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Local Authority Mutual Insurance Claims Management Service PDF Print E-mail

Local Authority Schools Absence Management Fund

Are you a Local Authority which runs their own mutual insurance fund to cover schools staff sickness costs?

Do you want to reduce costs (On average 15%* of fund costs) or save time and hassle?

Is your staff/teacher absence insurance provision really giving you and the schools “Best Value”?

Is your fund suffering from overspend each year or continually have schools leaving the fund?

Whether you call it a Supply Teacher fund, Mutual Fund or School Accident and Illness fund, the chances are you are not managing it as efficiently as you could be, and therefore losing valuable time and money. Our Absence and Claims Management System can help you acheive significant improvements in the way your fund is run.

ACMS

We can help you professionally manage your Staff Sickness Fund and offer the answer to your absence and attendance management headaches. The Esphera Absence & Claims Management System is a fully outsourced Internet based Absence and Claims processing and reporting application specifically designed to replace paper and spreadsheet based claims processes. Once using the system you will be able to receive absence returns and subsequent claims much more easily and monitor and manage absences and supply staff payments more effectively.

Essentially a Local Authority is able to configure the system for its own scheme rules and then allow schools to submit returns electronically to the Authority. These contain details relating to the school itself, holidays for the school, staff members, their absences and claims for payment against the Authority held fund. These are then easily checked on-line by the Authority administrators where feedback and claim outcomes can be notified to the schools immediately.

The reporting side of the system will enable you to report on absences across many different areas. This includes reports detailing or summarising all absence and claim details for particular returns, dates, individuals, causes and many other subjects of interest. An extensive search facility will allow you to find information on all or any of the submitted returns using detailed and complex search criteria where required.

The latest feature of the system is the Renewals Module. This analyses the absence and claims history for a school over a number of time periods and compares it to the average figures across all schools. Using appropriate weighting algorithms the estimator will provide figures on the expected absences for that school and allow the Authority to set a premium which is expected to cover the expected expenditure. These figures can be utilised in the quotation part of the module where schools can choose from a myriad of cover options and be sure that they are getting an equitable premium which external insurance providers cannot match. Not only does this module make setting the premiums a breeze but it also considerably reduces the time taken for the whole renewals process each year. By taking advantage of this facility an authority can refine the scheme to match their schools’ wishes and be confident of running a surplus which can then be used to safeguard future years and provide the best value scheme for the schools. In turn this will result in higher takeup for the scheme, reduced risk and less uncertainty.

Capita BestCapita BestAN ALARM PARTNER

The Esphera system is the only system recommended by Capita Absence Management Services to effectively manage your fund and provide accurate information on which they can more accurately base insurance premiums.

What Local Authorities are saying about their real-life experiences using the system:-

“For the first time our fund is up to date and under control”

“Costs of handling claims reduced by over 80%”

“Takes 30 seconds to do what used to take us 4 weeks”

“It costs us approximately 2.5% of fund – a small overhead compared to the benefits which way exceed that – we’re finding this a real help”

We couldn’t run our scheme effectively without it”

As used by  

MAJOR BENEFITS

  • Self-funding – savings outweigh costs. Typical savings 15% (That’s £450k on a £3m fund!), typical cost of system is 2.5% of fund value.
  • Potentially eliminates paperwork if used to full extent
  • Significantly reduces administrative overheads for both Authority and Schools
  • Reduces duplicate and erroneous claims
  • All processing carried out on-line (- can continue with some paper if required)
  • Simplifies process and allows claim payments to be made quickly and more accurately
  • Enhanced service between Authorities and Schools
  • Improved reporting & analysis of Returns, Absences and Claims resulting in fairer premiums
  • Speeds the location of absence and claim information for adhoc requests
  • Easy identification of problem areas or absence/claim trends
  • More efficient and cost effective management of absences through improved data quality
  • NEW Renewals module saves time and effort and helps reduce risk when setting premiums for forthcoming year
  • NEW Renewals module is highly likely to reduce losses or increase profitability and hence reduce premiums
  • Easy migration path from paper and spreadsheet based systems
  • Makes scheme more attractive to more schools

FEATURES

General

  • Transparent economical cost model
  • No hardware/network/installation or application support issues – just sign up, and start using the service.
  • Can be integrated into your existing website/intranet
  • Colours/ branding can be tailored to give look and feel of the Authority (at extra charge)
  • Context sensitive On-line help system so assistance always on hand
  • NO RISK NO OBLIGATION 3 MONTH TRIAL

