Blue Ridge Software is please to announce a strategic alliance with
Computer Associates to distribute and provide services for M+, an
award-winning medical underwriting framework for doing new business
and renewal underwriting for individual and small group healthcare
policies.  M+ also runs on a Web server to do standalone underwriting
or assist in the full enrollment of a prospect.

Overview of M+

Designed specifically for Individual and Group medical policy underwriting,
M+ allows a company to quickly automate its medical underwriting process
…and quickly realize the benefits of improved productivity, consistency of
decision making, increased effectiveness, and improved accuracy, leading to a
more desirable book of business.  There are two modules in M+ which work
together - M+ New Business & M+ Renewals.  M+ ASP (Application
Service Provider) is an option for M+ New Business as explained below.

M+ New Business  
    

M+ ASP

M+ ASP is an option for those companies that do not want the overhead of a new in-house
software application and database.  The same underwriter would define the rules as before, but the
execution of the program is done over the internet in more of a "detailed medical quick quote"
mode.  The same underwriting advantages apply, too.  What's missing is the link to existing claims
data and ongoing tracking of health risk for the person and block of business.  M+ ASP is
available now on a subscription basis.

M+ Renewals

M+ Renewals uses claims data to "answer" the same questions the underwriters defined for New
Business.  Once a claims data mart is established, this allows for the unattended running of renewing
groups (or a larger block of business).  No more pouring over claims printouts and having
underwriters make assessments on a snapshot of data.  Combined with medical conditions from
enrollment, the renewals system updates the health risk of an individual or group continually using
industry-standard fields like ICD-9 code, CPT codes, and drug categories.

M+ Components

At the heart of M+ is the intellectual knowledge of insurance and medical experts. It is the result of
years of underwriting rule development based on analysis of claims history, actuarial analysis and
formulae, and the expertise of medical doctors, nurses, and senior Medical Underwriters.  The
intellectual knowledge is delivered in three distinct software components of M+ : the Knowledge
Base, User Interface, and Technical Architecture.

Knowledge Base. Deep underwriting and actuarial knowledge captured in 1,000+ underwriting
business rules. Based upon a core set of proven and tested production medical underwriting rules,
the system automatically applies underwriting rules and guidelines to underwrite individual and group
business.

The business rules are automated using CA's Cleverpath Aion BRE, the industry's leading
rules-based development tool. The rules are conditionally applied based on medical data, and are
segmented by ICD-9 codes. The framework:

- Incorporates hundreds of ICD-9 specific medical underwriting rules, with support for “zero-debit”
and “dread” medical conditions.
- Determines debit levels and dread indicators. As with the rest of the framework, debit level
assignment and dread indicators are all customizable.
- Determines a recommended course of action, including referrals to underwriting.
- Provides individual debit scoring, as well as individual and group rate level determination.
- Generates an Audit Trail for the purposes of reporting and analysis.
- Incorporates rules for case management and medical management, as well as logic for reinsurance
candidate identification.

User Interface. The M+ framework has a Graphical User Interface (GUI) that is used for the
purpose of processing new business, as well as various underwriting and actuarial maintenance
functions. The GUI provides for efficient, intuitive screen navigation. The GUI drives the intelligent
collection of the information necessary for medical underwriting and:

- Provides a base set of screens for capturing enrollment information.
- Provides additional detailed medical condition-specific data collection capabilities.
- Provides additional detailed treatment and recovery-specific data collection capabilities.
- Provides an ICD-9 lookup facility, which is used by the end-user to equate medical diagnostic
codes to applicant conditions.
- Provides the ability to save and recall group and participant data.
- Provides the ability to store application data in a database for later recall or reporting.
- Is customizable, which allows for enhancements such as the automated underwriting worksheets.  
Lead underwriters can generate and maintain their own set of rules that are easily migrated through
the IT deployment process.

Technical Architecture. The M+ framework has an object-oriented application architecture
and supporting relational data model. The system has been designed to operate in a variety of
environments. Legacy system integration, as well as embedding the medical underwriting rules, is a
typical project step. Additionally, the application can execute on a variety of hardware platforms and
operating systems (Win32, UNIX, and MVS).

Summary

M+ has the potential to decentralize and distribute key knowledge and decision making to the
employees and offices that need it - making them more productive in their daily execution of core
business processes. In summary, M+:

- Automates underwriting, ensuring consistent decision making, thus enabling the timely processing of
a larger book of business.
- Executes the underwriting process, taking into account the many medical conditions and factors
that are applied to an underwriting decision.
- Utilizes 50 person years of research and development knowledge of medical underwriting experts
to underwrite and make recommendations on courses of action.
- Automatically underwrites the majority of medical underwriting for individual/group business
without human intervention, allowing senior Medical Underwriters to concentrate on the business that
requires human decision making.
- Implements a core component of tested, production-ready medical underwriting rules, thereby
providing rapid time to market.