Pega Underwriting for Insurance

Transcription

1 PEGA OPERATIONS Pega Underwriting for Insurance IMPLEMENTATION GUIDE 7.31

2 2017 Pegasystems Inc., Cambridge, MA All rights reserved. Trademarks For Pegasystems Inc. trademarks and registered trademarks, all rights reserved. All other trademarks or service marks are property of their respective holders. For information about the third-party software that is delivered with the product, refer to the third-party license file on your installation media that is specific to your release. Notices This publication describes and/or represents products and services of Pegasystems Inc. It may contain trade secrets and proprietary information that are protected by various federal, state, and international laws, and distributed under licenses restricting their use, copying, modification, distribution, or transmittal in any form without prior written authorization of Pegasystems Inc. This publication is current as of the date of publication only. Changes to the publication may be made from time to time at the discretion of Pegasystems Inc. This publication remains the property of Pegasystems Inc. and must be returned to it upon request. This publication does not imply any commitment to offer or deliver the products or services described herein. This publication may include references to Pegasystems Inc. product features that have not been licensed by you or your company. If you have questions about whether a particular capability is included in your installation, please consult your Pegasystems Inc. services consultant. Although Pegasystems Inc. strives for accuracy in its publications, any publication may contain inaccuracies or typographical errors, as well as technical inaccuracies. Pegasystems Inc. shall not be liable for technical or editorial errors or omissions contained herein. Pegasystems Inc. may make improvements and/or changes to the publication at any time without notice. Any references in this publication to non-pegasystems websites are provided for convenience only and do not serve as an endorsement of these websites. The materials at these websites are not part of the material for Pegasystems products, and use of those websites is at your own risk. Information concerning non-pegasystems products was obtained from the suppliers of those products, their publications, or other publicly available sources. Address questions about non-pegasystems products to the suppliers of those products. This publication may contain examples used in daily business operations that include the names of people, companies, products, and other third-party publications. Such examples are fictitious and any similarity to the names or other data used by an actual business enterprise or individual is coincidental. This document is the property of: Pegasystems Inc. One Rogers Street Cambridge, MA USA Phone: Fax: (617) DOCUMENT: Pega Underwriting for Insurance Implementation Guide SOFTWARE VERSION: 7.31 PUBLISHED: Thursday, November 16, 2017 Feedback If you have suggestions or comments for how we can improve our materials, send an to AppDocBug@pega.com.

3 CONTENTS Overview 7 Prerequisites 7 Implementation delivery methodology 8 Initiation stage 8 Delivery stage 9 Initiation stage 11 Creating your application 11 Enabling operator accounts 12 Sample data 13 Sample products ruleset 13 Delivery stage 14 Defining requirements 15 Application data model 15 Mapping your application data 16 Defining integration 17 Defining the case type modifications and attributes 18 Updating case types 18 Adding case types 19 Mapping case type or data type classes to a database table 19 Defining the security model and organization structure 20 Authentication schemes 21 Defining your authentication scheme 21 Defining your authorization scheme 22 Defining your organization structure 22 Defining the operator attributes 22 Defining the workbaskets 23 Defining the work groups 23 Defining work parties 23 Customizing the user experience 24 Designing portals 24 Pega Underwriting for Insurance Implementation Guide 3

4 Designing an application skin and styles 25 Designing for screen performance 25 Defining reporting requirements 26 Reviewing standard reports 26 Building features 27 Modifying the class structure 27 Integrating data 27 Configuring external data sources 29 Configuring data sources in the data page 29 Configuring underwriting routing for submission cases 29 Configuring submission routing for Pega Underwriting for Commercial Insurance 30 Configuring submission routing for Pega Underwriting for Group Benefits 30 Configuring intake of RFPs for Pega Underwriting for Group Benefits 31 Configuring service rules to create a submission case 31 Configuring submission routing for Pega Underwriting for Personal Insurance 32 Configuring submission routing for Pega Underwriting for Individual Insurance 32 Configuring additional settings for your application 33 Updating the class name map values for Pega Underwriting for Insurance 33 Updating the class name map values for Pega Underwriting for Commercial Insurance 33 Updating the class name map values for Pega Underwriting for Individual Insurance 35 Updating the class name map values for Pega Underwriting for Group Benefits 36 Copying work parties and data transform rules for Pega Underwriting for Group Benefits 38 Copying the work parties default rule 38 Copying the data transform rule for initializing application data 39 Updating the work ID prefixes for Pega Underwriting for Group Benefits 39 Updating the application case types for Pega Underwriting for Individual Insurance 39 Configuring the Bulk Upload utility for Pega Underwriting for Commercial Insurance and Pega Underwriting for Group Benefits 40 Updating Dynamic System Settings 40 Creating an Excel template 41 Configuring Pega Underwriting for Commercial Insurance for ACORD form submissions 41 Mapping ACORD form fields to properties 42 Configuring service rules to create a submission case 43 Pega Underwriting for Insurance Implementation Guide 4

