Solution

The Company needed a workflow-based solution with robust architectural capacities to reinforce its compliance management in a manner that would integrate several functions being carried out in silos.
After scrutinizing multiple options offered in the market, the Company selected MetricStream’s solution for its diverse compliance requirements. Along with MetricStream’s strong architectural capabilities, ability to support large organizations and flexibility, MetricStream team’s extensive prior experience in the health insurance space served as another key driving factor for this selection. The experience of other BCBS affiliated health insurance providers already using the MetricStream solution confirmed the selection.
MetricStream provided the Company with a comprehensive solution based on MetricStream GRC Platform with modules configured to address the Company’s specific compliance needs.
MetricStream solution provides end-to-end workflow automation across the Company’s business units and departments supporting the Company’s organizational model across all the regions and states it operates in, business units as well as their mapping to different functional roles and reporting relationships. Users have a role-based portal access with options required for initiating actions, responding to events, managing and assigning tasks, viewing reports and dashboards, limited to their roles. The system triggers email-based notifications and alerts to appropriate personnel to notify them of various events and requirements.

Regulatory alert tracking: MetricStream’s solution streamlines the regulatory workflow of the Company and supports task assignment, status tracking and reporting at every stage till the successful implementation of the regulation. The system captures every relevant regulation and allows the regulatory group at the Company to prepare legal summary of every applicable state law. The group assigns this regulatory alert to the compliance personnel of the region impacted by the law who then delegate tasks to the staff responsible for implementing the state law in their respective business units.
This module allows the Company’s regulatory group to assign and track all regulatory alerts, define and maintain a centralized structure of the overall regulatory alerts and compliance including entities, processes in scope, risks for the processes and plans, controls to address the risks and mechanism to assess the controls. The assessment plans can be designed and scheduled periodically or triggered based on occurrence of regulatory events.
Market conduct examination tracking: MetricStream system provides comprehensive capabilities for identifying the governing regulations, providing complete compliance evidence, tracking evidence status, policies, standard procedures associated with regulator audit