OMNIQ Design Criteria

OMNIQ is designed to integrate core processes including claims, policy administration, premium billing and receipting, payments and reporting with a single application to provide a complete solution.

Our design criteria follows nine guiding principles:

  1. To support multiple products and multiple underwriters
  2. To enable one member record to have multiple products:
    • Group Health
    • Group Risk – e.g. Life, Income protection, Trauma
  3. To have inbuilt flexibility in scheme design allowing for multiple group plans, product mixes and underwriters within a scheme
  4. To recognise that group business is about processing large numbers of insured persons in bulk including:
    • Administration overheads
    • Claims adjudication
    • Initial quoting and loading of member data 
    • Premium Billing
    • Cash match and reconciliation
    • Member records consistency with employer records and  movements collection
  5. To cater for individual member transactions and address Group and Retail markets
  6. To provide the secure and compliant electronic system to be the repository for insured data for all parties
  7. To have an automated claims adjudication process to deal with up to 95% of all claims, electronically and automatically, with rules based logic
  8. To have a sophisticated product configurator to enable complex and specific risk products to be generated rapidly
  9. To deliver the services and products via the internet to enable immediate on-line processing of member transactions and enquiries by users 

OMNIQ Group Health
Administration System

  • Share the information and the workload
  • Self service on line
  • Integrated cloud-based package solution
  • Flexible, scalable and fully configurable
  • Automated rule-based claims adjudication
  • IBM validated and accredited health insurance provider
  • Expert implementation advice on hand