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Strategic Solutions

Strategic Solutions for Life, Health and Accident Insurance Needs.

Policy Holders
Insurance Companies
Employer Self insured Plans
Insuretech Enablement
Agent/MGU Programs & PORC
Captive Programs
Comprehensive TPA services
 
Products
Life
Annuity
Health
Accident
Processes
Quotation & Illustration Interface
New Business
Underwriting
Policy Servicing
Billing & Collection
Claims Processing
Agency & Commission
Management
Reinsurance
Premium & Financial Accounting
Reporting & SLA
Document Management
Group
Individual
Worksite
 
Our Company
Third Party Administrator
Insurance Company
Reinsurer
Insurance Agency

Serving Policyholders since 1935, Universal Fidelity Life Insurance Company is licensed nationally as a TPA and in 7 states as an insurance company. For our TPA clients we process over 1,200,000+ claims a year and administer over 90,000 policies for over 350,000 insureds. Our subsidiary, Southern Life and Health has been in operation since 1895. Executive offices are in Oklahoma City and the administrative service center is in Duncan, Oklahoma.

We Care and We Deliver. Our company’s reputation is built upon providing superior services to individuals and other insurance companies.

Our Systems are Robust, Secure, Scalable, and Professionally Implemented.

Our Most Important Asset — Experienced, Engaged Management and Staff that are experts in a broad array of products.

We are SOC1 Type 2 Certified and as a licensed insurance company, we comply with all reporting, regulations, cybersecurity standards, governance, procedures and policy issues that our TPA clients do. We know an insurance company’s operating requirements and needs.

Legend Insurance Agency is a nationally licensed affiliate. It markets Direct to Consumer Medicare Supplement, Texas Student Accident Insurance and is an MGU for Employer Stop Loss for A+ rated carriers. As a result of our affiliation, we have a deep understanding of the challenges and issues of marketing insurance.

Our Values
  • Transparent Dealing Demonstrates Competence
  • Demonstrated Competence Builds Trusted Relationships
  • Trusted Relationships Enable Long Term Successful Partnerships
Products Supported
 
Insurance Products Supported
Traditional life insurance and riders
Interest sensitive WL/UL
Annuities/SPIA plans, qualified, MVA, MYGA, FIA
Voluntary and worksite benefits
Major medical and Hospital Indemnity
Supplemental Health Products – Group and Individual
Supported Riders – simple and complex
Medicare Supplement
Key Policy Administration Features
New business, underwriting, and policy issue
Billing and premium application
Agent and hierarchy management
Annuity management including qualified and RMD
Policy service, maintenance, and claims
Multi-company environment for multiple blocks
Product and rate increase maintenance
Reinsurance tracking for ceded coverage
System configuration and processing rules
Document, forms, and correspondence management
Reporting, including reserve valuation
Accounting integration to multiple packages
IRS 1099/5498 reporting and e-filing
Medicare Supplement
  • All states
  • All benefits, coinsurance, excess amounts, foreign travel
Claims engine dashboard with performance metrics
Business rules engine for benefit and procedure mapping
Manual claims queue with one-click re-adjudication
Rate increase filing and implementation management
New business and e-app import via ACORD file integration
EDI file integration with clearinghouse and EOB/payment vendors
Auto adjudication ratios at 95% and higher. 200 service lines/minute, multiple EDI files processed at the same time, 24 hr/day. Dashboard, real-time processing, 30-day historical adjudication metrics. Notifications via email
Eligibility/claims 837 EDI files. Integrates with Red Card. Agent onboarding, contracting, integration VUE agency software. New business submissions from 3rd party e-app applications via ACORD standard XML 103 policy files
Employer ERISA Self Insured Benefit Plans and Stop Loss Underwriting MGU Services
Claims processing for medical, dental, vision, and prescription drug plans
Precertification, PPO Administration, Letter Writing, Call Tracking, Referral, and Case Management
Capitation maintenance and payment processing
Consumer-driven healthcare admin, FSA, HRA, and HSA
Eligibility administration
Web Portal provides Real-Time data access, Enrollment, Member Registration, Call Tracking
Disability processing for both short/long-term benefits
Premium billing and agent commissions
COBRA Administration, Qualifying Event Notification Letters
PCORI and Transitional Reporting for ACA
1094-C & 1095-C Forms and Electronic Filing
HIPAA EDI Compliance
835 CAS Reason Code Mapping
835 RARC Code Mapping
835 RARC Code Mapping
1099 Forms and Electronic Filing
W-2 Forms and Electronic Filing
 