5 Configuring Directed Web Access for Pega Underwriting for Commercial Insurance 43 Creating an external operator ID 44 Configuring the public link URL 44 Extending your application 45 Viewing extension points 45 Extending an existing line of business for Pega Underwriting for Commercial Insurance 46 Creating a new line of business for Pega Underwriting for Commercial Insurance 47 Creating a new case type rule for a new line of business 48 Modifying the new case type rule for a new line of business 48 Extending an existing line of business for Pega Underwriting for Personal Insurance 51 Creating a new line of business for Pega Underwriting for Personal Insurance 53 Creating a new case type rule for a new line of business 53 Modifying the new case type rule for a new line of business 54 Extending an existing line of business for Pega Underwriting for Individual Insurance 56 Creating a new line of business for Pega Underwriting for Individual Insurance 58 Creating a new case type rule for a new line of business 58 Modifying the new case type rule for a new line of business 58 Implementing the security model 60 Updating access groups 61 Modifying the user interface 61 Determining which part of the user interface to modify 61 Locating the user interface element to change 61 Adding properties to sections 62 Adding sections 62 Updating the skin 63 Reports 63 Testing a new application 63 Testing your application in the Build environment 64 Testing in the Test or Production environments 65 Testing in the UAT environment 66 Packaging a new application 66 Merging application changes 66 Packaging an application for migration 67 Pega Underwriting for Insurance Implementation Guide 5

6 Importing the packaged application 67 Production maintenance and monitoring 68 Business rule maintenance in the Production environment 68 Application health monitoring 68 Identifying and reporting issues 69 Pega Underwriting for Insurance Implementation Guide 6

7 Overview Overview Pega Underwriting for Insurance provides case management features that automate many manual underwriting processes while increasing the visibility of submission cases across the business value chain. With Pega Underwriting for Insurance you can rapidly build, deploy, and manage new business processes, communicate case status, and quickly adapt to changing business needs and market conditions. Furthermore, you can reuse these processes across lines of business to reduce submission, multi-quote, and policy issuance processing times to help increase your company's productivity and improve the customer and producer experience. You can implement the following Pega Underwriting for Insurance applications: Pega Underwriting for Commercial Insurance Pega Underwriting for Group Benefits Pega Underwriting for Personal Insurance Pega Underwriting for Individual Insurance Prerequisites Before you start your Pega Underwriting for Insurance implementation, make sure you understand the following information about the application: Support for various browser versions. Review the Platform Support Guide. Designer Studio basics and the Designer Studio - Header and developer toolbar. Basic functionality of the Pega Underwriting for Insurance application. Review the Pega Underwriting for Commercial Insurance documentation on the Pega Underwriting for Commercial Insurance product page. Review the Pega Underwriting for Group Benefits documentation on the Pega Underwriting for Group Benefits product page. Review the Pega Underwriting for Personal Insurance documentation on the Pega Underwriting for Personal Insurance product page. Pega Underwriting for Insurance Implementation Guide 7

8 Overview Review the Pega Underwriting for Individual Insurance documentation on the Pega Underwriting for Individual Insurance product page. Basic functionality of the Product Builder for Insurance application. Review the Product Builder for Insurance documentation on the Pega Foundation for Insurance product page. Implementation delivery methodology In most cases, use a scrum-based, Agile delivery model for a Pega application implementation. In the rare cases where a waterfall-based implementation methodology is better suited, use Pega s Iterative Waterfall approach. These two implementation methodologies help break down the work into manageable components that you can deliver to production faster. The Pega delivery approach has the following primary stages: Initiation stage Delivery stage Initiation stage In the Initiation stage, the implementation teams build the foundation or baseline of the application and prepare for the work that is necessary to configure the first production release and subsequent extended production releases. Keep in mind that the first production release is the minimal required scope to go live into production. Other capabilities will be added as part of the extended production releases. Building a strong foundation to support expansion and reuse is key to the success of an implementation. The Initiation stage is further organized into the following sub-stages: Plan Align the vision and roadmap to establish the foundation for the implementation. The Plan sub-stage includes the following tasks: Defining the production release milestone Refining scope alignment Pega Underwriting for Insurance Implementation Guide 8

