How to File an Unemployment Insurance Claim in San Diego Ca - DOC by whv97216


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									               OFFICE OF SYSTEMS INTEGRATION

               REQUEST FOR PROPOSAL OSI 7100-181
                   MODERNIZATION PROJECT

                     SECTION 3 – CURRENT SYSTEM

                                     March 23, 2007

                                           ISSUED BY:

                                  STATE OF CALIFORNIA

                          DEPARTMENT OF GENERAL SERVICES
                              707 3RD STREET, 2ND FLOOR
                             WEST SACRAMENTO, CA 95605

OFFICE OF SYSTEMS INTEGRATION                                                                            RFP OSI 7100-181
UIMOD PROJECT                                                                                    SECTION 3 — PAGE 2 OF 36

                                      Table of Contents
                                (Section 3 – Current System)
3       CURRENT SYSTEM                                                                                                                   4
3.1      BACKGROUND ............................................................................................................ 4
3.1.1    UI Program .................................................................................................................... 4
3.1.2    Technology .................................................................................................................... 4
3.2      BUSINESS FUNCTIONS.............................................................................................. 5
3.2.1    Claim Filing .................................................................................................................... 6
3.2.2    Continued Claims .......................................................................................................... 7
3.2.3    Adjudications ................................................................................................................. 8
3.2.4    Reporting ....................................................................................................................... 9
3.2.5    Other Business Functions ............................................................................................. 9
3.3      ORGANIZATION.........................................................................................................10
3.3.1    Overview......................................................................................................................10
3.3.2    UI Branch Office ..........................................................................................................13
3.3.3    Goethe Tax Operations (GTO)....................................................................................16
3.3.4    Information Technology Branch ..................................................................................16
3.3.5    Department of Technology Services ...........................................................................17
3.4      TECHNICAL ENVIRONMENT....................................................................................17
3.4.1    Telephony....................................................................................................................17
3.4.2    Automation for Unemployment Insurance...................................................................22
3.4.3    Production Change Management ...............................................................................26
3.4.4    Maintenance and Testing ............................................................................................27
3.4.5    Security........................................................................................................................28
3.5      UI BUSINESS CHALLENGES WITHIN THE CURRENT SYSTEM ..........................29
3.5.1    The Continued Claims Redesign Subproject ..............................................................30
3.5.2    The Call Center Network Platform and Application Upgrade Subproject ...................33
3.5.3    Merge of the CCR and CCNPAU Subprojects............................................................35

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                                 Table of Figures
                           (Section 3 – Current System)
FIGURE 3.1 - UI BRANCH AT A GLANCE.............................................................................12

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This section describes the Employment Development Department‘s (EDD) current
business functions, organizational structure and technical environment supporting the
Unemployment Insurance (UI) Program and describes how they relate to the
continued claims and call center platform replacement subprojects. The information
presented in this section is intended for the reader‘s understanding of the current
system and does not convey any requirements for the Unemployment Insurance
Modernization (UIMOD) Project.

3.1 Background
3.1.1 UI Program
The UI Program is a joint federal and state partnership. The basic UI Program
framework is established by federal law, administered by state law, and funded by
employer tax contributions. The United States Department of Labor (DOL)
participates as the federal partner, providing direction and guidance to the states.
The California Unemployment Insurance Code (CUIC) and the California Code of
Regulations Title 22, Social Security Division I, and the EDD provide governance for
California‘s UI Program. The EDD UI Branch administers the UI Benefits Program
for California.

The UI Program provides assistance to individuals who have lost their job through no
fault of their own. To collect benefits, individuals must first file a claim and meet the
eligibility requirements before they receive benefits. The claim‘s benefit amount is
based on the claimant‘s earnings in a particular 12-month period, called the base
period. Claimants must certify that they have met eligibility requirements for each
week benefits are claimed.

The federal DOL establishes UI workload performance measures which must be met
by all states. The EDD‘s performance data must be reported to DOL within specific
timeframes. The data are used to obtain financial reimbursement from the DOL for
state UI operations, to determine state and federal labor statistics, and to serve as
leading economic indicators for the state and the nation.

3.1.2 Technology
Historically, the Department required claimants to report to an EDD office to file a
claim, certify for benefits, receive payment of benefits or inquire about claim status.
Through the years, the EDD has transitioned from in-person service delivery to
service delivery by mail, telephone, and the Internet. The UI process was migrated
from a paper-based manual system to a more efficient automated system.

Over the years, EDD has used various automated systems. The Department began
transitioning to an integrated database management system, known as the Single
Client Database (SCDB), in 1988. Today, the SCDB is the UI Program‘s primary

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data store. Currently, most of the UI processing is done through online or batch
COBOL programs that access the SCDB and run on a mainframe system. All UI
transaction information is posted to the SCDB. Nightly batch jobs read the SCDB
and extract information necessary to create UI benefit checks and other forms,
including continued claim forms. This information is sent to the Office of Documents,
Publications, and Distribution (ODPD) which prints and mails all benefit checks and
forms for the Department.

In 1992, the Department implemented the Continued Claims Automation (CCA)
system and installed two Optical Character Recognition (OCR) scanners which
automated the processing of continued claims certification and eliminated many
labor-intensive procedures. Continued claim form responses are stored in the
SCDB, making that information accessible to staff without requiring the use of the
paper forms.

In the mid 1990s, six statewide inbound call centers were established to provide UI
services. Individuals can now contact the call centers using a toll-free number to file
UI claims, and to obtain other UI services or general UI information. The call centers
operated independent of one another using the telephone company‘s central office
switch called the DMS 100. The switch is only available in some parts of the state.
Each local telephone company central office closest to a call center houses their
Interactive Voice Response (IVR) system and Automated Call Distribution (ACD)
groups, making them independent call centers. Each call center manages its own
ACD groups and agents through its own Management Information System (MIS).

In 1999, a major enhancement to the platform was the installation of an intelligent call
routing system making it possible to route calls across the enterprise rather than
independently to each center. The Intelligent Call Manager (ICM) is a product that
facilitates equitable distribution of calls between the call centers. A seventh call
center located at the Insurance Accounting Division (IAD) facility uses the same
platform as the other six, but does not use the ICM.

Historically, EDD‘s web-based service delivery platform has been mostly limited to
general informational sites; however, the EDD is interested in increasing customer
access to services by expanding the EDD web presence. Since March 2002,
claimants may submit an initial claim application electronically using the eApply4UI
application which is accessible from the EDD Website. Claimants may also submit
inquiries using the EDDCOMM application which is accessible from all EDD web
pages via the ‗Contact Us‘ link.

3.2 Business Functions
Individuals contact EDD for a multitude of reasons:

1. General program information.
2. Specific labor market data.

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3. Filing a claim.
4. Checking payment status.
5. Updating eligibility and/or demographic information.
6. Assistance with forms.
7. Responding to correspondence from the Department.
8. Reporting potential fraud.

When claimants request specific claim information, staff use the claimant‘s Social
Security Number (SSN) to access information in the system to authenticate them and
respond to their inquiries.

The EDD customers have the option to electronically submit a question or comment
via the web. Written correspondence is also accepted from claimants, employers,
and members of the general public.

The UI Program has three major business functions related to the administration of
benefits: Claim Filing, Continued Claims, and Adjudications.

3.2.1 Claim Filing
Individuals may file a UI claim by either calling a toll-free number, submitting an
online application via eApply4UI, or downloading and completing the UI Application,
DE 1101I, and either faxing or mailing it to EDD.

Prior to filing the initial claim, regardless of how a claimant chooses to file, staff
attempt to verify the claimant‘s identity by confirming employment and wage
information reported by employers and/or by reviewing prior claim information.
During claim filing, staff determine the claimant‘s monetary eligibility, collect
demographic information, wage and employment history, and responses to eligibility
questions. Depending on the claimant‘s responses, staff advise the telephone
claimants of their individual rights and responsibilities. Claimants who have filed
using the eApply4UI Internet application or the downloaded paper application do not
receive these individual instructions verbally. The EDD mails all claimants a
handbook that describes general eligibility rules and requirements.

While the eApply4UI application allows claimants to submit claim filing information
online, it does not directly interface with EDD systems; therefore filing the claim in the
SCDB requires staff intervention. If staff identify any potential eligibility issues during
claim filing, the claimant is scheduled for a determination of eligibility interview to
adjudicate eligibility. Wage discrepancies are resolved after a claim is filed and the
award is calculated.

Claimants are mailed a notice of award, which explains their benefit amounts and the
wages and employer information that established their award. The claimant is also

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mailed a continued claim form to begin certifying for benefits. A notice is mailed to
the claimant‘s last employer to validate the reason for separation as provided to EDD
by the claimant. The claimant and employer have 10 days to review their respective
notices and provide responses to EDD, if necessary.