Absence Recording and Claims Processing

  • Configurable by Local Authority allowing flexibility to
    • Choose staff categories and school types
    • Preset payment rates, excesses and maximum periods for claims across staff categories and school types to fit virtually any set of scheme rules
    • Delete and merge school information/records
    • Tailor an absence cause/reason hierarchy for reporting purposes
    • Receive email when return is received
  • Schools record details for
    • School, Staff and Holidays
    • Past Absences, Claims for these and Future Expected Absences
  • Intuitive step-by-step Return process – schools are led through in clear, easy to follow manner
  • Changes automatically included on Return to Authority
  • Warnings can be emailed to Authority or Schools when specific conditions arise
  • Return Checking – for Local Authority
    • Can easily see information submitted by the school
    • Can add notes which can optionally be relayed back to school if queries arise
  • Return Checking – for Schools
    • Cannot enter duplicate absences
    • Can easily see progress of Return at Authority
  • Claim Checking – for Local Authority
    • Claims automatically checked to see if within allowable claim limit parameters
    • Checks for multiple and related claims against an absence
    • Highlights other noticeable exception conditions such as
    • Claims outside teacher posting dates
    • Claiming for more days than supply staff used
    • Invalid payment criteria

Reporting

  • Flexible and powerful generic in-built reporting allowing virtually any information you require to be provided
  • Extensive value-add reporting allows viewing of individual details of Schools, Staff, Returns, Absences and Claims
  • Details can be summarised by many different attributes to provide ideal information for problem targeting
  • Reports are ideal for more equitable planning and setting of premium contributions
  • All reports can be instantly downloaded into CSV files for use within Excel
  • Special bespoke layout reports can be built on request (at extra charge)
  • Special bespoke output file formats can be built on request (at extra charge)
  • Schools can produce future absence reports to instantly see their supply teacher requirements at a glance.
  • When summarising by dates there is the option to summarise by the date, day, month, month/year or year to allow trending across various frequencies of time periods.
  • In both detailed and summary reports you can easily sort and filter by all elements allowing easy location of highest or lowest value selected.

Estimating Renewal Premiums/Fees

  • Provides ability to estimate the expected claim level for schools across multiple categories:-
    • Can factor in contingency
    • Can factor in admin calculation
    • Can factor in stoploss calculation
    • Allows parameterisation of estimate to suit Authority
    • Allows school to choose excess day requirement if Authority allows this
    • Allows school to choose benefit level if Authority allows this
    • Flexible history reporting to provide best absence pattern trending

Searching

  • Provides ability to specify multiple criteria for and locate:-
    • Schools using any combination of elements in the Schools element list
    • Staff using any combination of elements in the Schools and Staff element list
    • Returns using any combination of elements in the Returns and Schools element list
    • Past Absences or Claims using any combination of elements in the Returns, Schools, Staff, Past Absences and Claims element list
    • Complex searches that are required on a regular basis can be saved for easy retrieval the next time.

SECURITY

Confidentiality and security of data is always a prime concern and that’s why we have taken every precaution to ensure it stays safe. Security exists at many levels to protect your data

  • The application itself can only be used if you have a valid username and the corresponding password.
  • The application is hosted on a secure server with industry standard 128-bit SSL encryption between it and the user ensuring that deciphering of intercepted data traffic is virtually impossible.
  • All names in the system are 128-bit encrypted so even if a rogue party should get access to the database they will not be able to determine any link between names and data held.
  • The physical security of the data centre holding the server is one of the most secure sites in operation today. The building is manned and monitored 24 hours a day. No one comes in or out without being identified, verified and weighed. The building also has some of the most sophisticated fire and power protection systems available.

PERFORMANCE AND RELIABILITY

The system is run from a dedicated server with 9 times redundancy protection on a 40,000 Mbit Internet connection. The network has been engineered to avoid any single point of failure in connectivity, redundancy or power and there is around-the-clock staffing by specialist network technicians. It doesn’t get any faster or more reliable than this.

**Typical savings of 15% when using the Esphera Absence and Claims Management System based on a £3m fund. This is based on averages from existing users and equates to Local Authority administration time savings of 75% giving cost savings of 4.5%, School administration time savings of 50% giving cost savings of 2%, Eradication of invalid claims of 1.5%, 15% reduction in long term absences giving cost savings of 6%, 50% reduction of retained and insured layer premiums giving costs savings of 2%.