9 Overview Set up Validate and review the Pega-provided features and capabilities to see if they meet your requirements and expectations. This sub-stage includes the following tasks: Establishing environments and processes Creating the baseline application Loading customer data Demonstrating the baseline application Reviewing artifacts from the solution assessment Reviewing business needs and outcomes Prepare Prepare for the delivery of Pega Underwriting for Insurance by completing the following tasks: Confirming resources Enabling team members Establishing governance At the conclusion of the Initiation stage, the scope of the work for the first production release is clearly defined. For Scrum, the scope of the work is represented in an initial backlog. For Iterative Waterfall, a specification list and schedule are prepared and finalized. Delivery stage The Delivery stage is dependent on the methodology selected (Scrum or Iterative Waterfall). During this stage, the delivery team designs, builds, configures, and tests the application by using the selected implementation methodology. The goal is to accomplish the tasks that are described in this document by organizing the Application Feature backlog so that the delivery team can configure the application incrementally with the result being a fully tested and performance-tuned application in production. The Delivery stage is organized into the first production release and the extended production release types. Pega Underwriting for Insurance Implementation Guide 9

10 Overview First production release This release includes only the essential features that are defined during the solution proposal stage and are required for the first release into production. The first production release should be implemented in 90 days or less, depending on the scope of the essential features. This release type includes the following features: Core Pega-provided features Extended features considered essential for your business Key day-one integrations with your systems to get data that you require Extended production release This release includes the non-essential features that are defined during the solution proposal stage. The following features are implemented incrementally after the first production release: Non-essential Pega-provided features Extended features that you have identified as required for your business This guide provides information to support both Scrum and Iterative Waterfall implementation methodologies during the first production release and the extended production release. Pega Underwriting for Insurance Implementation Guide 10

11 Initiation stage Initiation stage The Initiation stage includes the following tasks: 1. Creating your application 2. Enabling operator accounts 3. Sample data 4. Sample products ruleset Creating your application The first step in implementing Pega Underwriting for Insurance to best meet your organization's needs is to create the application on which your extended application will be built. Use the New Application wizard to create your new application. The wizard creates the application structure for you. When you run the New Application Wizard for Pega Underwriting for Insurance, it creates a set of Pega-provided operators. For security purposes, these operators are disabled. To use the new application, you have to enable appropriate operators. See Enabling operator accounts. 1. Log in by entering the administrator user name with the password that you specified for the Pega Underwriting for Insurance application that you are implementing. 2. Create an operator ID to create the new application. You can create this operator ID by making a copy of the existing administrator operator ID. If you have already created an operator ID, update that ID to include the access group used by the administrator operator ID. 3. Log off and log in again using the operator ID you just created. 4. Create the application by following the steps in Creating an application with the New Application wizard. Keep in mind your application-specific requirements. 5. Log in to your new application after you enable the appropriate operator IDs. Pega Underwriting for Insurance Implementation Guide 11

12 Initiation stage Note: All procedures in this guide require that you log in to your new application by entering credentials for that application, unless otherwise noted. The New Application wizard creates the application class structure for you. You can reuse the classes and rulesets that are created by the wizard in future applications that you create. As you implement this application and future applications, you can apply class hierarchy and inheritance principles to help you decide where in the class structure to create your rules to improve the maintainability and overall efficiency of your application. For more information, see Class layers. Enabling operator accounts For most operations in Pega applications, you perform actions as different roles and operators. When you run the New Application Wizard for Pega Underwriting for Insurance, it creates a set of Pegaprovided operators. For security purposes, these operators are disabled. Before you can log in and use the access rights of any operator in your new application, you must enable that operator. For additional information, see Initial Operator IDs (Data-Admin-Operator-ID). 1. Log in as the administrator operator with the password that you specified for the Pega Underwriting for Insurance application that you are implementing. 2. Click Designer Studio > Org & Security > Authentication > Operator Access. This page lists all currently disabled operator accounts. 3. In the Disabled operators section, click the link for the Pega-provided operator that you want to enable. 4. Optional: In the Contact Information section on the Profile tab, fill out any information that your site requires. 5. On the Edit Operator ID page, on the Security tab, select the Force password change on next login check box and clear the Disable Operator check box. 6. Select Update password. 7. In the Change Operator ID Password window, enter a password that conforms to your site standards and click Submit. 8. Click Save and then close the page. Pega Underwriting for Insurance Implementation Guide 12