Once a valid UI claim is filed, it is in effect for 52 consecutive weeks known as the
claim benefit year. During the claim benefit year, the claimants may stop certifying
for benefits for several reasons, including re-employment, eligibility disqualification, or
personal reasons. To resume certifying for benefits, claimants must request their
claims be re-activated which will initiate the mailing of certification forms to them.

In the State Fiscal Year (SFY) 2003-2004, the EDD filed 2,686,173 initial claims. In
SFY 2004-2005, the EDD filed 2,302,942 initial claims. In Calendar Year (CY) 2004,
the EDD received 492,987 eApply4UI initial claim applications. In CY 2005, the EDD
received 667,773 eApply4UI initial claim applications.

3.2.2 Continued Claims
The Department normally issues two-week continued claim forms, although in some
cases a one-week form may be issued. The form requires claimants to answer six
(6) eligibility questions for each week and has additional space to record wage and
employer information, claimant address changes, work search efforts, and Instructor
signatures for approved training programs. Claimants complete and mail their forms
after the last day of the week for which they are certifying. To help EDD comply with
DOL‘s performance measures, claim forms for the first payable week of a claim are
mailed to a special post office box for priority handling and processing.

Processing continued claim forms is a labor intensive process. Envelopes must be
sorted for consistent size so they can be opened by staff using high speed mail
opening machines. Forms are hand-fed into a high-speed scanner which individually
numbers, scans, and images each one. After forms have been scanned, the data
are sent electronically to an editing system which allows staff to validate what the
scanner captured. Hand-printed data (e.g. wages, employer information, and sick
days), blanks, yes and no responses for the same question, and a request for
Voluntary Federal Income Tax withholding are all validated by staff. Once validated,
the form data are uploaded electronically to the system. The system processes any
form that does not contain hand-printed information, training signature verification,
required work search verification, or address changes. Staff must process any form
the scanner cannot handle. Any additional information that cannot be scanned or
captured must be entered into unstructured note fields by staff.

Whether handled by the scanner or staff, there are three outcomes for any form:
authorized, reissued, or routed. Forms meeting all the eligibility requirements are
authorized. Forms that are incomplete (or invalid) are reissued to the claimant for
completion. Forms that have potential eligibility issues or have payment barriers are
routed to an exception list from which staff reviews the form and either processes it
for payment or schedules an adjudication interview.

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Forms that cannot be scanned are processed by staff without any system validation
or data capture. These weeks are authorized manually, with all required information
being posted to unstructured note fields. These manual entry methods have multiple
opportunities for error. Once a week(s) is authorized, the system determines the
amount of the payment. This calculation takes into account any monies owed to
EDD or other agencies.

In the SFY 2003-2004, the EDD processed 24,821,573 weeks claimed (individual
weeks, not claim forms). Of the weeks claimed, 22,645,551 weeks were paid,
resulting in total benefits paid of $5,570,104,502.

In SFY 2004-2005, the EDD processed 20,533,628 weeks claimed. Of the weeks
claimed, 18,477,510 weeks were paid, resulting in total benefits paid of

3.2.3 Adjudications
When eligibility issues are detected, claimants are scheduled for an adjudication
appointment using the UI Scheduling System (UISS). This system manages all
adjudication appointments and interviewer schedules, tracks and displays individual
schedules by interviewer (pending, completed, backlogged), and provides statistics.

Once an appointment is scheduled, the claimant is notified by mail of the
appointment date and time and the specific issues(s) to be addressed. Staff
determine if claimants are eligible to collect benefits by conducting telephone
interviews with them, with employers or their representatives, and by reviewing
written statements. When an adjudication is completed, staff either authorize or deny
benefits and process any weeks that are pending because of the eligibility issue

Employers or claimants who disagree with the Department‘s decision, have the right
to appeal. If a decision is appealed, it is processed by the adjudication center and
heard by the California UI Appeals Board. If any week‘s payment is pending the
resolution of an appeal decision, the week(s) are processed when the appeal
decision is provided to the EDD from the Appeals office.

Continued claim exceptions routed to the exception list often need adjudication
appointments. The lists are reviewed by staff and cleared if sufficient information on
the claim is present. If it is unclear that an eligibility issue is present and insufficient
information is on the claim record, staff attempts to contact the claimant by
telephone. If the claimant is available, staff confirms the presence of an issue. If no
issue exists, the week is processed. If the claimant cannot be reached by telephone,
or if an issue exists, a determination is scheduled with UISS.

In SFY 2003-2004, the EDD scheduled 1,383,270 interview appointments and
processed 145,387 appeals. In SFY 2004-2005, the EDD scheduled 1,129,254
interview appointments and processed 153,300 appeals.

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3.2.4 Reporting
The EDD is required to report workload items for various reasons including collection
and aggregation of labor statistics and for performance monitoring.

The EDD uses standard and ad hoc reports for various purposes including UI staff
and workload management, budgetary forecasting, and economic trend analysis.
Data are gathered from multiple systems and databases.

In addition, the EDD receives numerous data requests from various sources
including public interest groups, the legislature, and other state and federal
departments. Often the requested information is not readily available on existing
reports, so queries must be developed or a request made to the Information
Technology Branch (ITB) to extract the data.

Online data tools allow UI management to see how the call routing system is
performing in real time, and provide the ability to immediately respond to changing
business conditions.

3.2.5 Other Business Functions Fraud Detection
In recent years, the Department has become aware of a significant increase in the
number of fraudulent UI claims, in part because employer records were
compromised. The Department developed the Identity (ID) Alert process to pro-
actively address identity theft by verifying the identity of individuals whose identity is

The UI Program attempts to confirm the identity of each customer during each
customer contact using information contained within EDD records. Additionally,
when a claim is filed, the SSN and the identity information associated with that SSN
are validated with the Social Security Administration.

When patterns of fraud indicate a substantial amount of benefits have been
fraudulently received, or multiple individuals may be involved (conspiracy), those
cases are escalated for investigation and possible prosecution.

The Benefit Audit process identifies claimants who have failed to properly report
earnings while drawing benefits. The Department cross-matches all employer wage
reports against benefits paid. Form 1099G
Each year UI claimants are sent a Form 1099G ―Report of Taxable Unemployment
Compensation Payments for the specified Tax Year‖, which shows taxable benefits
paid during the calendar year.

5ED05017-7532-4B2E-A95F-97A66E7B95D4.DOC                                                     MARCH 23, 2
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Overpayment of benefits may occur for several reasons: fraud; a retroactive
determination that finds the claimant ineligible for benefits that were already paid;
Department error; or a monetary recomputation that decreases the award amount.
Overpayments are usually established immediately after making an eligibility decision
or retroactively as part of the Benefit Audit process.

The overpayment collection process begins after the claimant‘s appeal period has
expired. A percentage of a claimant‘s current Disability Insurance (DI) or UI weekly
benefit amount may be offset to repay an overpayment. EDDCOMM
The EDDCOMM application allows the public to provide comments and suggestions,
and to ask questions over the Internet. The system provides general information
before allowing users to submit anything to the EDD. Staff respond to messages
received using an anonymous e-mail account or by calling the user by phone. Web Content Management
Staff creates web content and submit it for approval though an internal paper-based
process. When the content has been cleared, a copy of the material is provided to
the ITB web publishing group. The ITB staff uploads the content to the EDD
Website. The system does not maintain an archive of previously published web

3.3 Organization
3.3.1 Overview
The UI Branch is comprised of the following:

1. The UI Branch Office in Sacramento, which includes:
    The UI Division Central Office (UIDCO) in Sacramento,
2. The Unemployment Insurance Resource Management Office (UIRMO) in
3. The UI Claim Processing Division (UICPD) in Anaheim, which includes:
    a) Six Primary Call Centers (PCCs) in Sacramento, Oakland, Los Angeles,
       Orange County, San Diego, and Riverside.
    b) The Consolidated UI Services Center (CUISC) (previously comprised of the
       Central Authorization Centers [CACs]) in Sacramento and Redlands.
4. The UI Division Adjudication Centers (UIDAC) in Sacramento, which includes:
    a) Eight Primary Adjudication Centers (PACs) in Sacramento, San Francisco,
       San Jose, Los Angeles, Inglewood, Orange County (including the
       Overpayment Center), Riverside, and San Diego.

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    b) The Special Claims Office (SCO) (this office reports under the Sacramento
    c) Fifteen Transitional Adjudication Centers (TACs) and Remote Sites (RS).
5. The Insurance Accounting Division (IAD) in Rancho Cordova.

