MODEL AND PURSE AMOUNT FOR ENHANCED HEALTH SAVINGS ACCOUNTS
20210350331 · 2021-11-11
Inventors
Cpc classification
G06Q10/06393
PHYSICS
International classification
G06Q10/06
PHYSICS
G06Q40/00
PHYSICS
Abstract
Methods and systems may be associated with an enhanced Health Saving Account (“HSA”) offered by an employer to a plurality of employees. An advance limit calculation platform may access information in a member data store that contains information associated with the plurality of employees. The member data store may include, for each employee, an employee identifier, a communication address, and employment characteristics that were received from an employer human resources system. The advance limit calculation platform may then calculate, for each employee, an advance limit based on the employment characteristics (e.g., salary information, a date of hire, payroll deduction availability, a number of dependents, etc.). The system may then arrange to transmit, to each employee via the communication address and a distributed communication network, enhanced HSA information including the calculated advance limit. Moreover, embodiments may provide a scoring model and/or purse amount for the enhanced HSA.
Claims
1. A system associated with an enhanced Health Saving Account (“HSA”) offered by an employer to a plurality of employees, comprising: a member data store containing information associated with the plurality of employees, including, for each employee, an employee identifier, a communication address, and employment characteristics that were received from an employer human resources system; and an advance limit calculation platform, coupled to the member data store, including: a computer processor, and computer memory, coupled to the computer processor, storing instructions that, when executed by the computer processor, cause the advance limit calculation platform to: (i) access information in the member data store, (ii) compute score information using a score model and turnover information, (iii) automatically calculate, for each employee, an advance limit based on the computed score information and the employment characteristics, and (iv) arrange to transmit, to each employee via the communication address and a distributed communication network, enhanced HSA information including the calculated advance limit.
2. The system of claim 1, wherein the turnover information is associated with at least one of: (i) an industry turnover rate, and (ii) a company turnover rate.
3. The system of claim 1, wherein the employment characteristics include at least one of: (i) tenure, and (ii) gender.
4. The system of claim 1, wherein the communication address is associated with at least one of: (i) an email address, (ii) a postal address, (iii) a telephone number, (iv) a text chat interface, and (v) a streaming video interface.
5. The system of claim 1, wherein the employment characteristics include at least one of: (i) employee salary information, (ii) household salary information, (iii) a date of hire, (iv) payroll deduction availability, (v) a number of dependents, (vi) employer policies and preferences, and (vii) governmental regulations.
6. The system of claim 1, wherein an employee is registered as a member of the enhanced HSA.
7. The system of claim 6, wherein an advance is automatically activated when a member pays an HSA qualified bill in excess of an accumulated savings in their account up to the advance limit for that member.
8. The system of claim 7, wherein the advance is automatically repaid in increments over a pre-determined time period.
9. The system of claim 7, wherein a pre-determined fee is charged in connection with the advance.
10. The system of claim 1, further comprising: an HSA administration server, associated with a funding platform bank account to administer the enhanced HSA.
11. A computer-implemented method associated with an enhanced Health Saving Account (“HSA”) offered by an employer to a plurality of employees, comprising: computing score information using a score model and turnover information, including an industry turnover rate and a company turnover rate; accessing information in a member data store that contains information associated with the plurality of employees, including, for each employee, an employee identifier, a communication address, and employment characteristics that were received from an employer human resources system; calculating, by a computer processor of an advance limit calculation platform for each employee, an advance limit based on the employment characteristics; and arranging to transmit, to each employee via the communication address and a distributed communication network, enhanced HSA information including the calculated advance limit.
12. The method of claim 11, wherein the communication address is associated with at least one of: (i) an email address, (ii) a postal address, (iii) a telephone number, (iv) a text chat interface, and (v) a streaming video interface.
13. The method of claim 11, wherein the employment characteristics include at least one of: (i) employee salary information, (ii) household salary information, (iii) a date of hire, (iv) payroll deduction availability, (v) a number of dependents, (vi) employer policies and preferences, and (vii) governmental regulations.
14. The method of claim 11, wherein an employee is registered as a member of the enhanced HSA.
15. The method of claim 14, wherein an advance is automatically activated when a member pays an HSA qualified bill in excess of an accumulated savings in their account up to the advance limit for that member.