13 Initiation stage 9. On the Organization and Security: Operator access page, repeat steps 3 through 8 for each operator that you want to enable. Sample data Pega Underwriting for Insurance includes sample data to support the Pega-provided demonstration application. Pega recommends that you load customer-supplied sample data so that implementation efforts are more meaningful. For more information, see "Load the Sample Database" in the Pega Underwriting for Insurance Installation Guide 7.31 on the Pega Underwriting for Insurance product page. Sample products ruleset If you are implementing Pega Underwriting for Individual Insurance, you can include the PBISampleData: ruleset in your application when you install the application. This ruleset contains sample products that you can use to create a case and verify the application before you begin your implementation. You should remove the PBISampleData: ruleset after you define products for your application. Pega Underwriting for Insurance Implementation Guide 13

14 Delivery stage Delivery stage The Delivery stage includes the following tasks: Defining requirements Building features Testing a new application Packaging a new application Pega Underwriting for Insurance Implementation Guide 14

15 Defining requirements To ensure that you stay on target for a successful deployment, use a structured approach for your implementation methodology. You will need to prepare for your implementation and determine key aspects of the design that will affect the behavior of your application. Defining requirements for an implementation includes the following tasks: Reviewing extension requirements Refining customizations and determining the availability of required data and integrations Prioritizing, for example, revising the solution backlog, re-estimating the effort for extensions and customizations, and confirming the project scope Defining your requirements also involves DCO sessions and incorporating those requirements into the application design. During these sessions, you review each of the case types and process flows that the application already provides. The Implementation Planning Workbook helps you capture decisions as you define your requirements. You can download the Implementation Planning Workbook from the Pega Underwriting for Insurance product page. Application data model Mapping your application data Defining integration Defining the case type modifications and attributes Defining the security model and organization structure Customizing the user experience Defining reporting requirements Application data model The application provides a set of data types, data pages, and sample data, which you can use to begin implementing your application. Pega Underwriting for Insurance Implementation Guide 15

16 Data modeling involves creating a conceptual model of how data items relate to each other in an application. In the Pega Platform, the data model refers to a set of rules that work together to populate the data in your application. The system displays this data to help you process the information and can help you make decisions in your sales processes. The following rule types constitute your data model: Data types Data type is another name for a class in your application. It holds data that the application uses. A data type has one or more data pages and several property definitions associated with it. Properties Properties define the format and visual presentation of data in your application. Data pages Data pages define the content of a clipboard page and also control the loading of that data from a source system. A related concept to data pages is integration. Integration controls how the data is retrieved from the systems of record to populate your application data pages. Data mapping rules determine how the data from the system of record corresponds to your application data model. Pega Underwriting for Insurance and the underlying Pega Foundation for Insurance provide a robust industry-standard model that is used in the application and can be used for additional extensions. When planning your data model, work with the data modeling resource at your site to understand the attributes of the data types that need to be supported by your application. Note: Pega Underwriting for Insurance uses Pega's system of record for application data. Optional: You can integrate your application data with your Pega's system of record. Mapping your application data The application data types provide a default set of properties for your use. You can add or remove properties from these data types depending on your requirements. You can also add new data types. Use the "Data model" worksheet in the Implementation Planning Workbook to record your decisions during this procedure. 1. In the Designer Studio Explorer panel, click Data. 2. Click the data type that you want to modify. Pega Underwriting for Insurance Implementation Guide 16

17 3. On the Data model tab, determine the properties to add, remove, or leave unchanged. For more information about data types, see Viewing data type details. Repeat these steps for any other data types, as necessary. Defining integration Inventory the external applications and databases that exist at your site and plan how to connect to them. Some common integration points for the Pega Underwriting for Insurance application include interfaces to the following systems: Customer system of record Agent and agency system of record Policy administration system Rating system Billing system Form generation system External reference systems (for example MVR and MIB, or Rx systems for Pega Underwriting for Individual Insurance) Tip: Identify integration points as early in your planning as possible. If a connection to an external data source is required and either the data does not exist or the interface to that data does not exist, you must account for the time to publish these data sources and the time to configure the interface for this application. The External Data Entities landing page lists the application data types and shows the source for that data. To record your decisions during this procedure, use the "Integration" worksheet in the Implementation Planning Workbook. 1. Identify all integration points for your application. 2. Identify which data is needed from each system of record, if you have not already done so. 3. Determine whether an interface to that system of record already exists and how to connect to it. For more information, see Integration services. Pega Underwriting for Insurance Implementation Guide 17