Historically, the UI Program was de-centralized with hundreds of local field offices
spread throughout California. Beginning in the 1990‘s, local offices were
consolidated into regional centers and in-person UI services were replaced by
telephone services. The Figure 3.1, UI Branch At-A-Glance, provides an overview of
the organization and each office‘s business processes.

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                                                                           Figure 3.1 - UI Branch at a Glance

    UI Branch Intranet Version
    March 2003                                                        UI BRANCH AT-A-GLANCE
                                                                                                                 Eligible                                                               n
                                                                                                                                                                                    Ca efit

                                                                                                                                                                                      sh s

                                                                                                                         Base                                                             ed
                                                                                                           Rulings                                                        Accou

                                                                                                                        Period                                                  n                Accounting
                                                                  Last Employer
                                                                                                     Ca                Employers
                         Workers                                                                       l
                                                                                                            Is                                                      Notice to
                                                                  Returns Notice                              su

                         Employers                                                                                                                                 Base Period

                                                                   (DE 1101CZ)                         s         e

                                                                                       Authorization                                                               Employers

      UI Branch                                      k
                                                 Pin                                                                                        Cross Match             (DE 1545)

                                                      p                                   Centers

                                                                                                                                           DE 1296B / NER                             Base Period
                                                                         Claimant Returns

                                                                         Continued Claim                                                                                              Employers

                                                          Notice to Last

                                                                             (DE 4581)


                                      1-800 EDD            (DE 1101CZ)                               SCO         OPC                               OPs
                                                                                                   Adjudication Centers
                                           ICRSO                                                                     Recomp
                                                                                                                     Requests             Disqualification

                                                               Continued Claim
                                                                 to Claimant           ue

                                                                                                                                                                                     u ir
                                                                  (DE 4581)         Iss

                                      Call Centers                               Recom                                                                                                     Call Center
                                                                                              Valid          Amended                            Appeals
                                                                                              Claim         Award Notice                                                    CUIAB
                                                                                                              (DE 429)
      U I DC O                           Planning                          Policy                            Legislation                            Regulations                                Procedures
   UI Division Central Office    Intelligent Call Routing           UI Claim Processing Division                       UI Adjudication Center Division              Insurance Accounting Division
                                      System Office
         • Planning                                            Call Centers        Authorization                       •   Determinations   • TAA/NAFTA                  • Accounting
                                       • Call Routing                                                                  •                    • SSSB                       • Recomputations
         • Policy                                              • File Claims       Centers                                 Appeals
                                       • Forecasting                                                                   •                    • Workshare                  • Benefit Audit Cross Match/
         • Legislation                                         • Identify Issues   • Benefits Payments                     Exception List
         • Regulations                                         • Information Calls • Rulings                           •   Special Claims   • OP Center                    NER
         • Procedures                                          • Recomp Requests • DE1101CZ                                Office                                        • Call Center

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3.3.2 UI Branch Office
The Branch Office oversees the administration of the UI Program, and develops
program policies and procedures that comply with federal and state laws governing
the Program. The Branch Office is also responsible for maintaining the integrity of
the UI Program and the UI Trust Fund. Branch Office staff handle confidential and
sensitive workload dealing with human resource issues, legislative bill position, and
facilities. Unemployment Insurance Division, Central Office (UIDCO)
The UIDCO coordinates program activities across the Branch and with other
Department entities, state agencies, and federal partners. The UIDCO is responsible
for administrative oversight of the UI Program including developing and implementing
policy and procedural changes as a result of legislation, coordinating enhancements
or changes to systems and applications, ensuring performance measures are met,
and coordinating each UI Division‘s services to meet customer demand. Unemployment Insurance Resource Management Office (UIRMO)
The UIRMO operates the call routing system software tool that intelligently routes
incoming calls for UI services from the toll-free 800 network to the best available
answering point in the six telephone call centers. The UIRMO partners with ICR
system vendors and the ITB, Call Center Operations Group to provide this service.
In addition, the UIRMO provides the UI call centers with forecasts of call demand and
with the number of agents they predict will need to be available to handle that
demand. This office also provides information to help UI Program managers make
data based decisions regarding service delivery, and oversees the UI Branch fiscal
resources. Unemployment Insurance Claims Processing Division (UICPD)
The mission of the UICPD is to provide customer access to responsive, courteous,
and efficient services through the use of mail, telephonic, and electronic media. Primary Call Centers (PCC)
The PCCs serve as the direct customer intake point for claim filing and for
information services to the public. Call centers are open from 8 a.m. to 5 p.m.
Monday through Friday, except for State holidays.

Customers have full access to services statewide through five language-based toll-
free 800 numbers (English, Spanish, Mandarin, Cantonese, and Vietnamese) and
one toll-free number for TTY. English and Spanish callers are routed to an
Interactive Voice Response (IVR) system where the customer can choose to get pre-
recorded information, automated check information, or request to speak with an

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In addition to claim filing calls, staff handles calls requesting general UI information
and specific claim information. If a customer requests agent service, the call is
routed based on the selections made from the automated menu in the IVR system
and routed to the agent. The ICM assigns the call to the agent who has been
available the longest or the appropriate queue with the shortest anticipated wait time.
Callers using the Mandarin, Cantonese, or Vietnamese numbers are sent directly to
an agent or queue. Callers using the TTY number are connected to the Sacramento
PCC (not part of the call routing platform) which has four workstations equipped to
provide services to deaf and hard of hearing customers. Due to the diversity of the
staff, the UICPD can assist customers in 34 other languages including Tagalog,
Punjabi, German, French, and Portuguese.

The call workload arrives randomly with Monday being the traditionally heavy
workload day. The EDD attempts to have as many staff as possible available on
Monday to assist customers. As call workload lightens, staff are re-assigned to file
claims received by mail, fax, and online applications. In the San Diego PCC, staff
also respond to customer contacts received via the EDDCOMM application. Consolidated UI Services Center (CUISC) (formerly the Central
          Authorization Centers [CAC])
Currently the only method for claimants to report their eligibility information is by
submitting Continued Claim forms. The CUISC processes continued claim forms.

Claimants cannot mail continued claim forms until the Saturday after the week for
which they are claiming benefits has passed. Because there is no mail service on
Sunday, and assuming time for transit, the heaviest processing day is traditionally
Wednesday. The EDD attempts to have as many clerical and Employment Program
Representative (EPR) staff as possible available Wednesday through Friday to
process payments.

The CUISC also processes rulings, employer responses resulting from notifications
of initial claim filing, returned mail, and returned benefit checks. Most of the CUISC
workload is expected to be completed by Friday of each week. Rulings have an
annual deadline in August so that decisions are made in time for the annual employer
statement of account mailings. Unemployment Insurance Division Adjudication Centers (UIDAC)
Staff conducts adjudication interviews to determine whether claimants are entitled to
benefits. Staff must determine whether or not an employer account is liable for
benefits (rulings), and must also determine which employer accounts are liable for
those benefits when a claimant‘s base period contains wages from more than one

Because previous court decisions have defined UI benefits as a type of claimant
property, any possibility of benefit denial requires due process of law. This means
that the claimant must be notified in advance that an adjudication interview will be

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held. For this reason, all interviews are scheduled 5 to 11 days after issue detection
so that the claimant can receive notification of their rights prior to the adjudication.
Since UISS schedules are based on the number of staff available, rather than on the
number of determinations required, there is not a traditionally heavy workload day.
Interview requests are held in a queue and assigned to a generic schedule of 13 to
16 interviews. Scheduling is controlled so that work can be evenly distributed
throughout the workweek or however the business needs dictate. Individual
interviewers are not generally assigned a schedule until the day before.

The PAC staff process continued claim exceptions routed to the exception lists. If the
claimant contacts EDD prior to the scheduled determination, interview staff can
confirm the issue and appointment time, or process the continued claim if no issue
exists. Staff must then cancel the determination appointment otherwise the
appointment remains on the schedule.

The Special Claims Office (SCO) handles claim filing, continued claims and
adjudication determinations for the Trade Readjustment Act (TRA), Work Sharing
(WS), and State School Special Benefits (SSSB) UI Programs.

These programs apply special criteria and have unique eligibility requirements, and
SCO staff receives specialized training to process TRA, WS, and SSSB claims.