16. The method of claim 15, wherein the advance is automatically repaid in increments over a pre-determined time period.
17. The method of claim 15, wherein a pre-determined fee is charged in connection with the advance.
18. A non-transitory, computer-readable medium storing instructions, that, when executed by a processor, cause the processor to perform a method associated with an enhanced Health Saving Account (“HSA”) offered by an employer to a plurality of employees, the method comprising: accessing information in a member data store that contains information associated with the plurality of employees, including, for each employee, an employee identifier, a communication address, and employment characteristics that were received from an employer human resources system; calculating, by a computer processor of an advance limit calculation platform for each employee, an advance limit based on the employment characteristics; arranging to transmit, to each employee via the communication address and a distributed communication network, enhanced HSA information including the calculated advance limit; attempting to access HSA funds of a particular employee; if sufficient HSA funds are not available, accessing a purse amount, associated with the calculated advance limit, of that particular employee.
19. The medium of claim 18, wherein the communication address is associated with at least one of: (i) an email address, (ii) a postal address, (iii) a telephone number, (iv) a text chat interface, and (v) a streaming video interface.
20. The medium of claim 18, wherein the employment characteristics include at least one of: (i) employee salary information, (ii) household salary information, (iii) a date of hire, (iv) payroll deduction availability, (v) a number of dependents, (vi) employer policies and preferences, and (vii) governmental regulations.
21. A system to grant a person credit, without doing a credit check, to pay for qualified medical expenditures of a Health Saving Account (“HSA”) offered by an employer to a plurality of employees, comprising: an advance limit calculation platform, including: a computer processor, and computer memory, coupled to the computer processor, storing instructions that, when executed by the computer processor, cause the advance limit calculation platform to: (i) receive from the employer information about the person's salary and date of hire, (ii) convert the date of hire to a tenure value, (iii) convert the tenure value to a probability of termination based on industry data, (iv) test a plurality of different credit limits with a credit limit algorithm and pick the credit limit that maximizes net cash to the system, and (v) stack accounts, including a notional advance account the HSA, such that if funds are in the HSA, a transaction is first processed through the advance account and funds are then recovered the HAS.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION
[0034] In the following detailed description, numerous specific details are set forth in order to provide a thorough understanding of embodiments. However, it will be understood by those of ordinary skill in the art that the embodiments may be practiced without these specific details. In other instances, well-known methods, procedures, components and circuits have not been described in detail so as not to obscure the embodiments.
[0035] One or more specific embodiments of the present invention will be described below. In an effort to provide a concise description of these embodiments, all features of an actual implementation may not be described in the specification. It should be appreciated that in the development of any such actual implementation, as in any engineering or design project, numerous implementation-specific decisions must be made to achieve the developers' specific goals, such as compliance with system-related and business-related constraints, which may vary from one implementation to another. Moreover, it should be appreciated that such a development effort might be complex and time consuming, but would nevertheless be a routine undertaking of design, fabrication, and manufacture for those of ordinary skill having the benefit of this disclosure.
[0036] Note that healthcare costs are growing at rates that are unmanageable for many Americans and their employers. HDHPs were created to encourage members to make more considered healthcare treatment decisions, and research shows that they generally achieve that objective and reduce costs as a result. However, prior to meeting deductibles, cash-strapped members often forego care they truly need. And with 75% of Americans having household savings of $1,000 or less, people accustomed to the higher level of financial protection often afforded by a Preferred Provider Organization (“PPO”) or Health Maintenance Organization (“HMO”) hesitate to switch to HDHPs, even when the difference in premiums more than offsets the difference in deductible.
[0037] To avoid this, embodiments may provide an enhanced HSA account including a scoring model and/or purse amount for a computing environment in a secure, automatic, and efficient manner. For example,
[0038] As used herein, devices, including those associated with the system 100 and any other device described herein, may exchange information via any communication network which may be one or more of a Local Area Network (“LAN”), a Metropolitan Area Network (“MAN”), a Wide Area Network (“WAN”), a proprietary network, a Public Switched Telephone Network (“PSTN”), a Wireless Application Protocol (“WAP”) network, a Bluetooth network, a wireless LAN network, and/or an Internet Protocol (“IP”) network such as the Internet, an intranet, or an extranet. Note that any devices described herein may communicate via one or more such communication networks.