18 Pega Underwriting for Commercial Insurance integrations with third party applications and services If you plan to integrate your Pega Underwriting for Commercial Insurance application with Pegasupported third party applications and services, such as Dun & Bradstreet and Pitney Bowes, you must build your application implementation layer on both of the following applications: PegaInsurancePACL PUI3rdPartyAPI Defining the case type modifications and attributes Your application includes a set of predefined case types. Each case contains one or more processes that will be extended or created to meet your business requirements. If you do not see an existing case type, you can create one during your planning process. For additional information, see Case types. When you define a new case type, you provide stages for that case type. A stage is the first level of organizing work in your case type. Each stage has one or more steps. Note: The Pega-provided application lets you select legacy case types that were created in earlier versions of the application. However, during configuration, you will notice that the legacy case types have fewer options than the newer, stage-based case types. To define case types, complete the steps in the following topics: Updating case types Adding case types Mapping case type or data type classes to a database table Updating case types If an existing case type is close to meeting your business requirements, you can modify it and use it. 1. In the Designer Studio Explorer panel, click Cases. 2. Click the case type that you want to modify. 3. Update the settings for a case type. Pega Underwriting for Insurance Implementation Guide 18

19 4. Update the processes associated with the case type. In addition, you can add processes by using the Case Designer. Repeat these steps for any other case types, as necessary. Adding case types If you require a case type that is not similar to an existing case type, create a new one that meets your business requirements. 1. In the Designer Studio Explorer panel, click Cases. 2. Click Add a case type. 3. Enter the Name for the new case type. 4. Click Advanced Settings. 5. Select the Derived from (Directed) class. 6. Select the Derives from (Pattern) class. 7. Select the appropriate Ruleset and Ruleset version. 8. Click Submit. 9. Define a life cycle for the case type. 10. Click Finish. Mapping case type or data type classes to a database table When you run the New Application wizard to create your initial case types and data types, the system creates a default class group mapping for each case type and data type. Mapping a class to a physical database table affects data storage and security decisions. For example, if you expect the volume of the case types to be low, consider sharing the table with other case types. To update the default database table to a user-specified database table, perform the following steps: 1. In the Designer Studio Explorer panel, click Records > SysAdmin > Database Table. 2. Open the class that you want to modify. 3. Review the default database name and the table name that the class points to. Pega Underwriting for Insurance Implementation Guide 19

20 4. To point the chosen database table to your specific class, edit the database name and table name. 5. To confirm your changes, click Save. 6. Click Test connection to check if the configuration succeeded. If the test results display errors, for example, missing properties, review the data and correct them. 7. Update the class to point to the table specified above: a. In the Designer Studio Explorer panel, click App. b. Right-click the class name that you referred to in the steps above and select Definition. c. On the General tab, click Test connection to check if the configuration succeeded. Perform the steps above for the other case type or data type classes, if needed. Defining the security model and organization structure Security planning involves defining authorization and authentication strategies for your application. Authentication Proves to the application that you are who you say you are. Authorization Determines the functions that you can perform in the application. This corresponds to access group and role configuration. Security planning also involves setting up the organization structure and operator attributes. The application provides security in the form of access settings and denial rules. Many integration rules also incorporate authentication. For more information about the additional aspects of security, enroll in the Lead System Architect course on Pega Academy and cover the Security lessons that correspond to the following topics: Authentication schemes Defining your authentication scheme Defining your authorization scheme Defining your organization structure Pega Underwriting for Insurance Implementation Guide 20

21 Defining the operator attributes Defining the workbaskets Defining the work groups Defining work parties Authentication schemes The Pega Platform offers the following authentication types: PRBasic Based on passwords in the Operator ID data instances and the login form. This is defined by the rule, which your application can override. PRSecuredBasic Similar to PRBasic, but passes credentials using Secure Sockets Layer (SSL) using Basic HTTP authentication. The login form is defined by the rule, which your application can override. PRCustom Supports access to an external LDAP directory or a custom authentication scheme. PRExtAssign Supports external assignments (Directed Web Access). J2EEContext Specifies that the application server in which the Pega Platform is deployed uses JAAS to authenticate users. Defining your authentication scheme Your site can use a centralized, automated means of maintaining operator data instead of maintaining it manually in your application. To record your decisions during this procedure, use the "Security Model" worksheet in the Implementation Planning Workbook. 1. Discuss Authentication schemes with your site's security and application server teams. 2. Determine the appropriate authentication type. Pega Underwriting for Insurance Implementation Guide 21

