant Privacy and Confidentiality Filter)

What does this report show?

This report ranks the top DINs claimed under the plan by either total amount paid or number of claims. A unique DIN is issued for every strength of a drug, as well as a brand, generic, and biosimilar. Additional information for each DIN claimed is provided, including the therapeutic class, paid rank, amount paid, percentage of total amount paid, number of occurrences, percentage of total number of occurrences, and occurrence rank.

This report will only produce results when the grouping has 15 or more claimants within the selected reporting period.

How can I use it?

This report can be used to understand the top DINs claimed under the plan.

Note

Use the Privacy and Confidentiality Claimant Filter to generate the reports above. Choose between:

• 15
• 25

Top Pharmacy Provider Ranking Report

What does this report show?

This report ranks pharmacy providers by either total amount paid or number of Occurrences. Information about the pharmacy's location, the number of members, number of unique claimants that have filled prescriptions at each pharmacy, number of occurrences, total dispensing fee submitted, total dispensing fee paid, average dispensing fee paid, average amount paid, and total amount reimbursed at each pharmacy is included in the report. This report excludes all Quebec and reimbursement claims.

How can I use it?

This report can be used to understand which are pharmacies are being used by claimants and allows for a comparison of each pharmacy's average dispensing fee.

Utilization Report

What does this report show?

This report displays benefit, benefit category, benefit description, number of unique members, number of unique claimants, number of occurrences, total amount submitted, total amount eligible, and total amount reimbursed for the population who has reached the utilization threshold within the reporting period.

How can I use it?

This report can be used to identify detailed information about the claimants who reached the utilization threshold within the reporting period.

Drug Claims Cost by Division Report

What does this report show?

This report shows the division, number of occurrences, number of reversals, total ingredient cost, average ingredient cost, total dispensing fee, average dispensing fee, member payment and benefits paid for all drug claims with a claims paid date during the selected reporting period, according to the division and claimant, sorted by division. The numeric results are displayed in ascending order by division.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review drug claims information regarding the number of occurrences, ingredient cost (total and average), dispensing fee (total and average) and benefits paid by division.

The report will include:

• the number of occurrences by division and total for all divisions for the selected reporting period; and
• the total ingredient cost by division and total for all divisions for the selected reporting period; and
• the average ingredient cost by division and total for all divisions for the selected reporting period; and
• the total dispensing fee by division and total for all divisions for the selected reporting period; and
• the average dispensing fee by division and total for all divisions for the selected reporting period; and
• the benefits paid by division and total for all divisions for the selected reporting period.

Drug Claims Cost Trend Report

What does this report show?

This report shows the interval, number of occurrences, total ingredient cost, average ingredient cost, total dispensing fee, average dispensing fee and benefits paid for all drug claims with a claims paid date during the selected reporting period, according to the division and claimant, sorted by interval. The results are displayed in ascending order by interval.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review drug claims information regarding the interval, number of occurrences, ingredient cost (total and average), dispensing fee (total and average) and benefits paid over various report intervals.

The report will include:

• the number of occurrences by interval and total for all intervals for the selected reporting period; and
• the total ingredient cost by interval and total for all intervals for the selected reporting period; and
• the average ingredient cost by interval and total for all intervals for the selected reporting period; and
• the total dispensing fee by interval and total for all intervals for the selected reporting period; and
• the average dispensing fee by interval and total for all intervals for the selected reporting period; and
• the benefits paid by interval and total for all intervals for the selected reporting period.

Drug Claims Cost Trend Benchmark Report

What does this report show?

This report shows the interval, number of occurrences, total ingredient cost, average ingredient cost, total dispensing fee, average dispensing fee and benefits paid for all drug claims with a claims paid date during the selected reporting period, according to the division and claimant, sorted by interval. The results are displayed in ascending order by interval.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review drug claims information regarding the interval, number of occurrences, ingredient cost (total and average), dispensing fee (total and average) and benefits paid over various report intervals.

The report will include:

• the number of occurrences by interval and total for all intervals for the selected reporting period; and
• the total ingredient cost by interval and total for all intervals for the selected reporting period; and
• the average ingredient cost by interval and total for all intervals for the selected reporting period; and
• the total dispensing fee by interval and total for all intervals for the selected reporting period; and
• the average dispensing fee by interval and total for all intervals for the selected reporting period; and
• the benefits paid by interval and total for all intervals for the selected reporting period.