[0039] The advance limit calculation platform 140 may store information into and/or retrieve information from various data stores (e.g., the member data store 130), which may be locally stored or reside remote from the advance limit calculation platform 140. Although a single advance limit calculation platform 140 and load servicing platform 150 are shown in
[0040] A user or administrator may access the system 100 via a remote device (e.g., a Personal Computer (“PC”), tablet, or smartphone) to view information about and/or manage operational information in accordance with any of the embodiments described herein. In some cases, an interactive graphical user interface display may let an operator or administrator define and/or adjust certain parameters (e.g., to define advance rules or business logic) and/or provide or receive automatically generated recommendations or results from the system 100.
[0041] Some embodiments described herein provide a system 100 with a high level of convenience that provides a full suite of spending accounts, including HSA, Flexible Spending Account, (“FSA”), dependent care, and transportation using a single membership card. Embodiments may also offer peace of mind by leveraging account technology to give members access to a consumer health account platform to offer affordable health coverage, health treatment financing, and loans for treatments.
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[0043] At S210, the system may access information in a member data store. The member data store may, for example, contain information associated with a plurality of employees, including, for each employee, an employee identifier, a communication address, and employment characteristics that were received from an employer human resources system. The communication address might be associated with, for example, an email address, a postal address, a telephone number, a text chat interface, a streaming video interface, etc. The employment characteristics might include, for example, salary information (employee or household salary, a date of hire, payroll deduction availability, a number of dependents, employer policies and preferences, governmental regulations, etc.
[0044] At S220, an advance limit calculation platform may automatically calculate, by for each employee, an advance limit based on the employment characteristics. The system may the arrange to transmit, to each employee via the communication address and a distributed communication network, enhanced HSA information including the calculated advance limit at S230.
[0045] An employee may then be registered as a member of the enhanced HSA, and an advance may be automatically activated when a member pays an HSA qualified bill in excess of an accumulated savings in their account (up to the advance limit for that member). The advance may then be automatically repaid in increments over a pre-determined time period. Note that a system administering the enhanced HSA may charge a pre-determined fee in connection with the advance (e.g., a $20 fee).
[0046] In this way, embodiments may meaningfully improve the quality and affordability of healthcare. Moreover, embodiments may mitigate financial risks and help people make the appropriate decisions regarding HDHPs via an enhanced HSA account. The member may be provided an advance limit when they enroll in the enhanced HSA. The advance might be, for example, repaid over one year (or less) through pre-tax HSA contributions deducted from payroll, thereby effectively saving the member over 30% on their medical bills. The enhanced HSA may also allow members with savings balances to earn more than the market rate of interest on HSA money they have saved. According to some embodiments, a system administering the enhanced HSA may bear some or all of the risk of default (instead of the employer) and may reduce the employer's payroll taxes when more medical expenses are paid with pre-tax HSA dollars.
[0047] According to some embodiments, the size of an advance made available to a member is not determined by a score, but is rather based on: [0048] an ability to recover the advances through payroll deductions, including a deduction of the amount outstanding from their final paycheck if they leave the company, [0049] tenure of employment, [0050] income level (individual and/or household), and [0051] a number of dependents.
[0052] After an advance is issued, the member might be charged no interest, but rather a per-payroll fee (e.g., $5 or $20) based on the advance balance outstanding. This fee might be paid with pre-tax dollars. Both the employee and employer may benefit from greater HDHP and HSA enrollment and utilization, higher employee satisfaction and engagement, reduced financial anxiety, income and payroll tax savings, etc.
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[0059] At (G), an advance limit calculator 351 (e.g., associated with one or more credit algorithms or models as described with respect to
[0060] In this way, employers may have maximum flexibility to offer an enhanced HSA product as a standalone or bundled with other tax advantaged accounts (e.g., flexible spending, dependent care, and transportation accounts). The system may simplify implementation by working with an existing broker, consultant, and/or benefits administrator to easily integrate and exchange data with current systems. Moreover, employees may have access to a state-of-the-art web portal allowing them to view their balances, see their outstanding advances, and/or withdraw money to cover expenses that were not paid via their card. An employer may also receive reporting that helps them understand where there are opportunities to continue to help employees maximize the value of a benefits programs.