The Centralized Overpayment Center (in the Anaheim PAC) is responsible for
establishing benefit overpayments in cases where eligibility issues (other than wages
or false statements) exist. Insurance Accounting Division (IAD)
The IAD operates an independent call center outside of the regular PCC call routing
system. This call center provides customer service for the Form 1099G and
Overpayment functions. The IAD also accepts information via voice mail. The Form
1099G related calls come in year round, however, the peak period begins mid-
January and runs through mid-April. Overpayment calls are static throughout the

The IAD‘s ID Alert unit completes all identity verifications. The ID Alert staff work with
UIDCO and the Investigation Division when they discover fraud and benefits have
been paid. The Investigation Division takes over the investigation and requests
prosecution only after pre-defined criteria (e.g. threshold of benefits paid or persons
involved) have been reached.

The IAD is responsible for the Benefit Audit cross-match process which identifies
claimants who have failed to properly report earnings while drawing benefits. The
Department cross-matches all employer wage reports against benefits paid. A
Benefit Audit is sent to the employer when a match occurs. The IAD establishes the
fraud overpayments identified by the Benefit Audit cross-match process.

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The IAD also reconciles all UI and DI (including Paid Family Leave) benefit
payments. Their duties include making claim recomputations to remove or add
wages from customer wage records.

3.3.3 Goethe Tax Operations (GTO)
The Goethe Tax Operations (GTO) facility processes employer forms and
remittances for Tax Branch, Paid Family Leave (PFL) forms for Disability Insurance
Branch (DIB), and the continued claim forms for UIB. The GTO sorts and opens the
mail, scans/images the documents and captures the data that is passed to other
EDD systems for processing. The continued claim information is passed to the
Unemployment Insurance System (UIS) for processing and storing onto the SCDB.
Images of the continued claim forms are stored in a separate data store and can be
accessed and viewed by authorized UI staff when necessary.

3.3.4 Information Technology Branch
The ITB is responsible for Department-wide automation, planning, development,
maintenance, support of centralized automated systems, and integration of new
technologies. Included within the ITB functions, is the support of telecommunications
systems that encompasses cabling, voice, and data equipment. The ITB is
responsible for the development of standards and procedures for acquisition,
maintenance, and support of equipment and software.

The Infrastructure Solutions and Management Division (ISMD) is responsible for
designing, building, deploying, supporting, and maintaining the integrity of EDD‘s
computer infrastructure. These responsibilities extend to data networks, server
management, and desktop services and replacements. The ISMD ensures sufficient
hardware, software, and other IT services are available to meet EDD‘s IT
requirements and to manage IT equipment. The ISMD provides system support for
network, server, and personal computer platforms.

The Production and Operations Management Division (POMD) provides for the day-
to-day operations and support of EDD‘s production environment. This includes
Operations Management; Change, Configuration, and Release Management;
System Testing; Service Desk/Incident Management; and Call Center Operations.
The POMD develops, implements, and supports call-processing applications, which
includes the 800 network, IVR, ICM, ACD, and Call Center Management Information
System (CCMIS) systems. The POMD is responsible for client server operations and
the scheduling of EDD‘s batch and online mainframe jobs. The POMD also develops
and maintains database management systems.

The Application Services Division (ASD) provides application development services
(including design, development, implementation, maintenance, and support) for
EDD‘s Program branches.

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The Technology Foundation Services Division (TFSD) provides a variety of
administrative functions within the ITB, such as personnel, budget, business
services, and training administration. The TFSD also provides procurement,
telecommunications support, IT Help Desk and ―move, add and change (MAC)‖
requests for other entities within the Department. The TFSD is responsible for
services that cross ITB division lines (e.g., IT policy/standards, project management,
enterprise architecture, strategic planning, IT consulting, and feasibility study

To maintain independence from the IT Divisions and objectivity in project oversight
activities, the ITB created the Project Oversight Review Team (PORT) within the IT
Branch office. The PORT provides IT project oversight ensuring DOF guidelines and
best practices are followed. The PORT develops processes, practices, and policies
for conducting project oversight reviews and conducts project audits. Additionally, the
PORT administers Independent Project Oversight (IPO) and independent verification
and validation (IV&V) contracts for EDD IT projects.

3.3.5 Department of Technology Services
The Department of Technology Services (DTS) provides network services,
application hosting, internet services, electronic messaging, IT training, and large-
scale information technology project management to state departments, counties,
and cities throughout California. The DTS also has the authority and responsibility for
strategic oversight and acquisition of the statewide network including
telecommunications services.

The DTS houses mainframe services that host the mainframe EDD applications
which support EDD‘s UI Program. The DTS provides data storage and retrieval,
backup and recovery capabilities, system security, and monitors computing
performance. The DTS also offers hosting support services that allow EDD to host
some of their Websites, web applications, and SQL databases at the Data Center.

3.4 Technical Environment
3.4.1 Telephony
The current service platform is leased services through the California Integrated
Information Network (CalNET) contract. Two vendors provide toll-free 800 service,
the ICM system equipment and network, and IVR and Automated Call Distribution
(ACD) systems. The Management Information System (MIS) is owned by EDD and
linked to the telephone company for ACD status and data.

The ICM is an intelligent call routing system that routes calls to six of the seven UI
Call Centers. The ICM collects data describing the number of lines and ports
available, and the agent status, from the DMS switch. These data are used to make
call routing decisions.

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The ICM system resides on a private network Local Area Network (LAN), separate
from the EDD network. The data passed from the DMS 100 switch is stored in a
historical database for reporting. Presently the ICM requires a database application
that supports a minimum of 22 gigabytes a year, with storage capacity of up to 5
years. A Compucall link is used to provide a connection from the call routing system
to the telephone company.

The ICM first routes a call to the IVR. If the caller navigates through the IVR menu
and requests to speak to an agent, the ICM, using the collected data, delivers the call
to the ACD with the most available agents, or to the ACD queue with the minimum
expected wait condition. The ICM does not collect or use individual agent
information because the Compucall link cannot pass agent specific information to the

AT&T provides two IVR units for each Call Center. This provides a capacity of 541
simultaneous calls. The IVR prompts callers to make service selections using their
touchtone telephone keypads and identifies the specific caller-requested services
based upon their selections.

The IVR either provides general information to callers and/or passes them to an ACD
group. If callers request information about their payment, the system prompts to
enter a Personal Identification Number (PIN). If the claimant has not previously
selected a PIN, the system requests claim record information to establish a PIN.

The mailing date of the last benefit check, and Job Services assistance office
locations within or nearest the caller‘s zip code are examples of automated IVR
services obtained based upon customer-supplied information. About 30 percent of
all calls end in the IVR because caller information needs were satisfied, or when they
hear what information is needed to file a claim and they don‘t have it, they hang up
and call back later. About 70 percent want some type of agent assistance to file a
claim, have claim-specific issues or questions, or have general program questions
not obtained in the IVR.

The IVR system provides pre-recorded generic UI information from menu selections
24-hours-a-day for:

1. General information.
2. Job service office locations.
3. Requirements to file a claim.
4. Information regarding overpayments.
5. Report of Taxable Unemployment Compensation – Form 1099G.

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During regular business hours, the IVR provides customer access to agents.
Currently, a caller‘s information is not passed to the agent by the IVR when a call is
delivered. The IVR reads a VSAM file to deliver check status information.

Six of the seven call centers each have ten independent ACD groups. The seventh
center has four ACD groups. Calls are routed to these ACD groups based on caller
responses in the IVR and then are either delivered to an available agent, assigned to
the ACD group or held in a queue associated with the ACD group while waiting for an
agent to become available. After a call is sent to an ACD group, the call routing
system cannot retrieve the call if an agent at another location becomes available.
When an agent answers a call, the telephone set displays the call type identified in
the IVR.

The UI call centers have a training ACD group that is not used or configured in the
ICM system. Each ACD presents messages to customers in queue. The EDD
provides the wording and recordings for these scripts, and the telephone company is
responsible for installation. The recordings have time limitations on the length of the

The ACD music that callers hear while on hold is provided by a Bogen music source
connected to the Central Office by an analog data circuit. The Bogen units were part
of the original installation in the mid 1990‘s. The media used for the music are
cassette tapes.

Each call center has a CCMIS which allows the call center to administer ACD
groups, configure wall boards that allow agents to see how many individuals are
waiting, and manage agent ACD group assignments (real time status of queue
groups and individual agents). In addition, the CCMIS collects data for various

Each call center operates its own independent CCMIS which requires manual
compilation of data for enterprise reporting. Agent management cannot be
accomplished on an enterprise level. The CCMIS is connected to the telephone
company‘s central office (for ACD information) and also connected to EDD‘s
LAN/WAN. Even with these connections, each CCMIS server stands alone. Agent
information by ACD group is passed from the CCMIS through the Compucall link to
the ICM.