Services Offered
New Business
Product Development Support
Policy Issue, Policy Print & Delivery
E-Delivery, E-Signature, Voice Signature
Interfaces to quoting and e-app systems
Underwriting
Fully Underwritten
Guaranteed Issue
Simplified Issue
Policy Administration
Policy Changes, Riders
Address/Ownership/Beneficiary Changes
Billing, Collecting and Premium Processing
Policy Reinstatement
Dividend/NFO Processing
Surrender & Loan Processing
Customer Correspondence
Undo/Redo Processing
Commissions Processing
Payment; Reversals; Corrections, Advances
Agent and Agency
License, Contract, Appoint & Maintenance
Call Center Operations
Policy holders, Agents, Applicants, Providers
Claims
Life, Annuity, Health, Waiver of Premium
Non-contestable Claims Review
Adjudication, Auto Adjudication and Payment
Claims with reinsurance
Accounting Services
Policy Accounting – Individual, Group, Worksite
General Accounting Services
Bank reconciliation and check aging
Commission Accounting
Reinsurance Accounting
Actuarial Support
Collaborate to optimize product configuration
Extracts to valuation & reserve systems
Product Development and Filing Assistance
Reinsurance Administration
Compliance & Regulatory Support
Blue Book Preparation
Virtual Company Management
 

 

 

Strategic Solutions for Life, Health and Accident Insurance Needs.

+
Policy Holders
 
Unique solutions for your health and financial wellbeing.
+
Insurance Companies
 
Comprehensive TPA Services for all lines of business.
+
Employer Self insured Plans
 
Full TPA Group Administration and MGU Stop Loss services.
+
Insuretech Enablement
 
In the fast-moving Insuretech space, many new companies do not have the infrastructure, systems, compliance or licensing that is needed to implement their vision. We are an insurer, reinsurer, agency and TPA. We can fill the Gaps your company needs.
+
Agent/MGU Programs & PORC
 
Many large or growing agency programs may desire to have their own exclusive programs. We setup, enable and administer them. As an alternative to ordinary income taxation of profit shares, Producer Owned Reinsurance Captives allow tax advantaged accumulation of underwriting earnings and the potential to grow into an admitted insurer if desired.
+
Captive Programs
 
Self Insurance of company risks is a tax efficient, risk controlled and cost-effective solution for many companies. As an insurance company ourselves, we are uniquely situated to assist in the setup, administration, and reinsurance structuring of your company’s Captive Insurer.
A single end to end solution for all stages of an insurance product’s life-cycle
Rapid creation of new insurance products and versions
Proven Implementation Plans
Consultative Process
 
Products
Life
Annuity
Health
Accident
Processes
Quotation & Illustration Interface
New Business
Underwriting
Policy Servicing
Billing & Collection
Claims Processing
Agency & Commission
Management
Reinsurance
Premium & Financial Accounting
Reporting & SLA
Document Management
Group
Individual
Worksite
Third Party Administrator
Insurance Company
Reinsurer
Insurance Agency

Serving Policyholders since 1935, Universal Fidelity Life Insurance Company is licensed nationally as a TPA and in 7 states as an insurance company. For our TPA clients we process over 1,200,000+ claims a year and administer over 90,000 policies for over 350,000 insureds. Our subsidiary, Southern Life and Health has been in operation since 1895. Executive offices are in Oklahoma City and the administrative service center is in Duncan, Oklahoma.

We Care and We Deliver. Our company’s reputation is built upon providing superior services to individuals and other insurance companies.

Our Systems are Robust, Secure, Scalable, and Professionally Implemented.

Our Most Important Asset — Experienced, Engaged Management and Staff that are experts in a broad array of products.

We are SOC1 Type 2 Certified and as a licensed insurance company, we comply with all reporting, regulations, cybersecurity standards, governance, procedures and policy issues that our TPA clients do. We know an insurance company’s operating requirements and needs.