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[0067] In some cases, people don't realize that they can reimburse themselves for prior year qualified medical expenses that were not reimbursed through their HSA—all the way back to the time they first opened their HSA. Today, employees can still take advantage of this opportunity, putting cash in their hands and reducing employer payroll taxes. To facilitate this, some embodiments described herein may provide a “retrospective HSA.” In such an approach, the system may help employees by identifying prior year HSA qualified medical bills paid with after-tax dollars. If the member agrees, the system may enable a simultaneous HSA contribution and reimbursement, thereby creating a tax savings benefit. As a result, the member may receive their usual paycheck plus the extra cash (which could be thousands of dollars).
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[0072] Note that the embodiments described herein may also be implemented using any number of different hardware configurations. For example,
[0073] The processor 1210 also communicates with a storage device 1230. The storage device 1230 may comprise any appropriate information storage device, including combinations of magnetic storage devices (e.g., a hard disk drive), optical storage devices, mobile telephones, and/or semiconductor memory devices. The storage device 1230 stores a program 1212 and/or an enhanced HSA engine 1214 for controlling the processor 1210. The processor 1210 performs instructions of the programs 1212, 1214, and thereby operates in accordance with any of the embodiments described herein. For example, the processor 1210 may access information in a member data store 1300 that contains information associated with the plurality of employees. The processor 1210 may then calculate, for each employee, an advance limit based on the employment characteristics (e.g., salary information, a date of hire, payroll deduction availability, a number of dependents, etc.). According to some embodiments, the processor 1210 may then arrange to transmit, to each employee via the communication address and a distributed communication network, enhanced HSA information including the calculated advance limit.
[0074] The programs 1212, 1214 may be stored in a compressed, uncompiled and/or encrypted format. The programs 1212, 1214 may furthermore include other program elements, such as an operating system, clipboard application, a database management system, and/or device drivers used by the processor 1210 to interface with peripheral devices.
[0075] As used herein, information may be “received” by or “transmitted” to, for example: (i) the platform 1200 from another device; or (ii) a software application or module within the platform 1200 from another software application, module, or any other source.
[0076] In some embodiments (such as the one shown in
[0077] Referring to
[0078] The member identifier 1302 might be a unique alphanumeric label that is associated with an employee (with name 1304) who is participating in an enhanced HSA program. The annual salary 1306 (either individual or household) and date of hire 1308 (tenure information) m ay be used to calculate an appropriate advance limit 1310 for that member.
[0079] Thus, in addition to traditional account features, some enhanced HSA program embodiments described herein may offer: [0080] automatic advances with a single card swipe regardless of current HSA account funding, [0081] up to twelve months for advance repayment (with advances repaid with pre-tax dollars), [0082] payroll tax savings for employers, and/or [0083] limited risk to an employer (the enhanced HSA may instead bear the credit risk).
Moreover, during implementation employers may take advantage of retrospective solution embodiments that let members recoup tax savings for prior year medical bills (creating an immediate cash benefit to both employees and employers).
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[0086] At S1520, the system may compute score information using a score model and turnover information (e.g., an industry turnover rate and/or a company turnover rate). At S1530, an advance limit calculation platform may automatically calculate, by for each employee, an advance limit based on score information and employment characteristics (e.g., demographic information such as tenure and/or gender). Note that S1530 is an optional step (as illustrated by a dashed line in
[0087] Up to fifty million Americans are enrolled in High Deductible Health Plans (“HDHPs”) and many of those people struggle to pay for healthcare.
[0088] Some embodiments utilize payments through pre-tax payroll deductions over twelve months. Consider
[0089] According to some embodiments, HSA advances may be automatically activated when needed. For example,
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[0091] According to some embodiments, risk may be segmented into three distinct tiers or “buckets.” For example,
[0092] Note that the increasing risk may be almost entirely driven by likelihood of termination (either voluntary or involuntary). The risk may be primarily mitigated by the system's ability to recover amounts due from an employee's last paycheck. This amount is expected, at a minimum, to be worth 7-10 days of payroll given the usual lag between payroll dates and payroll cycles. Additional amounts could be recovered from company-specific policies such as extended notice periods, Paid Time Off (“PTO”), sick-day payouts, severance, etc. The credit-model may thus become a function of two things—salary and probability of turnover. The credit-model may also become a key input into a sophisticated simulation model that gauges the potential performance of a portfolio of advances.