The current call center environment uses a wide variety of switching and
communication protocols to provide service to the call centers. These connections
include 56 Kbps to T1 lines, Dial Up analog lines (POTS and Centrex), X.25, TCP/IP
AND, ISDN, Frame Relay, 2001 Analog Data Lines, and toll-free service. The San
Diego call center (located in Chula Vista) requires a D4 Channel Bank to speed data
and voice transmission due to the distance from the closest DMS 100 switch in the
National City telephone central office.

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The call centers use Centrex telephone service provided by the telephone company
for voice traffic. Basic telephone features such as call forwarding, transfer, and three-
way-calling are available for agents, support staff, and supervisors. Electronic
Business Sets (EBS) are used in conjunction with Centrex service.

The telephone company provides voice mail service. The call centers use a
standard voice mail feature package. At this point, voice mail is not networked, and
unified messaging is not an option.

All call centers have the following Service Level Expectation goals:

1. Answering incoming claim filing calls - within five (5) minutes.
2. Answering information calls - within four (4) minutes.

The IVR system is configured with capacity to meet the goal for minimal call
blockage, with no more than five percent busies on 95 percent of workdays. All calls
that are directed to a busy signal are sent to a custom busy message.

The current call center ACDs are configured to allow a maximum of 90 calls in an
ACD queue or a maximum of the longest queue time of 1800 seconds before
deflecting calls. Each center is configured with four (4) to 10 ACDs for receiving calls
and one (1) to two (2) ACDs for administrative purposes. Agent seats range from 74
to 275. There are 12 to 18 Primary ISDN Trunks per location. The total number of
ports for the IVRs is 551.

The Figure 3.2, Current Unemployment Insurance Branch PCC Call Flow, shows
how a call moves through the call center platform for six of the seven offices. The
seventh call center does not go through the Intelligent Call Management (ICM)

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Figure                  Figure 3.2 - Current Unemployment Insurance Branch PCC Call Flow

Current Unemployment Insurance Branch PCC Call Flow

                             PUBLIC SWITCHED
           PHONE CALL                                                                                  INTELLIGENT
             TO 800 #       TELEPHONE NETWORK                  TOLL FREE                                   CALL
                                                                 SERVICE                                 MANAGER


                                                                T1 TRUNKS                                              DATA LINE

                 MUSIC                                       CENTREX SERVICE
                                    LINE                                                                   IVR
                SOURCE                                                                      CENTREX

                                                           ACD GROUPS AND QUEUES

                                   INFO                                                                      DATA LINE

                                          CALLS                                            CALLS
                                                  ACD PHONES      CALLS

                    Supervisor                     Agent           Agent           Agent



    3 ICM DIRCTS 800 PROVIDER WHERE TO PRE-ROUTES CALL                                     DATA LINE


   6 ICM DIRECTS IVR TO TRANSFER CALL TO AGENT                                                  CURRENTLY 6 OF THE 7 UI
                                                                                                 CALL CENTERS
   7 AGENT ANSWERS AND BEGINS INTERACTION WITH CLAIMANT                                           ARE
                                                                                                 ARE USING ICM


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Individual call center and IVR reports are provided by the MIS, IVR, and the PIN
system. These components are standalone and collective, therefore reporting must
be done manually. Additionally, comprehensive data about each individual call
cannot be determined since parts of the call are handled by different technologies,
and there is no common identifier for the call across the technologies. The 800
service provider produces reports for each 800 number. The ICM reports collectively
for the enterprise with regard to call routing. However, the ICM cannot report
individual agent data. Both the MIS and ICM provide real time and historical data
including Current Status, Performance by Office (in incremental time frames), Trend
Analysis, Agent Forecast, and Port Status. Data is downloaded to other systems
using various manual methods.

3.4.2 Automation for Unemployment Insurance Claim Filing
Staff access the Unemployment Insurance System (UIS) claim filing applications to
file and compute claims. The UIS is a collection of Common Business Oriented
Language (COBOL)/Customer Information Control System (CICS) programs running
on the OS390 IBM mainframe at the DTS. The primary data store for the UIS is the
SCDB, an Integrated Database Management System (IDMS) v15.2 database
management system using Logical Record Facility (LRF) and native Data
Manipulation Language (DML) data access methods.

The SCDB is segmented into eleven partitions. Ten of the partitions contain client
specific information and correspond to each of the possible terminal digits of the
SSN. The 11th partition contains non-client specific information. The SCDB contains
approximately 100 compressed gigabytes and 150 uncompressed gigabytes of data.
This includes 20 million client records.

The claim filing applications access the Base Wage Database (BWDB) for wage
information to compute the claim award. The BWDB is a DB2 database also running
on the OS390 IBM mainframe. The BWDB contains approximately 60
uncompressed gigabytes of data, including 314.3 million data rows.

Claimants can also complete an application for UI benefits through the eApply4UI
system, a public facing website that was developed in Visual Studio 2003 with an
ASP.NET front-end and an MS SQL2000 database. The
website is hosted at the DTS on Windows 2000 network load balanced web servers.
The web application writes data to an SQL 2000 server also located at the DTS. The
eApply4UIPrint application displays the information submitted by the claimant to UI
call center staff for claim processing. The Claim Filing Tool (CFT), an Attachmate
application (macro) reads and transfers data from eApply4UIPrint to UIS screens and
invokes processing in UIS to complete claim filing.

The online UIS creates transaction records that are used to drive nightly batch
processing as well as workload and statistical reporting. Batch processing includes
creation of form print files that generate the benefit checks, continued claim forms,

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and other notices. This information is transmitted via secure File Transfer Protocol
(FTP) to the ODPD which prints and mails all benefit checks and forms for the
Department. The ODPD uses Hewlett-Packard Proliant DL380 G3 servers with
Windows 2000, and development is done on their Universal Data Server in PERL.
The ODPD uses Exstream Dialogue as their document design tool and Nearstar
Dataserver as their print manager, both of which are proprietary tools.

Claimants required to actively seek work, are sent a notice advising them they must
register in CalJOBSSM, the Department‘s labor exchange application, and a file with
basic claimant information is sent to CalJOBSSM to create a starter record. CalJOBSSM
is a web-based internet application running on Windows 2000 and utilizing an
Informix database.

One batch process updates the Profiling database with new claim information. The
Profiling system is an automated system that uses claimant demographics and a
statistical model to identify UI claimants who are likely to exhaust their benefits.
Selected claimants are referred to mandatory workshops for job search assistance.
The Profiling system is a collection of COBOL and SQL programs running on the
OS390 IBM mainframe and a UNIX server. The system uses a DB2 database.

Job search assistance activities are provided by the Workforce Services Branch
One-Stop Offices. Services are scheduled and attendance is tracked on the Activity
Calendar and Event Scheduler (ACES), a web-based intranet application that uses
an Informix database.

Another batch process creates a file to update the PIN system with new or changed
claimant identifying information which is used to authenticate claimants when they
set or reset their password. The DI and UI activities such as initial claim filing and the
recomputation of existing claims can result in changes to client identifiers that are
maintained in the PIN Lightweight Directory Access Protocol (LDAP) database.

The custom applications supporting the administration of the PIN system run on a
Regatta server located at DTS. The IVR and PIN systems communicate through a
CICS sockets interface. Changes in a client PIN result in the creation of a notification
file that is transmitted to the mainframe via secure FTP. The FTP file is used by
custom software to generate and mail PIN change/creation notices back to clients.

In order to maintain data synchronization between the SCDB and the SecureWay
Directory/LDAP database the EDD executes a batch update process five (5) times a
week. The batch update process consists of a series of automatically scheduled
mainframe jobs that gather the pertinent transaction data and transmit the data via
secure FTP to the PIN Regatta server where a series of custom applications update
the SecureWay Directory/LDAP database.

The detection of an eligibility issue at claim filing or during continued claims requires
the scheduling of an adjudication appointment. Staff access UIS to request an

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adjudication appointment. The UIS writes a record to a VSAM file which is read at
intervals during the day by the Unemployment Insurance Scheduling System (UISS).
The UISS is a collection of CICS/COBOL applications using a DB2 database. The
applications were developed using Sterling‘s Application Development Workbench
(ADW) which is no longer supported. The Department is in the process of migrating
the front-end UISS processes to a .NET platform using Attachmate‘s Screen
Connector and CICS Connector. Continued Claims
Claimants mail their continued claim forms to the EDD. The mail is processed by the
GTO using high-speed mail-opening machines, automated extractors and high-
speed sorters. First payments are sorted for priority processing. The forms are
scanned using three IBML Image TRAC II high-speed scanners and the data is
captured using iCapture 3.0 software. An image of the form is sent to the InfoImage
management and imaging workflow system for archive and may be retrieved by
authorized UI staff when they need to view the actual continued claim form, such as
for signature verification. A file with the continued claim certification data is
transmitted to the DTS mainframe via secure FTP for processing by the UIS. The
UIS attempts to authorize the certification record.

