Case Study: Benefit Plan Administrator Leaps Forward 20 Years

Challenge

Modernizing a technology platform with zero disruption to a 24x7 fund office operation.

Landscape

MIDIOR was engaged by a Benefit Plan Administrator to support their migration from a legacy IT platform for health eligibility and claims processing, to a more modern system, featuring a multi-tier architecture with numerous advantages in terms of reliability and scalability. The legacy system served as the operational hearts and lungs of the benefit fund’s back office, representing an archive of historical records which supported eligibility calculations and the adjudication of health claims as well as embodied thousands of accumulated business rules. 

MIDIOR’s assignment was to move the project out of slow motion and onto a fast track to completion, including retirement of the legacy system. A second order goal was to evolve the in-house team by developing the appropriate skills and resources needed to ensure future success.

Process

First, MIDIOR conducted a comprehensive requirements analysis that provided the roadmap for establishing development priorities as well as a project plan that everyone could believe in. Using MIDIOR’s Operations Map, a complete set of operating process documentation that captured the business logic embedded within the legacy system combined with the various exception processes implemented by the administrator’s staff was also created.

Next a software vendor was engaged, using the updated documentation and requirements as the basis for the program budget and schedule commitments. MIDIOR worked with the Plan Administrator and software vendor to implement an agile development program with multiple parallel release/test cycles, resulting in a 12 month implementation schedule. A key to the accelerated timeframe was a testing methodology and process that allowed for rapid regression tests of all new functionality.

In parallel, the MIDIOR team tackled the data conversion effort which included mapping, cleansing and reformatting 20 years of data history in order populate the new system with an accurate record. Finally, MIDIOR assisted the client in the reengineering of business processes from their “as is” state to a more efficient set of processes that take advantage of the new platform.

Impact

The Benefit Plan Administrator was able to completely overhaul its back office infrastructure for health eligibility and claims with little downtime to the operation and no impact on the plan participants. The internal staff emerged with new skills and capabilities ensuring the organization can be more self-sufficient when it comes to managing their technology platforms going forward.