Overview
Every agency is looking for policy gaps and additional selling opportunities. This article includes report examples that you can build and run in Custom Reporting to help you find them. You can build and save these reports to use on a regular basis, and share them across your agency.
IN THIS ARTICLE
Individual coverage audit
In Custom Reporting, you can build reports that show all policies an individual is covered under. An individual may have coverage as a policyholder, a group policy enrollee, or a covered member on a relation's policy. With this in mind, you can customize this report to look for gaps in coverage types.
To get started:
- Select the report type
- We recommend using the ‘Individuals’ report type, so your results will include every individual record that meets your filters and columns.
- Add filters
- Here are examples of filters that you might add to help you dig into your data and find records that fit your custom criteria.
-
- Individual Details > Associated Policy Summaries > Policy Coverage - This filter may be useful if you’re looking for individuals with policies of a specific coverage type.
- Individual Details > Personal Info > Individual ID - This filter may be useful if you’re looking for individuals that only have or don’t have policies of a certain coverage type. This filter will include or exclude individual IDs that can be found within a subquery. See the subquery example in this section for setup instructions.
- Add columns
- Here are examples of fieldsets that you might add columns from. These may vary depending on the type of report you want to run.
-
- Individual Details > Personal Info - Individual ID, name, DOB, age, gender, SSN, and etc.
- Individual Details > Client Info - Individual type and status, Medicare info, smoker status, and servicing agent info.
- Individual Details > Associated Policy Summaries - Policy and coverage info on all/other existing policies.
- Individual Details > Employment Info - Employment status, salary, hire date, term date, and notes.
When you’re satisfied with the results, remember to save your custom report. Once saved, you can run it again and again on a regular basis and share across your agency.
Dig deeper with subqueries
When creating filters for a custom report, you can set up subqueries to drill even further into the data.
Here is an example that you can use to find individuals that waived enrollments for group life policies AND aren’t covered under an individual policy. Only individuals that meet these exact criteria will appear in the report results.
| Individual | Group life policy enrollment | Individual life policy |
|---|---|---|
| John | Enrolled | Yes |
| Tayler | Enrolled | No |
| Bob | Waived | Yes |
| Jill | Waived | No |
Subquery 1
This subquery will only include individuals that waived enrollment to life group policies in your report results.
- Add filter
- Individual Details > Personal Info > Individual ID > in sub query >
- Set up subquery
- Individual Details > Associated Policy Summaries > Enrollment Status > is equal to > Waived
and
Individual Details > Associated Policy Summaries > Policy Coverage > is equal to > Life
Subquery 2
This subquery will exclude all individuals that have any life policy coverages from your report results.
- Add filter
- Individual Details > Personal Info > Individual ID > not in subquery >
- Edit subquery
- Related Options > Policy details > Policy Info > Coverage Type > is equal to > Life
Note: You can customize the subquery examples in this article and apply them across a wide range of scenarios, such as custom group census reports. You may need to make adjustments when setting them up in other report types.
Individual coming of age
In Custom Reporting, you can build reports that show all individuals that are turning 65 or 26. Run this report to find affected covered members and selling opportunities, such as adults aging into Medicare and children aging off of a parent’s plans. You can also customize this report for other age-based or time-based reporting.
To get started:
- Select the report type
- We recommend using the ‘Individuals’ report type, so your results will include every individual record that meets your filters and columns.
- Add filters
- Here are examples of filters that you might add to help you dig into your data and find records that fit your custom criteria.
-
- Individual Details > Personal Info > Age - This filter may be useful if you want to find individuals that are currently 25 or 64.
- Individual Details > Personal Info > Birth Date - This filter may be useful if you want to find individuals that will be turning 65 or 26 within a specific date range. Please note, you’ll need to update the date range every time you run the report.
- Individual Details > Associated Policy Summaries > Policy Coverage - This filter may be useful if you only want to see individuals that have policy coverage or do not have policy coverage. You can also target individuals with policies of a specific coverage type.
- Individual Details > Associated Policy Summaries > Covered Member Individual ID - This filter may be useful if you’re looking for covered members that are turning 26 or 65 and aging off of their relation’s policies. This filter will include or exclude individual IDs that can be found within a subquery. See the subquery example in this section for setup instructions.
- Add columns
- Here are examples of fieldsets that you might add columns from. These may vary depending on the type of report you want to run.
-
- Individual Details > Personal Info - Individual ID, name, DOB, age, gender, SSN, and etc.
- Individual Details > Client Info - Individual type and status, Medicare info, smoker status, and servicing agent info.
- Individual Details > Associated Policy Summaries - Policy and coverage info on all/other existing policies.
- Related Options > Policy Details > Individual Policy > Elections > Covered Members - Policy election info, such as name, DOB, age, and smoker status for all covered members of the policy elections.
When you’re satisfied with the results, remember to save your custom report. Once saved, you can run it again and again on a regular basis and share across your agency.
Dig deeper with subqueries
When creating filters for a custom report, you can set up subqueries to drill even further into the data.
Here is an example that you can use to find all covered members that are turning 26 or 65 in a certain month.
Subquery
This subquery will only include the relations of individuals that are currently 25 or 64 and have a birthday in the month specified in your report results.
- Add filter
- Individual Details > Associated Policy Summaries > Covered Member Individual ID > in sub query >
- Edit subquery
- Column:Individual Details > Relationships > Relation > Individual ID
Individual Details > Relationships > Relation Age > is in list > 25,64
and
Individual Details > Relationships > Relation Birth Date > in month > specify month
Note: You can customize the subquery examples in this article and apply them across a wide range of scenarios, such as custom group census reports. You may need to make adjustments when setting them up in other report types.