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- Group Insurance Admin
- Frequently asked questions
Questions, answered
Practical answers for the first group policy and its operating cycle.
Group Insurance Admin
10 questions
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How do I get started?
Click Get started, then use Proto to configure Group Insurance Admin for your business. Pilot one employer organization, one policyholder group, a dated policy and a reviewed eligibility extension.
Who prepares a policy?
The Insurance Coordinator records the organization, policyholder group, assigned owner, premium, effective date and coverage lines.
Who decides whether a submitted revision is acceptable?
The Authorized Underwriter records an independent decision and reason against the source revision.
Where does employer eligibility live?
The eligibility extension belongs to its parent policy and organization, with employer, effective date, member count and plan reference.
How are coverage changes retained?
Coverage lines have dated terms and revisions. Endorsements retain their reason, effective date, approval and carrier receipt.
Does an issued policy mean the premium was received?
Premium receipts have their own received date, provider event identity, amount and verification state.
What decides which cover applies to a claim?
The loss date is compared with the policy’s effective coverage windows, exclusions, limits and deductible.
When is a claim settled?
A reasoned authorized decision establishes the approved benefit. Confirmed payment evidence is reconciled before settlement.
How can we follow an uncertain operation?
The operation receipt keeps the stable key, expected revision, result state and external reference for reconciliation.
Who can read the decision trail?
The Auditor has read access to policy, review, claim, payment and operation evidence within the configured scope.
Set up Group Insurance Admin your way.
Start free, then use Proto to change fields, steps and approvals before your team goes live.