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Dental Claims by Service Report

What does this report show?

This report shows the number of occurrences, benefits paid and associated percentage for all dental claims with a claims paid date during the selected reporting period, according to the division and claimant, sorted by service. The numeric results are displayed in descending order by either number of occurrences or benefits paid.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the number of occurrences and benefits paid by service.

The report will include:

• the number of occurrences, associated percentages by service category and total for all service categories for the selected reporting period; and
• the benefits paid, associated percentages by service category and total for all service categories for the selected reporting period.

This report may include the following service categories:

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Dental Claims Trend by Service Report

What does this report show?

This report shows the percentage of total dental claims or percentage of dental health benefits paid by service category for five consecutive report intervals with a claims paid date during the selected reporting period, according to the division and claimant, sorted by service. The numeric results are displayed in descending order by either number of occurrences or benefits paid.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the percentage of total dental claims or percentage of total dental benefits paid by service for up to five consecutive report intervals.

This report may include the following service categories:

Dental Claims Trend by Service Benchmark Report

What does this report show?

This report shows the percentage of total dental claims or percentage of dental health benefits paid by service category for five consecutive report intervals with a claims paid date during the selected reporting period, according to the claimant, sorted by service. The numeric results are displayed in descending order by either number of occurrences or benefits paid.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the percentage of total dental claims or percentage of total dental benefits paid by service for up to five consecutive report intervals.

This report may include the following service categories:

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Dental Claims by Age Report

What does this report show?

This report shows the number of occurrences, benefits paid and associated percentage for all dental claims with a claims paid date during the selected reporting period, according to the division and claimant, sorted by age band. The numeric results are displayed in ascending order by age band.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the number of occurrences and benefits paid by age band.

The report will include:

• the number of occurrences, associated percentages by age band and total for all age bands for the selected reporting period; and
• the benefits paid, associated percentages by age band and total for all age bands for the selected reporting period.

This report may include the following service categories:

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Dental Claims by Gender Report

What does this report show?

This report shows the number of occurrences, benefits paid and associated percentage for all dental claims with a claims paid date during the selected reporting period, according to the division and claimant, sorted by gender. The numeric results are displayed in ascending order by gender category.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the number of occurrences and benefits paid by gender.

The report will include:

• the number of occurrences, associated percentages by gender category and total for all gender categories for the selected reporting period; and
• the benefits paid, associated percentages by gender category and total for all gender categories for the selected reporting period.

This report may include the following service categories:

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Dental Claims by Procedure Report

What does this report show?

This report shows the ranked dental procedures, number of occurrences, benefits paid and associated percentage for all dental claims with a claims paid date during the selected reporting period, according to the division and claimant, sorted by dental procedure. The numeric results are displayed in descending order by either number of occurrences or benefits paid.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the procedure rank, number of occurrences and benefits paid by dental procedure.

The report will include:

• the dental procedure rank and dental procedure rank for benchmark, for the selected reporting period;
• the number of occurrences, associated percentages by dental procedure category and total for all dental procedure categories for the selected reporting period; and
• the benefits paid, associated percentages by dental procedure category and total for all dental procedure categories for the selected reporting period.

This report may include the following service categories:

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Dental Claims by Service & Relationship Report

What does this report show?

This report shows the benefit category, associated sub-categories for service, benefits paid for each type of claimant (employee, spouse and child) and the associated percentage for all dental claims with a claims paid date during the selected reporting period, according to the division. The numeric results are displayed in ascending order by benefit category and then ascending order according to the associated service sub-category.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the dental benefits paid for each type of claimant.

The report will include:

• the benefits paid, associated percentages by service sub-category and total for each type of claimant for the selected reporting period, and
• the total benefits paid for each service sub-category.

This report may include the following service categories:

Dental Claims by Service Detail Report

What does this report show?

This report shows the number of occurrences, benefits submitted, benefits covered, benefits paid and average cost per occurrence for all dental claims with a claims paid date during the selected reporting period, according to the division, claimant and age band, sorted by service. The numeric results are displayed in descending order by either number of occurrences or benefits paid.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review dental claims information regarding the number of occurrences, benefits submitted, benefits covered and average cost per occurrence by service category.