If the certification record fails application program edits or encounters barriers to
payment, the application program labels it as an exception. The program identifies
two types of exceptions which are processed by staff at either the CUISC or PAC
sites. Each exception is processed individually by staff using various UIS screens.
The authorization process also calculates the payment amount. Some authorizations
may not result in a payment to the claimant if payment reductions (e.g., overpayment
offsets, wages) or a disqualification reduces any payable amount to zero.
Certifications that result in an authorization are processed in a nightly batch process.
The ODPD prints and mails the checks with the continued claim forms for the next
certification period. Claimants who are not entitled to a payment receive a non-
payment or ―unpaid weeks‖ notice.

With each nightly payment batch process, the system creates a VSAM file for the
IVR to respond to ―Where‘s my check‖ calls from claimants. The system also notifies
the Profiling system when it issues the first benefit check. The Profiling system can
then assign the claimant a statistical score and determine if referral to re-employment
services is appropriate. Additionally, the Profiling system must be updated whenever
there is an address change. This ensures the claimant is referred to the nearest Job
Service office for job search assistance.

The Profiling system generates a payment barrier when a claimant fails to participate
in mandatory services. A payment barrier may also be generated when a claimant
fails to register in CalJOBSSM as instructed. Staff must verify CalJOBSSM registration
prior to removing the payment barrier.

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The Benefit Accounting System (BAS) is used for the accounting of all benefit
payments and overpayments. During the authorization process, if an overpayment
exists, the UIS calls BAS to obtain information related to the overpayment in order to
calculate the amount to be reduced from the benefit payment. The BAS
overpayment accounting programs post the amount offset from the benefit payment
to the overpayment account. The BAS applications also maintain the status of
benefit checks issued and track any deductions made, such as income tax
withholdings. The BAS, like UIS, is a collection of COBOL/CICS programs running
on the OS390 IBM mainframe at DTS, and uses the SCDB.

The Taxable Unemployment Compensation (TUX) system produces form 1099G in
January for claimants who received taxable UI, DI, and PFL benefit payments during
the previous tax year. This batch COBOL system reads the SCDB for taxable
payments and reductions, consolidates payments into one record per SSN, and
creates one file for the IRS and another file for ODPD to be used while printing forms.
The 1099G information is also written to a VSAM file used by the IAD and IVR
provides callers with 1099G information. In June, a second tape is prepared and
transmitted in July to the Internal Revenue Service with all of the corrected 1099G tax
data for the previous year. Adjudications
Adjudicators use the UIS to produce determination and/or ruling notices when
benefits are denied and/or to notify employers whether or not their account will be
charged for benefit payments. The UIS also has applications which produce
overpayment notices.

The PAC staff use the UIS to process exceptions and authorize or deny benefits.
They also process requests for adjudication appointments by accessing UISS,
creating schedules for appointments and selecting requests to fill available time slots.
During the nightly batch process, UISS creates files with appointment notice
information for the claimants. The ODPD prints and mails the appointment notices.
Adjudicators create a record of interview findings using MS Word. Staff print the
document, attach any supporting documentation, and store the paper file in the office
archives. Claim Corrections
Staff in IAD use the UIS applications to make claim corrections. These corrections
include adding missing claimant wages or removing wages which do not belong to
the claim. A claim correction is also initiated to change the claim effective date,
cancel a claim, or transfer a claim to a different SSN. The claim correction
application recalculates the claim award each time it is invoked and creates or
updates the records in the SCDB. Customer Service
In addition to the UIS, staff may access several other systems to respond to inquiries
from claimants and the public. The Unemployment Insurance Intranet Information

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(UIII) system is an ASP web-based website that provides staff access to UI Program
information, news, resources including UI manuals and program notices. It also
provides links to applications such as eApply4UI, EDDCOMM, and ID Alert (which is
used to report suspected identity fraud information).

The Web Based Claim Filing (WBCF) Project, a project underway to improve claim
filing processes for UI staff, plans to use UIII to launch its applications.

Many of the resources are maintained using Xerox Docushare, an IBM intranet-
based enterprise document management server. The UIDCO staff uploads UI
manuals, UI Program notices, training materials, and program documentation to
Docushare. The Department plans to migrate documents from Docushare to MS
SharePoint Portal Server in the near future.

The EDDCOMM is a web application that runs on a secure, encrypted web server.
The EDD‘s customers access EDDCOMM via the ‗Contact Us‘ link on the EDD
website. The back end is a desktop application accessed by staff via the UIII web
page. The EDD staff are assigned to NT groups which control what categories of
information they can view (UI staff are restricted to viewing UI information). Staff
select an inquiry, enter a response, and may e-mail the response or respond via
another medium.

The UIS also provides information to or receives information from various entities and
systems. The primary mode of data exchange between the UIS and external
systems is through nightly batch jobs that read or update the database. All UI
transaction information is posted to the SCDB. The SCDB daily transaction records
are read, sorted, and written to various files. Other SCDB records may also be read
to extract data not found on the transaction records. These files are then further
processed to extract the data required by other systems. The files may be used to
create reports, downloaded to other systems, sent via FTP, or written to other media
for use by other entities. Batch jobs also process files received from other systems
and then update the SCDB.

3.4.3 Production Change Management
The ITB utilizes a production change management process to manage not only client
server custom application changes but also any server, network, database, or
workstation changes. Any proposed changes (additions, deletions, updates) which
modify the hardware, software, or application components running in the production
environment need to comply with the change management process.

The ITB uses Remedy for incident, service, and change management. A Request
for Change (RFC) is submitted by entering the change request into the Remedy tool.
The proposed change, what the change will impact, and which configuration item (s)
it involves are entered into the Remedy Help Desk module associated with the
change request. The RFC is then referred to the Infrastructure Change Control
Board (ICCB) where it is reviewed and either approved, denied, deferred for further

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analysis, or elevated to the IT Executive Team (ITET). The Infrastructure ICCB core
members are release, configuration, network, security, and infrastructure systems
managers and lead staff. Single Point of Contact (SPOC) from various technology
domains serve as consultants, when needed.

Each change request is assigned a change priority to assist managers who
determine implementation schedules for the proposed changes. After an RFC is
approved, the requestor (change owner) may begin implementation of the change.
The RFC schedules are maintained by the Customer Services Group on the IT Event
Calendar. The change owner coordinates change scheduling with affected groups
and is responsible for planning and implementing the change within the IT

Changes to the DTS network are also tracked as informational changes and do not
require Infrastructure ICCB approval. However, they are presented to the ICCB for
communication and planning purposes.

Within ITB there are several other Configuration/Change Control Boards tasked with
evaluating and recommending change requests which will affect systems under their
control. The Boards‘ change requests are approved, developed, and tested prior to
presentation to the ICCB for implementation approval. For example, all changes
affecting network security (e.g., intrusion detection, access control, encryption
services) must be coordinated with the Security Configuration Control Board (SCCB).

3.4.4 Maintenance and Testing
Changes to client server applications follow a similar change process using different
tools. Configuration items (CIs) such as, source code and builds, are tracked in the
Configuration Management Database (CMDB). After receiving formal ITB change
authorization approval for development, the programmer promotes the CI from the
production baseline to the development baseline. The programmer checks out
production source code, makes the necessary changes and completes unit testing.
The revised source code is then checked into the Productions Solutions Layer (PSL)
Definitive Software Library. The source code is promoted to the integration test
environment and a build is created for integration testing. Once integration testing is
completed the build is moved to the LAN test staging area and the source code PSL
CI is promoted to the system test baseline. The System Test Group (STG)
completes a structured, end to end system test, stress/load test (if applicable) and
provides the environment and necessary data for customers to perform further
acceptance testing. The STG notifies the integrator of successful test results who
then provides the pre-production baseline CI to configuration management. Change
management forms are updated and forwarded to the Change and Release Group
for formal change authorization approval for promotion to the production baseline and
deployment to the production environment.

Maintenance and testing for the current call center platform is provided by the ITB‘s
Call Center Operations Group (CCOG), the UIB‘s Unemployment Insurance

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Resource Management Office (UIRMO), and various vendors. The UIRMO has the
primary responsibility for the ICM system. The CCOG has responsibility for
maintaining the 800 services, IVR, ACD, and MIS. The equipment and services used
by the call centers are either owned by EDD or leased.

