GAO Releases Benefits System Checklist
The U.S. General Accounting Office has released a 395-question checklist that federal agencies, their inspectors and their auditors can use to evaluate their employee benefits computer systems.
The GAO developed the checklist to help agencies implement standards developed by the Joint Financial Management Improvement Program in September 2001. Congress authorized the creation of the program in 1996 in an effort to improve the governments financial management systems and make them easier to understand.
Jeffrey Steinhoff, the GAO managing director who led the team that developed the checklist, warns in his introduction against assuming a system must comply with every suggested requirement in the checklist.
“Those using this tool must apply experienced judgment in its interpretation and application,” Steinhoff writes. “They must consider the impact of a completed checklist on an entire benefit system and whether the system, as a whole, substantially complies with requirements.”
But the checklist could also be useful to insurers trying to evaluate their own benefit systems, or to software vendors and standards groups trying to develop tools for evaluating commercial systems.
The GAO checklist includes one section on “Functional Requirements” that deals with topics such as claims acceptance and tracking, claims processing, benefits payment administration, reporting and quality assurance.
A second section, on central “Information Stores,” contains questions about application information, claimant master records and financial information.
Under claims acceptance, for example, the GAO lists 15 questions. Some deal with system flexibility. Users are advised to ask about accommodations for system users with disabilities, and whether the system users have the ability to flag a claimants paper-based application as incomplete and to suspend further processing.
Other questions, such as one about whether a system will be able to accept electronic claims submissions by 2003, deal with the nuts and bolts of electronic benefits administration.
A technical functions chapter in the Functional Requirements section addresses some of the burning issues that have been irritating users of all kinds of computers for decades. One question in the chapter, Number 292, asks whether a “benefit system provides all users the capability to perform a print screen function.”
The complete checklist is available on the Web at http://www.gao.gov/new.items/d02762g.pdf.
Reproduced from National Underwriter Life & Health/Financial Services Edition, September 23, 2002. Copyright 2002 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.