The report will include:

• the number of occurrences and associated average costs per occurrence by service category and total for all service categories for the selected reporting period; and
• the benefits submitted by service category and total for all service categories for the selected reporting period; and
• the benefits covered by service category and total for all service categories for the selected reporting period; and
• the benefits paid by service category and total for all service categories for the selected reporting period.

This report may include the following service categories:

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Graduated Return to Work Report

What does this report show?

This report shows the number of claims, number of claims involved in a graduated return to work program and associated percentage according to the selected reporting interval, claim status, benefit type and claims listing group. The information was sorted by reporting period.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the number of claims, number of claims involved in a graduated return to work program and the associated percentage over a specified reporting interval.

The report will include:

• the number of claims which have had a payment within the reporting period; and
• the number of claims involved in a graduated return to work program which have had a payment within the reporting period; and
• the percentage of claims involved in a graduated return to work program.

Information on Disability Claim Summary Report

What does this report show?

This report provides general disability claim information including policy information, member information, claim details, case management Information and payment information (where applicable). Results are sorted by plan member name in alphabetical order and reflect all current active claims, as well as any closed claims within a 24 month period from the specified date.

How can I use it?

You can set parameters for your report including benefit and division or class, and produce a summary report of all plan members within your specified criteria. You can also search for plan member specific results by using name or certificate number search functions. Some additional features include the ability to click the plan member name from the summary screen to view, print or save a PDF copy of a one page Individual Member Claim Status Report for the specific plan member. You may also click the hyperlinked case manager's e-mail address to quickly launch an email to that individual in case you need to ask any case specific questions. Finally, the entire summary report can also be downloaded to a spreadsheet format to include all fields within the individual form for your ease of use.

Additional information on how to use the online disability claim status reports can be found in the online training library under the reports section.

For more information please review:
Disability claim status report field descriptions - LTD/STD
Disability claim status report training tutorial - LTD/STD
Disability claim status report how to and FAQ - LTD/STD

Information on Disability Case Status Report

What does this report show?

This report provides general disability claim information including policy information, member information, case details, case management information and case history. Results are sorted by plan member name in alphabetical order and reflect all current active cases, as well as any closed cases within a 24 month period from the specified date.

How can I use it?

You can set parameters for your report including benefit and division or class, and produce a summary report of all plan members within your specified criteria. You can also search for plan member specific results by using name or certificate number search functions. Some additional features include the ability to click the plan member name from the summary screen to view, print or save a PDF copy of a one page Member Case Status Report for the specific plan member. You may also click the hyperlinked case manager's e-mail address to quickly launch an email to that individual in case you need to ask any case specific questions. Finally, the entire summary report can also be downloaded to a spreadsheet format to include all fields within the individual form for your ease of use.

Additional information on how to use the online disability claim status reports can be found in the online training library under the reports section.

For more information please review:
Disability claim status report field descriptions - AMS
Disability claim status report training tutorial - AMS
Disability claim status report how to and FAQ - AMS

Disability Claims Profile by Diagnosis, Gender, Age and Status

What does this report show?

This report shows a summary of claims by various demographic categories, including diagnostic category, gender, age and claim status.

How can I use it?

This is a useful one-page snapshot that can be used to better understand the causes, profile and status of the current disability claims, such as:

• Determine the most common diagnostic categories based on current claims,
• Assess the distribution of claims by male and female claimants,
• Review a snapshot of the age demographic of the current open claims,
• Understand where most disability claims are in the adjudication process, based on the claim status

NOTE:

There must be a minimum of ten claims in total over three diagnostic categories with at least 3 claims in each category for a report to be produced.

Disability Paid Claims by Diagnosis, Gender and Age

What does this report show?

This report summarizes the disability claims paid in the period according to diagnostic category, gender and age. It includes all claims, regardless of status, where a payment or payment adjustment was processed in the period.

How can I use it?

For short term disability claims, this report can be used to review the volume of claims and total dollars paid for benefits in the period specified. Claims will be broken down by accident and sickness, age, diagnostic category, claim submission timing, and gender.