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[0094] Independent of these variables, each profile is then assigned a likely HSA contribution given a known distribution of how HSA accounts are funded and capped at the IRS limits for family and individual contribution amounts (less the employer contribution amount). The system may then capture plan specific information (deductibles, employer HSA contribution amounts and timing, payroll policies, etc.) and calculate for each of the thousands of profiles the “need” for an advance. The “need” is defined as the gap between the employee's out of pocket amount due for a medical expense and their current HSA balance.
[0095] An Employee cost share may be calculated using the plan design cost-sharing formula (co-insurance, deductible threshold, and max-out-of-pocket threshold). An HSA balance is the daily remaining portion in the HSA account calculated as the accumulated employer and employee contributions less the employee's accumulated out of pocket expenses. When the HSA balance is zero, this triggers the need for an HSA advance to fill the gap. Note that the need for an advance does not automatically mean the entire amount is available for advance. In some embodiments, there are two limits to the advance needed that will ultimately define the advance given or provided. The two factors are the lower of (1) the IRS HSA contribution limit or (2) the set advance limit.
[0096] In the Risk Pool simulation, the Advance Limit ranges from 8-days to 28-days of gross salary. The model runs through all 21 scenarios adjusting each output for each of the thousands of profiles by changing the advance limit from 8-days to 28-days in one-day increments. Loss may be calculated for each scenario as the total amount unrecovered divided by total amount advanced. As used herein, the term “unrecovered” may refer to a portion of each profile's unpaid advanced amount up to the moment of separation less any amount recovered from a final paycheck. The term “total advanced” may refer to the sum of total advances given to each profile up to each profile's moment of separation and limited based on the lower of the (i) the needed advance, (ii) the IRS limit less all realized and planned annual HSA contributions and (iii) the advance limit.
[0097] As a result, each risk pool box may have the summation of all losses for each of the thousands of profiles, given each incremental day of advance limit increase. After all 21 scenarios (8-days to 28-days) are captured, the model may look back at all calculated loss rates in each of the 21 scenarios days of advance limits to identify the maximum days of advance that can be given before the loss rate exceeds a predetermined target loss rate. The resulting output is a matrix with salary bands on one axis and average monthly defaults on the other axis and maximum days of advance in each risk pool box.
[0098] Now that the system has established how much it is advancing to each risk pool, in a second step the system may assign or “slot” employees into the right pool. Slotting employees correctly becomes a function of predicting their likely probability of turnover since we know with certainty what their salary band is going to be. To do that, the system may look at termination as two components as illustrated 2200 in
[0099] Referring again to
[0100] The system may also look at company-specific turnover rates (e.g., for the past 3-years) to determine if the employer has higher or lower turnover relative to the industry. The system compares a company's historical turnover rates with industry turnover rates for the same periods. The outcome of this analysis creates a multiplier (e.g., 1.1× to denote a company with 10% higher historical turnover relative to the industry average) for that employer. This multiplier then becomes a proxy that captures the additional implied involuntary turnover risk specific to the employer.
[0101] Then, below the employer-level the system might look at the individual employee profile and assign risk multipliers based on the employee's tenure and gender (two highly correlated factors that predict potential turnover based on extensive studies). This multiplier becomes a proxy that captures the additional voluntary turnover specific to each employee.
[0102] A third step may use each employee's turnover probability and salary to assign each employee to a unique risk pool to determine an appropriate advance limit. At this point, the system may have a full employee roster and, next to each employee, an initial advance limit that they will be offered. In a fourth step, to further stress test the portfolio and simulate performance, the system run another Monte Carlo simulation model that mimics the process that was used to determine risk pool outputs, but instead of forcing a specific salary and turnover probability input, the simulation may use the employee's specific profile to rerun the same scenario and summarize the losses. This then creates a feedback loop that lets the system recalibrate assumptions made in the first two steps and re-run the models to mitigate against outlier scenarios.
[0103] Some embodiments may be associated with an algorithm to set credit limits.
[0104] According to some embodiments, the algorithm 2300 is probabilistic. Given the inputs, and a high use claims experience, it calculates the expected gains and losses for each of 761 straight days (which is one year of Advances, an additional year and 1 month to repay them—the additional one month may be necessary because draws occurring in the last 14 days of a year become advances first month of the following year). These gains and losses are based on the probability that the employee remains employed and sums those numbers across all 761 days to determine net cash for the year for that employee. Unlike a simulation, the algorithm 2300 is not calculating an expected experience for any given single employee. Rather, it is calculating the expected average result for an employee given large number of employees who look the same in terms of salary, expected turnover rate, health plan design, HSA contributions, and claims experience. The algorithm 2300, using a spreadsheet application data table, may then calculate the expected net cash position for each of 100 potential credit limits.