22 For more information on authentication scheme planning, see Authentication in the Pega Platform. Defining your authorization scheme Pega Underwriting for Insurance comes with a predefined set of access groups, roles, and privileges. You can use the application roles as a starting point, but you should create your own applicationspecific access groups and roles to avoid any future problems when upgrading. Other rule types such as sections, flow actions, and activities use roles and privileges to allow access to these rules at run time. Defining your organization structure Use the organization structure for routing and reporting within the application. Typically, the application organization structure does not map operators exactly to the site's organization chart but instead, it maps the work that those operators do. Tip: For design guidance, see Organization landing page. Use the "Organization structure" worksheet in the Implementation Planning Workbook to record your decisions during this procedure. 1. Click Designer Studio > Org & Security > Organization > Organizational Chart. 2. Review the existing structure. 3. Determine the organization, division, and unit levels of the hierarchy. Defining the operator attributes An operator's access group affects what the operator can do in the application. In addition to the access group, the following fields in the operator record influence how the application handles assignment of work to the user: Work group Skills Calendar Pega Underwriting for Insurance Implementation Guide 22

23 Tip: In many implementations, it is more efficient for the application to set values in the operator record during the authentication process than it is to have an administrator manually maintain these records. These rules must be configured as part of the authentication mechanism for your site. For more information, see More about Authentication Services. For more information, see About Operator ID data instances. Defining the workbaskets A workbasket is a queue of open assignments in the application. 1. Click Designer Studio > Org & Security > Tools > Work Baskets to display a list of workbaskets. 2. Review and modify the list if necessary. For more information, see Initial Workbaskets. Defining the work groups A work group determines which workbaskets you can access. 1. Click Designer Studio > Org & Security > Tools > Work Groups to display a list of associated work groups. 2. Review and modify the list if necessary. Note: The application uses UnderwriterILA work groups for implementations in the United States and UnderwriterILAUK work groups for implementations in the United Kingdom. Because work groups are used in submission routing, if you customize these work groups for your implementation, you must update the routing rules. For more information, see Configuring submission routing for Pega Underwriting for Commercial Insurance on page 30. For more information, see Initial Work Groups. Defining work parties A work party represents a person, business, or organization that is involved in a case. It receives correspondence, such as , and can be an active or passive participant based on its role. Pega Underwriting for Insurance comes with default work parties, but you might need to configure them for site-specific requirements. Pega Underwriting for Insurance Implementation Guide 23

24 1. In the Case Type Explorer, click the name of the case of which you want to modify the work parties. 2. Click the Settings tab and select Parties. 3. Click the work party name to open the settings for the work party. 4. Make your modifications and click OK. For more information, see Defining the stakeholders of a case. Customizing the user experience While Pega Underwriting for Insurance is fully functional immediately after installation, you may change portions of the user experience (UX) to meet the needs of the users at your site. To design the user experience, complete the steps in the following topics: Designing portals Designing an application skin and styles Designing for screen performance Designing portals Review the content of the portals to ensure that only relevant data is presented. To record your decisions during this procedure, use the "Portals" worksheet in the Implementation Planning Workbook. 1. From the Designer Studio Launch menu, select New Business Case Manager. 2. Review each of the portal sections. 3. Repeat this process for the Underwriter, User Portal, and Account Owner portals. 4. Repeat this process for the Underwriter and User Portal portals. 5. Repeat this process for the Group Operator and Agent Portal portals Pega Underwriting for Insurance Implementation Guide 24

25 Designing an application skin and styles Your site very likely has user experience (UX) standards for the appearance of your applications. Your task is to determine which styles have to change to adhere to those standards. To record your decisions during this procedure, use the "Skinning" worksheet in the Implementation Planning Workbook. 1. In Designer Studio, click Application name > Definition. 2. In the Presentation section, enter PUI in the Skin field and click Save. 3. Click Designer Studio > User Interface > Skins, interfaces, & templates. 4. On the Skins tab, double-click the PUI skin. 5. Click the Component Styles tab. 6. Review each component. Note: As you plan your application styles, consider using mixins to provide incremental style changes. For more information, see Using mixins in the skin to drive consistency and efficiency. Designing for screen performance You want your application to respond immediately as your end users interact with customers. As you design your user interface, complete the following steps: 1. Review transactional service level agreements. For example, the customer details must be available in one second or less while a representative is on the phone with the customer. 2. Review service performance, such as how long it takes back end systems to gather the data needed to display customer details. 3. Review data requirements to determine which fields contain the information that the representatives absolutely need for the task that they need to perform. 4. Determine if any network configuration could cause latency, for example, if there are representatives logged in through a corporate VPN or in a remote location. Pega Underwriting for Insurance Implementation Guide 25