This report includes:

• the total volume of claims for each category
• the average number of days for claim submission from the date of disability
• the total and average days paid in each category
• the total and average benefit paid in each category

For long term disability claims, this report can be used to review the volume of claims and total dollars paid for benefits in the period specified. Claims will be broken down by age, diagnostic category, and gender.

This report includes:

• the total volume of claims for each category
• the total and average months paid in each category
• the total and average benefit paid in each category

NOTE:

There must be a minimum of ten claims in total over three diagnostic categories with at least 3 claims in each category for a report to be produced.

Disability Claim Activity Summary

What does this report show?

This report shows a summary of claim activity in each of several claim status categories. It provides a beginning and ending balance of claim volume and the activity that has happened over the period selected.

How can I use it?

This report can be used to review and understand the total volume of claim activity for a specific time period.

The report includes a summary of claim activity volume for each of the following:

• active claim activity
• pending claim activity
• appealed claim activity
• recurring claim activity
• litigation claim activity
• rehabilitation case activity on active claims

Disability Claim Duration by Gender Report

What does this report show?

This report shows the number of claims, days disabled and associated average of all disability claims that have been resolved during the selected reporting period according to the benefit type and claim listing group, sorted by gender.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about how long claims have continued until resolution, and the number of claims for each gender.

The report will include:

• the number of claims that were resolved within the reporting period for each gender; and
• the total number of days disabled for all claims during the selected reporting for each gender; and
• the average days disabled for all claims within the selected reporting period for each gender.

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Disability Claim Duration by Age Report

What does this report show?

This report shows the number of claims, days disabled and associated average of all disability claims that have been resolved during the selected reporting period according to the benefit type and claim listing group, sorted by the age at the start of disability.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about how long claims have continued until resolution, and the number of claims that fell into an age category.

The report will include:

• the number of claims that were resolved within the reporting period for each age category; and
• the total number of days disabled for all claims during the selected reporting for each age category; and
• the average days disabled for all claims within the selected reporting period for each age category.

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Disability Claims Trend by Gender

What does this report show?

This report shows the percentage of total claims or percentage of total benefits paid by gender for five consecutive report intervals according to the selected report interval, benefit type, Claim Listing Group, claim status, sorted by gender.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the percentage of total claims or percentage of total benefits paid by gender for up to five consecutive report intervals.

Disability Claims Trend by Age

What does this report show?

This report shows the percentage of total claims or percentage of total benefits paid by age band for five consecutive report intervals according to the selected report interval, benefit type, claim listing group, claim status, sorted by age band.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the percentage of total claims or percentage of total benefits paid by age band for up to five consecutive report intervals.

Disability Claims Distribution by Gender

What does this report show?

This report shows the number of claims, benefits paid and associated percentage by gender for the report period according to the benefit type, claim listing group and claim status, sorted by gender.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the number of claims and benefits paid by gender.

The report will include:

• the number of claims with associated percentage and total by gender for the reporting period; and
• the total benefits paid with associated percentage and total by gender for the reporting period.

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Disability Claims by Diagnosis

What does this report show?

This report shows the number of claims, total benefits paid and associated percentage by diagnosis category for the report period according to the selected benefit type, claim listing group, claim status, age band and gender, sorted by diagnosis.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the number of claims and benefits paid by diagnosis category

The report will include:

• the number of claims with associated percentage and total by diagnosis category for the reporting period and
• the total benefits paid with associated percentage and total by diagnosis category for the reporting period

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Disability Claims Trend By Diagnosis

What does this report show?

This report shows the percentage of total claims or percentage of total benefits paid by diagnosis category for five consecutive report intervals according to the selected report interval, benefit type, claim listing group, claim status, age band and gender, sorted by diagnosis.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the percentage of total claims or percentage of total benefits paid by diagnosis category for up to five consecutive report intervals.

Long-Term Disability Claims Payment Duration Detail Report

What does this report show?

This report shows the total amount paid over the life of the claim for all disability payments issued while claimants were disabled during the selected reporting period; sorted by claimant.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information for claimants who incurred claims in a specific time period.

The report will include:

• the current status of the claim,
• the start and end dates for benefits,
• the overall benefit duration of the claim, and
• the total amount paid.