[0105] The algorithm 2300 calculates two parallel sets of numbers. The first set is expected performance assuming the employee remains employed throughout the entire period. The second set adjusts those numbers for the probability that the employee terminates at some point throughout the period, based on the turnover probability provided to the algorithm. For each day, the algorithm 2300 determines how much of the proposed credit line is likely to be used. To do so, it first determines the amount of the claim (if any) at 2310. The algorithm 2300 uses the same claims experience for every employee, and the claims experience modeled may, for example, represent $168,000 in claims over the course of one year. The algorithm 2300 then calculates the employee responsibility for that claim based on progress in meeting deductible and maximum out of pocket cost. If the employee has no responsibility, there is no need to draw against the credit line. If the employee does bear some responsibility, the algorithm 2300 then checks whether the HSA savings balance is adequate to cover the employee claim responsibility. If the savings balance is adequate to cover the employee's portion of the claim, there is no need to draw against the credit line. If not, the algorithm 2300 then checks whether the employee has already utilized the full line of credit. If not, the algorithm 2300 creates a draw that equals the minimum of the credit capacity remaining against the line of credit and remaining patient responsibility (after the HSA savings balance, if any, is exhausted). With this step completed the draw has now been determined for any given day. Draws are accumulated across all days to keep a running balance of money that has been disbursed.
[0106] The next task for the algorithm 2300 is to turn daily draws into an advance at 2330. To do so, the algorithm 2300 checks whether the current day is a statement date. The statement dates occur 14 days prior to a pay date, and pay dates are determined by the client's payroll cycle. On the statement date, the advance balance is determined by accumulating draws that have occurred since the last statement date. With the advance created, the algorithm 2300 must now determine the repayment schedule at 2340. Repayments may include principal, an origination fee (e.g., 5% of the original advance principal), and a periodic finance fee. The repayment schedule may vary based on payroll cycle: [0107] 52 pay periods: Two weeks after the advance is established the origination fee is drawn. Two weeks after that, the principal repayments begin and continue to be drawn every two weeks for 50 weeks. The amount of each principal repayment is advance amount divided by 25. [0108] 26 pay periods: Two weeks after the advance is established the original fee is drawn. Two weeks after that, the principal repayments begin and continue to be drawn every two weeks for 50 weeks. The amount of each principal repayment is advance amount divided by 25. [0109] 24 pay periods: Two weeks after the advance is established the origination fee is drawn. The principal repayments begin on the next pay date, which is either the 15th or last day of the month and continue to be drawn twice per month for the next 11.5 months. The amount of each principal repayment is advance amount divided by 23. [0110] 12 pay periods: Two weeks after the advance is established the origination fee is drawn along with a partial principal payment. For the next 11 months, principal repayments are drawn at the end of each month (or on the relevant pay date during the month). Payments are determined by summing the origination fee and total principal and dividing that number by 12. The first payment includes 100% of the origination fee and a principal repayment of 3.75% of the original principal balance. The next 11 principal payments represent 8.75% of the original principal balance.
[0111] Note that these repayment calculations may be subject to minimums. For each advance, the minimum payment may be, for example, $3 per pay period. In aggregate, the minimum payment across all advances may be $10. The algorithm 2300 accurately reflects these minimums when determining the repayment schedule for each advance.
[0112] A periodic finance fee may be calculated based on the average daily balance of a specific advance during the previous 75-day period. A tiered approach for the fee may be applied (e.g., if the average advance balance over prior 75 days was under $100 the fee might be $2, if the average advance balance over prior 75 days was between $100 and $250 the fee might be $5, etc.).
[0113] For each advance, the algorithm 2300 may determine which days represent 75, 150, 225 and 300 days after the advance has been created and ensures the periodic finance fee is assessed on each for each of those days and paid on the next pay date that is at least 14 days in the future (so the fee can, in practice, be reflected on the next statement). Note that the algorithm 2300 might not assess a periodic finance fee if the outstanding principal balance on the assessment date is $0 (regardless of whether there was a positive principal balance during the prior 75 days).