Changes, enhancements, and testing to the ICM are the responsibility of EDD.
Changes to the IVR, ACD or other call center components, require vendor

Programmers within the ASD maintain the applications for the various EDD
programs, including UI, while ISMD staff maintain and test the network infrastructure.
Macros used by field staff are created and maintained by UIDCO staff or selected
field staff under the direction of UIDCO.

The UI Program staff submit change requests and report processing errors via an IT
Service Request (ITSR). The ITSR is assigned to a programmer who completes an
analysis and works with UI staff to ensure changes meet UI requirements.
Mainframe application changes are managed through Change Man, an automated
version control software tool for application development within the MVS mainframe
environment. All components requiring changes are ―checked out‖ of the Change
Man ―baseline‖ (production) libraries into a programmer‘s package. The programmer
uses Change Man to modify the components in staging libraries. Once the
components are staged, they may be ―promoted‖ to a designated environment for

Mainframe application programmers unit test any code changes in their own version
of the database where they build their own test data. After unit testing is completed,
the application is moved to the system test environment where testing staff conduct
regression testing, functional testing, and integration testing, as well as user
acceptance testing.

Occasionally, an application is also tested in a production parallel testing
environment which contains a production-sized database. This database can house
one entire production partition for volume, scheduling and timing tests by
programmers. This is referred to as the conversion database and contains production
data which are refreshed weekly. After all testing is completed the Change Man
package is ―frozen‖, which initiates the approval process. The installation date is
coordinated with UIDCO staff to ensure they have time to make any necessary
procedural changes and notify field staff of the changes. When the final approval is
received, the package is scheduled for installation into the production environment.

3.4.5 Security
The current technology environment addresses security on each of its platforms
including using IBM‘s Resource Access Control Facility (RACF) on the mainframe
and Windows desktop security on the desktop.

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The DTS firewall, and routers located at both the DTS and EDD provide security at
the network level. Access into the EDD network is password protected. At the
application layer, EDD applies user authentication and authorization protocols to limit
access based upon internal policies. There are role-based access levels (e.g.,
update and inquiry) and segregated access to screens within the applications.

The ICM is a stand-alone network protected behind an EDD firewall. The CCMIS on
the EDD network provides vendor dial-up access. Security for the IVR benefit
payment information is provided through PIN authentication using the SecureWay
LDAP Directory service.

3.5 UI Business Challenges within the Current System
Increasing public access to UI services and improving the efficiency of UI service-
delivery are two of the UI Program‘s highest priorities. Technology currently
supporting the UI Program does not allow for flexible and efficient processing of UI
business functions. Many of the existing functions are labor intensive or present
challenges due to current system inabilities.

As technology becomes an increasingly larger part of every Californian‘s life, both at
home and in the marketplace, public expectations increase. Government is expected
to provide the same level of service as the private sector. Increased access,
improved efficiency, and greater security are the UI Program‘s first priorities.

In 2002, the UI Branch published the UI Program Business Plan for 2002-2007 that
included several initiatives which addressed the overarching challenges facing the UI
Program. There are six key business challenges facing the UI Program.

1. Access and Integration of UI Services -- providing customers the services they
   need when and where they need them.
2. Modernization -- of the UI Program technology and infrastructure to support
   modern methods of service delivery.
3. Program Quality -- improving timeliness and accuracy of services in order to meet
   customer expectations and federal mandates.
4. Staff Resources -- finding innovative ways to meet current and future staffing
5. Program Funding -- the ability to maintain sufficient funding levels to pay benefits
   and administer the Program.
6. Fraud – which is persistent and sophisticated.

On March 13, 2002, an $8 billion Reed Act distribution was made to the UI accounts
of all 50 States. The DOL strongly recommended states set aside a portion of this
unprecedented distribution for UI system automation and modernization projects.
The DOL further recommended the focus of these projects be to improve state

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performance in DOL mandated areas, reduction of UI fraud and abuse, and
improvements to UI claim filing and payment methods.

Several Feasibility Study Reports (FSR) were proposed as a result of the Reed Act
disbursement, however only two projects were approved by the Department of

1. Continued Claims Redesign (CCR).
2. Call Center Network Platform and Application Upgrade (CCNPAU).
These projects address UI Branch‘s two highest priority initiatives in the UI Program
Business Plan.

The current systems impede staff efforts to meet service level objectives and
contribute to a lack of quality and efficiency in the administration of the UI Program.
The EDD is not meeting the performance measures as mandated by the DOL. In
addition, the current technical infrastructure is outdated and does not support the
implementation of self-service capabilities customers need and want.

The current system also does nothing to prevent and detect fraud within the UI
system, and an inability to properly authenticate a claimant‘s identity is an exploitable

Each project also addresses other, more specific challenges unique to their scope.

3.5.1 The Continued Claims Redesign Subproject
The CCR subproject includes telephone continued claims, Internet continued claims
certification, a new database and tools for fraud detection, verification of all claimant
address changes, replacement of payment programs/systems, and website content
management. The CCR subproject reduces rework in the continued claims process,
improves the UI Program‘s ability to meet payment time-lapse requirements, reduces
the risk of system failure and simplifies customer contact via the Internet.

The CCR subproject will address the following challenges:

1. The Department cannot meet Federal performance guidelines for UI payment
The current UI certification system was developed more than ten years ago and the
only method for individuals to certify for benefits is to complete and submit their
continued claim forms by mail. Claimants routinely submit these forms too early
(before the certification period is complete), fail to provide responses to eligibility
question(s) on the form, or they provide incorrect responses (e.g. answering both
‗yes‘ and ‗no‘ to a given question). Forms that contain incorrect, or incomplete
information, and forms that are submitted early must be reissued to the claimant for
proper completion or timely submission. Reissued forms result in delayed payments.

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Furthermore, handling a form two, and sometimes three, times for the same week(s)
claimed, creates workload for staff resources already straining to process the existing
claim load.

An excessive number of continued claim certifications flow to the exception list
because of the inability to configure the software for complex eligibility requirements
and compliance conditions, and the paper process‘ limitations on collecting the data
necessary to validate these requirements and conditions. Approximately 60 percent
of certifications still require some level of manual intervention, which delays payment
as each exception must be reviewed and processed by UI staff. When claimants do
not receive their payments, they call or e-mail the Department to inquire about the
status of their claims. Staff must respond to these inquiries. These inquiries divert
staff from other claim processing activities that promote quality and protect the
integrity of the UI Program. The current exception process has no ability to manage
workflow and leverage staff resources to liquidate the workload in a timely manner.

2. The quality of the continued claims data is unacceptable.
Paper claim forms do not promote the accurate detection of eligibility issues.
Claimants cannot be prompted to provide responses to secondary questions that
confirm the presence of eligibility issues. Thus certifications containing out of pattern
responses must be routed for clarification. If staff are able to speak to the claimant,
the condition on the form that caused the exception is discussed and clarified unless
determined to be an eligibility issue. Staff proceed to adjudicate the issue and pay or
deny benefits.

Claimants who are not reached by telephone are scheduled to (and mailed a notice
for) an adjudication interview when in some cases, only a clarification is needed.
Frequently, claimants will call when the notice is received (prior to the interview

Staff record important data in unstructured notes fields which, upon review, may be
used to clear a potential issue. However, the problem remains that each clarification
must be processed on a case-by-case basis. If staff fail to cancel a determination
appointment for an issue that is clarified prior to the scheduled date, the appointment
ties up an available workload slot.

When a claim is recomputed and the benefit award is changed, the process staff use
to determine whether or not the claimant has been under- or over-paid is manual,
therefore susceptible to human error. Currently, if the benefit award is increased,
staff must calculate the difference due the claimant for weeks previously paid at the
lower benefit amount, and must authorize an adjustment payment. The process
often results in an erroneous payment if staff incorrectly calculates the adjustment
amount. Similarly, staff may miscalculate the amount of the overpayment when the
benefit award is decreased. Both of these situations lower the quality of the
continued claims process.

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3. The quality and integrity of claimant addresses is poor.
The existing process for capturing, storing and retrieving the address of record for the
UI claimant for mailing benefit checks does not support US Postal Service guidelines
for address standardization. The effects of non-compliance include delays in the
delivery of mail (3-5 days), loss of Postal discounts (8.2 cents per piece of mail), and
increased handling costs during the print-and-mail process. In addition, delayed
mailing adds to the call volume when claimants call regarding lost or undeliverable
benefit checks.

Lack of address validation also contributes to the likelihood that addresses will not
meet US Postal standards. Inconsistencies in address entry reduces their value for
fraud detection and prevention measures because comparison and sorting
techniques are impeded by variations in entry fields (e.g. Sac, Sacto., and
Sacramento are all viewed as different by the system).