Short-Term Disability Claims Payment Duration Detail Report

What does this report show?

This report shows the total amount paid over the life of the claim for all disability payments issued while claimants were disabled during the selected reporting period; sorted by claimant.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information for claimants who incurred claims in a specific time period.

The report will include:

• the current status of the claim,
• the start and end dates for benefits,
• the overall benefit duration of the claim, and
• the total amount paid.

Short-Term Disability Claims Payment Duration Detail Report

What does this report show?

This report shows the total amount paid over the life of the claim for all disability payments issued while claimants were disabled during the selected reporting period; sorted by claimant.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information for claimants who incurred claims in a specific time period.

The report will include:

• the current status of the claim,
• the start and end dates for benefits,
• the overall benefit duration of the claim, and
• the total amount paid.

Health Claims by Service Report

What does this report show?

This report shows the number of occurrences, benefits paid and associated percentage for all health claims with a claims paid date during the selected reporting period, according to the division and claimant, sorted by service. The numeric results are displayed in descending order by either number of occurrences or benefits paid.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the number of occurrences and benefits paid by service.

The report will include:

• the number of occurrences, associated percentages by service category and total for all service categories for the selected reporting period; and
• the benefits paid, associated percentages by service category and total for all service categories for the selected reporting period.

This report may include the following service categories:

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Health Claims Trend by Service Report

What does this report show?

This report shows the percentage of total health claims or percentage of total health benefits paid by service category for five consecutive report intervals with a claims paid date during the selected reporting period, according to the division and claimant, sorted by service. The numeric results are displayed in descending order by either number of occurrences or benefits paid.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the percentage of total health claims or percentage of total health benefits paid by service for up to five consecutive report intervals.

This report may include the following service categories:

Health Claims by Service Detail Report

What does this report show?

This report shows the number of occurrences, benefits submitted, benefits covered, benefits paid and average cost per occurrence for all health claims with a claims paid date during the selected reporting period, according to the division, claimant and age band, sorted by service. The numeric results are displayed in descending order by either number of occurrences or benefits paid.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review health claims information regarding the number of occurrences, benefits submitted, benefits covered and average cost per occurrence by service category.

The report will include:

• the number of occurrences and associated average costs per occurrence by service category and total for all service categories for the selected reporting period; and

• the benefits submitted by service category and total for all service categories for the selected reporting period; and

• the benefits covered by service category and total for all service categories for the selected reporting period; and

• the benefits paid by service category and total for all service categories for the selected reporting period.

This report may include the following service categories:

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Health Claims by Age Report

What does this report show?

This report shows the number of occurrences, benefits paid and associated percentage for all health claims with a claims paid date during the selected reporting period, according to the division and claimant, sorted by age band. The numeric results are displayed in ascending order by age band.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the number of occurrences and benefits paid by age band.

The report will include:

• the number of occurrences, associated percentages by age band and total for all age bands for the selected reporting period; and

• the benefits paid, associated percentages by age band and total for all age bands for the selected reporting period.

This report may include the following service categories:

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Health Claims by Gender Report

What does this report show?

This report shows the number of occurrences, benefits paid and associated percentage for all health claims with a claims paid date during the selected reporting period, according to the division and claimant, sorted by age band. The numeric results are displayed in ascending order by age band.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the number of occurrences and benefits paid by gender.

The report will include:

• the number of occurrences, associated percentages by gender category and total for all gender categories for the selected reporting period; and

• the benefits paid, associated percentages by gender category and total for all gender categories for the selected reporting period.

This report may include the following service categories:

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Health Claims by Service & Relationship Report

What does this report show?

This report shows the benefit category, associated sub-categories for service, benefits paid for each type of claimant (employee, spouse and child) and the associated percentage for all health claims with a claims paid date during the selected reporting period, according to the division. The numeric results are displayed in ascending order by benefit category and then ascending order according to the associated service sub-category.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the health benefits paid for each type of claimant.

The report will include:

• the benefits paid, associated percentages by service sub-category and total for each type of claimant for the selected reporting period, and

• the total benefits paid for each service sub-category.

This report may include the following service categories:

Health Claims Trend by Service Benchmark Report

What does this report show?