[0114] With these steps, the algorithm 2300 tracks outstanding principal balance for each day, and principal repayments, origination fees and periodic finance fees on the days they are due. In effect, the algorithm 2300 is maintaining a daily ledger for the employee given the specific input characteristics, the claims experience, and the credit limit.
[0115] Next, the algorithm 2300 may evaluate expected losses or gains at 2350. As used herein, the term “gains,” or net cash, may represent the total of origination fees and periodic finance fees minus the cost of capital minus expected losses from scheduled repayments that do not occur. If the system collects payments through paycheck deductions, for all practical purposes, the only way that losses can occur is if an employee terminates with an outstanding principal balance. To model potential losses, the algorithm 2300 may consider the probability that an employee terminates on any given day, and the implications on that termination on expected recovery of outstanding principal.
[0116] This section of the algorithm 2300 may begin by calculating a probability that the employee remains employed at the start of each day and the probability that the employee terminates on that day. These calculations can be thought of as binary, with the probability that the employee terminates on any day equaling:
(1+monthly turnover rate).sup.1/30
[0117] That probability of termination is reduced each day by 0.01%, reflecting the fact that, the longer an employee is employed, the more likely they are to stay employed. The probability that the employee remains employed at the start of any given day equals 1 minus the sum of probabilities of termination on all previous days.
[0118] For each day, the expected advances, principal repayments, origination fees and periodic finance fees equal those numbers (as calculated in the first part of the algorithm 2300) times the probability that the employee remains employed on that day. For example, if a $100 principal payment is due on a day when the expected probability of the employee remaining employed is 90% day, the expected principal repayment on that day will be $90. The same logic applies to all payments due on any given day. In addition, if the employee terminates on a given day, the system may expect to recover some or all of the principal balance owed from the next paycheck. The expected recovery from a final paycheck on any given day will be the amount that we can recover from the final paycheck times the probability that the employee terminates on that day. To summarize, the formula for net cash on any given day is:
daily expected net cash=(P×E)+(F×U)
where P represents payments due on that day, E represents a probability that the employee remains employed through that day, F represents an amount that can be recovered from the final paycheck U represents a probability of termination on that day.
[0119] The expected loss on that day same day is:
daily expected loss=MINIMUM($0,C−O)×U
where: C represents a final paycheck amount, E represents an outstanding principal balance, and U represents a probability of termination on that day.
[0120] To calculate net cash, the system may sum the expected gains and losses on each of the 761 days and the subtract the sum of the cost of capital for each day. The cost of capital for each day equals the daily interest rate multiplied by the outstanding balance on that day.
[0121] To determine the credit limit for each employee, the algorithm 2300 may run this for each of, for example, one hundred different limits and picks the limit among those hundred that maximizes net cash. The algorithm 2300 can determine credit limits for an entire population of client employees by running, for example, one hundred potential limits and picking the limit that maximizes net cash for each employee.
[0122]
[0123] The DOL has been tracking turnover rates for 23 industries through its Job Openings and Labor Turnover Survey (“JOLTS”) program. That information is downloadable and available to the general public. This data provides a reasonable baseline for turnover rates by industry. But it is also known that turnover rates vary significantly depending by tenure with the current employer. For example, in the construction industry, average monthly turnover rates for people with less than 4 years of tenure is 5.1% while monthly turnover rates for people with 20 years or more of tenure is 0.8%, a six-fold difference within that industry. Therefore, knowing only the industry turnover rate is insufficient to make turnover predictions at the individual level. Note that tenure categories may be divided into multiple categories, such as: less than 4 years, 4 to 6 years, 6 to 9 years, 9 to 12 years, and over 12 years.