26 Defining reporting requirements Based on your login and portal, your application provides numerous pre-configured reports to monitor case and work inventory as well as monitor workforce productivity and quality. These standard reports are driven by the case and work object life-cycle infrastructure as well as the work and assignment-level service level rules for goals and deadlines used in managing the life cycle of a case. For additional information, see the following articles: Pega Underwriting for Commercial Insurance reports Pega Underwriting for Group Benefits reports Pega Underwriting for Personal Insurance reports Reviewing standard reports You can review the standard reports available in the application from any of the application portals. To record your decisions during this procedure, use the worksheet in "Reports" in the Implementation Planning Workbook. 1. In Designer Studio, click the Launch and select one of the available portals. 2. Click the Reports link. 3. Review each of the reports in the Public Categories section. 4. Determine who needs the report, what it contains, and when and why it's needed. For additional information, see Standard reports and categories. Pega Underwriting for Insurance Implementation Guide 26

27 Building features To build your application features, complete the steps in the following topics: Modifying the class structure Integrating data Configuring underwriting routing for submission cases Configuring additional settings for your application Configuring the Bulk Upload utility for Pega Underwriting for Commercial Insurance and Pega Underwriting for Group Benefits Configuring Pega Underwriting for Commercial Insurance for ACORD form submissions Configuring Directed Web Access for Pega Underwriting for Commercial Insurance Extending your application Implementing the security model Modifying the user interface Reports Modifying the class structure Pega Underwriting for Insurance automatically creates your class structure. When you modify the structure, follow the correct naming conventions. For more information, see More about Class rules. Integrating data To integrate data into a Pega Underwriting for Insurance application: 1. Generate data class to connect to your external data. This could be using a Connector to a web service or the Database Table Class Mapping wizard for a database. 2. Create a report definition to retrieve the data. Pega Underwriting for Insurance Implementation Guide 27

28 3. Create an Implementation class based on the PegaIns-Interface class that you are implementing. 4. Update the data pages for that class by changing the sourcing of the data page to the report definition that you created. 5. Create response data transform for the data page to convert the data class fields to the interface class fields. 6. Repeat this process to populate all of the data pages you recorded in Defining the data model. Example: Loading account data from an external database Here is an example of the process that you follow to load account data from an external database for an application named MyApp. 1. Use the Database Table Class Mapping wizard to generate a data class named MyApp-Data- Account that accesses the external database table with Policy information. 2. Create a report definition named GetAccountByLastName that returns a list of policies where the last name is matched with a value entered in the UI. 3. Create an implementation class by doing a save as from PegaIns-Interface-Account and naming that class MyApp-Interface-Account. 4. Update the MyApp-Interface-Account data pages (for example, D_Account_Details) to use the report definition that you created. 5. Create a response data transform in the MyApp-Interface-Account class to map the Interface and Data classes. Pega Underwriting for Commercial Insurance integrations with third party applications and services If you plan to integrate your Pega Underwriting for Commercial Insurance application with Pegasupported third party applications and services, such as Dun & Bradstreet and Pitney Bowes, you must build your application implementation layer on both of the following applications: PegaInsurancePACL PUI3rdPartyAPI Pega Underwriting for Insurance Implementation Guide 28

29 Configuring external data sources Pega applications come with data types that you configure to point to a site's data. This helps you to bring information from external sites into the Pega Underwriting for Insurance application. You configure these data types to integrate the site's data source into the application. Data types that should point to external data are marked with the Simulated data source provided sample data sources. icon. This replaces the For more information, see Viewing external data entities. Configuring data sources in the data page Update the data pages to refer to the data source for the implemented application. 1. In the Designer Studio header search text field, enter data page name and select it from the result list. 2. Click Save as. 3. In the Apply to field, enter the appropriate inherited class in the implementation layer. 4. Select a ruleset from the Add to ruleset list, and click Create and open. 5. Update the data sources section. Some options you may consider are internal reports, external reports, web services, and simulated data, and so on. For more information, see the Data sources tab in the Data page rules. 6. Click Save. Configuring underwriting routing for submission cases After you create your baseline application, you can configure underwriting routing for submission cases. Complete the steps to configure underwriting routing for the application you are implementing: Configuring submission routing for Pega Underwriting for Commercial Insurance Configuring submission routing for Pega Underwriting for Group Benefits Configuring submission routing for Pega Underwriting for Personal Insurance Configuring submission routing for Pega Underwriting for Individual Insurance Pega Underwriting for Insurance Implementation Guide 29