This report shows the percentage of total health claims or percentage of total health benefits paid by service category for five consecutive report intervals with a claims paid date during the selected reporting period, according to the claimant, sorted by service. The numeric results are displayed in descending order by either number of occurrences or benefits paid.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the percentage of total health claims or percentage of total health benefits paid by service for up to five consecutive report intervals.

This report may include the following service categories:

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Disability Claims Distribution by Age

What does this report show?

This report shows the number of claims, total benefits paid and associated percentage by age band for the report period according to the selected benefit type, claim listing group and claim status, sorted by age band.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

How can I use it?

To review information about the number of claims and benefits paid by age band.

The report will include:

• the number of claims with associated percentage and total by age band for the reporting period; and
• the total benefits paid with associated percentage and total by age band for the reporting period

About Benchmarks

There must be enough plans with sufficient claims in the same reporting period to produce a credible comparison and useful benchmark. For industry benchmarks, if there are not enough plans with claims available, the actual industry used to create a benchmark may vary. Additionally, all benchmarks will be made against information available during the requested reporting period. Benchmarks include information from all plans with data available during the requested reporting period.

Transaction Log Summary Report

The Transaction Log Summary Report provides a summary of the web reports, which includes information on usage and is sub-totalled by report, company id and user role.

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

Transaction Log Report

NOTE:

If you schedule your request, the values for 'Reporting Interval' or 'Reporting Period' are not used, but you will be able to specify additional parameters to have the report run on a regular basis automatically.

The following information is a listing of the report title, parameter numbers and associated description of each parameter number.

The columns in the report result page will display the parameter number (but not the description) in each column header. This window can be used as a reference to describe each parameter number.