[0124] At 2410, the turnover algorithm 2400 combines the two data sets to create a lookup table by industry and tenure that provides monthly turnover estimates for any individual employee. The first step is to broaden the tenure categories through extrapolation and interpolation. To do so, the system may assume the reported data represents the mid-point of the range—for example, the turnover rate reported for less than four years is assumed to be the turnover rate for someone with two years of tenure, the number reported for four to six years is assumed to be the turnover rate for someone with five years of tenure, etc. With those points established, the system can develop change rates per year for data between each point. For example, if the two year tenure rate is 5% and the five year tenure rate is 2%, then the rate of change per year of tenure is 1% and the assumed three year tenure rate becomes 4%, the assumed four year tenure rate becomes 3% (i.e., 5%, 4%, 3%, 2% for 2, 3, 4, and 5 years of tenure, respectively). The algorithm 2400 may use that same rate of change to get zero year and one year tenure (in this case 7% and 6% for zero and one year tenure, respectively). The system may use the same methodology to flesh-out tenure rates for every year from zero (which represents less than 12 months of tenure) to over 20 years of tenure. When this step is completed, 21 tenure-based monthly turnover rate estimates may be created for each of eight industry classifications.
[0125] At 2420, the algorithm 2400 may map the payroll processing company data to the DOL data. This may be done assigning each DOL industry classification to the payroll processing company industry classification that it most closely matches. With 2420 complete, there may be 21 tenure-based estimated monthly turnover rate estimates for all 23 industries in the DOL database (i.e., a lookup table that is 23 rows by 21 columns for a total of 483 monthly turnover estimates (of which 8×21 or 168 are unique points).
[0126] When the algorithm 2400 is run for new or prospective clients, the first step is to assign that client company to one of the 23 BOL industry classifications, which is typically a straightforward exercise completed by an experienced business professional. By this point, the client will have provided us a roster of employees that includes date of hire. With date of hire, we estimate tenure at the plan start date by calculating the number of days between hire date and plan start date and dividing that number by 365.25 to get tenure expressed in year. We then perform a simple lookup in which we match industry and tenure in the lookup table to find the unique cell that contains our monthly turnover rate estimate. That monthly turnover rate number, along with salary, become the primary inputs to a credit limit model.
[0127] Some embodiments may grant credit to people to pay for qualified medical expenditures (as defined by the IRS) without doing a credit check.
[0128] a. The system may go to market through employers and receive from employer's information on salary and date of hire.
[0129] b. The system converts date of hire to “tenure” and then convert tenure to a probability of termination based on industry data.
[0130] c. The system then sets credit limits by testing 100 different limits with a credit limit algorithm and picks the one that maximizes net cash.
[0131] Embodiments may administer the advance program by “stacking” accounts in a particular way: an advance account is set up as a “notional” account, which means it is only funded when used so unlike an HSA account, in which dollars have to be present to be spent, a notional account allows a limit to set, and dollars to be used and then reimbursed to account. To do this, the account may be based on an “HSA shell”—which means using a structure similar to that of an HSA, but without some of the typical reporting. The advance account is then stacked, so that transactions can process in a particular order. For example, the transactions may first process through the HSA and once those funds are exhausted, whatever's left is processed using advance notional dollars (up to the limit). Some embodiments may first process transactions through the advance account and then essentially reimburse the advance account with real dollars from the HSA if they exist (e.g., for a $1,000 transaction, if there is $200 in the HSA account, the system may process the entire $1,000 through the advance account first and then recover the $200 from the HSA account.
[0132] The following illustrates various additional embodiments of the invention. These do not constitute a definition of all possible embodiments, and those skilled in the art will understand that the present invention is applicable to many other embodiments. Further, although the following embodiments are briefly described for clarity, those skilled in the art will understand how to make any changes, if necessary, to the above-described apparatus and methods to accommodate these and other embodiments and applications.
[0133] Although specific hardware and data configurations have been described herein, note that any number of other configurations may be provided in accordance with some embodiments of the present invention (e.g., some of the information associated with the databases described herein may be combined or stored in external systems). Moreover, although some embodiments are focused on particular types of spending accounts, any of the embodiments described herein could be applied to other types of applications. Moreover, the displays shown herein are provided only as examples, and any other type of user interface could be implemented. Any of the embodiments described herein may provide a Pharmacy Benefit Manager (“PBM”) that lets employees purchase medicine through their employer. Moreover, embodiments might provide add-on services (e.g., diabetes management) and the most appropriate services might be automatically matched with members. In still other embodiments, a sweepstakes or lottery might be tied to an HSA, etc.
[0134] The present invention has been described in terms of several embodiments solely for the purpose of illustration. Persons skilled in the art will recognize from this description that the invention is not limited to the embodiments described, but may be practiced with modifications and alterations limited only by the spirit and scope of the appended claims.