Legend Insurance Agency is a nationally licensed affiliate. It markets Direct to Consumer Medicare Supplement, Texas Student Accident Insurance and is an MGU for Employer Stop Loss for A+ rated carriers. As a result of our affiliation, we have a deep understanding of the challenges and issues of marketing insurance.

T ransparent   D ealing   D emonstrates   C ompetence
D emonstrated   C ompetence   B uilds   T rusted   R elationships
  T rusted   R elationships   E nable   L ong   T erm   S uccessful   P artnerships
Insurance Products
Medicare Supplement
ERISA TPA & Stop Loss MGU
Insurance Products Supported
Traditional life insurance and riders
Interest sensitive WL/UL
Annuities/SPIA plans, qualified, MVA, MYGA, FIA
Voluntary and worksite benefits
Major medical and Hospital Indemnity
Supplemental Health Products – Group and Individual
Supported Riders – simple and complex
Medicare Supplement
Key Policy Administration Features
New business, underwriting, and policy issue
Billing and premium application
Agent and hierarchy management
Annuity management including qualified and RMD
Policy service, maintenance, and claims
Multi-company environment for multiple blocks
Product and rate increase maintenance
Reinsurance tracking for ceded coverage
System configuration and processing rules
Document, forms, and correspondence management
Reporting, including reserve valuation
Accounting integration to multiple packages
IRS 1099/5498 reporting and e-filing
Medicare Supplement
  • All states
  • All benefits, coinsurance, excess amounts, foreign travel
Claims engine dashboard with performance metrics
Business rules engine for benefit and procedure mapping
Manual claims queue with one-click re-adjudication
Rate increase filing and implementation management
New business and e-app import via ACORD file integration
EDI file integration with clearinghouse and EOB/payment vendors
Auto adjudication ratios at 95% and higher. 200 service lines/minute, multiple EDI files processed at the same time, 24 hr/day. Dashboard, real-time processing, 30-day historical adjudication metrics. Notifications via email
Eligibility/claims 837 EDI files. Integrates with Red Card. Agent onboarding, contracting, integration VUE agency software. New business submissions from 3rd party e-app applications via ACORD standard XML 103 policy files
Employer ERISA Self Insured Benefit Plans and Stop Loss Underwriting MGU Services
Claims processing for medical, dental, vision, and prescription drug plans
Precertification, PPO Administration, Letter Writing, Call Tracking, Referral, and Case Management
Capitation maintenance and payment processing
Consumer-driven healthcare admin, FSA, HRA, and HSA
Eligibility administration
Web Portal provides Real-Time data access, Enrollment, Member Registration, Call Tracking
Disability processing for both short/long-term benefits
Premium billing and agent commissions
COBRA Administration, Qualifying Event Notification Letters
PCORI and Transitional Reporting for ACA
1094-C & 1095-C Forms and Electronic Filing
HIPAA EDI Compliance
835 CAS Reason Code Mapping
835 RARC Code Mapping
1099 Forms and Electronic Filing
W-2 Forms and Electronic Filing
expand abc
New Business
Product Development Support
Policy Issue, Policy Print & Delivery
E-Delivery, E-Signature, Voice Signature
Interfaces to quoting and e-app systems
expand
Underwriting
Fully Underwritten
Guaranteed Issue
Simplified Issue
expand
Policy Administration
Policy Changes, Riders
Address/Ownership/Beneficiary Changes
Billing, Collecting and Premium Processing
Policy Reinstatement
Dividend/NFO Processing
Surrender & Loan Processing
Customer Correspondence
Undo/Redo Processing
expand
Commissions Processing
Payment; Reversals; Corrections, Advances
expand
Agent and Agency
License, Contract, Appoint & Maintenance
expand
Call Center Operations
Policy holders, Agents, Applicants, Providers
Claims
Life, Annuity, Health, Waiver of Premium
Non-contestable Claims Review
Adjudication, Auto Adjudication and Payment
Claims with reinsurance
Accounting Services
Policy Accounting – Individual, Group, Worksite
General Accounting Services
Bank reconciliation and check aging
Commission Accounting
Reinsurance Accounting
Actuarial Support
Collaborate to optimize product configuration
Extracts to valuation & reserve systems
Product Development and Filing Assistance
 
Reinsurance Administration
 
Compliance & Regulatory Support
 
Blue Book Preparation
 
Virtual Company Management