• DIS1/C/B/D - Disability Claim Detail List
1. 1. Contract Id
2. 2.Benefit Type
3. 3. Claim List Group
4. 4. Claim Stat Code
5. 5. Benefit Duration in Weeks or Months
6. 6. Total Claim Pd
7. 7. Reporting Pd
• DIS3/B - Disability Claims Distribution by Diagnosis
1. 1. Contract Id
2. 2. Claim List Group
3. 3. Benefit Type (Short / Long Term)
4. 4. Status Type (All / Active / Resolved)
5. 5. Report Basis (Disabled / Paid)
6. 6. Payment Period
7. 7. Results by Number of Claims or Amt
8. 8. Gender option (both / Male / Female)
9. 9. Age Range
10. 10. Benchmark Chosen (None / Industry / Manulife)
• DIS4/B - Disability Claims Trend by Diagnosis
1. 1. Contract Id
2. 2. Claim List group
3. 3. Benefit Type (Short / Long Term)
4. 4. Status Type (All / Active / Resolved)
5. 5. Report Basis (Disabled / Paid)
6. 6. Interval - Ending Date
7. 7. Results by Number of Claims or Amt
8. 8. Gender option (both / Male / Female)
9. 9. Age Range
• DIS5I - Disability Claims Distribution by Age
1. 1. Contract Id
2. 2. Claim List group
3. 3. Benefit Type (Short / Long Term)
4. 4. Status Type (All / Active / Resolved)
5. 5. Report Basis (Disabled)
6. 6. Reporting Period
7. 7. Benchmark (None / Industry / Manulife)
• DIS6I - Disability Claims Trend by Age
1. 1. Contract Id
2. 2. Claim List group
3. 3. Benefit Type (Short / Long Term)
4. 4. Status Type (All / Active / Resolved)
5. 5. Report Basis (Disabled)
6. 6. Interval - Ending Date
7. 7. Results by Number of Claims or Amt
• DIS7I - Disability Claims Distribution by Gender
1. 1. Contract Id
2. 2. Claim List group
3. 3. Benefit Type (Short / Long Term)
4. 4. Status Type (All / Active / Resolved)
5. 5. Report Basis (Disabled)
6. 6. Interval - Ending Date
7. 7. Results by Number of Claims or Amt
• DIS8I - Disability Claims Trend by Gender
1. 1. Contract Id
2. 2. Claim List group
3. 3. Benefit Type (Short / Long Term)
4. 4. Status Type (All / Active / Resolved)
5. 5. Report Basis (Disabled)
6. 6. Reporting Period
7. 7. Benchmark (None / Industry / Manulife)
• DIS9I - Disability Claims Duration
1. 1. Contract Id
2. 2. Claim Status Terminated (default, hidden value)
3. 3. Benefit Type (Short / Long Term)
4. 4. Reporting Pd Type (Claims Disabled / Claims Resolved)
5. 5. Reporting Period
6. 6. Benchmark (None / Industry / Manulife)
• DIS10I - Disability Claims Duration by Diagnosis
1. 1. Contract Id
2. 2. Claim Status Terminated (default, hidden value)
3. 3. Benefit Type (Short / Long Term)
4. 4. Reporting Pd Type (Claims Disabled / Claims Resolved)
5. 5. Reporting Period
6. 6. Results by Incidence or Days Disabled
7. 7. Benchmark (None / Industry / Manulife)
• DIS11I - Disability Claim Duration by Age
1. 1. Contract Id
2. 2. Claim List group
3. 3. Status Type (Resolved)
4. 4. Benefit Type (Short / Long Term)
5. 5. Report Category Code (T)
6. 6. Reporting Period
7. 7. Benchmark (None / Industry / Manulife)
• DIS12I - Disability Claim Duration by Gender
1. 1. Contract Id
2. 2. Claim List group
3. 3. Status Type (Resolved)
4. 4. Benefit Type (Short / Long Term)
5. 5. Report Category Code (T)
6. 6. Reporting Period
7. 7. Benchmark (None / Industry / Manulife)
• DIS14I - Short-term Disability Repeat Claimants Detail Report
1. 1. Contract Id
2. 2. Benefit Type (Short Term)
3. 3. Claim List group
4. 4. Status Type (All codes)
5. 5. Reporting Period
6. 6. Repeat Claims (2,3,4,5)
7. 7. Report Basis (Disabled)
• DIS15I - Graduated Return to Work
1. 1. Contract Id
2. 2. Claim List group
3. 3. Benefit Type (Short / Long Term)
4. 4. Status Type (All / Active / Resolved)
5. 5. Interval - Ending Date
6. 6. Benefits Paid (!=0)
• HD1/DT1 - Health / Dental Claims by Service
1. 1. Contract Id
2. 2. Division List group
3. 3. Claimant (All / Employee / Spouse / Child)
4. 4. Reporting Period
5. 5. Results by Number of Claims or Amt
6. 6. Benchmark (None / Industry / Manulife)
• HD2/DT2 - Health / Dental Claims Trend by Service
1. 1. Contract Id
2. 2. Division List group
3. 3. Claimant (All / Employee / Spouse / Child)
4. 4. Reporting Period
5. 5. Results by Number of Claims or Amt
• HD3/DT3 - Health / Dental Claims Trend by Service Benchmark
1. 3. Claimant (All / Employee / Spouse / Child)
2. 4. Reporting Period
3. 5. Results by Number of Claims or Amt
4. 4. Benchmark (Industry / Manulife)
• HD4/DT4 - Health / Dental Claims by Service Detail
1. 1. Contract Id
2. 2. Division List group
3. 3. Claimant (All / Employee / Spouse / Child)
4. 4. Reporting Period
5. 5. Results by Number of Claims or Amt
6. 6. Benchmark (None / Industry / Manulife)
• HD5/DT5 - Health / Dental Claims by Age Report
1. 1. Contract Id
2. 2. Division List group
3. 3. Claimant (All / Employee / Spouse / Child)
4. 4. Reporting Period
5. 6. Benchmark (None / Industry / Manulife)
• HD6/DT6 - Health / Dental Claims by Gender Report
1. 1. Contract Id
2. 2. Division List group
3. 3. Claimant (All / Employee / Spouse / Child)
4. 4. Reporting Period
5. 6. Benchmark (None / Industry / Manulife)
• DT7 - Dental Claims by Procedure Report
1. 1. Contract Id
2. 2. Division List group
3. 3. Claimant (All / Employee / Spouse / Child)
4. 4. Reporting Period
5. 5. Results by Number of Claims or Amt
6. 6. Benchmark (None / Industry / Manulife)
• HD13/DT13 - Health / Dental Claims by Service & Relationship Report
1. 1. Contract Id
2. 2. Division List group
3. 4. Reporting Period