30 Configuring submission routing for Pega Underwriting for Commercial Insurance The Pega Underwriting for Commercial Insurance application routes the submission work objects to an underwriter after a quote is accepted in the Application stage of a submission case. You can modify the line of business and the underwriter operator values provided with the application to support the routing requirements for your implementation. 1. In the Designer Studio header search text field, search for and select the FindProductSpecificUnderwriter decision table. 2. Update the values in the LOB and Return columns. The default submission routing logic selects an available underwriter from a work group. Cases are assigned to operators belonging to the work group that you select. Replace the work group if you are using a different one for your organization. 3. Use the grid controls and buttons to insert and delete rows, columns, and conditions. 4. Click Save. Configuring submission routing for Pega Underwriting for Group Benefits The Pega Underwriting for Group Benefits application routes the submission work objects to an underwriter for review. You can modify the group size and the product type values provided with the application to support the routing requirements for your implementation. 1. In the Designer Studio header search text field, search for and select the DetermineBenefitAssignee decision table. 2. In the rows for Group Size and Product ID, update the values in the Product ID and Return columns. The default submission routing logic selects an available underwriter from a work group based on the group size. Cases are assigned to operators belonging to the work group that you select. Replace the work group if you are using a different one for your organization. Pega Underwriting for Insurance Implementation Guide 30

31 When assigning a case to an underwriter, change the Benefit Case Assign Type to list. When assigning a case to a workbasket, change the Benefit Case Assign Type to basket. Use the grid controls and buttons to insert and delete rows, columns, and conditions. 3. Click Save. Configuring intake of RFPs for Pega Underwriting for Group Benefits You can configure Pega Underwriting for Group Benefits to automatically create a group plan submission case from an . When an agent s group plan application documents, the Pega Underwriting for Group Benefits routes the to an intake workbasket and creates an empty group plan submission case with the attachments from the . Configuring service rules to create a submission case Use the wizard to configure the rules and data objects that are required to manage incoming s that deliver work to the Pega Underwriting for Commercial Insurance application. 1. Click Designer Studio> Integration > > Wizard. 2. Complete the forms in the wizard to create an service and account for receiving , an listener data object, and an service rule. For information on completing the forms in the wizard, see the following topics: Entering information in the wizard Configuring the listener in the wizard Configuring the service package in the wizard Configuring the account in the wizard Resolving duplicate records in the wizard Reviewing the configuration and completing the wizard Pega Underwriting for Insurance Implementation Guide 31

32 Configuring submission routing for Pega Underwriting for Personal Insurance The Pega Underwriting for Personal Insurance application routes the submission work objects to an underwriter after a quote is accepted in the Application stage of a submission case. You can modify the line of business and the underwriter operator values provided with the application to support the routing requirements for your implementation. 1. In the Designer Studio header search text field, search for and select the FindProductSpecificUnderwriter decision table. 2. Update the values in the LOB and Return columns. Cases are assigned to operators directly. Replace the operator with the work group or a different operator, depending on your organization's routing strategy. 3. Use the grid controls and buttons to insert and delete rows, columns, and conditions. 4. Click Save. Configuring submission routing for Pega Underwriting for Individual Insurance The Pega Underwriting for Individual Insurance application routes the submission work objects to an underwriter after the fields required to create a submission are complete in the Application stage of a submission case. You can modify the line of business and the underwriter operator values provided with the application to support the routing requirements for your implementation. 1. In the Designer Studio header search text field, search for and select the SetUnderwriterBasedonAvailability data transform. The rule recommends using the UnderwriterILA work group for implementations in the United States and the UnderwriterILAUK work group for implementations in the United Kingdom. Cases are assigned to operators belonging to the work group that you select. Replace the work group if you are using a different one for your organization. 2. Click Save. Pega Underwriting for Insurance Implementation Guide 32

33 Configuring additional settings for your application Some of the Pega Underwriting for Insurance applications require that you configure additional settings after you create your baseline application. Complete the configuration steps for the application you are implementing: Updating the class name map values for Pega Underwriting for Insurance Updating the class name map values for Pega Underwriting for Commercial Insurance Updating the class name map values for Pega Underwriting for Individual Insurance Updating the class name map values for Pega Underwriting for Group Benefits Copying work parties and data transform rules for Pega Underwriting for Group Benefits Updating the work ID prefixes for Pega Underwriting for Group Benefits Updating the application case types for Pega Underwriting for Individual Insurance Updating the class name map values for Pega Underwriting for Insurance To pick a product defined in the Product Builder for Insurance application for a Pega Underwriting for Insurance application, you must update the map values for class names to point to your application layers. Save a copy and then update the class name in the DetermineLOBDetails decision table defined in the PegaIns-Work class. Updating the class name map values for Pega Underwriting for Commercial Insurance To execute a case in the Pega Underwriting for Commercial Insurance application, update map values for class names to point to your application layers. The application uses these class names to create embedded pages, as well as parent and child cases. Update the class name map values for the following classes: PegaIns-PAB-CL-Work class DetermineProposalClass map value Pega Underwriting for Insurance Implementation Guide 33