Address changes provided by telephone allow staff to ask verification questions,
ensuring that the claimant is the one providing the updated address. However,
address changes submitted in writing (either on the continued claim form or through
claimant correspondence) are assumed to be submitted by the claimant, but no
validation of the new and old addresses is performed.

4. The UI fund is subjected to fraudulent activity (due to identify theft).
The Department is unable to collect all the necessary information that helps identify
―hijacked‖ claims and fraud schemes. The current system has limited resources for
validating the establishment and maintenance of an identity. The Department lacks
the ability to aggregate and analyze data from multiple sources, impacting EDD‘s
ability to detect patterns of fraud.

The Department has determined some cases of fraudulent activity occur when an
individual ―hijacks‖ a claim by posing as the claimant and then changing the
claimant's address to collect benefits. The current system has no mechanism to
verify whether the address change was made by the claimant or an imposter. Once
a fraud pattern or technique is identified, the Department cannot trigger an alert to
take a specific action on a claim that is subsequently suspected of being fraudulent
when conditions in the certification process match the fraud pattern.

5. An opportunity exists to reduce the administrative costs associated with the
   continued claims process.
The current process, while supported by scanning technology, includes manual and
labor-intensive activities. Paper forms must be opened, sorted and batched for
scanning. Even accurately completed forms require pre-scanning preparation and in
many cases, validation. By expanding the channels claimants use to certify for
benefits and reducing the pre-scanning form preparation workload through the paper
based process, the Department has the opportunity to significantly reduce the labor
costs required to process continued claims.

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3.5.2 The Call Center Network Platform and Application Upgrade
The current call center platform was created incrementally as the UI Program
converted from providing services in person to a call center environment. Systems
were not replaced, but simply added onto, to provide additional capacity and
functionality. The system cannot be expanded throughout the state nor can it provide
functionality to allow adding features, such as ―screen pops‖ to the agent‘s desktop
computer that could reduce costs. The current configuration cannot provide
networked IVR services or networked queues that could provide better access for
customers. Nor can the current system collect enterprise end-to-end data that is
needed to increase fraud detection and improve program processes to reduce costs.
The hardware and software used for the current system is outdated and has passed
its expected life span.

The CCNPAU project will address the following challenges:

1. The public experiences periodic call blockages or extended waits when
   attempting to file unemployment insurance claims or receive information about
―Call blockage‖ means the caller cannot connect to the IVR system or to an agent
due to capacity limitations. The current call center facilities have been expanded to
the maximum capacity and cannot provide additional call center seats. Four of the
existing PACs are located outside of the geographical area served by the current call
center telecommunications platform. As a result, the EDD is unable to manage the
call workload on a statewide basis.

The current ICM system cannot fully operate, as the DMS 100 switch cannot pass
sufficient data to the ICM. The ICM cannot take advantage of features available on
the ICM such as individual agent data, or use features such as skills-based routing.
This means the ICM can only make decisions based on agent group information
rather than individual agent information. This limits the ICM‘s ability to make the most
efficient decision about call routing.

The current IVR system is not an ―enterprise IVR system‖ capable of realizing the
economies of scale expected from an enterprise-wide system. The current IVR
system is comprised of 14 IVRs, 2 associated with each call center. The system was
designed for stand-alone call centers. Twelve of the IVRs are used for what is
referred to as the ―enterprise‖ call center system. However, telephone lines and ports
cannot be shared among these 12 IVRs. The size of this system limits the ability to
answer all calls, and callers are routed to a custom busy message and must try again
to reach the IVR. To increase this capacity under the current solution would cost one
million dollars and EDD would still lack the flexibility for future upgrades and

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Calls arrive randomly in call centers, with 28 percent of the calls arriving on Mondays.
To provide an acceptable level of service, call centers would need many more agents
on Monday than can be housed in the current call centers. The current call center
system was designed in several stages, as call centers were developed. Not all call
centers use the same platform, with some using an enterprise call routing system
and others using an ACD call routing system. While the call centers remain on
different systems, staffing resources cannot be shared. This causes a disparity in
services because staff may be available and waiting for calls in one center and, in the
others, they may have too many calls.

2. The EDD has limited information available at initial contact with a caller to
   properly validate the identity of the caller and protect the Program from identity
   theft and other fraud schemes.
The current platform cannot provide features such as the collection of information
from the individual in the IVR, which would help establish the caller‘s identity, and
data collection for fraud deterrent activities. Currently, agents must solicit sufficient
data from the individual to identify the caller and manually enter this data into the
individual‘s records. In addition, end-to-end call data is not available. Once the call is
delivered to the IVR, the call cannot be traced to its final destination. Without data
about the call‘s final destination, caller information such as the number from which
the caller dialed cannot be connected to the claim activity, reducing the ability to deter
fraud. In addition, without end-to-end data, process improvement decisions are
made with insufficient data. This limits the ability to make changes to the system to
improve fraud detection.

3. The design of the system and age of the call center equipment has put the EDD
   at serious risk of extended disruption of services to unemployment insurance
The current platform uses the DMS 100 telephone company switch. This twenty-five-
year-old technology does not provide service throughout the State and has limited
features. The ICM was installed in 1999 and has had 1 upgrade in 2004 with an
equipment lifetime expectancy of 3 to 4 years. The system was designed for 6 call
centers and operates using a private network. The ICM equipment has a series of
computers and servers that reside in each call center, the call center field division
office, and the EDD central office. The EDD has experienced equipment failures in
past years, including hard drive failures, power unit failures, and monitor failures.
While the ICM software and hardware were upgraded, it still is integrated with old
technology, i.e., the DMS 100 platform and the X.25 CompuCall link. The upgrade
did not eliminate the limitations of the current system, such as skills-based routing.

4. The current ACD configuration is not networked, which limits capacity to answer
   the call in the least amount of time.
Call centers have independent ACD groups for each call type. Each call center has
10 ACD groups for each call type. Once a call is delivered to the ACD group, it must
remain in that group until the call is either answered or abandoned, regardless of

5ED05017-7532-4B2E-A95F-97A66E7B95D4.DOC                                                     MARCH 23, 2
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whether an agent becomes available in another center in a like ACD group. The
fewer staff in an ACD group, the lower the efficiency rate and requires a higher
number of agents than larger ACD groups to accomplish the same amount of work.
For example, assume a call is 3.5 minutes long. If there are 9 agents in a group they
will each answer an average of 5.6 calls in a half hour period. If there are 65 agents
in a group, they will each answer an average of 7.7 calls in a half hour period.1

5. The inadequacy of the current IVR system requires excessive agent intervention
   for routine customer transactions.
The current IVR solution provides minimal capability for existing claimants to obtain
claimant-specific benefit payment information, and to provide claim-affecting
information, without agent intervention. It has limited customer access to check status
information. Callers can find out when their last payment was mailed using the IVR
without speaking to an agent. However, customers cannot verify an appointment
date and time or receive any other status about their claim. If a customer needs to
verify when an appointment is scheduled they must speak to an agent. The agent
must look up the information to provide it to the caller.

3.5.3 Merge of the CCR and CCNPAU Subprojects
During the initial planning stages of each project, multiple complex interdependencies
emerged, including:

1. A CCR developed telephone certification application that will leverage CCNPAU‘s
   new IVR application and platform.
2. A CCR Client Registry database that will collect client specific information some
   of which will be obtained through the CCNPAU telephone system.
3. Integrated reporting capabilities that will use information from both CCR and
   CCNPAU applications to aid with the detection and prevention of fraud.
Additional issues were encountered: problems coordinating project schedules,
ensuring that platform system requirements met current and future business needs,
and assigning system integration responsibilities. Combining the projects allows
State staff to focus on one procurement rather than two; resulting in a higher quality
product and reduction of coordination and scheduling conflicts.

Therefore, the approval to merge the projects was sought, and in May 2005, the
CCR and CCNPAU projects were merged into a single project – the UIMOD Project.
The merge allows for a single prime vendor to have the responsibility for the delivery
of all the components of CCR and CCNPAU including the integration of the
telephony, client data (Client Registry), reporting requirements and fraud detection
and prevention components.

 This example is derived from industry standard random call routing formulas. Reference: Brad Cleveland & Julia Mayben, Call
Center on Fast Forward, Call Center Press, Annapolis, MD, 1997

5ED05017-7532-4B2E-A95F-97A66E7B95D4.DOC                                                                                       MARCH 23, 2
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UIMOD PROJECT                                           SECTION 3 — PAGE 36 OF 36

Although merged into a single project and managed as a single project, CCR and
CCNPAU have two distinct scopes and functional implications to the UI Program

5ED05017-7532-4B2E-A95F-97A66E7B95D4.DOC                                            MARCH 23, 2

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